This can lead to social isolation, disapproval and prejudice, and shame and feelings of immorality (2008).
Arreola et al. (2009) state that LGBM are one of the groups that participate in some of the riskiest sexual behaviors among gay and bisexual men. This prevalence of risky behavior among gay and bisexual men is higher in instances where the men have been sexually abused as a child; it is even higher among LGBM (2009). Unprotected anal intercourse was significantly related to a history of childhood sexual abuse in a study conducted by Carballo-Dieguez and Dolezal (2005) (Morales 2009). In another study of adult men who sleep with men, there was a significantly higher portion of LGBM who reported sexual abuse before age 13 years (22%) than did non-Latino men who sleep with men (11%). Furthermore, studies have shown that childhood sexual abuse can significantly predict negative health outcomes including HIV / AIDS-risk and mental health problems like depression, suicide ideation, and substance abuse among LGBM (2009).
Sandfort, Melendez and Diaz (2007) conducted a study that explored whether or not gender nonconformity in gay and bisexual men is related to mental problems and if so, whether the relationship is mediated by negative experiences that are likely linked with gender nonconformity, including both abuse and harassment. LGBM who considered themselves to be effeminate had higher rates of mental distress and had reported more negative experiences compared with LGBM who did not consider themselves to be effeminate.
Morales (2009) notes that LGBM often lead lives that are put into different categories; they are compartmentalized into different social areas: the gay community; the Latino community; and the predominantly heterosexual, White society. Though a person may take part in different sexual behaviors, their identity as LGBM is "relative to their level of self-awareness or their coming out process" (2009).
There may be limited resources for LGBM in their communities because of a myriad of factors. The factors may consist of language use, acculturation, their level of assertiveness, their managing immigration (there may be a constant threat of deportation, etc.) (Morales 2009). Because some LGBM may feel isolated by cultural views and/or religion, they may have their need to conceal their sexuality reinforced. Morales notes that among the LGBM who had access to social support, they were 40% - 60% less likely to engage in risky anal intercourse with a partner (2009).
Jernewall, Zea, Reisen, and Poppen (2005) conducted a survey in which the purpose was to look at the degree to which HIV-positive LGBM used complementary and alternative medicine (CAM), as well as to explore the relationship between CAM use and adherence to treatment. The study found that those who did use CAM were less likely to keep doctors' appointments, follow doctors' recommendations and adhere to the prescribed medication regiments in the past three days (2005).
Toro-Alfonso, Varas-Diaz, and Andujar-Bello (2002) present an evaluation of an HIV prevention model and intervention that targets LGBM and men who have sex with men in Puerto Rico. A series of workshops were created that were based on the health belief model in combination with concepts of self-efficacy, cognitive theory, and community development (2002). After the intervention, the participants involved showed lower risk indexes (2002).
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