Self-esteem instability and its implications for HIV prevention among gay men.

This study, using a modified State Self-Esteem Scale (SSES), examined self-esteem instability and its association with risky sexual behavior among 455 gay and bisexual men. A self-administered questionnaire included the SSES and measures of intimacy, loneliness, social support, and ways of coping. Analysis of variance showed that the self-esteem of participants who recently engaged in unprotected anal intercourse with nonprimary partners was more unstable than the self-esteem of participants who did not engage in unprotected anal intercourse. Self-esteem instability was associated with higher avoidance coping, higher loneliness, and lower social support. Episodes of self-esteem injury might motivate some gay men to engage in risky sex. HIV prevention strategies with gay men should target the quality of their interpersonal relationships and community supports.