Internalized homonegativity and psychological distress among Black and White young MSM

BACKGROUND: Negative feelings about one's sexuality can have an impact on mental health and relationships. More needs to be known about the effect of internalized homonegativity on psychological distress, particularly among young gay and bisexual men who are in the process of identity formation.

METHODS: As part of the evaluation of a community-level HIV-prevention intervention for young Black and White gay and bisexual men in Philadelphia, we recruited 282 MSM ages 15 to 29, at venues and through chain referrals. At baseline, interviewers administered part of the survey, while participants utilized ACASI to complete more sensitive sections. Internalized homonegativeity (IH) was measured by an 8-item scale (alpha = .79) and psychological distress was measured by a 6-item scale (alpha = .67).

RESULTS: Men who identified as bisexual or straight reported higher rates of IH than gay-identified men (p <.001). Black men reported more IH than White men (p <.04), controlling for gay identity and age. IH was significantly related to greater psychological distress (beta = .220, p<.001), and to lower self esteem (beta = -.251, p<.001), controlling for race, age and gay identity. The relationship between IH and distress was stronger for White men (beta = .286, p<.002) than for Black men (beta = .158, p<.05). Both Black and White men with higher levels of IH were less likely to disclose their same sex behavior to family members (p <.002) and to straight friends (p<.03).

CONCLUSIONS: Negative feelings about oneself can affect relationships with family and friends and lead to distress and depression. Programs for young MSM, particularly bisexual men, should aim to reduce homonegativity and promote a positive self-image.