A longitudinal report of 156 gay, lesbian, and bisexual youths examined changes in sexual identity over time. Fifty-seven percent of the youths remained consistently self-identified as gay/lesbian, 18% transited from bisexual to gay/lesbian, and 15% consistently identified as bisexual over time. Although youths who consistently identified as gay/lesbian did not differ from other youths on time since experiencing sexual developmental milestones, they reported current sexual orientation and sexual behaviors that were more same-sex centered and they scored higher on aspects of the identity integration process (e.g., more certain, comfortable, and accepting of their same-sex sexuality, more involved in gay-related social activities, more possessing of positive attitudes toward homosexuality, and more comfortable with others knowing about their sexuality) than youths who transited to a gay/lesbian identity and youths who consistently identified as bisexual. Contrary to the hypothesis that females are more sexually fluid than males, female youths were less likely to change identities than male youths. The finding that youths who transited to a gay/lesbian identity differed from consistently gay/lesbian youths suggests that identity integration continues after the adoption of a gay/lesbian sexual identity.

This longitudinal report of 145 lesbian, gay, and bisexual (LGB) youths examined ethnic/racial differences in the coming-out process. No significant differences emerged in sexual developmental milestones, sexual orientation, sexual behavior, or sexual identity. However, Black youths reported involvement in fewer gay-related social activities, reported less comfort with others knowing their sexual identity, and disclosed that identity to fewer people than did White youths. Latino youths disclosed to fewer people than did White youths. Analyses of change indicated Black youths had greater increases in positive attitudes toward homosexuality and in certainty in their sexual identity over time than did White youths. These findings support the authors' hypothesis that cultural factors do not impede the formation of identity but may delay identity integration.

Sexual risk behaviors of young gay and bisexual men must be understood within the context of other health concerns (e.g., anxiety, substance abuse), population specific factors (i.e., the coming-out process and gay-related stress), childhood sexual abuse, and other theoretical factors (e.g., safer-sex intentions). The current report proposes and longitudinally examines a model of risk factors for subsequent sexual risk behaviors among young gay and bisexual men in New York City. As hypothesized, more negative attitudes toward homosexuality, more substance abuse symptoms, and poorer intentions for safer sex were directly associated with a greater likelihood of unprotected anal sex over the following year. Furthermore, lower self-esteem, more anxious symptoms, and childhood sexual abuse were related to more unprotected anal sex indirectly through more sexual partners, sexual encounters, and substance abuse symptoms. These findings suggest that interventions targeting sexual risk behaviors of young gay and bisexual men may be more effective if they also address mental health concerns and aspects of the coming-out process.

The longitudinal relations between gay-related stress (i.e., gay-related stressful events, negative attitudes toward homosexuality, and discomfort with homosexuality) and emotional distress (i.e., anxious symptoms, depressive symptoms, and conduct problems) were examined at 3 assessment periods (baseline, 6 months, and 12 months) among 140 gay, lesbian, and bisexual (GLB) youths. Although some findings were consistent with the hypothesis that stress would be associated with subsequent distress among GLB youths, the larger number of nonsignificant relations and the presence of relations between distress and subsequent gay-related stress indicate that the hypothesis was unsupported. The authors discuss the potential reasons for the lack of hypothesized relations and offer suggestions for future research.

Overall, evidence for harm reduction was identified; however, significant differences across the two cities were found. The complicated nature of the sexual practices of gay and bisexual men are discussed, and the findings have important implications for prevention efforts and future research studies.

Objective Although bisexual men report lower levels of mental health relative to gay men, few studies have examined the factors that contribute to bisexual men’s mental health. Bisexual men are less likely to disclose, and more likely to conceal (i.e., a desire to hide), their sexual orientation than gay men. Theory suggests that this may adversely impact their mental health. This report examined the factors associated with disclosure and with concealment of sexual orientation, the association of disclosure and concealment with mental health, and the potential mediators (i.e., internalized homophobia, social support) of this association with mental health. Method An ethnically-diverse sample of 203 non-gay-identified, behaviorally-bisexual men who do not disclose their same-sex behavior to their female partners were recruited in New York City to complete a single set of self-report measures. Results Concealment was associated with higher income, a heterosexual identification, living with a wife or girlfriend, more frequent sex with women, and less frequent sex with men. Greater concealment, but not disclosure to friends and family, was significantly associated with lower levels of mental health. Multiple mediation analyses revealed that both internalized homophobia and general emotional support significantly mediated the association between concealment and mental health. Conclusions The findings demonstrate that concealment and disclosure are independent constructs among bisexual men. Further, they suggest that interventions addressing concerns about concealment, emotional support, and internalized homophobia may be more beneficial for increasing the mental health of bisexual men than those focused on promoting disclosure.

Research on whether disclosure of sexual orientation promotes lower substance use among lesbian, gay, and bisexual (LGB) individuals has been inconsistent. One reason for this may be that disclosure results in accepting and rejecting reactions. The current report longitudinally examines whether the types of reactions to disclosure are associated with substance use and abuse among an ethnically diverse, urban sample of 156 LGB youths (ages 14 -21 years). Neither the number of disclosures nor the numbers of accepting or neutral disclosure reactions experienced were associated with substance use or abuse. However, the number of rejecting reactions to disclosure was associated with current and subsequent alcohol, cigarette, and marijuana use even after controlling for demographic factors, social desirability, and emotional distress. Further, high numbers of accepting reactions were found to moderate or protect youths from the negative role of rejecting reactions on alcohol use, but not other substances. This research indicates that, rather than disclosure per se, it is the number of accepting and rejecting reactions in response to disclosure that are critical to understanding substance use among LGB youths. Further, the results suggest that to be maximally effective in helping LGB youths, substance use prevention and treatment efforts should address the rejecting reactions to disclosure of sexual orientation. KeywordsAlcohol; Cigarette; Marijuana; Self-Disclosure; Rejection; Acceptance; Sexual Orientation; Sexual Identity; Longitudinal Extensive research using large representative samples has examined the potential role of sexual orientation as a risk factor for substance use and abuse among adolescents and young adults Address correspondence to Margaret Rosario, Ph.D., Department of Psychology, The City University of New York -City College and Graduate Center, NAC Building 7-120, Convent Avenue and 138 th Street, New York, NY 10031; mrosario@gc.cuny.edu. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/journals/adb NIH Public Access e.g., Bontempo & D'Augelli, 2002;Eisenberg & Wechsler, 2003a;Russell, Driscoll, & Truong, 2002). A recent meta-analysis of this research concludes that lesbian, gay, and bisexual (LGB) youths are significantly more likely to report alcohol, tobacco, and other drug use than are heterosexual youths (Marshal et al., 2008). The meta-analysis also finds that the higher risk among LGB youths occurs among both sexes and regardless of definition of sexual orientation (e.g., self-identification as LGB...

Focused interviews were conducted with a sample of 45 HIV-infected mothers to identify the reasons women offer for disclosing or not disclosing the illness to their uninfected children, the women's perceptions of their children's reactions to such disclosure, and what effects this disclosure may have on subsequent relationships with their children. Two-thirds (66%) of the mothers had disclosed their HIV infection to one or more of their children. Disclosure rates varied according to age of the child, mother's current disease stage, and whether the child lived with the mother. Mothers reported many reasons for disclosing their HIV infection to their children, including wanting to educate their children about HIV, wanting their children to hear it from them, wanting their children to know before they became very ill, and wanting to be honest with their children. Reasons for nondisclosure included believing that their children were too young or immature, believing it would be too much of an emotional burden for their children, not wanting their children to experience rejection, not wanting their children to fear losing their mother, and wanting their children to recover from previous losses. Although adverse reactions were reported in a few children, most mothers reported that their children, although emotional at first, experienced little, if any, lasting negative impact. Indeed, many reported that the relationship with their children had become closer following disclosure.