Body Dissatisfaction and Eating Disorders in a Sample of Gay and Bisexual Men

Does Resilience Mediate the Relationship Between Negative Self-Image and Psychological Distress in Middle-Aged and Older Gay and Bisexual Men?

Aging gay and bisexual men may have negative self-images due to body image dissatisfaction and internalized ageism, resulting in psychological distress. Gay and bisexual men with HIV may be at greater risk for distress because of research linking HIV to accelerated aging. We examined associations between self-image and psychological distress, and potential mediating effects (resilience, fitness engagement), and whether these relationships were moderated by HIV serostatus. We tested our hypotheses with structural equation modeling using data from gay and bisexual men with HIV (n = 525, Mage = 57.6) and without HIV (n = 501, Mage = 62.2). We observed significant positive associations between self-image and distress and significant mediation effects (resilience, fitness engagement) that were moderated by HIV serostatus (resilience was only significant for men with HIV). We conclude that resilience interventions may be beneficial in alleviating distress from negative self-image among aging gay and bisexual men with HIV.

The Pattern of Physique Preferences on Gay Dating App "Blued" in China: A Multiple Group Latent Class Analysis

Previous studies have indicated homogamy in partner preferences among gay and bisexual men. Individuals on Blued (the most popular gay dating app in China) could identify their body type and preferred physiques according to six categories: monkey (thin gay men), average, muscularity, bear (heavy and hairy gay men), baboon (smaller than bears), and pig (plumper than bears). This study examined patterns of physique preferences across body types as well as sexual self-labels (tops, bottoms, versatiles, and others). In total, 188,716 Blued profiles (Mage = 31.1, SD = 7.1) were obtained. Multiple group latent class analysis was used to examine the patterns of physique preferences across the body type groups. The results revealed seven classes of physique preference. The four common physique preferences shared by all body type groups were "like averages," "like monkeys," "like muscularity," and "like bears." Individuals with a monkey or average body type exhibited a specific pattern of physique preference: "dislike bears." The two physique preferences specific to gay bear men were "like averages and muscularity," and "dislike monkeys." The highest preference for each physique was observed among individuals of the same body type. Furthermore, tops were more likely to have a muscular body and prefer a monkey physique, whereas bottoms were more likely to have a monkey body and prefer a muscular physique. These findings indicate body type-specific physique preferences based on an individual's own body type and sexual self-label identification, thus partially supporting the concept of homogamy in the physique preferences of gay men.

Interventions, Barriers, and Facilitators to Address the Sexual Problems of Gay, Bisexual and Other Men Who Have Sex with Men Living with HIV: A Rapid Scoping Review

Sexual problems are common among gay, bisexual, and other men who have sex with men (GBM) after diagnosis with HIV. However, these are often overlooked in care and research, where sexual risk reduction and biomedical aspects of sexual health tend to dominate. We conducted a rapid scoping review to investigate which sexual problems of GBM living with HIV are addressed by interventions, and the barriers and facilitators to their implementation. Literature from high-income countries published in English since 2010 was reviewed. Medline, Embase, PsycInfo, and Scopus databases were searched on July 4, 2022. Targeted sexual problems were categorized according to the ten dimensions of Robinson's Sexual Health Model, and barriers and facilitators, according to the five domains of the Consolidated Framework for Implementation Research (CFIR). Interventions focused solely on the dimension of Sexual Health Care/Safer Sex were excluded. Relevant information was extracted from the qualifying documents with NVivo 12 software for content analysis. Fifty-two documents were included, referring to 37 interventions which mainly took place in the United States (n = 29/37; 78%), were group-based (n = 16; 41%), and used counselling techniques (n = 23; 62%; e.g., motivational interviewing, cognitive-behavioral therapy). Their settings were mostly primary care (n = 15; 40%) or community-based (n = 16; 43%). On average, interventions addressed three sexual health dimensions (SD = 2; range: 1-10). The most targeted dimension was Sexual Health Care/Safer Sex (n = 26; 70%), which concerned sexual risk reduction. Next, Challenges (n = 23; 62%), included substance use (n = 7; 19%), sexual compulsivity (n = 6; 16%), sexual abuse (n = 6; 16%), and intimate partner violence (n = 4; 11%). Third was Talking About Sex (n = 22; 59%) which mostly concerned HIV disclosure. About a third of interventions addressed Culture/Sexual identity (n = 14; 38%), Intimacy/Relationships (n = 12; 33%), and Positive sexuality (n = 11; 30%). Finally, few targeted Body Image (n = 4; 11%), Spirituality (n = 3; 8%), Sexual Anatomy Functioning (n = 2; 5%) or Masturbation/Fantasy (n = 1; 3%). Forty-one documents (79%) mentioned implementation barriers or facilitators, particularly about the characteristics of the interventions (41% and 78%, respectively; e.g., cost, excessive duration, acceptability, feasibility) and of the individuals involved (37% and 46%; e.g., perceived stigmatization, provider expertise). The other three CFIR dimensions were less common (5%-17%). The search strategy of this review may not have captured all eligible documents, due to its limit to English-language publications. Overall, most interventions incorporated a focus on Sexual Health Care/Safer Sex, at the expenses of other prevalent sexual problems among GBM living with HIV, such as intimate partner violence (Challenges), erectile dysfunction (Sexual Anatomy Functioning), and Body Image dissatisfaction. These findings suggest they could receive more attention within clinical care and at the community level. They also highlight the importance of cost-effective and acceptable interventions conducted in non-stigmatizing environments, where patients' needs can be met by providers who are adequately trained on sexuality-related topics.

Twinks, Jocks, and Bears, Oh My! Differing subcultural appearance identifications among gay men and their associated eating disorder psychopathology

Gay men have increased risk of body dissatisfaction and disordered eating compared to heterosexual men, and it is unclear what differentiates their risk for thinness- and muscularity-oriented eating psychopathology. Differing subcultural appearance identifications (SAIs) among gay men are one potential factor that may relate to varied eating psychopathology, but this has not been studied. We examined gay men's SAIs: twinks, jocks, and bears; any "other" self-identified SAI; or no SAI, as well as the relationship between men's SAIs and traditional eating psychopathology and unhealthy dieting (both facets of thinness-oriented psychopathology), and muscularity-oriented psychopathology using univariate ANOVAs controlling for participant age. 264 U.S. gay-identified participants self-reported sexual orientation, SAIs, and eating psychopathology. Self-identified twinks did not report higher traditional eating psychopathology or unhealthy dieting than other SAIs or those without a SAI, as hypothesized. Self-identified twinks, jocks, and bears all reported greater muscularity-oriented eating pathology than those without a SAI. Self-identified jocks also reported higher muscularity-oriented disordered eating than those with an "other" self-identified SAI and bears. Thus, having a SAI may increase risk for disordered eating; specifically, identifying as a twink, jock or bear may confer greater risk for muscularity-oriented eating pathology.

Establishing initial validity and factor structure for the muscularity-oriented eating test in gay men

Eating disorders (EDs) affect men at higher rates than previously estimated, with many traditional ED measures likely underestimating the prevalence of eating and exercise-related pathology among males. The development of the Muscularity-Oriented Eating Test (MOET) represents an important advancement in ED assessment, enabling valid and reliable assessment of muscularity-oriented ED pathology among men. The current study sought to provide initial validity of the MOET among gay men. N = 264 gay men, recruited via MTurk, participated in a brief online survey, completing the MOET and other well-validated measures of eating pathology and body image psychopathology. Factor structure, mean, standard deviation, and intercorrelation between measures were assessed. The MOET demonstrated adequate factor structure, similar to that reported in the initial validation sample, and was significantly correlated with other measures of eating and body image psychopathology. The current study suggests initial validity of the MOET for use among gay men. Future research is needed among younger and more diverse samples of SM men, along with evidence of adequate test-retest reliability and absence of differential item functioning among gay men.

Disordered eating- and exercise-related behaviors and cognitions during the first year college transition

ObjectiveDuring the college transition, vulnerability to disordered eating and exercise behaviors and cognitions may increase. We studied how behaviors and cognitions change differentially over time, in the context of gender, athletic participation, and contingencies of self-worth. Participants: 229 diverse, first-year students at a competitive liberal arts college. Methods: Three-wave longitudinal study employing surveys before, during, and following the first semester, using linear mixed model analyses. Results: There were changes over time in one measure of disordered exercise-related cognitions and exercise frequency; disordered eating showed no significant changes over time. Athletic participation and basing a lower amount of self-worth on appearance were protective against subclinical disordered cognitions and behaviors; gender was not predictive. Conclusion: Health personnel should consider athletic participation and contingencies of self-worth when assessing students' risk for ED symptoms, in both genders. Early interventions may be useful, as changes were observed within the first three months of college.

Implications for Psychological Practice with Sexual Minority Men around Body Image Issues: An Addendum to the APA's Guidelines for Psychological Practice with Boys and Men

In 2018, the American Psychological Association published Guidelines for Psychological Practice with Boys and Men, in which there was only one mention of issues related to body image. This commentary explores the effects of body image concerns on men, with a particular focus on the experiences of sexual minority men. Using minority stress theory as a framework, this article aims to highlight the myriad negative mental and physical health outcomes related to body image concerns and eating disorder symptomatology in sexual minority men. Recommendations are provided to guide psychological practice related to body image concerns in sexual minority men.

Realizing Yoga's all-access pass: a social justice critique of westernized yoga and inclusive embodiment

In the 21^st century, the ancient mind-body practice of yoga has surged in popularity among western enthusiasts for its numerous health benefits. Particularly, a growing evidence base supports yoga for cultivating positive embodiment and reducing risk for disordered eating. Nevertheless, amidst its rise are concerns about yoga's departure from its spiritual foundations and increasing assimilation into the appearance- and commercial-driven exercise and fitness culture. Consequently, an exclusionary identity has been perpetuated in shaping norms surrounding who can and does practice yoga, which contradicts earlier egalitarian visions of a yoga for all. Therefore, we adopt a social justice lens in offering a focused analysis of the intersection of yoga, embodiment, and inclusion for select marginalized social identities typically underrepresented among yoga practitioners and in yoga scholarship. Data are synthesized from both qualitative and quantitative sources and integrate an understanding of how confined media representations of "the yoga body" and other practical constraints may undermine the perceived access to the practice for members of diverse groups. We conclude with inviting future considerations towards fostering more interdisciplinary community-based research partnerships among the variety of stakeholders invested in advancing the accessibility and inclusion of yoga and positive embodiment for all bodies.

Eating disorders and disordered eating behaviors in the LGBT population: a review of the literature

BACKGROUND

According to past research, lesbian, gay, bisexual, and transgender (LGBT) individuals experience a higher prevalence of psychopathology, which is attributable to the increased stress (i.e., stigma and prejudice) that they experience, as detailed by the minority stress model (MSM).

MAIN

This current literature review examined the empirical literature regarding the rates and types of, and risk factors for eating disorders and disordered eating behaviors in LGBT adults and adolescents, in addition to each individual subgroup (i.e., lesbians, gay males, bisexuals, transgender and gender-nonconforming individuals).

CONCLUSION

LGBT adults and adolescents experience greater incidence of eating disorders and disordered eating behaviors than their heterosexual and cisgender counterparts. Additionally, gay, bisexual, and transgender adults and adolescents were all at increased risk for eating disorders and disordered eating behaviors. Mixed results were found for lesbian adults and adolescents. Results are discussed within the framework of the MSM.

Does it Get Better? Change in Depressive Symptoms from Late-Adolescence to Early-Adulthood, Disordered Eating Behaviors, and Sexual Identity

Sexual minority youth are often described as at-risk for mental health comorbidities, including disordered eating behavior (DEB) and depression. This study assesses differences in late-adolescent DEB and depressive symptoms among gay/lesbian, bisexual, or mostly-heterosexual individuals, and how their symptoms change across early-adulthood. While sexual minority youth were more likely to report DEB and elevated depressive symptoms in late-adolescence relative to exclusively heterosexual peers, gay/lesbian individuals experienced improvement in early-adulthood depressive symptoms. Conversely, bisexual individuals maintained elevated depressive symptoms into early-adulthood, and additional depressive symptoms associated with DEB. DEB may be a unique risk-factor shaping the mental health of bisexual youth.

Trends and disparities in disordered eating among heterosexual and sexual minority adolescents

OBJECTIVE

Disordered eating has decreased for all youth over time, but studies have not focused specifically on lesbian, gay, and bisexual (LGB) youth. Research has found that LGB youth report disordered eating behaviors more often compared to their heterosexual counterparts, but no studies have documented trends over time for LGB youth and considered whether these disparities are narrowing or widening across sexual orientation groups.

METHOD

We use pooled data from the 1999 to 2013 Massachusetts Youth Risk Behavior Surveys (N = 26,002) to investigate trends in purging, fasting, and using diet pills to lose or control weight for heterosexual and sexual minority youth. We used crosstabs, logistic regression, and interactions in regression models, stratified by sex.

RESULTS

The prevalence of disordered eating has decreased on all three measures across nearly all groups of heterosexual and sexual minority youth. However, we found disparities in reported disordered eating behaviors for LGB youth persisted across all survey years, with LGB students reporting significantly higher prevalence of disordered eating than heterosexuals. The disparities in fasting to control weight widened between the first and last survey waves between lesbian adolescents and heterosexual females.

DISCUSSION

The significant reductions over time in prevalence of disordered eating among some youth are encouraging, but the disparities remain. Indeed, the increasing prevalence of fasting, diet pill use, and purging to control weight among lesbians may warrant targeted prevention and intervention programs. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:22-31).

Can community consciousness be a bad thing? A moderated mediation analysis of heterosexism, mental health and body appreciation in sexual minority men

This study examined the connections between heterosexism, mental health, body appreciation and community consciousness in sexual minority men (SMM). Participants (n = 89) completed a national online survey. Simultaneous multiple regressions found that heterosexism explained 9.4% of the variance in body appreciation and 25.8% of the variance in mental health; mental health accounted for 28.0% of the variance in body appreciation. Within these models, harassment/rejection heterosexism was a unique positive predictor of mental health problems and a unique negative predictor of body appreciation; depression was a unique negative predictor of body appreciation. A moderated mediational model found that depression mediated the relationship between harassment/rejection heterosexism and body appreciation, but only in men who endorsed high community consciousness. Intervention research might benefit from helping SMM explore the ways in which body image is affected by heterosexism and mental health, as well as the ways that contemporary Western gay communities might contribute to these connections.

Depression, Compulsive Sexual Behavior, and Sexual Risk-Taking Among Urban Young Gay and Bisexual Men: The P18 Cohort Study

Young gay, bisexual, and other men who have sex with men (YMSM) are at increased likelihood of experiencing depression and engaging in condomless sexual behaviors. The goal of the current investigation was to examine the relationship between negative mood and compulsive sexual behavior (CSB) and to assess for their individual and combined influence on sexual risk-taking behavior among a diverse sample of YMSM in New York City (the P18 Cohort Study). We first analyzed sociodemographic, depressive symptoms, CSB, and sexual risk-taking from the cross-sectional data of 509, 18- or 19-year-old YMSM recruited using non-probability sampling. We found a significant positive correlation between CSB and depression and between CSB and frequency of condomless anal sex acts reported over the last 30 days. Multivariate results found that the presence of both depression and CSB contributed to elevated sexual risk-taking among these urban YMSM. Clinical implications include the importance of assessing for CSB when depression is present and vice versa in order to improve HIV prevention. Informed by minority stress theory and syndemic theory, our results suggest that interventions focused on the health of YMSM recognize that mental health and social context all interact to increase physical health vulnerability vis-a-vis sexual behaviors, depression, and CSB. Thus, HIV prevention and intervention programs need to incorporate mental health components and services that address these needs.

Body Dissatisfaction in a Diverse Sample of Young Men Who Have Sex With Men: The P18 Cohort Study

Young men who have sex with men (YMSM) may be at greater risk for body dissatisfaction, compared to their heterosexual peers. However, differences within YMSM populations are understudied, precluding the identification of YMSM who are at greatest risk. This study examined body dissatisfaction in a racially/ethnically diverse sample of YMSM ages 18-19 in New York City. Using cross-sectional data from the baseline visit of a longitudinal cohort study of YMSM (N = 591), body dissatisfaction was assessed using the Male Body Attitudes Scale. Three outcomes were modeled using linear regression: (1) overall body dissatisfaction, (2) muscularity dissatisfaction, and (3) body fat dissatisfaction. Covariates in the models included race/ethnicity, sexual orientation, BMI, gay community affiliation, and internalized homonegativity. White YMSM experienced greater body dissatisfaction across the three models. Internalized homonegativity was a statistically significant predictor of dissatisfaction across the three models, though its association with body dissatisfaction was relatively small. The findings point to future avenues of research, particularly qualitative research to explore demographic and cultural nuances in body attitudes among YMSM.

The association between sexual orientation, susceptibility to social messages and disordered eating in men

OBJECTIVE

Much research points to higher levels of disordered eating and more negative body image in gay and bisexual men than in heterosexual men. The reasons for this difference, however, remain unclear. We hypothesized that disturbed body image and eating attitudes in gay and bisexual men would be partially explained by susceptibility to social messages.

METHODS

Two hundred and sixty-two men (203 heterosexual, 46 gay and 13 bisexual) between 18 and 35 years of age participated in the study. They completed measures of disordered eating, body image, internalization of attitudes toward appearance, and concern for appropriateness. In addition, they were asked to what extent they were influenced by ten advertisements, four that emphasized physical appearance, and six that did not.

RESULTS

As shown in previous research, gay and bisexual men reported higher levels of disordered eating and dissatisfaction with their bodies than heterosexual men. In addition, the gay and bisexual men were more susceptible than the heterosexual men to social messages, and reported being significantly more influenced than heterosexual men by advertisements focusing on physical appearance, but not by other advertisements. Susceptibility to social messages fully mediated the association between sexual orientation and disordered eating.

DISCUSSION

Results provide support for the hypothesis that sensitivity to social messages about appearance explains, at least partially, the link between sexual orientation and disordered eating in men.

"Aren't labels for pickle jars, not people?" Negotiating identity and community in talk about 'being gay'

Understanding how people in any given population think about and experience their sexuality is fundamental to developing and implementing good health policy, research, and practice. Yet despite several decades of focus on sexual identity and HIV risk within health research, gay men as a category are often treated in an uncomplicated way. This article reports on focus group discussions held with 45 gay and other men who have sex with men in New Zealand to identify how they talked about issues of gay identity and gay community/ies. The men negotiated and renegotiated their gay identity and being gay was reported as just one part of most men's lives. Many men did not like to be labeled as gay and downplayed aspects of their gay identity. Only a few men proclaimed being gay. Men reported very mixed experiences with the gay community/ies. Understanding how men experience being gay, provides information vital to enhancing policy, research and practice responses to gay men's health issues. A major challenge for health service provision to appropriately engage with men who have sex with other men but resist being labeled as gay was identified.

Sexual healthcare preferences among gay and bisexual men: a qualitative study in San Francisco, California

Background

Research on gay and other men who have sex with men's (G/MSM) preferences for sexual healthcare services focuses largely on HIV testing and to some extent on sexually transmitted infections (STI). This research illustrates the frequency and location of where G/MSM interface with the healthcare system, but it does not speak to why men seek care in those locations. As HIV and STI prevention strategies evolve, evidence about G/MSM's motivations and decision-making can inform future plans to optimize models of HIV/STI prevention and primary care.

Methods

We conducted a phenomenological study of gay men's sexual health seeking experiences, which included 32 in-depth interviews with gay and bisexual men. Interviews were transcribed verbatim and entered into Atlas.ti. We conducted a Framework Analysis.

Findings

We identified a continuum of sexual healthcare seeking practices and their associated drivers. Men differed in their preferences for separating sexual healthcare from other forms of healthcare (“fragmentation”) versus combining all care into one location (“consolidation”). Fragmentation drivers included: fear of being monitored by insurance companies, a desire to seek non-judgmental providers with expertise in sexual health, a desire for rapid HIV testing, perceiving sexual health services as more convenient than primary care services, and a lack of healthcare coverage. Consolidation drivers included: a comfortable and trusting relationship with a provider, a desire for one provider to oversee overall health and those with access to public or private health insurance.

Conclusions

Men in this study were likely to separate sexual healthcare from primary care. Based on this finding, we recommend placing new combination HIV/STI prevention interventions within sexual health clinics. Furthermore, given the evolution of the financing and delivery of healthcare services and in HIV prevention, policymakers and clinicians should consider including more primary care services within sexual healthcare settings.

Perceptions of HIV risk among internet-using, HIV-negative barebacking men

The current study examines the risk perceptions of HIV-negative men who have sex with men (MSM) who use the Internet to seek unprotected sex. The research questions include the following: How great do these men perceive their HIV risk to be? Are their perceptions based on HIV knowledge or related to their risk behaviors? What factors are associated with greater/lesser perceived risk? Results revealed that more than half of the men believed that they had no or only a slight chance of contracting HIV. Risk perceptions were not related to HIV knowledge or to involvement in HIV risk practices. Four factors were identified as being associated with greater perception of HIV risk: self-identity as a sexual "bottom," having sex while high, greater use of bareback-focused websites, and younger age. Internet-using HIV-negative men who have sex with men tend to underestimate their risk for acquiring HIV, and interventions need to help them accurately assess their risk.

Predictors of eating attitudes and behaviors among gay Hispanic men

Gay men are a vulnerable population at risk for a number of health disparities, but little is known about eating disorders among gay Hispanic men. The purpose of this study was to examine the relationship of eating attitudes and behaviors with alcohol abuse, body image, depression, self-esteem, and sexual behaviors to determine predictors of eating attitudes and behaviors in a community sample of gay Hispanic men. Significant numbers of the participants were at risk for eating disorders (13%), alcohol abuse (18%), body image disturbance (29%), depression (25%), low self-esteem (12%), and high-risk sexual behaviors (34%). Alcohol abuse, body image, depression, self-esteem, and sexual behaviors were significant predictors of eating attitudes and behaviors and accounted for 38% of the variance in eating attitudes and behaviors. Nurses providing care to this population of gay men must be aware of this cluster of related mental health conditions that are experienced by these men. Addressing and treating these health conditions as a group of related mental health conditions are necessary. More research is needed to further explore this cluster of health issues among gay Hispanic men.

Measuring masculinity in research on men of color: findings and future directions

The purpose of this study was to examine the association between masculinity and the health of US men of color aged 18 years and older. We identified 22 population-based studies that included a measure of masculinity and a measure of health behavior, mental health, or physical health. The associations between masculinity and health were complex and varied by construct and health outcome, though they generally were significant in the hypothesized directions. Future research should explore the centrality of masculinity versus other identities and characteristics, how the relationship between masculinity and health varies by health outcome, and the identification of the conceptions and aspects of masculinity that are most relevant to and associated with specific health behaviors and health outcomes.

Factors associated with a drive for muscularity among gay and bisexual men

Among gay and bisexual men, body dissatisfaction can manifest itself in the form of a desire for increased muscularity. Possibly in response to homophobia, the socio-sexual culture of gay and bisexual men privileges muscularity and may help to perpetuate a sense of body dissatisfaction. Little is known about factors associated with a drive for muscularity among gay and bisexual men. This study recruited participants (n = 400) at Toronto's 2008 lesbian, gay, bisexual and transgender festival to provide data used to examine the relationship between a drive for muscularity and demographics (age, race, education, HIV status), psychological factors (depression, disordered eating, internalised homophobia, substance use), body mass, a history of childhood sexual abuse and sexual risk. Multivariate analyses revealed that a drive for muscularity was associated with age, disordered eating, depression, sexual risk and internalised homonegativity. These findings can be used to advance the health and wellbeing of gay and bisexual men, particularly interventions designed to mitigate the effects of internalised homonegativity and policies aimed at reducing homophobia.

Cigarette smoking as part of a syndemic among young men who have sex with men ages 13-29 in New York City

The prevalence of cigarette smoking among young men who have sex with men (YMSM) is significantly higher than among their heterosexual peers. We undertook an analysis to examine cigarette smoking in relation to demographic factors and other risk behaviors among 580 YMSM, ages 13-29, in New York City. Cross-sectional data were collected as part of larger study of risk behaviors using palm devices and targeted active recruitment strategies across all five boroughs of the city. Multivariate modeling suggests that Asian or Pacific Islander and White YMSM are more likely to report cigarette smoking than other racial and ethnic groups, as are men reporting a middle class socioeconomic status. In addition, smoking was related to the likelihood of using a variety of illicit substances, as well as alcohol and pharmaceuticals without a prescription, during the period of assessment. YMSM who smoke cigarettes reported a greater number of casual sex partners and a greater number of transactional sex partners than non-smokers. Episodic analysis of sexual behaviors with casual partners indicated that smokers were more likely to engage in illicit drug and alcohol use immediately before or during sex than did non-smokers. These findings are understood as part of a larger syndemic among YMSM, and suggest that smoking prevention and cessation programs should be embedded as part of larger more holistic health and wellness programs targeting YMSM.

Gender roles, eating pathology, and body dissatisfaction in men: a meta-analysis

The current study reviewed relationships between gender roles and (a) eating pathology, (b) body dissatisfaction, and (c) muscle dissatisfaction among men via meta-analysis. Moderators of sexual orientation and type of gender role measure were also investigated. Results revealed the relationship between femininity and eating and body-related variables did not significantly differ from zero. Sexual orientation moderated the relationship between femininity and muscle dissatisfaction (i.e., femininity was negatively related to muscle dissatisfaction for heterosexual but not gay men). Masculinity was negatively associated with eating pathology and body dissatisfaction. Type of masculinity measure moderated the relationship between masculinity and body dissatisfaction (i.e., trait-based measures produced a negative association, multidimensional measures yielded nonsignificant relationships). Type of masculinity measure produced a cross-over interaction when examining muscle dissatisfaction (i.e., trait-based instruments yielded a negative association and multidimensional instruments revealed a positive relationship). Findings highlight the salience of masculinity in men's eating and body concerns.

Body dissatisfaction and methamphetamine use among HIV-positive gay and bisexual men: a pilot study

Methamphetamine use is strongly associated with risky sex and increased reports of HIV and other sexually transmitted infections among gay and bisexual men (GBM) who attend dance/circuit parties. The psychological mechanisms underlying methamphetamine use in this subculture, however, remain unclear. These exploratory findings are from a 2004 dataset measuring body dissatisfaction and drug use among 42 HIV-positive GBM in South Florida who attended at least one bar/club/circuit party within 3 months of participating. A multivariate regression model revealed that body dissatisfaction accounted for a small but significant amount of variance in methamphetamine use. Treatment implications and recommendations for future research are discussed.