The Relations of Identity Development and Sexual Debut to Unprotected Sex and Mental Health in Men Who Have Sex With Men

The present analysis measured recent unprotected anal intercourse (UAI), depression, and suicidality in young men who have sex with men (YMSM) to determine if these outcomes were predicted by early identity development, sexual debut, or race/ethnicity. Retrospective semi-structured interviews and self-report computer surveys were used to collect data from 598 racially diverse YMSM between the ages of 18-19 living in the New York City area. Non-parametric Spearman's correlations showed experiencing early sexual awareness was correlated with a greater number of recent UAI acts in the past 30 days. Specifically, first awareness of same-sex attractions correlated with insertive UAI acts, rs (594) = -.068, p = .045, and receptive UAI acts, rs (594) = -.115, p = .005; first realization that same-sex attractions were sexual correlated with insertive UAI acts, rs (594) = -.080), p = .021, and receptive UAI acts, rs (594) = -.106 , p = .002; and first same-sex fantasies correlated with insertive UAI acts, rs (592) = -.079), p = .023, and receptive UAI acts, rs (592) = -.091, p = .008. Additionally, experiencing first mutual masturbation, rs (449) = -.107, p = .024, first oral sex received, rs (566) = -.158, p < .000, and oral sex given, rs (571) = -.114, p = .006, at younger ages was correlated with a greater number of recent insertive UAI acts. Disclosure latency labeling positively correlated with the number of receptive acts in the past 30 days (rs (586) = .122, p = .003). Overall, it was shown that antecedents to sexual risk behaviors develop at a young age (M age of awareness = 10.47). As such, interventions should be developed for pre-adolescent MSM