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Background: Though there continues to be a significant amount of research aimed at understanding factors associated with participating in sexual risk behavior in populations of YBMSM, there has been far less research concerned with understanding how psychological distress may influence sexual risk behaviors and how emotional bond formation may affect the relationship between psychological distress and sexual risk behavior. This study aims to better understand the relationship between psychological distress and sexual risk behavior as well as the moderating effect of adult attachment insecurity on this relationship. Methods: Three data collection strategies were utilized to address the study aims: 1) cross-sectional (n = 228), 2) eight-week structured diary (n = 153), and 3) semi-structured interview (n = 30). The cross-sectional survey provided measurement information on adult attachment style using a modified version of the Experiences in Close Relationships Scale (ECR) that consists of the attachment avoidance and anxiety subscales, the Brief Symptoms Inventory (BSI) and the Kessler-10 (K10). Sexual risk was measured by assessing unprotected anal intercourse (UAI) and serodiscordant UAI in the last two months. The eight-week structured diary utilized weekly reports of UAI encounter vs. no UAI encounter, and serodiscordant UAI encounter vs. no serodiscordant UAI encounter. The K10 and the Profile of Moods (POMS) anxiety and depression subscales measured psychological distress. The semi-structured interview assessed childhood attachment. Regression analyses were used to analyze the cross-sectional data. Random effects and population average regression models were used to analyze the structured diary data. A thematic inductive analysis technique was utilized to analyze the qualitative data. Results: Overall, participants reported slightly elevated mean scores on the attachment anxiety subscale while scores on the attachment avoidance subscale remained low. Participants reported an average of two UAI partners in the last month and an average of 1.3 UAI encounters over the eight-week diary period. Psychological distress scores were slightly elevated in the cross-sectional survey and depression scores were elevated in the diary component. For Aim 1, men higher on attachment insecurity (anxiety and avoidance) had higher levels of general psychological distress, depression, and anxiety in comparison to men who were more secure. The qualitative data supported the quantitative findings and showed that subjective appraisal of traumatic events and sexual orientation disclosure may mediate the relationship between childhood attachment and adult mental health. For Aim 2, the quantitative findings suggested that attachment insecurity was not related to sexual risk behavior. However, the qualitative component suggested that participants who were anxious used sex as a means to try to create an emotional bond, while participants who were avoidant used sex as a means to feel good without wanting to create an emotional bond. Both anxious and avoidant men seemed to participate in more concurrent sexual relationships which could increase their likelihood of HIV/STI transmission. For Aim 3, men who were more depressed and had higher levels of general psychological distress were more likely to report a serodiscordant UAI encounter in a given week. The qualitative data supported the quantitative findings and suggested that men might use sex as a means of escape their negative mood. This model of "escapism" could have lead to participation in sexual practices that increased men's risk of HIV/STI transmission. For Aim 4, adult attachment insecurity did not moderate the relationship between psychological distress and sexual risk. The qualitative data suggested that secure attachment in childhood was important to adequately coping with stressful situations, which in turn promoted overall well-being. Conclusion: Study findings suggest that understanding adult attachment may lead to a better understanding of psychological distress and sexual risk behavior among YBMSM. The results highlight the importance of considering childhood and young adult emotional bond formation in the development of HIV/STI prevention intervention activities aimed at addressing the heightened rates of sexual risk behavior among YBMSM. This research could have valuable implications for the development of HIV/STI and mental health prevention interventions aimed at reducing sexual risk behaviors and promoting well-being in populations of YBMSM

Increasingly the Internet has been used by men who have sex with men (MSM) to facilitate social and sexual relationships. Finding from studies investigating the relationship between sexual risk and MSM who meet sex partners on the Internet in either venue-based (offline) and Internet-based (online) settings have been mixed. In an effort to contribute to the knowledge base on this topic, this study analyzed data from two samples of MSM recruited in New York City: Web-based HIV Behavioral Surveillance (WHBS) and National HIV Behavioral Surveillance (NHBS). The relationship between sexual risk behaviors including unprotected anal intercourse (UAI), drug use, number of sexual partners, use of performance enhancing drugs (also known as erectile dysfunction drugs or PDE5 inhibitors), and group sex participation and mode of sex partner recruitment are examined. Univariate, bivariate, and multivariate analysis were used to examine the research questions and hypothesis.

This thesis investigates the relationship between identity, behaviour and desire to examine the nature of research among homosexually active men. The hypothesis is that samples of such men necessarily reflect the definitions of sexuality and homosexuality, and their interpretation, by both the researchers themselves and their research subjects, meaning that the research process itself is marked by the subjectivity of the field of sexuality. The relationship between the observer and the observed is intrinsic to research into homosexual subjectivity and the samples obtained, therefore, represent particular kinds of sexual subjects in a particular social and sexual cultural milieu. Research in this field has given pre-eminence to behaviour over identity and desire, and, as such, has usually failed to account for these differences in sexual subjectivities. To investigate this problem, I have reviewed the relevant literature both on subjectivity and on methodological approaches to research among homosexual men, and I have appraised my own ideological and personal relationships with the subject matter. I have examined the nature of the samples of homosexual men I have obtained during my work as a researcher within the Sydney gay community and reanalysed these with regard to the particular problematic I have identified. These investigations and analyses have shown that there are numerous differences within and between the various samples of homosexual men obtained, indicating that methodological frameworks can determine the nature of the samples obtained. These differences in samples also appear to reflect differences in the ways of enacting homosexual desire among the men in the studies. However, they also parallel differences in the definitions and understandings of the target population by the researchers themselves. These differences reflect differences in definition and understanding both of homosexuality and of the population of gay men, but they also represent differing patterns in the ways of being and living ?gay?, differences in sexual subjectivity. ?Gayness? and homosexuality, as concepts in research, are both the subjective basis on which the research endeavour itself is based, as well as its representational outcome.

This thesis explores the psychosocial dynamics of sexual risk-taking in men who have sex with men, with particular focus on the dilemmas that gay men face in establishing trust in themselves and reasonable trust and intimacy with their sexual partners. As well, the practical function of this study is to analyze past and current social marketing efforts aimed at reducing the spread of HIV/AIDS, and to offer suggestions for how to approach a strategy to reduce HIV incidence in gay men and at the same time bolster efforts to assist men who have sex with men (MSM) in adhering to safer sex guidelines. In part, this thesis uses a sample of participants of the Vanguard Project cohort (St. Paul's Hospital, Vancouver, British Columbia), in order to explore the social meanings attributed by MSM towards sex, risk, intimacy, and attitudes toward HIV/AIDS. Through the use of first-person narratives, this thesis examines the concordance or discordance of MSM beliefs and behaviour with long-standing theoretical models of harm reduction methods concerning sexual risk. The study reveals that, in great measure, due to past life course events, many gay men suffer from a lack of trust in themselves, which results in a tendency to make irrational or unreasonable decisions concerning their long-term sexual health, and a lack of trust in other gay men. As welL through the misguided and often untruthful health models that advocate fewer sexual partners and rely upon the false assumption that all potential sex partners are carriers of contagion, the sense of mistrust has been reinforced. The lack of confidence in self and others further translates into a suspicion of the motives and/or efficacy of social institutions entrusted with community health development and maintenance, rendering their efforts even less effective. Moreover, traditional harm reduction messages, especially 'fear campaigns', often act as a deterrent, rather than as an incentive, to harm reduction. Of more appeal are supportive harm reduction messages delivered by someone whom the recipient trusts, especially when the social meanings of sex, risk, trust and intimacy are, for many gay men, less fixed and more contingent than for the population at large. This means that attempts to modify risky behaviour must acknowledge and negotiate multiple meanings, shifting values and changing social climates, as well as routine epidemiological concerns. The research identifies four key themes within a problematic of trust, risk and intimacy, and delineates the harm reduction social complexities experienced by gay men in the study group; these recurring themes deal with family and early sociahzation, internalized homophobia, contingency and instability of meanings of risk, trust and sex, and the toistworthiness of the messengers of harm reduction strategies. Out of these recurring themes come a number of recommendations for remedial programs aimed at both mid- and long-term reductions in HIV incidence. The recommendations are grounded in the recognition that homophobic and/or dysfunctional social conditions are, to a great extent, implicated in sexual risk behaviour, and therefore must be eliminated or ameliorated before meaningful harm reduction gains can be realized. The discussions with the gay men in the study reveal their need for positive role models and communal social support in their efforts to combat HIV infection, suggesting a need to rethink the meanings of what it is to be gay, a need to redevelop and revitalize what was once a vibrant and cohesive corrimunity, and bearing in mind the lessons of the past, a need to re-approach the task of sternming the tide of HIV infection in ways that are sensitive to the factors that adduce high-risk sexual behaviour.

This thesis examines the lived experiences of young men, addressing their sexual health using Interpretative Phenomenological Analysis (IPA). It is known that young men do not access sexual health services in the same numbers as young women (Pearson, 2003a) and their masculinities are posited as a contributory factor to this. IPA was used to analyse data, collected using semi-structured interviews. Participants were young men, aged 16-20 years (n=7), recruited through local authority leisure centres; convenience sampling was used. Six semi-structured interviews were used as two participants were interviewed jointly. Interviews were conducted exclusively by the researcher, a young woman. The study aimed: • To discover young men’s lived experiences of addressing, or failing to address, their sexual health. • To discover young men’s experiences of negotiating masculinities, relating to their sexual health. Young men were found to have little knowledge of sexual health and sexually transmitted infections and asserted their wishes about sex over their partners. Women were characterised as the source of sexually transmitted infections and the young men sought to ‘protect’ themselves from their partners. However, contraception was seen as the preserve of women, despite unplanned pregnancy being a great concern for the young men. Young men’s ideals of masculinities often did not correspond to their personal ideals; in order to preserve their masculinities, the young men explained the compromises they made. In this way, they negotiated their masculinities with themselves and society. The study has contributed new knowledge and understanding about young men’s negotiation of their masculinities when considering their sexual health. A contribution to knowledge about methodology of interviewing young men has also been made, as the researcher was a young woman who was successful in eliciting rich data about a sensitive subject from young men.

This thesis explores the psychosocial dynamics of sexual risk-taking in men who have sex with men, with particular focus on the dilemmas that gay men face in establishing trust in themselves and reasonable trust and intimacy with their sexual partners. As well, the practical function of this study is to analyze past and current social marketing efforts aimed at reducing the spread of HIV/AIDS, and to offer suggestions for how to approach a strategy to reduce HIV incidence in gay men and at the same time bolster efforts to assist men who have sex with men (MSM) in adhering to safer sex guidelines. In part, this thesis uses a sample of participants of the Vanguard Project cohort (St. Paul's Hospital, Vancouver, British Columbia), in order to explore the social meanings attributed by MSM towards sex, risk, intimacy, and attitudes toward HIV/AIDS. Through the use of first-person narratives, this thesis examines the concordance or discordance of MSM beliefs and behaviour with long-standing theoretical models of harm reduction methods concerning sexual risk. The study reveals that, in great measure, due to past life course events, many gay men suffer from a lack of trust in themselves, which results in a tendency to make irrational or unreasonable decisions concerning their long-term sexual health, and a lack of trust in other gay men. As welL through the misguided and often untruthful health models that advocate fewer sexual partners and rely upon the false assumption that all potential sex partners are carriers of contagion, the sense of mistrust has been reinforced. The lack of confidence in self and others further translates into a suspicion of the motives and/or efficacy of social institutions entrusted with community health development and maintenance, rendering their efforts even less effective. Moreover, traditional harm reduction messages, especially 'fear campaigns', often act as a deterrent, rather than as an incentive, to harm reduction. Of more appeal are supportive harm reduction messages delivered by someone whom the recipient trusts, especially when the social meanings of sex, risk, trust and intimacy are, for many gay men, less fixed and more contingent than for the population at large. This means that attempts to modify risky behaviour must acknowledge and negotiate multiple meanings, shifting values and changing social climates, as well as routine epidemiological concerns. The research identifies four key themes within a problematic of trust, risk and intimacy, and delineates the harm reduction social complexities experienced by gay men in the study group; these recurring themes deal with family and early sociahzation, internalized homophobia, contingency and instability of meanings of risk, trust and sex, and the toistworthiness of the messengers of harm reduction strategies. Out of these recurring themes come a number of recommendations for remedial programs aimed at both mid- and long-term reductions in HIV incidence. The recommendations are grounded in the recognition that homophobic and/or dysfunctional social conditions are, to a great extent, implicated in sexual risk behaviour, and therefore must be eliminated or ameliorated before meaningful harm reduction gains can be realized. The discussions with the gay men in the study reveal their need for positive role models and communal social support in their efforts to combat HIV infection, suggesting a need to rethink the meanings of what it is to be gay, a need to redevelop and revitalize what was once a vibrant and cohesive corrimunity, and bearing in mind the lessons of the past, a need to re-approach the task of sternming the tide of HIV infection in ways that are sensitive to the factors that adduce high-risk sexual behaviour. / Arts, Faculty of / Sociology, Department of / Graduate

This research is based on an ethnographic study conducted in 2008. The study took place in Ecuador's coastal province of Manabâi and investigates the lives of a community of transvestite males, known locally as travestâis. This research holds that the social space in which the travestâis live and work, in Puerto Lopez, is negotiated and maintained through a complex interchange of three key factors: the experience of mother's love, the local economy, and sexual desire. The social space itself is defined as a "binary passage." Most of the travestâis are employed as hairdressers, and they draw a wide range of clientele from Puerto Lopez and surrounding smaller villages. Yet, how is it that travestâis can lead open and productive lives in a region that highly values machismo? This research focuses on both the origins of the travestâis' social space and the means by which it is maintained through key discourses. / by Eve E. Brooks. / Thesis (M.A.)--Florida Atlantic University, 2009. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2009. Mode of access: World Wide Web.

ENGLISH ABSTRACT: This research study examines the beliefs related to HIV/AIDS risks and the perceived effectiveness of preventative measures among men who have sex with men (MSM) in the Philippines. Using a questionnaire developed using the Health Belief Model (HBM), this study endeavors to understand beliefs and thus improve counseling guidelines for MSM who continue to engage in risky sexual behaviors following VCT and a negative HIV test. The impact of HIV/AIDS on the Philippines is beginning to increase, affecting men and their partners. The rapid growth of HIV/AIDS among Filipino MSM indicates that more attention must be paid to the barriers and benefits of condom use within this high-risk population. A background of the presence and prevalence of HIV/AIDS is presented. This study aims to answer the question of why MSM choose to have unprotected sex despite the risk of HIV/AIDS. Multiple barriers to condom use are identified, including the availability of condoms, partner resistance, and reduced pleasure. The impacts of culture and society, the media, role models, social networking, drug use, and riskseeking behavior on safer sex are assessed. Currently, supplying condoms and providing voluntary testing and counseling is the primary mode of preventing the spread of HIV/AIDS, but this study sheds light on the critical issues of condom availability, perceived benefits and barriers to condom use, and the disconnect between belief and behavior regarding HIV/AIDS and unprotected sex among MSM in the Philippines. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie is ‗n ondersoek na die gelowe (beliefs) teenoor MIV/Vigs van mans wat seks het met mans. Die studie poog verder om ondersoek in te stel na moontlike voorkomende maatreëls wat ingestel kan word om die pandemie te bekamp. Vir die doel van hierdie studie is ‗n vraelys ontwikkel , deur gebruik te maak van die Health Belief Model, met die doel om ‗n beter begrip te kry van die redes vir risikogedrag onder mans wat seks het met mans in die Fillipyne. Die voorkoms van MIV/Vigs by mans wat seks het met mans is steeds aan die toeneem in die Fillipyne en dringende maatreëls is nodig om die groei van die pandemie te beperk. Die studie gee ‗n agtergrond tot MIV/Vigs in die Fillipyne. Die ondersoek gaan dan voort om te probeer bepaal waarom risikogroepe steeds voortgaan om aan onbeskermende seksuele aktiwiteite deel te neem. Resultate van die studie toon aan dat daar verskeie faktore is wat die gebruik van kondome ontmoedig in die risikogroep wat in hierdie studie aangespreek word. Kondome is nie altyd beskikbaar nie; seksuele vennote wil nie kondome gebruik nie en die vermindering in seksuele plesier word as redes aangevoer. Hierdie studie maak ‗n betekenisvolle bydrae tot die kennisbasis van die gelowe en houdings van mans wat seks het met mans ( en dan MIV-positief raak) en sal na alle waarskynlikheid betekenisvol bydra tot die meer suksesvolle bestuur van hierdie risikogroep in die Fillipyne.

Pubertal timing is a human life history variable representing a trade-off between early reproduction and continued growth. Dominance is an important feature to male mate value. These two variables should have far-reaching effects on adult male life. Chapter 1 reviews evolution, r/K selection and life history theory to derive hypotheses concerning variation in male mating strategy. Chapters 2-4 investigate the effects of pubertal timing and dominance on mating strategy using sociosexual orientation and preferences for faces and mate characteristics. Both early puberty and high dominance associate with unrestricted sociosexuality (increased interest in casual sex) as predicted. Dominance is shown to relate to preferences for cues of sociosexuality but not femininity, while pubertal timing relates to neither facial characteristic. Earlier and later developing men do not differ in their mate characteristic preferences, while dominant men exhibit enhanced female-typical mate preferences counter to predictions. A dominance-dependent, dual, male mating strategy is proposed to account for results. Chapter 5 introduces sensitivity to putative human pheromones as an indicator of mating strategy. Dominant men are found to be more sensitive to and more averse to a putative female pheromone. Pubertal timing has no effect on sensitivity. Results are interpreted in terms of dominant male avoidance of infertile matings. Chapter 6 finds that early puberty associates with facial masculinity, attractiveness and apparent age. Chapter 7 offers a hormonal underpinning of effects related to pubertal timing, showing that early development associates with higher levels of testosterone in men. Chapter 8 uses digit length ratios to show that early developing men may have been exposed to greater levels of uterine testosterone, suggesting prenatal influences on male pubertal timing. Chapter 9 shows dominance associates with bodily, vocal and general attractiveness but not facial attractiveness. Chapter 10 reports that dominance associates with high levels of the stress hormone cortisol, suggesting costs of high dominance. Chapter 11 shows early pubertal timing relates to the visual appearance of skin, perhaps because of lower sebum production among early developing men, leading to them having darker, less reflective skin. This may reflect accelerated ageing of early developing males, potentially representing a cost to longevity.