A model of predictors and outcomes of outness among lesbian and bisexual women.

In a structural equation model of 2,401 lesbian and bisexual women, three variables of lesbian sexual identity were found to predict outness, which predicted lower psychological distress, which, in turn, predicted lower suicidality. The model held true for the subsamples of European-American and African-American women, and to a lesser extent for those of Latina, Asian-American, Native-American, and Jewish women.

Multiple levels of analysis and intervention in HIV prevention science: exemplars and directions for new research.

The need to continue the scientific development of evidence-based HIV-1 prevention strategies is clear. The epidemic continues to rage out of control, and a vaccine against HIV-1 is nowhere in sight. We think that it is important to consider the influence of multiple social units on HIV risk behavior. In this article, we use ecological theory to outline multiple levels of analysis at which preventive interventions can be conceptualized. These levels include the individual, dyadic/small group, organizational, community, and societal/cultural. We discuss advantages and disadvantages of locating HIV risk at each level, and provide exemplars of HIV prevention for each in an effort to encourage HIV prevention scientists to consider the level at which they are locating the determinants of HIV risk behavior when conducting research. We conclude by stating that scientists and research funding has favored the individual level of analysis, but that to be most successful, the field of HIV prevention science should address risk behavior at all levels of analysis.

Very young gay and bisexual men are at risk for HIV infection: the San Francisco Bay Area Young Men's Survey II.

OBJECTIVES: To compare HIV seroprevalence and sexual risk behavior among very young gay and bisexual men (aged 15-17 years) and their older counterparts (aged 18-22 years). To examine drug-use patterns and correlates of sexual risk behavior in both of these age groups. DESIGN AND METHODS: An interviewer-administered cross-sectional survey of 719 gay and bisexual males between 15 and 22 years old was conducted through a venue-based sampling design. Blood specimens were collected and tested for HIV antibodies, hepatitis B, and syphilis. Interviews assessed sexual and drug-use behavior as well as psychosocial variables believed to be related to sexual risk-taking, including self-acceptance of gay or bisexual identity, perceptions of peer norms concerning safer sex, and perceptions of the ability to practice safer sex (safer sex self-efficacy). RESULTS: Of the 719 participants, 100 (16.2%) were aged between 15 and 17 years. HIV seroprevalence was somewhat lower among those aged 15 to 17 years (2.0%) compared with those aged 18 to 22 years (6.8%). Overall, the prevalence of hepatitis-B core antibody was significantly lower in the younger age group (5.0%) than in the older group (14.1%). The men aged 15 to 17 years used alcohol, ecstasy, and heroin less frequently than those aged 18 to 22 years. The age groups did not differ in the proportion of men who reported any unprotected anal intercourse in the previous 6 months (31.2%). In both age groups, use of amphetamines, ecstasy, and amyl nitrate was associated with unprotected anal intercourse. Self-acceptance of gay or bisexual identity was related to less sexual risk for those aged 15 to 17 years. In both age groups, greater safer sex self-efficacy was linked to less HIV sexual risk-taking. In the younger group, perceptions of peer norms that support safer sex were related to less risk behavior. CONCLUSIONS: Very young gay and bisexual men engage in unprotected anal sex at rates comparable with those for their somewhat older counterparts, raising serious concern over their risk of acquiring HIV infection. To prevent seroconversions, interventions must target those <18 years of age, and prevention programs should address the use of certain drugs in relation to sex and sexual risk-taking. To be most effective, programs should develop innovative communication strategies to take into account lack of self-acceptance of gay or bisexual identity and low self-efficacy for practicing safer sex.

Is offering post-exposure prevention for sexual exposures to HIV related to sexual risk behavior in gay men?

OBJECTIVE: To examine the impact of the availability of postexposure prevention (PEP) for sexual exposures to HIV on sexual risk behavior among gay men. METHODS: Two cross-sectional samples of 529 gay men in San Francisco (June 1998, January 1999) completed face-to-face street interviews assessing sexual risk behavior and whether they had heard of PEP in general as well as whether they knew that PEP was available in San Francisco. The second sample was collected after a community-wide outreach campaign had been conducted to increase people's knowledge that PEP was available in San Francisco. RESULTS: Of those who had heard of PEP at Time 1, 24% had recently had unprotected anal intercourse, versus 26% of those who had not heard of PEP. At Time 2, 37% of those who had heard of PEP had recently engaged in unprotected anal intercourse versus 26% of those who had not heard of PEP (chi2, 4.06; P = 0.03). At both time points, however, men who actually knew that PEP was available in San Francisco did not report more risk behavior than men who did not know PEP was available in San Francisco. In addition, only a small percentage at both time points self-reported that PEP had the effect of increasing their sexual risk behavior. CONCLUSIONS: There is little evidence that the availability of PEP for sexual exposures may be related to increased sexual risk-taking among gay men in San Francisco. The potential impact of PEP on risk behavior must, however, still be considered as part of the larger context of HIV/AIDS treatment optimism and possibly escalating levels of risk behavior among gay men.

Postexposure prophylaxis for human immunodeficiency virus (HIV) infection following sexual assault.

Although the 1998 Centers for Disease Control and Prevention's guidelines for treatment of sexually transmitted diseases recommend offering postexposure prophylaxis for human immunodeficiency virus (HIV) infection following sexual assault, there are no detailed protocols on how to provide this treatment. Postexposure prophylaxis has been shown to lower the risk of seroconversion following occupational exposure to HIV by 81%, but has not yet been evaluated following sexual exposure. Though scientific data are limited, victims of sexual assault should be given the best information available to make an informed decision regarding postexposure prophylaxis. When the choice is made to take medications to prevent HIV infection, treatment should be initiated as soon as possible, but no later than 72 hours following the assault, and should be continued for 28 days. HIV postexposure prophylaxis should be provided in the context of a comprehensive treatment and counseling program that recognizes the physical and psychosocial trauma experienced by victims of sexual assault.

Out on campus: sexual orientation and academic climate in a university context.

Although lesbian, gay, and bisexual (LGB) students often "come out" in university settings, empirical studies have demonstrated that these environments are often hostile toward them. The current paper posits that such hostile contexts adversely affect their educational experiences. Results from a survey of a stratified random sample of 1,927 undergraduate and graduate students on a scale measuring perceptions of academic climate (General Campus Climate) supported this claim: LGB students had more negative perceptions of a variety of campus factors. In addition, a scale measuring perceptions of Lesbian, Gay, and Bisexual Campus Climate found that LGB students were more likely than heterosexuals to perceive the campus as inhospitable to LGB people. Women and racial and ethnic minorities were also more likely to rate the LGB climate as hostile. Finally, data from two scales measuring attitudes believed to influence these perceptions yielded gender, racial/ethnic, religious, and sexual orientation differences in theoretically meaningful directions. Results indicate that LGB students often experience the university in more negative ways than heterosexual students, and that certain campus communities--particularly women and racial/ethnic minorities--are more aware of this negativity and contribute to it less because of their relatively more progay attitudes. Implications for how to improve LGB students' experiences are discussed.

Antecedents and consequences of victimization of lesbian, gay, and bisexual young people: a structural model comparing rural university and urban samples.

Research indicates that antigay victimization is widespread and that lesbian, gay, and bisexual young people may be very vulnerable to such victimization. The current study builds upon previous work by Hershberger and D'Augelli (1995), who studied the consequences of sexual orientation-based victimization in 194 urban lesbian, gay, and bisexual youths. Using structural equation modeling, the present study models both antecedents and consequences (including psychological distress, self-esteem, and suicidality) of victimization via a secondary analysis of their data set. In addition, a second sample of 54 lesbian, gay, and bisexual youths from a rural university setting was examined to cross-validate and generalize the relationships found in urban settings. Results indicated that a revised model of victimization exhibited sufficient fit to the urban sample data and provided preliminary support for the generalizability of the model beyond the initial sample. Additional similarities were found between the urban and rural university community samples, including a high prevalence of reported suicide attempts: 42% of the urban sample and 32% of the rural university sample had attempted suicide at least once. Results indicated that victimization based on sexual orientation has similar correlates for young people in different community settings.

Are men sexually harassed? If so, by whom?

Research on sexual harassment has recently expanded to include examination of men's experiences. Such research, however, has ignored the power dynamics involved in sexual harassment and typically assumed exclusively heterosexual situations. We examine legal cases illustrating the many forms that male-male harassment may take and the complex array of situations in which such harassment occurs. We then report the frequencies of experiences of harassment in three large samples of working men as well as the sex of the perpetrators of the harassment. Finally, we examine men's evaluations of these situations to determine the degree to which they found them to be harassing in a psychological sense. Our results indicate that men experience potentially sexually harassing behaviors from other men at least as often as they do from women; however, men in all samples reported relatively few negative reactions to these experiences. Future research should examine the predictors and outcomes of such situations to clarify the meaning of such behavior for male targets.

Should I come out to my students? An empirical investigation.

Lesbian, gay, and bisexual educators have faced many barriers in their professions, including harassment, discrimination, and even nationwide antigay political campaigns. Recently, lesbian, gay, and bisexual educators, particularly on college campuses, have challenged such stigmatization by coming out. Because previous research has demonstrated that interpersonal contact with lesbians, gay men, and bisexuals is related to less heterosexist attitudes, the current study investigated the impact of a gay instructor's coming out on his students' attitudes toward lesbians and gay men. Data were collected from 156 undergraduate students enrolled in an Introductory Psychology course, 40 of whom were taught by a gay instructor. Herek's (1984, 1994b) Attitudes Toward Lesbians and Gay Men (ATLG) scale was used to measure students' relative levels of heterosexism and was administered to students at the beginning and end of the semester. Midway through the semester, the gay instructor disclosed his gay identity to his students as part of a lesson about sexual orientation. Results from the postcourse survey indicated that students in the gay instructor's course section exhibited improved attitudes. Conversely, students enrolled in the same course in sections taught by heterosexual instructors demonstrated no change in their attitudes. Implications of these findings are discussed, and it is argued that gay instructors' coming out may positively affect their students' attitudes toward lesbian, gay, and bisexual people. However, these efforts by individual instructors must only be a small part of more comprehensive institutional efforts by university communities to address homophobia and heterosexism in educational settings.