Reclaiming the Body: Body Esteem and Condomless Receptive Anal Intercourse among Young Gay and Bisexual Men

Researchers have noted inconsistent associations between body mass index (BMI) and sexual risk among MSM, yet it remains unclear how these relationships manifest in men's lives. We sought to examine the association between BMI and the number of unprotected receptive anal intercourse partners (URAIP) among young gay and bisexual men (YGBM). Specifically, we hypothesized that three components of body esteem [i.e., body dissatisfaction (α=.86), body pride (α=.88), and body attributions made by others (α=.84)] would mediate the relationship between BMI and URAIP. Using cross-sectional data from a study exploring YGBM's partner-seeking behaviors online (N=376, ages 18-24), we used structural equation modeling (SEM) to examine the direct and indirect relationships between BMI and URAIP, after accounting for participation in the gay community and mental health correlates (self-esteem and internalized homophobia). BMI was positively associated with body dissatisfaction (β = .13) and negatively associated with body attributions (β = -.37) and body pride (β = -.39). We did not find a direct relationship between BMI and URAIP; however, body pride was associated with URAIP (β = .22), offering some support for the indirect association between BMI and URAIP. We found no relationship between URAIP and YGBM's body dissatisfaction and/or body attributions, respectively. In light of our findings, we critique the literature examining the relationship between BMI and sexual risk among MSM, and discuss the importance of addressing body esteem into HIV/AIDS prevention programs for YGBM.