HIV RISK AND COMING-OUT AMONG GAY AND LESBIAN ADOLESCENTS

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Similar to heterosexual peers, a central developmental task of gay and lesbian adolescents is to explore their personal identity, particularly with respect to their sexual orientation. The exploration of sexual orientation is typically labeled the "coming-out" process: a period of presumed heterosexuality, followed by recognizing oneself as lesbian or gay, exploring one's homosexuality by gaining information about homosexuality and the lesbian/gay community, disclosing one's orientation to others, and becoming comfortable with and accepting of one's sexual orientation. The strong social norms endorsing heterosexual orientation, the negative reactions by families and peers towards homosexuality, and the lack of positive role models increase the likelihood that gay and lesbian adolescents will experience stress and become socially isolated as they explore their personal identities. These difficulties are exacerbated for adolescents because they have fewer resources than those who come-out in early adulthood. The stress generated by societal reactions lead adolescents who are coming-out to be at higher risk for engaging in sexual and substance use HIV risk acts, non-HIV related problems (e.g., school problems, depression, suicidality, delinquency), compared to their heterosexual peers. However, gay and lesbian adolescents who successfully cope with the increased developmental challenges posed to them have increases self-esteem and interpersonal problem solving skills that enhance adjustment. To examine this process, a consecutive series of 75 lesbian and 75 gay male adolescents aged 14-21 who contact agencies providing social and recreational services to lesbian and gay adolescents will be recruited. The coming-out process, HIV-related and non-HIV related risk acts, and positive adaptive outcomes will be monitored at three points over 12 months. In addition, there have been no assessments of social norms and adaptive responses to cope with situations that may place youths at high risk. Therefore, we will develop a videotape measure to assess these norms. Specifically, we will examine: 1) the developmental process of coming-out over one year; 2) how the coming-out process impacts HIV-related and non-HIV risk acts, as well as adaptive outcomes; and 3) identify social norms and socially competent responses for negotiating safer acts and coming-out. The results from this study will indicate whether HIV prevention programs must target lesbian girls, provide guidelines for tailoring HIV prevention programs to the youth's place in the coming-out process; and provide guidelines for the direction of social skills training programs regarding the norms for coping in high risk situations.