Aspects of mental health among older lesbian, gay, and bisexual adults.

This study examined aspects of mental health among 416 lesbian, gay, and bisexual adults aged 60 to 91 years old, attending social and recreational programs. Mental health indicators were perceived mental health status; self-esteem; internalized homophobia; loneliness; alcohol and drug abuse; and suicidality. Better mental health was correlated with higher self-esteem, less loneliness, and lower internalized homophobia. Compared to women, men reported significantly more internalized homophobia, alcohol abuse, and suicidality related to their sexual orientation. Less lifetime suicidal ideation was associated with lower internalized homophobia, less loneliness, and more people knowing about participants' sexual orientation.

The theory of planned behavior as related to intention to exercise and exercise behavior.

In a previously reported study we sought to assess the usefulness of the theory of planned behavior in explaining the exercise behavior of 73 adults enrolled in an exercise program over a 5-mo. period. The correlation between scores on Intention to Exercise and Exercise Behavior was moderate and inverse, conflicting with a primary tenet of the Theory of Planned Behavior. In this analysis of the data we sought to explain that finding by partitioning participants into groups based on a median split of their scores on Intention to Exercise and Exercise Behavior. Using the four Intention by Behavior groups as independent variables and scale scores as dependent variables, post hoc tests for Fitness Attitude showed significant differences only when High Intention conflicted with Low Intention, irrespective of Exercise Behavior. Perceived Behavioral Control showed opposite tendencies, i.e., differences were significant when High Behavior conflicted with Low Behavior, irrespective of Intention to Exercise. We conclude that Perceived Behavioral Control defines one's ultimate Exercise Behavior over a 5-mo. period while scores on Fitness Attitude define Intentions to Exercise.

Scale construction for measuring attitude, beliefs, perception of control, and intention to exercise.

BACKGROUND: Using the Theory of Planned Behavior as a framework, the Fitness Attitude, Expectations of Others, Perceived Behavioral Control, and Intention to Exercise Scales were developed. Professionals in exercise physiology generated items for the instruments. Experts in clinical psychology and exercise physiology established content validity. METHODS: Each of the scale items is phrased in a rating scale format. Both unipolar and bipolar scales were developed with seven response choices offered. Following the pilot testing and subsequent revisions, 19 items were retained in the Fitness Attitude Scale, seven items were retained in the Expectations of Others Scale, three items were retained in the Perceived Behavioral Control Scale, and 11 items were retained in the Intention to Exercise Scale. RESULTS: Correlation coefficients for the total instruments were significantly positive for stability and internal consistency, ranging from a = 0.75 to a = 0.87. Exercise specialists may wish to implement the use of these scales in their practices to develop intervention techniques for the promotion of positive fitness attitudes, good perception of control over the ability to exercise, and good intentions to exercise. CONCLUSIONS: The positive results in this study s sample suggest that these scales are ready for application in the field, but they should be pilot-tested with each group to check reliability with the particular population.

Social support networks of lesbian, gay, and bisexual adults 60 years of age and older.

The social support networks of 416 lesbian, gay, and bisexual adults aged 60 to 91 years were examined. Participants averaged 6 people in their support networks, most of whom were close friends. The gender composition of support networks was greatly influenced by the gender of the respondent. Most support network members knew about respondents' sexual orientation. The most common type of support provided by close friends and social acquaintances was socializing support, and the most common support provided by partners, siblings, and other relatives was emotional support. The sexual orientation, gender, and age of network members did not influence respondents' satisfaction with the support received. Participants were more satisfied with support from those who knew of their sexual orientation. The more satisfied respondents felt with the support they received, the less lonely they felt. Those living with domestic partners were less lonely and rated their physical and mental health more positively than those who lived alone.

Health problems of gay and bisexual men.

Significant mental and physical morbidity occurs among gay and bisexual men because health care providers are often unaware of their actual or potential health concerns. Mental health problems include anxiety, depression, suicide, and both alcohol and substance abuse. Physical health concerns include HIV disease, hepatitis, and other sexually transmitted diseases, as well as an increased risk of heart disease and certain cancers. Health care professionals, who are clinically competent in the care of men who have sex with men, have the opportunity to reduce the risk of disease, while providing unbiased, quality care which recognizes the unique problems of this population of men.

Self-esteem and supportiveness as predictors of emotional distress in gay male and lesbian youth.

Many gay male and lesbian youth experience isolation, self-hatred, and other emotional stressors related to harassment and abuse from peers and adults, leading to risk factors associated with alcohol and substance abuse, suicide, prostitution, running away, and school problems. Research findings have indicated that high levels of self-esteem and social supports may moderate gay-identified stressors. The current study examined self-esteem and satisfaction with supportiveness as predictors of emotional distress in a sample of 90 self-identified urban gay male and lesbian youth.

Attitudinal, social, and practical correlates to fitness behavior: a test of the theory of planned behavior.

Professional management personnel (N = 73) who exercise were studied to assess the efficacy of the theory of planned behavior in predicting intention to exercise and amount of exercise. Four rating scales were used for the assessment of attitude toward fitness, subjective norm, perceived behavioral control, and intention to exercise. In addition, frequency of exercise was measured and recorded for five months. Hierarchical multiple regression analyses indicated that 26.6% of the variance of intention to exercise was contributed by both fitness attitude and subjective norm, with the unique contribution of attitude toward fitness (part r = .36) slightly greater than that of subjective norm (part r = .33). 8% of the unique variance of exercise was explained by intention to exercise. Hierarchical multiple regression analyses also indicated that perceived behavioral control did not account for a significant variance in intention to exercise but did account for a significant variance in amount of exercise (R2 change = .21). In the environment in which it was tested, results support the theory of planned behavior for understanding the exercise behavior of professional management personnel who exercise.

At risk, infected, and invisible: older gay men and HIV/AIDS.

Older gay men over the age of 50 have been and continue to be an invisible part of the HIV/AIDS epidemic. The reasons for this phenomenon are many, but among them are societal beliefs, myths, and stereotypes emanating from ageism and homophobia. In addition, HIV/AIDS is sometimes misdiagnosed in older adults because many of its symptoms mimic other illness that affect older people. Among the HIV risk factors of older gay men are internalized homophobia, denial of risk, alcohol and other substance use, and anonymous sexual encounters. The challenge for nurses and other providers is to reach, educate, and assist older gay men effectively in changing and maintaining safe behaviors when they are engaging in sexual and drug-using behaviors that can transmit HIV.

Homophobia: a cofactor of HIV disease in gay and lesbian youth.

Whether they "come out" or hide their sexual orientation, most gay and lesbian youth experience the effects of prejudice and stigmatization emanating from society's homophobia. Having to cope with a disparaging and oppressive society creates unique stresses and developmental variations in identity development that are cofactors for HIV infection and disease. These cofactors include cognitive, emotional, and social isolation; feelings of alienation and despair; suicidal ideation; alcohol and other substance abuse; and furtive sexual contacts. Nurses and other providers need to be informed about these cofactors so they may provide meaningful HIV/AIDS prevention education to gay and lesbian youth.

Facilitating support groups for professionals working with people with AIDS.

Social workers, nurses, and other health care professionals who work with people with human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS) are experiencing burnout from the excessive demands on their energy, strength, and resources. Support groups, with their focus on awareness, shared experiences, supportive and helping relationships, and the emotional consequences of working with people with AIDS, help health care professionals manage stress and enhance their capacity and effectiveness to work with these clients. In addition, support groups help participants feel less isolated and share feelings regarding such difficult issues as death, anger, helplessness, and loss. The use of this type of group work is identified, including its administration, effective intervention techniques, and issues of health care professionals who work with the HIV/AIDS epidemic. Problems related to group membership and dropout rates are explored as unresolved issues.

Gay men and HIV/AIDS: understanding the double stigma.

Many men with HIV/AIDS are and will continue to be homosexual or bisexual. Effective care requires understanding the impact of the double stigma of being gay and having HIV/AIDS. While providers have traditionally focused on gay men with HIV disease as individuals, this article directs providers' attention to the importance of social dimensions in creating a plan of care.