Use of MSM-specific apps was not uncommon among this sample of AMSM. Patterns of risk behavior and HIV testing were similar to samples of adult MSM app users. Further research should investigate AMSM's app-related sexual and HIV/sexually transmitted infection prevention decision-making to guide sexual health education efforts for AMSM.

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Previous research using the Mood and Sexuality Questionnaire (MSQ) has revealed substantial variability in how negative mood impacts sexual response and behavior. However, the MSQ does not address differences between desire for solo or partnered sexual activity, examine the effects of sexual activity on mood, or assess the effects of positive mood. This paper presents the development and factor structure of the Revised Mood and Sexuality Questionnaire (MSQ-R). An exploratory factor analysis in a sample of heterosexual men, homosexual men, and heterosexual women (N = 1983) produced 8 factors. Considerable variability was found in how moods influence sexual desire and arousal, in the effects of mood on sexual behavior, and in the reciprocal effects of sexual activity on mood. Among other findings, heterosexual women were less likely than heterosexual and homosexual men to experience increased sexual desire and arousal when anxious or stressed, whereas homosexual men and heterosexual women were less likely than heterosexual men to experience increased desire when sad or depressed. Heterosexual men and women were more likely than homosexual men to report increased desire when in a positive mood. Intercorrelations and correlations with various sexual behaviors varied by group. Limitations and implications of the findings are discussed.

While a number of studies have assessed the role of personality traits, situational variables, and drug use on sexual risk behaviors, fewer studies have employed experimental methods to examine cognitive processes that may underlie risky sexual decision making. This study used a go/no-go paradigm to examine how individual difference variables and sexual arousal influence discrimination learning and sexual and nonsexual decision making. A total of 28 men (M age = 20 years) and 25 women (M age = 19 years) completed self-report measures of impulsivity, abstract intellectual ability, and sexual excitation and inhibition and participated in a laboratory experiment. The experiment consisted of two go/no-go tasks with sexual stimuli and two tasks with neutral stimuli, preceded by either sexually arousing or sexually neutral stimulus presentations. Task performance was measured by totals of false alarms and misses. Individuals high in impulsivity and low in abstract intellectual ability committed more false alarms in conditions involving sexually arousing stimuli. Furthermore, higher sexual excitation scores were linked to more misses. These findings indicate that cognitive processes associated with decision making that occurs in the “heat of the moment” are influenced by a combination of situational and sexual and nonsexual individual difference variables.

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Limited research has examined relationship development among lesbian, gay, bisexual, and transgender (LGBT) couples in emerging adulthood. A better understanding of LGBT couples can inform the development of relationship education programs that reflect their unique needs. The following questions guided this study: 1) what are the stages and processes during young LGBT couples’ relationship development? and 2) how do these compare to existing literature on heterosexual adults? A secondary goal was to explore similarities and differences between couples assigned male (MAAB) and female at birth (FAAB). Thirty-six couples completed interviews on their relationship history. Qualitative analyses showed that relationship stages and processes were similar to past research on heterosexuals, but participants’ subjective experiences reflected their LGBT identities and emerging adulthood, which exerted additional stress on the relationship. These factors also affected milestones indicative of commitment among heterosexual adults (e.g., introducing partner to family). Mixed-methods analyses indicated that MAAB couples described negotiating relationship agreements and safe sex in more depth than FAAB couples. Relationship development models warrant modifications to consider the impact of sexual and gender identity and emerging adulthood when applied to young LGBT couples. These factors should be addressed in interventions to promote relationship health among young LGBT couples.

Background Adolescent men who have sex with men (AMSM), aged 13 to 18 years, account for more than 80% of teen HIV occurrences. Despite this disproportionate burden, there is a conspicuous lack of evidence-based HIV prevention programs. Implementation issues are critical as traditional HIV prevention delivery channels (eg, community-based organizations, schools) have significant access limitations for AMSM. As such, eHealth interventions, such as our proposed SMART program, represent an excellent modality for delivering AMSM-specific intervention material where youth are. Objective This randomized trial aimed to test the effectiveness of the SMART program in reducing condom-less anal sex and increasing condom self-efficacy, condom use intentions, and HIV testing for AMSM. We also plan to test whether SMART has differential effectiveness across important subgroups of AMSM based on race and ethnicity, urban versus rural residence, age, socioeconomic status, and participation in an English versus a Spanish version of SMART. Methods Using a sequential multiple assignment randomized trial design, we will evaluate the impact of a stepped-care package of increasingly intensive eHealth interventions (ie, the universal, information-based SMART Sex Ed; the more intensive, selective SMART Squad; and a higher cost, indicated SMART Sessions). All intervention content is available in English and Spanish. Participants are recruited primarily from social media sources using paid and unpaid advertisements. Results The trial has enrolled 1285 AMSM aged 13 to 18 years, with a target enrollment of 1878. Recruitment concluded in June 2020. Participants were recruited from 49 US states as well as Puerto Rico and the District of Columbia. Assessments of intervention outcomes at 3, 6, 9, and 12 months are ongoing. Conclusions SMART is the first web-based program for AMSM to take a stepped-care approach to sexual education and HIV prevention. This design indicates that SMART delivers resources to all adolescents, but more costly treatments (eg, video chat counseling in SMART Sessions) are conserved for individuals who need them the most. SMART has the potential to reach AMSM to provide them with a sex-positive curriculum that empowers them with the information, motivation, and skills to make better health choices. Trial Registration ClinicalTrials.gov Identifier NCT03511131; https://clinicaltrials.gov/ct2/show/NCT03511131 International Registered Report Identifier (IRRID) DERR1-10.2196/19701

Although many sexual and gender minorities (SGM) assigned male at birth (AMAB) use sexual networking applications intended for adult sexual minority men, little is known about adolescents' use of these technologies and characteristics of their online-met partners. We conducted an online survey of 219 sexually experienced SGM AMAB adolescents in the USA aged 15-17 (39.3% racial/ethnic minority; 74.9% gay; 94.1% cisgender male). Questions assessed app use patterns, partner-seeking behaviors on sexual minority male-specific apps vs. social media/other dating apps, app-met partner characteristics, and sexual behavior with app-met partners. Most (70.3%) used apps for sexual minority men, 14.6% used social media/other apps to meet partners, and 15.1% used neither. Nearly 60% of adolescents who used any type of app reported having met people from the apps in person, and nearly 90% of these reported at least one online-met sexual partner. Most partners were reportedly older than participants, and participants were more likely to report condomless receptive anal sex with older (vs. younger) online-met partners. Although partnerships were primarily sexual in nature, a minority reported friendships or serious partnerships. Meeting same-sex/gender partners via applications for adults may be common among SGM AMAB adolescents, which has implications for their sexual health and well-being.