Moderators of the relationship between internalized homophobia and risky sexual behavior in men who have sex with men: a meta-analysis.

Research on internalized homophobia (IH) has consistently linked it to both mental and physical health outcomes, while research on its relationships with other variables has been inconsistent. Some research and theory support the association between IH and risky sexual behavior, but much of this research has been plagued by methodological issues, varying measures, and has produced inconsistent findings. Coming to a better understanding of the utility of IH as a potential mechanism or predictor of risky sex in men who have sex with men (MSM) may help to inform future studies of HIV risk in this population as well as the development of prevention interventions. The current study used hierarchical linear modeling to perform meta-analysis combining effect sizes across multiple studies of the relationships between IH and risky sexual behavior. Additionally, the use of multilevel modeling techniques allowed for the evaluation of the moderating effects of age, year of data collection, and publication type on this relationship. Sixteen studies were meta-analyzed for the relationship between IH and risky sexual behavior (N = 2,837), revealing a small overall effect size for this relationship. However, a significant moderating effect was found for the year of data collection, such that the correlation between these two variables has decreased over time. The current utility of this construct for understanding sexual risk taking of MSM is called into question.