title: Young Men's Shame about Their Desire for other Men Predicts Risky Sex and Moderates the Knowledge - Self-Efficacy Link.
abstract: BACKGROUND
  Nationally, HIV incidence is rising rapidly among young (18-24 years old) men who have sex with men (YMSM). Knowledge of safer sex generally enhances self-efficacy for safer sex, an important predictor of safer-sex behaviors. Recent findings suggest that a strong negative social emotion (i.e., shame) increases YMSM's sexual risk-taking. Unchangeable shame (e.g., desire for other men) might undermine (moderate) the link between knowledge and self-efficacy or between self-efficacy and unprotected anal intercourse (UAI): this may be less likely for changeable shame (e.g., shame about risky sexual behavior).
  
  
  OBJECTIVE
  To test the hypotheses that shame (i.e., sexual desire shame), but not shame about behavior (i.e., sexual behavior shame), will be positively related to UAI and will moderate the relationship between knowledge and self-efficacy and/or self-efficacy and UAI among YMSM.
  
  
  METHODS
  In an online national study, 1177 young adult (18-24 years old) MSM reported one or more acts of UAI in the past 90 days with a casual partner. Eligible MSM filled out a survey in which they provided information about their knowledge of safer sex, self-efficacy for safer sex, reported levels of shame, and reported past 90-day UAI.
  
  
  RESULTS
  Sexual desire shame was negatively correlated with knowledge and self-efficacy and positively correlated with UAI, the pattern reversed for sexual behavior shame. Sexual desire shame significantly lowered the knowledge to self-efficacy and the self-efficacy to UAI links. Sexual behavior shame also reduced the link from knowledge to self-efficacy, but not the self-efficacy to UAI link.
  
  
  CONCLUSIONS
  The present study shows that there are different types of shame that may produce different effects with different implications for health behavior. Sexual desire shame may better reflect an emotion that is activated prior to risky behavior (e.g., when men reflect upon or feel desire for another man). Sexual behavior shame, on the other hand, better reflects what has already happened, thus, those higher in knowledge, efficacy, and therefore, safer sex are least likely to experience shame behavior.
authors.affiliation: Annenberg School for Communication and Journalism, University of Southern California , Los Angeles, CA , USA.
authors.forename: Mina
authors.initials: M
authors.lastname: Park
authors.affiliation: Annenberg School for Communication and Journalism, University of Southern California , Los Angeles, CA , USA.
authors.forename: Janeane N
authors.initials: JN
authors.lastname: Anderson
authors.affiliation: Department of Communication, University of Connecticut , Storrs, CT , USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Christensen
authors.affiliation: Annenberg School for Communication and Journalism, University of Southern California , Los Angeles, CA , USA.
authors.forename: Lynn Carol
authors.initials: LC
authors.lastname: Miller
authors.affiliation: Annenberg School for Communication and Journalism, University of Southern California , Los Angeles, CA , USA.
authors.forename: Paul Robert
authors.initials: PR
authors.lastname: Appleby
authors.affiliation: Department of Psychology, University of Southern California , Los Angeles, CA , USA.
authors.forename: Stephen John
authors.initials: SJ
authors.lastname: Read
keywords: HIV/AIDS; safe sex; safe-sex knowledge; self-efficacy; sex behaviors; shame; young MSM; young adult