Perceived Risk, Optimistic Bias, and United Action: A socio-ecological examination of COVID-19 prevention behaviors among sexual minority men.

Sexual minority men (SMM) disproportionately experience psychosocial risk factors and comorbid health concerns (e.g., HIV infection) that increase their vulnerability to COVID-19 infection and distress. The current study applied a socioecological approach to the Health Belief model to understand associations among perceived risk, optimistic bias (a perceived lower risk relative to similar others), united action (perceived community capacity for collective action) and COVID-19 behavioral prevention strategies among COVID-19-negative adult cisgender SMM. Participants (n = 859), recruited via a geo-location-based dating app in May 2020, completed an online survey. Results indicated significant interactions between perceived risk and optimistic bias on social distancing (B = -.03, p < .05), and between perceived risk and united action on number of preventive precautions (B = -.01, p < .01) and number of casual sex partners (B= -.20, p < .05). At low and average levels of perceived risk, socioecological constructs were positively associated with behavioral prevention strategies. At average levels of perceived risk and above, united action was negatively associated with number of casual sex partners, demonstrating evidence of the interaction between perception of interpersonal and community factors and perceptions of one's own risk. These findings may help to inform how to mobilize increased engagement in COVID-19 behavioral prevention strategies among cisgender SMM.

Keeps me awake at night: The potential of the COVID-19 pandemic to affect sleep quality among sexual minority men in the U.S.A.

Sleep health, a crucial component and predictor of physical and mental health, has likely been adversely impacted by the stress and disruption wrought by the COVID-19 pandemic. This brief report sought to assess self-reported sleep quality among sexual minority men across the U.S.A. in the early months of the pandemic. In a cross-sectional online survey of a racially-diverse sample of 477 sexual minority men (mean age of 41.2; range 18-75 years) recruited from popular geo-social networking apps in early May 2020, participants reported on their recent experiences regarding sleep and mental health (anxiety, depression, and pessimistic repetitive future thinking). Almost 75% endorsed some level of restless sleep in the past week, 203 (42.6%) reported worse-than-usual sleep quality since the pandemic, and 77 (16.1%) reported sleeping longer than usual but not feeling better rested. Further, of the 280 reporting worse-than-usual sleep or feeling not rested, almost 85% reported that worry about the pandemic had been contributing to their troubles with falling or staying asleep. Rates of worsened sleep were highest among those whose financial situation had been adversely affected and those not in full-time employment, whereas restless sleep was highest among those in the Northeast region of the U.S.A., which, during the study's timeframe of late April and early May 2020, was the most severely affected by the pandemic. Greater emotional distress was associated with each sleep variable. Addressing and improving sleep health is critical to overall health and requires particular attention during the COVID-19 pandemic.