ABSTRACT

Homophobia is associated with sexual risk among sexual minorities, including Black sexual minority men, though experienced homophobia may differ across sexual identities. We conducted latent class analysis of sexual identities and experienced homophobia associated with sexual risk, and tested mediators of this association. We used longitudinal data from the HIV Prevention Trials Network Study 061 (n = 1,553). We generated rate ratios between baseline latent classes of experienced homophobia and sexual identity and 12-month outcomes: Condomless receptive anal intercourse (CRAI), number of partners, and transactional sex. Mediators included 6-month internalized homophobia, depression, social support, and substance use. We selected the following 7-class model: “Bisexual, rare homophobia” (reference), “Mixed identities, mixed homophobia”, “Bisexual, frequent homophobia”, “Heterosexual/Same-gender loving, frequent homophobia”, “Gay, frequent homophobia”, “ Gay/Same-gender loving, frequent homophobia,” and “Gay, rare homophobia.” All other classes had greater CRAI than the reference. For bisexual/mixed/heterosexual classes, approximately 20% of this association was positively mediated through our mediators (p < .05). The Heterosexual/Same-gender loving class had the largest proportion mediated through internalized homophobia. For gay-identifying classes, mediation was marginally significant (.05 < p < .10). Classes of sexual identity and experienced homophobia were associated with CRAI among Black sexual minority men, partially mediated through internalized homophobia, depression, social support, and substance use.

摘要

同性恋恐惧症与性少数群体（包括黑人性少数男性）的性风险有关，尽管经历过的同性恋恐惧症可能因性别身份而异。我们对性身份和经历与性风险相关的同性恋恐惧症进行了潜在类别分析，并测试了这种关联的中介。我们使用了来自 HIV 预防试验网络研究 061 (n = 1,553) 的纵向数据。我们生成了经历过同性恋恐惧症和性身份的基线潜在类别与 12 个月结果之间的比率：无安全套接受性肛交 (CRAI)、伴侣数量和性交易。中介因素包括 6 个月内化的恐同症、抑郁症、社会支持和物质使用。我们选择了以下 7 类模型：“双性恋，罕见同性恋恐惧症”（参考），“混合身份，混合同性恋恐惧症”，“双性恋，频繁的同性恋恐惧症”，“异性恋/同性别的爱，频繁的同性恋恐惧症”，“同性恋，频繁的同性恋恐惧症”，“同性恋/同性的爱，频繁的同性恋恐惧症”和“同性恋，罕见的同性恋恐惧症”。所有其他类的 CRAI 都大于参考。对于双性恋/混合/异性恋班级，大约 20% 的这种关联是通过我们的调解员积极调解的（p < .05)。异性恋/同性爱好阶层通过内化的同性恋恐惧症介导的比例最大。对于识别同性恋的班级，调解的作用微乎其微（0.05 <  p < .10）。性别认同和经历过的同性恋恐惧症与黑人性少数男性的 CRAI 相关，部分通过内化的同性恋恐惧症、抑郁、社会支持和物质使用来调节。