Correlates of High-Risk Sexual Behavior Among Young MSM

Published: January 1, 2004

Data from a sample (n = 154) of young men who have sex with men (YMSM),
aged 13-21, residing in five mid-sized cities in themidwestern United Stateswere
used to test the hypothesis that personality variables (impulsive decision making,
sensation seeking, anxiety/depression, internalized homophobia) contribute
uniquely to the prediction of unprotected anal sex beyond what is accounted for
by other high-risk behaviors (i.e., substance use and number of sex partners) and
partner status (having a dating partner). Results of hierarchical regression analyses
indicated that number of reported anal sex partners and partner status were
positively associated with self-reported frequency of unprotected anal sex. Beyond
these factors, impulsive decision making significantly contributed to the
predictive model. These findings indicate that designing effective prevention programming
for YMSMshould take into consideration relationship status and the
impulsiveness of sexual decision making among members of the target group.
Young men who have sex with men (YMSM) face an increased risk of contracting
HIV relative to their exclusively heterosexual peers (Blake et al., 2001; Bok & Morales,
1998; Faulkner&Cranston, 1998). No sexual behavior is more risky than unprotected
anal sex, and evidence indicates that the percentages ofYMSMwho engage
in this specific sex behavior remain high. In one study, 37% of the young men sampled
reported engaging in unprotected anal sex in the last year (Hays et al., 1997). Because
of the high-risk for contracting HIV, documenting factors associated with unprotected
anal intercourse among YMSM is important to efficacious education and
prevention programming.

Problem behavior theory (R. Jessor, 1992; R. Jessor, Graves, Hanson, & R.
Jessor, 1968; R. Jessor, Van-Den-Bos, Vanderryn, & Costa, 1995) hypothesizes that
risk behavior results from the interaction of three systems composed of the aspects of
the personality, aspects of the environment or situation, and behaviors aligned with nonconventional, or “deviant,” rather than conventional norms. To date, problem
behavior theory has primarily focused on understanding adolescent substance use
(Donovan, R. Jessor,&Costa, 1999; S.L. Jessor&R. Jessor, 1975) and early transition
to sexual intercourse (Costa, R. Jessor, Donovan&Fortenberry, 1995; R. Jessor,
S. L. Jessor,& Finney, 1973) among presumably heterosexual youth. To our knowledge,
no research has extended this model to sexual minority youth. Given the largely
atheoretical nature of research on YMSM, the potential utility of problem behavior
theory for understanding high-risk sexual behavior in this population is worthy of exploration.
Although fully testing this model is beyond the scope of this initial study,
we do utilize the tripartite framework to explore selected personality, environmental,
and behavioral contributions to the reported frequency of unprotected anal intercourse
in a sample of adolescent males who have sex with men. Given that the majority
of studies (reviewed below) have focused on environmental and/or behavioral
correlates, the focus of this particular study is the unique contribution of selected personality
variables (impulsive decision making, high sensation seeking, internalized
homophobia, and depression) to a model predicting the frequency of unprotected anal

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