Epidemiological studies have found that young men who have sex with men (YMSM) represent the majority of young people infected with HIV annually in the U.S. Further, they are one of the few risk groups to show an increase in the rate of infections in recent years. In addition to these disparities in prevalence and infection rates, there is an inequity in prevention and intervention research on this population. The purpose of this article is to review the existing YMSM literature on HIV epidemiology, correlates of risk, and intervention research. We conclude that promising future directions for basic research include a focus on multiple clustering health issues, processes that promote resiliency, the role of family influences, and the development of parsimonious models of risk. In terms of intervention research, we suggest that promising future directions include Internet-based intervention delivery, integration of biomedical and behavioral approaches, and interventions that go beyond the individual level to address partnership, structural, community, and network factors.

Researchers have documented the psychological and physical health benefits of being in a relationship among heterosexuals, although there has been limited research to examine such benefits among gay and bisexual men. Gay and bisexual men demonstrate considerable variety in the nature of their relationships, particularly in terms of the degree to which they are monogamous. In order to better understand the psychological and behavioral impact of same-sex relationships on the health of gay and bisexual men, demographic characteristics, psychological factors, sexual behavior, and substance use data were examined in a sample of 819 gay and bisexual men who self-identified as single (n=503) or were classified as being in monogamous (n=182), open (n=71) or monogamish (n=63) relationships. Monogamish relationships were those in which both men have agreed that any sexual activity with casual partners must happen when both members of the couple are present and involved (e.g., “threeways” or group sex). Findings indicated that being in a same-sex relationship had health benefits compared to being single among gay and bisexual men. Men in monogamous relationships reported the least amount of substance use compared to all other groups, and less substance use during sex than single men or men in open relationships. Men in monogamish relationships demonstrated psychological and sexual health benefits relative to single men and men in open relationships. Gay and bisexual men in monogamish relationships more closely resembled those in monogamous relationships, in terms of psychological and sexual health benefits, rather than men in open relationships, suggesting that varying forms of non-monogamy should be explored for their relevance to health behaviors.

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Men who have sex with men (MSM) appear to experience barriers to health care compared with general population men. This report examines individual differences in health care access within a diverse sample of urban MSM (N = 871). The authors examined demographic differences in health care access and the relation between access and health-related attitudes, health behaviors, and HIV transmission risk. They operationalized health care access in terms of three indicators: perceived barriers, insurance status, and recent medical visit. Twenty-seven percent (n = 227) of MSM reported zero or one health care access indicator. African American and Latino race/ethnicity, lower income, and HIV-unknown status were associated with limited health care access. Limited health care access was related to health care attitudes (mistrust in the health care system and difficulty disclosing MSM status to providers), general health behaviors (smoking, never being HIV-tested, and drug abuse), and sexual risk-related variables (low self-efficacy for sexual safety, consistent drug use during sex, and HIV transmission risk). Overall, among MSM, less health care access relates to several adverse psychological constructs and health behaviors. Researchers and public health officials should address limited health care access, and its consequences, in this population.