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We used repeated cross-sectional data from intercept surveys conducted annually at lesbian, gay, and bisexual community events to investigate trends in club drug use in sexual minority men (N = 6489) in New York City from 2002 to 2007. Recent use of ecstasy, ketamine, and [gamma]-hydroxybutyrate decreased significantly. Crystal metethamphetamine use initially increased but then decreased. Use of cocaine and amyl nitrates remained consistent. A greater number of HIV-positive (vs HIV-negative) men reported recent drug use across years. Downward trends in drug use in this population mirror trends in other groups. (Am J Public Health. 2010;100:1892-1895. doi: 10.2105/AJPH.2009.175232)

Whether homosexuality or internalized homo-negativity is the critical variable affecting the mental health of men who have sex with men has long been debated. As part of a larger study, 422 Midwestern homosexual men completed questionnaires examining degree of homosexuality, internalized homo-negativity, and depression. Logistic regression modeling identified internalized homo-negativity, but not degree of homosexuality, as significantly associated with greater adjustment depression (OR = 1.5), major depression (OR = 2.6), dysthymia (OR = 1.5), and likelihood of being in therapy (OR = 1.4). Internalized homo-negativity was also negatively associated with overall sexual health, psychosexual maturation, comfort with sexual orientation, 'outness,' and peer socialization. Internalized homo-negativity, not homosexuality, appears associated with negative health outcomes. Providers should promote sexual health and avoid interventions that reinforce internalized homo-negativity. KEYWORDS. Homosexuality, sexual orientation, internalized homo-negativity, homophobia, sexual health, mental health, depression, gay men.

Objectives. We examined the characteristics of young Internet-using men who have sex with men (MSM) and risks associated with seeking sex online, offline, or through both strategies. Methods. Data were obtained from MSM aged 18 to 24 years who completed a 45-minute online survey regarding sex and Internet use in the preceding 3 months. Results. Significantly more Internet-using MSM who had met sexual partners both online and offline (43%) reported unprotected anal intercourse than did those who had met sexual partners exclusively online (29%) or offline (34%). MSM who met sexual partners exclusively offline reported the fewest partners but the greatest proportion of partnerships involving unprotected anal intercourse (49%). Meeting sexual partners both online and offline (odds ratio [OR]=3.38-58.42) and being drunk (OR=1.57) or high (OR=2.24) increased the odds of having more sexual partners. The same factors increased the odds of having unprotected anal intercourse (online and offline sexual partners, OR=1.60; being drunk, OR=1.43; being high, OR=1.61). Conclusions. Risky sexual behavior was prevalent among all of the study subgroups. Our findings suggest that online sex seeking is associated with greater numbers of sexual partners but neither promotes nor discourages unprotected anal intercourse. Regardless of where sexual partners met, being drunk and high were significant risks for unprotected anal intercourse.

This essay critically engages challenges made against the federally mandated deferral policies which prohibit 'men who have sex with other men' from donating blood. I argue that 'passing' and 'protest' are dialogically dependent on one another as two separate but related tactics of resistance. Drawing on interview materials from men who have both 'passed' and 'protested,' the essay explores the implications of this dialogical tension for understanding stranger-relationality, enacting civic identity, and disciplining queer bodies. Keywords: Passing; Stranger-Relationality; Blood Donation; Resistance; Identity

Using qualitative interviews with gay men with HIV and with reference to identity, expertise and HIV medical technologies. This article contributes to debate concerning the concept of risk reflexivity. Since the mid 1990s, people with HIV in the affluent, global North have had access to HIV treatment that substantially improves health. Recent research has expressed fears that, by satisfying hopes for effective treatment among affected citizens, HIV prevention will be undermined. This paradoxical idea has sharpened focus on how users apply knowledge regarding the effects of treatment on the dsk of HIV transmission through sexual practice. This article argues that the concept of risk reflexivity has value because it draws attention to the limitations of extant assumptions about the users of HIV medical technologies, But this concept requires development in terms of the positioning of the person with HIV in risk reflexivity and the related mobilization of blame. KEY WORDS gay men / HIV treatment / medical technology risk reflexivity

Health departments, community-based organizations (CBOs), and AIDS service organizations (ASOs) in the United States and abroad distribute large quantities of free condoms to sexually active individuals; however, little is known about where individuals who use condoms actually acquire them. This community-based participatory research (CBPR) study was designed to identify factors associated with the use of free condoms during most recent anal intercourse among self-identifying gay and bisexual men who reported condom use. Data were collected using targeted intercept interviewing during North Carolina Pride Festival events in Fall 2006, using the North Carolina Condom Acquisition and Preferences Assessment (NCCAPA). Of the 606 participants who completed the assessment, 285 met the inclusion criteria. Mean age of participants was 33 ([+ or -]10.8) years. The sample was predominantly white (80%), 50% reported being single or not dating anyone special, and 38% reported the use of free condoms during most recent anal intercourse. In multivariable analysis, participants who reported using free condoms during most recent anal sex were more likely to report increased age; dating someone special or being partnered; and having multiple male sexual partners in the past 3 months. These participants were less likely to report ever having had a sexually transmitted disease. Despite being in the third decade of the HIV epidemic, little is known about condom acquisition among, and condom preferences of, gay and bisexual men who use condoms. Although more research is needed, our findings illustrate the importance of free condom distribution.

A study was conducted to assess whether men who have sex with men (MSM) are more likely to report unprotected anal intercourse (UAI) with partners met on-line compared with those met off-line. Results reveal that MSM recruited on-line who reported a new or casual sex partner(s) in the prior 3 months are at considerable risk of HIV or other sexually transmitted infections but they are equally likely to report UAI whether sex partners were met on-line or off-line.

Trends in sexual risk among gay men in the largest city in England, London and the largest city in Scotland, Glasgow are compared. The results conclude that city-specific factors should be considered in the development of appropriate sexual health interventions.

This study examined the effects of relationship characteristics, as measured by Rusbult's (1980) investment model, on safer-sex behavior between steady gay male partners. Analyses showed that low satisfaction with the relationship was associated with more risky unprotected anal intercourse (UAI). High commitment to the relationship was associated with more practice of negotiated safety (i.e., having safe UAI after both partners have tested negative for HIV and have reached sexual safety agreements). High relationship investment was associated with more risky UAI (borderline significant). We conclude that using relationship satisfaction, commitment, and investment as co-determinants of sexual risk behavior could prove useful in the development of new HIV-prevention strategies for gay men in relationships.

This study examined the role of gender in both implicit and explicit attitudes toward sexuality. Implicit attitudes are judgments or evaluations of social objects that are automatically activated, often without the individual's conscious awareness of the causation. In contrast, explicit attitudes are judgments or evaluations that are well established in awareness. As described in Oliver and Hyde's (1993) meta-analysis of self-report (explicit) data, women report greater negative attitudes toward sexuality than do men. In the current study, we used the Sexual Opinion Survey (SOS) developed by Fisher, Byrne, White, and Kelley (1988) to index explicit attitudes and the Implicit Association Test (IAT) developed by Greenwald, McGhee, and Schwartz (1998) to index implicit attitudes. Research has demonstrated that the IAT reveals attitudes that participants may be reluctant to express. Independent variables examined were participant gender, social acceptability of sexual words, and order of associated evaluations in the IAT (switching from positive to negative evaluations or the reverse). The IAT data revealed a significant Order X Gender interaction that showed that women had more negative implicit attitudes toward sexuality than did men. There was also a significant Order X Acceptability interaction, indicating that implicit attitudes were more strongly revealed when the sexual words used in the IAT were more socially unacceptable. As expected, on the SOS, women had more negative explicit attitudes toward sexuality. There was no significant correlation between explicit and implicit attitudes. These data suggest that at both automatic (implicit) and controlled (explicit) levels of attitudes, women harbor more negative feelings toward sex than do men. KEY WORDS: implicit attitudes; explicit attitudes; gender differences; sexual attitudes.

Objective: To report changes in sexual behaviour among gay men in Sydney from 1986 to 2003. Methods: Baseline data from four studies of gay men in Sydney were used: the Social Aspects of the Prevention of AIDS study (1986/87:91 HIV-positive and 444 HIV-negative men); the Sydney Men and Sexual Health cohort (1993-95:237 HIV-positive and 910 HIV-negative men); the Health in Men cohort of HIV-negative gay men (2001-03:1,148 men); the Positive Health cohort of HIV-positive gay men (2001/02:237 men). Each sample was recruited and interviewed using similar methods. Results: Fewer HIV-positive men had sex with casual partners over time (76.9% in 1986/87 to 63.7% in 2001/02; p=0.001), but more HIV-negative men had sex with 10 or more casual partners in the previous six months (27.7% in 1986/87 to 37.7% in 2001-03; p=0.012). The proportions engaging in particular sex practices with casual partners changed over time: anal intercourse without condoms that included ejaculation in the rectum fell from 29.4% among HIV-positive men and 32.4% among other men in 1986/87 to 17.8% and 10.0% respectively in 1993-95 (p=0.034 and p Conclusion: Gay men's sexual behaviour with casual partners has changed over time, perhaps partly in response to HIV and partly as a general expansion of sexual repertoires. These changes have implications for gay men's health.

This Internet research project examined the relationship between consumption of muscle and fitness magazines and/or various indices of pornography and body satisfaction in gay and heterosexual men. Participants (N = 101) were asked to complete body satisfaction questionnaires that addressed maladaptive eating attitudes, the drive for muscularity, and social physique anxiety. Participants also completed scales measuring self-esteem, depression, and socially desirable responding. Finally, respondents were asked about their consumption of muscle and fitness magazines and pornography. Results indicated that viewing and purchasing of muscle and fitness magazines correlated positively with levels of body dissatisfaction for both gay and heterosexual men. Pornography exposure was positively correlated with social physique anxiety for gay men. The limitations of this study and directions for future research are outlined. KEYWORDS. Body image, gay men, eating disorders, sexual orientation, pornography, social comparison, sociocultural theory

The Internet is becoming a new erotic oasis for obtaining sex online or in person. We reviewed the literature on cybersex and compared differences in data from samples of homosexually active men obtained on identical questionnaires from a conventional written questionnaire, distributed through the mailing and contact lists of a large national gay organization in Sweden, and through the same organization's website and chat room. A total of 716 written questionnaires and 678 Internet questionnaires were obtained. The Internet sample was younger, more likely to live in small towns or cities, live with parents or a girlfriend, and have lower formal education. They are less likely to have previous sexual experience solely with other men (one in three of the Internet sample vs. 1 in 14 of the written sample defined themselves as bisexual) and more likely to visit erotic oases such as bathhouses, video clubs and erotic movie houses. They also visited Internet chat rooms more frequently (86% of the Internet sample vs. 50% of the written sample). One third of the Internet sample wanted the opportunity to talk with an expert about HIV compared with a quarter of the written sample. Sexual practices between the two samples were generally similar, although the Internet sample reported significantly less body contact, kissing, hugging, mutual masturbation, and more condom use for anal intercourse with steady partners. Over four times as many of the Internet samples reported sex with women in the past year as the written sample. These data indicate that Internet data collection is feasible and that this mode of data collection, despite the nonrandom and self-selected nature of both types of samples, is likely to be more significantly oriented toward the young, geographically more isolated, and more behaviorally and self-identified bisexual respondent than conventionally distributed written questionnaires.

Many gay men might agree to test themselves for HIV infection at home using the Orasure home collection kit. This was the conclusion of a study of 615 gay men who were contacted by phone and offered the kit by mail. Sixty-seven percent received the kit and returned their blood sample for processing.

Self-identified homosexual (n = 30), bisexual (n = 29), and heterosexual (n = 31) men were compared on measures of gender-typical behavior, sex role, ego strength, and lipid levels. Homosexual men differed significantly from the heterosexual men on the gender-typical behavior and feminine sex-role measure (both in adulthood and in childhood), and several trends and significant differences were found on the biochemical measures of lipid levels (especially when 7 obese men were removed from the analyses). As a rule, the bisexual men were different from the heterosexual men on the above measures, but were indistinguishable from the homosexual men. Bisexuals differed from both of the other two groups, however, by scoring lower on the ego strength scale and by reporting themselves to be more often troubled, lonely, and depressed. We caution that the lipid analyses were made on single blood samples and require an extended replication; however, we report the data because of their possible theoretical interest and because they replicate work of 20 years ago.

Sexual risk taking for HIV infection was measured for 487 gay men in Buffalo, New York. High levels of sexual risk taking, including unprotected anal and vaginal sex, were reported in comparison to other homosexual populations. Sexual risk takers were found to be more sexually opportunistic, less able to use social skills to reduce their risk of AIDS, and more likely to frequent gay bars than those who were less risky in their sexual behaviors. Respondents were found to be ambivalent in their feelings about condom use and inconsistent in their behavior. We conclude by suggesting that community environment may be a critical factor affecting AIDS-related behaviors and that findings from studies of gay men in the original AIDS epicenters cannot be genealized to all gay men.

In a national study of gay men's sexual behavior in the context of HIV transmission, a schema was evolved for encoding and reporting the structure of sexual activity: the Sexual Behaviour Code (SBC). It has linguistic properties, is easily learned and employed, and generalize easily to heterosexual behaviour. Each sexual session (sentence) comprises a sequence of sexual acts (words), which in turn consists of a sexual behaviour (root), the modality (prefix), and the outcome/ejaculation (suffix). Others aspects (partner/s, drugs, condoms) are encoded as precedents and accompaniments of the acts. The SBC is also used to define a comparable and flexible research instrument for eliciting systematic information on sexual behaviour: the Inventory of Sexual Behaviour (ISB), now used in all WHO/GPA studies of homosexual response. Issues of validity and realiability are addressed, and forms of analysis of the resulting data are discussed for sexual diaries and inventories.