The purpose of this study was to explore heterosexual bias in the diagnosis and treatment of gay males. Two hundred-fifty (134 males and 116 females) mental health professionals from the Division of Psychotherapy (29) of the American Psychological Association participated in the study. Participants were randomly assigned to one of two case history conditions, which presented a 35-year-old male seeking therapy. Both conditions were equivalent with regards to the presenting problem (i.e., diagnostic symptoms) with the exception of his significant other (i.e., gay vs. non-gay condition). Potential bias was measured through a diagnostic rating Likert scale and a treatment plan questionnaire. Other independent variables that could potentially have an effect on diagnostic ratings were explored, such as gender, year of graduation, and theoretical orientation of the respondents. Results of the statistical analyses failed to confirm evidence of heterosexual bias. Implications for further research and training are discussed.

This study examined the effects of behavior change on psychological health among gay and bisexual men of Portland, Oregon who were at risk for contracting AIDS. Cross-sectional self-reports of personal experiences were obtained in Summer, 1991. Sexual behaviors were used as predictors of self-efficacy, depression, anxiety, and subjective well-being. Adopting safer sexual behaviors was psychologically more costly than continuing to engage in high risk behaviors, or long-term adherence to safer behaviors. Behaviors amenable to short-term change differed from those conducive to long-term maintenance. Behavior change was also found to have a beneficial effect on self-efficacy. These findings suggest that behavior change, traditionally considered as the endpoint of a process, might more appropriately be considered as an interim stage influenced by earlier, and having an influence on later, psychological health. By integrating models of behavior change from research on alcohol and drug use, smoking, and weight control, researchers studying AIDS-related behavior might better understand the place of behavior change in the process of change, relapse, and maintenance.

The present study examined psychosocial variables as predictors of psychological distress and well-being in gay men with Human Immunodeficiency Virus (HIV) and the Acquired Immunodeficiency Syndrome (AIDS). The psychosocial variables investigated included communal and agentic personality variables, social support, as well as social hindrance, and self-determination variables. The total sample comprised 126 gay men. Forty-eight were seropositive for the HIV infection, 40 received a diagnosis of AIDS, and 38 were seronegative for the HIV infection. The participants with HIV and AIDS were recruited from Immunodeficiency clinics and the HIV$-$ participants were friends and acquaintances of the HIV+ and AIDS participants. The three groups of participants completed questionnaires assessing stable personality traits such as dependency and self-criticism, intimacy, affiliation, achievement, and power strivings, perceived and received social support, social hindrance of personal strivings, and levels of self-determination such as introjective and identified striving motivation. / Multiple hierarchical regression analyses were conducted to assess the predictive utility of each independent variable in predicting psychological distress and well-being. Perceived social support, striving intimacy, and striving achievement were found to be negatively associated with distress and positively associated with well-being across the three groups. Dependency, self-criticism, social hindrance, social hindrance of striving power, and introjective striving motivation were positively associated with distress and negatively with well-being. When all significant independent variables were entered in a regression analysis and simultaneously predicted the outcome variables, perceived social support, self-criticism and social hindrance of strivings significantly predicted psychological distress, and perceived social support, self-criticism, identified and introjective striving motivation predicted psychological well-being. Several independent variables were stronger predictors of distress in the HIV+ group than in the AIDS group: striving power, social hindrance of striving power, dependency, and perceived social support. Results suggest that the HIV+ group is distinct psychologically from the AIDS group. The self-concept theory and the cognitive adaptation theory were discussed in order to explain these group differences. The findings of the present study highlight the important impact psychosocial variables can have on the psychological adjustment of gay men with HIV and AIDS.

No description available.

Older gay men and lesbians may be at greater risk for depression than older sexual majority adults due to a lifetime of sexual minority stress. We hypothesize that aggression and being single are positively associated with depression. Resilience is negatively associated with depression. Aggression, being single and resilience account for a significant proportion of variance in depression. Resilience moderates the relationship between aggression and depression. Significant differences between older gay men and older lesbians' aggression, resilience and depression scores exist. For our older gay men and lesbian combined group, a moderation analysis indicated that in addition to aggression and resilience, being single significantly predicted depression accounting for approximately 57% of the variance in depression. Furthermore, resilience significantly moderated the relationship between aggression and depression in our model of older gay men and lesbians. For our older gay men-only group a moderation analysis (indicated that and resilience significantly predicted depression accounting for approximately 57% of the variance in depression. Furthermore, resilience significantly moderated the relationship between aggression and depression in our model, in our sample of older gay men. Four our lesbian-only group a moderation analysis indicated that being single and resilience significantly predicted depression accounting for approximately 54% of the variance in depression.

Renewed efforts are needed to address rapidly rising HIV incidence among sexual and gender diverse (SGD) individuals—particularly cisgender gay, bisexual, and other men (MSM) and transgender and nonbinary individuals (TSM) who have sex with men—in Kazakhstan. Intervention research is uniquely positioned to advance HIV prevention through surveying factors shaping the HIV epidemic among MSM and TSM in Kazakhstan, developing and testing the effects of an HIV prevention intervention, and assessing overall social impacts of conducting research. This research proceeded to describe strategies and lessons learned during implementation of a stepped wedge clinical trial of an intervention designed to increase the number of MSM and TSM in the HIV care continuum in Kazakhstan cities of Almaty, Shymkent, and Nur-Sultan. Thus, this three-paper dissertation aimed to: (1) identify psychosocial factors associated with lifetime, past-12-month, and past-6-month HIV testing among a sample of MSM and TSM enrolled in the clinical trial; (2) describe the process of implementing remote training of facilitators for remotely delivering the HIV preventive intervention; and (3) assess social impacts of participating in the clinical trial. MSM and TSM from the study cities were recruited into the clinical trial and administered a structured behavioral survey at their primary visit and at follow-up visits every six months thereafter. After a period of no intervention implementation (‘pre-implementation period’), the intervention was implemented sequentially every six months in the study cities. Among 304 MSM and TSM enrolled in the clinical trial during the pre-implementation period, lifetime and past-12-month HIV testing were positively associated with polydrug use and negatively with sexual transmission HIV risk, and past-6-month HIV testing was negatively associated with sexual risk. The process of developing and implementing remote training of facilitators was guided by a protocol outlining phases involving formative assessment and planning, fundamentals training, and feedback loop and technical assistance. Out of 627 MSM and TSM who completed their primary assessment during the clinical trial, 579 (92%) returned for at least one follow-up visit; of these individuals, 88% reported at least one positive social impact, while 2% reported at least one negative social impact. Findings underscore the value of expanding access to substance use treatment for HIV prevention among MSM and TSM in Kazakhstan, the viability of remote training of facilitators for remote intervention delivery, and the feasibility of conducting HIV prevention research involving MSM and TSM with many benefits and few risks.