One of the most widely studied topics in the decades of research on LGBT health has been the concept of "internalized homophobia." Although definitions of IH differ somewhat depending on the theorist, the concept generally refers to the internalization of society's homophobic attitudes within a lesbian, gay, or bisexual (LGB) person. Over the years, researchers have found internalized homophobia to correlate with a variety of psychological, behavioral, and medical outcomes like depression, substance use, and sexual behaviors that put one at risk for HIV and other sexually transmitted infections.

Research on internalized homophobia and sexual risk taking began in the late 1980s in the midst of the HIV/AIDS crisis centered in the gay community. The goal was to understand how anti-gay stigma and victimization affect the health and behaviors of sexual minorities. Ultimately the hope was to use this understanding to help prevent HIV transmission. Since that time many studies have been published on this topic, but the results have been inconsistent.

My graduate student Michael Newcomb (lead author) and I recently published a paper in the journal Archives of Sexual Behavior using an approach called meta-analysis. This approach uses statistics to combine findings across many studies and also lets you test for factors that may explain differences in findings between studies. Our meta-analysis included 16 studies representing research on nearly 3,000 men.

Overall we found a very small relationship between internalized homophobia and sexual risk taking (correlation = .10, p = .053). Most interestingly, we found that the correlation got significantly smaller over time (correlation dropped .02 for every year since 1988) to the extent it is likely to be negligible today. We suggest that negative attitudes towards being gay/bisexual were more important in terms of sexual orientation in the late 1980s and early 1990s, a time when HIV/AIDS was less treatable, carried more stigma, and was more linked to the gay community than it is today. Acceptance of the gay community has also increased during these years. This does not of course negate the reality that LGBT people still face discrimination and harassment.

Based on these findings we suggest that researchers should begin focusing their efforts elsewhere instead of continuing to test the direct association between internalized homophobia and sexual risk taking in gay men. However, internalized homophobia may have more complex association with sexual risk taking or may be important in terms of other health outcomes. We are currently completing a meta-analysis on the relationship between internalized homophobia and mental health and I will report out findings when they come out.

Newcomb, M & Mustanski, B. (2010). Moderators of the Relationship Between Internalized Homophobia and Risky Sexual Behavior in Men Who Have Sex with Men: A Meta-Analysis. Archives of Sexual Behavior. Online first.

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