Determinants of safer sex patterns among gay / bisexual male adolescents.
A consecutive series of male youths of mean age 16.8 years, of range 14-19 years, seeking services at the Hetrick-Martin Institute, a New York City community agency providing social and recreational services to male and female homosexual youths, was recruited from the counseling drop-in program and the school program between June 1988 and February 1991 to participate in a study of safer sex practices among gay and bisexual male adolescents. 66% of the final sample of 136 young men reported their sexual orientation as homosexual, 25% as bisexual, 3% as heterosexual, and 6% as other. 53% were Hispanic, 29% Black, 12% White, and 7% of other ethnic background, mainly Asian- and Native-American. The parents of 90% of the participants did not know the youths' sexual orientation. Over their lifetimes, 86% had engaged in oral or anal sex with male partners. Among the sample, 47% had not engaged in anal sex during the three months preceding the study interview, and 46% of those who were sexually active used condoms during every act of anal sex during the preceding three months. 71% of the sample was therefore classified as engaging in consistent safer anal sex with same-sex partners. During the three months preceding the study interview, 38% abstained from oral sex and 18% of sexually active youths used condoms on every occasion of oral sex. 49% of the sample was therefore classified as engaging in consistent safer oral sex with same-sex partners. 27% of the young men did not use condoms consistently during either oral or anal sex. Youths reporting both consistent safer sex for oral acts and those for anal acts were similar in age and ethnicity to those reporting inconsistent safer sex. Whites had a significantly higher level of AIDS knowledge than the youths of other ethnic backgrounds. The social cognitive, peer influence, and components of the health belief model were, however, similar across ethnic groups. Sexual risk practices were also similar across ethnic groups, except alcohol use, which was more frequent among White youths. The youths who practice consistent safer anal sex perceived themselves to be significantly more susceptible to HIV, had more positive attitudes toward practicing safer sex, and perceived greater self-efficacy and self-control in sexual situations. The authors note that unlike most other adolescent populations, perceptions of peer support for preventive acts among gay male adolescents are not related to abstinence and consistent condom use. This may be so due to a sense of alienation and rejection many young homosexuals and bisexuals feel from their schoolmates and neighbors. Finally, this study found that anxious feelings have an impact upon abstinence and consistent condom use.