title: Internalised homophobia is differentially associated with sexual risk behaviour by race/ethnicity and HIV serostatus among substance-using men who have sex with men in the United States.
abstract: OBJECTIVE
  There is a continuing need to identify factors associated with risk for HIV transmission among men who have sex with men (MSM), including a need for further research in the ongoing scientific debate about the association of internalised homophobia and sexual risk due partly to the lack of specificity in analysis. We assess the association of internalised homophobia by race/ethnicity within HIV serostatus for a large sample of substance-using MSM at high risk of HIV acquisition or transmission.
  
  
  METHODS
  Convenience sample of substance-using (non-injection) MSM reporting unprotected anal sex in the prior 6 months residing in Chicago, Los Angeles, New York and San Francisco. The analytic sample included HIV-negative and HIV-positive black (n=391), Latino (n=220), and white (n=458) MSM. Internalised homophobia was assessed using a published four-item scale focusing on negative self-perceptions and feelings of their own sexual behaviour with men, or for being gay or bisexual. Analyses tested associations of internalised homophobia with recent risk behaviour, stratified by laboratory-confirmed HIV serostatus within race/ethnicity, and controlling for other demographic variables.
  
  
  RESULTS
  In multivariate analysis, internalised homophobia was inversely associated (p<0.05) with recent unprotected anal sex among black MSM, and not significantly associated with sexual risk behaviour among white and Latino MSM.
  
  
  CONCLUSIONS
  More research is needed to further identify nuanced differences in subpopulations of MSM, but these results suggest differentially targeted intervention messages for MSM by race/ethnicity.
authors.affiliation: CDC Division of HIV/AIDS Prevention, Atlanta, Georgia, USA.
authors.forename: Gordon
authors.initials: G
authors.lastname: Mansergh
authors.affiliation: CDC Division of HIV/AIDS Prevention, Atlanta, Georgia, USA.
authors.forename: Pilgrim
authors.initials: P
authors.lastname: Spikes
authors.affiliation: CDC Division of HIV/AIDS Prevention, Atlanta, Georgia, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Flores
authors.affiliation: New York Blood Center, New York, New York, USA.
authors.forename: Beryl A
authors.initials: BA
authors.lastname: Koblin
authors.affiliation: University of Illinois-Chicago, Chicago, Illinois, USA.
authors.forename: David
authors.initials: D
authors.lastname: McKirnan
authors.affiliation: Health Research Association, Los Angeles, California, USA.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Hudson
authors.affiliation: San Francisco Department of Public Health, San Francisco, California, USA.
authors.forename: Grant N
authors.initials: GN
authors.lastname: Colfax
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000208:ethnology / Q000523:psychology*; D002641:Chicago / Q000453:epidemiology; D005006:Ethnicity; D006679:HIV Seropositivity / Q000150:complications / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D063509:Homophobia / Q000523:psychology*; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D009518:New York / Q000453:epidemiology; D012307:Risk Factors; D012309:Risk-Taking; D012495:San Francisco / Q000453:epidemiology; D012649:Self Concept; D012725:Sexual Behavior / Q000208:ethnology / Q000523:psychology*; D012747:Sexual Partners / Q000523:psychology*; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology*; D014481:United States / Q000453:epidemiology
keywords: GAY MEN; HIV; PSYCHOLOGY; SEXUAL BEHAVIOUR