Trauma symptoms, internalized stigma, social support, and sexual risk behavior among HIV-positive gay and bisexual MSM who have sought sex partners online.

Gay, bisexual, and other men who have sex with men (MSM) remain the highest risk group for HIV infection. One reason is the increased use of the Internet to meet potential sex partners, which is associated with greater sexual risk behavior. To date, few studies have investigated psychosocial predictors of sexual risk behavior among gay and bisexual men seeking sex partners online. The purpose of the current study was to test a conceptual model of the relationships between trauma symptoms indexed on the event of HIV diagnosis, internalized HIV stigma, and social support on sexual risk behavior among gay and bisexual MSM who seek sex partners online. A sample of 142 gay and bisexual MSM recruited on- and offline completed a comprehensive online assessment battery assessing the factors noted above. A number of associations emerged; most notably internalized HIV stigma mediated the relationship between trauma-related symptoms indexed on the event of HIV diagnosis and sexual risk behavior with HIV-negative and unknown serostatus sex partners. This suggests that gay and bisexual MSM who are in greater distress over their HIV diagnosis and who are more sensitive to HIV stigma engage in more HIV transmission risk behavior. As sexual risk environments expand with the increasing use of the Internet to connect with others for sex, it is important to understand the predictors of sexual risk behavior so that tailored interventions can promote sexual health for gay and bisexual MSM seeking sex online.