Does sexual identity development matter for HIV prevention with sexual minority youth?

Sexual minority male youth are at high risk for HIV infection, yet we know relatively little about the impact of sexual identity development on sexual risk behaviors. This presentation utilizes cross-sectional data from a mixed-method study investigating pathways of HIV risk among sexual minority youth to examine the relationships among HIV-related cognitive risk factors (informed by Fisher & Fisher's IMB model), sexual identity development, and sexual risk behaviors (SRB) among a sample of 156 males. Youths ranged in age from 14-24 years (x¯ =18.64) and identified as Gay (72%), Bisexual (19%), Transgender (4%), and other (6%). Sixty-seven percent were African American, 18% were Caucasian, 9% Biracial, and 6% other. Fewer primary SRB (i.e., behaviors that can directly prevent HIV infection) were associated with more positive attitudes toward LBGT people (rs = - .22, p<.01) and exclusively male sexual attractions and behaviors (rs = - .27, p<.001). Fewer secondary SRB (i.e., behaviors that compound HIV risk but do not directly prevent infection) were associated with more HIV prevention information (rs = -.34, p<.001), more motivation to prevent HIV infection (rs = -.23, p<.01), and more positive attitudes toward LBGT people (rs = - .21, p<.01). Having a sex-centered identity development sequence was associated with more primary SRB (rs = .24, p<.01). These findings suggest that sexual identity development may be an important addition to existing models of HIV risk for sexual minority adolescents. Discussion of quantitative results will be augmented with qualitative findings to identify culturally specific targets for HIV-preventive interventions.