Am J Psychiatry 1995; 152:588-595
Copyright © 1995 by American Psychiatric Association
Predicting patterns of sexual acts among homosexual and bisexual youths
MJ Rotheram-Borus, M Rosario, H Reid and C Koopman
Department of Psychiatry, University of California, Los Angeles.
OBJECTIVE: This longitudinal study examined predictors of patterns of
change in HIV sexual risk acts among homosexual and bisexual adolescent
males. METHOD: A consecutive series of 136 homosexual and bisexual males
aged 14-19 years were recruited into the study. Subjects were predominantly
Hispanic (51%) and African American (31%) and seeking services at a
homosexual-identified community-based agency in New York City. All subjects
participated in an intensive HIV intervention program. Patterns of change
in HIV sexual risk acts were based on assessments at four points (intake
and 3, 6, and 12 months later) and were used to classify youths as
demonstrating one of five patterns of anal and oral sexual acts: protected
(anal: 45%, oral: 25%), improved (32% and 28%, respectively), relapse (5%
and 8%), variable (8% and 15%), and unprotected (10% and 24%). Components
of the health belief, self-efficacy, peer influence, coping, and distress
models were assessed as predictors of these patterns. RESULTS: Protected
and improved patterns of sexual risk acts were associated with low levels
of anxiety, depression, and substance use and high self-esteem.
CONCLUSIONS: These data suggest that HIV interventions must address non-
HIV-related issues confronting youths in difficult life circumstances,
particularly emotional distress and the role of peer networks for
homosexual and bisexual youths.
