Identity formation, outness, and sexual risk among gay and bisexual men.

Research on HIV among men who have sex with men has focused on individual behavioral and biomedical factors driving transmission risks, but these cannot be fully understood without also understanding the social context within which sexual minorities live. Using data from 703 gay and bisexual men in Atlanta, this study explores the factors associated with homosexual identity formation and disclosure ("outness") and examines how these constructs are associated with sexual risk taking. In multivariable regression models, sexual identity and outness were associated with age, race, education, employment, and experience of discrimination. Independent of these factors, having a more established and open homosexual identity was associated with lower sexual risk behaviors. These results highlight the need to address discriminatory policies and values in society and call for programs to provide support and promote healthy identity development among vulnerable groups.