Date of Completion

10-5-2018

Embargo Period

10-5-2021

Keywords

MSM, HIV, mental health, sexual health, childhood sexual abuse

Major Advisor

Dean Cruess, PhD

Associate Advisor

Conall O'Cleirigh, PhD

Associate Advisor

Amy Gorin, PhD

Field of Study

Psychology

Degree

Doctor of Philosophy

Open Access

Open Access

Abstract

Gay, bisexual, and other men who have sex with men carry a disproportionate burden of new HIV infections in the United States. This same group is also particularly vulnerable to experiences of childhood trauma, including sexual abuse, and subsequently developing psychiatric disorders later in adulthood. This study examines how particular psychiatric disorders and their underlying symptom clusters impair sexual health knowledge and condom use self-efficacy, and also increase sexual risk taking behavior. A total of 296 HIV-uninfected men who have recently had condomless sex with other men completed a baseline survey and psychodiagnostic interview. Among the measures included in this study were demographics, HIV/AIDS knowledge questionnaire, condom use self-efficacy, recent sexual behavior, and a psychodiagnostic assessment (the MINI and SCID) with a trained study clinician. Over two-thirds of the sample (67%) met diagnostic criteria for at least one of these major psychiatric disorders. A diagnosis of Major Depressive Disorder and its underlying cognitive / affective and physical symptom clusters were significantly related to decreased sexual health knowledge and lower condom use self-efficacy. A diagnosis of Generalized Anxiety Disorder was associated with sexual risk taking behavior. The underlying cognitive /affective and physical symptom clusters of Generalized Anxiety Disorder were associated with decreased sexual health knowledge. These findings underscore the need for interventions that are flexible and capable of addressing multiple mental health issues, particularly for gay and bisexual men with developmental trauma histories. Improving the health and mental wellness of this group may ultimately counter new HIV infections.

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