Date of Award

2011

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Social Work

Abstract

This study examined the impact of factors associated with minority stress theory, including experiences of external prejudice, expectations of rejection and internalized homophobia, upon a cohort sample of men who have sex with men (MSM). Resultant associations with substance use, defined as one time use of a club drug prior to baseline; and sexual risk behavior, defined as unprotected insertive and receptive anal intercourse with primary and non-primary partners, was examined. In addition, this study compared whether each individual aspect of minority stress (external prejudice, expectations of rejection and internalized homophobia) independently or collectively predicted substance use and sexual risk behavior among MSM with their primary and non-primary partners. Factors and outcomes associated with substance use and sexual risk behaviors were investigated via binary logistic regression and use of multivariable modeling for subsequent analysis. Odds ratios for all models were examined utilizing dichotomized variables for minority stress and sociodemographic factors found in the descriptive statistics of the study population, and compared to specific types of sexual risk behavior among the cohort sample. Expectations of rejection demonstrated significance as a protective factor for decreased likelihood of MSM engaging in unprotected insertive anal intercourse with primary and non-primary partners while on drugs and while not on drugs. Additionally, there was validated significance related to decreased likelihood of engaging in unprotected insertive and receptive anal intercourse with both primary and non-primary partners among older study participants (25-40+). Implications are discussed for continued research associated with minority stress factors, substance use and sexual risk behavior among MSM, along with future directions. Such conclusions assist in informing social work clinical practice and behavioral interventions associated with HIV prevention, substance use education, prevention and treatment among the MSM community.

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

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