Condomless Sex: Considerations for Psychotherapy with Individual Gay Men and Male Couples Having Unsafe Sex

Loneliness, Internalized Homophobia, and Compulsive Internet Use: Factors Associated with Sexual Risk Behavior among a Sample of Adolescent Males Seeking Services at a Community LGBT Center

“…Loneliness in adulthood has been associated with unprotected receptive anal sex (Parsons, Halkitis, Wolitski, & Gómez, 2003) and other high risk sexual behaviors among MSM (Semple, Patterson, & Grant, 2000). Clinically, feelings and perceptions of loneliness have been considered important targets for therapeutic intervention when working with MSM who engage in unsafe sexual practices (Shernoff, 2005;Torres & Gore-Felton, 2007).…”

Depression and HIV Risk Taking Among Men Who Have Sex with Other Men and Who Use the Internet to Find Partners for Unprotected Sex

“…Mental health conditions such as depressive symptoms and altered self-esteem combined with high-risk sexual behaviors render MSM vulnerable to both STI and HIV infection.” Adam and colleagues (2005) suggested that when men feel depressed, they get into an “I don’t care” mood, which leads them to an increased likelihood of engaging in unsafe sex. On this subject, the authors wrote (p. 242): “If life does not seem worth living now and the future appears bleak as well, then self-preserving actions no longer make sense.” Speaking from a clinical psychology perspective, Shernoff (2005) noted that depression often leads gay men to be hyperactive sexually and to engage in unprotected sex.…”

Understanding the Influence of Loneliness on HIV Risk Behavior in Young Men Who Have Sex with Men

“…Additional venues (e.g., bars, clubs, and bathhouses) were also frequented by YMSM who were seeking sexual partners. As Shernoff (2005) found in his clinical case studies of gay men, for those individuals who felt lonely or isolated, sex often was a vehicle to suppress such feelings. Other studies have shown that substance use, often in conjunction with sex, is utilized by YMSM as a coping mechanism to provide temporary relief from psychological states (Dowshen, Binns, & Garofalo, 2009).…”

“…If this is not done, further interventions aiming to address the connections between loneliness and HIV risk behavior might approach the problem as one of individual-level psychological deficits on the part of YMSM. This would be erroneous and ineffective, as it is clear that neither YMSM's feelings of loneliness nor their HIV risk behaviors occur in a vacuum (Dowshen et al, 2009;Halkitis, 2008;Mustanski et al, 2007;Shernoff, 2005). Meyer's (2007) Minority Stress Model, which shows how a hostile social environment (including stigma, discrimination, and prejudice) can be internalized and expressed as individual-level mental health problems, underscores the importance of addressing social context when addressing mental health and health outcomes of LGBT populations.…”

“…There is an evident relationship between psychological distress and UAI in YMSM Salomon et al, 2009), and YMSM continue to engage in risky behaviors for HIV infection, including heavy and social drug use, insertive UAI, and receptive UAI with presumed HIV-negative or partners of unknown status (Salomon et al, 2009). In his analysis of clinical case studies, Shernoff (2005) found that sexual behavior is often a coping mechanism for lonely and isolated gay men. Barebacking, the purposeful engagement in UAI, is one method of decreasing feelings of isolation and loneliness (Halkitis, 2008).…”