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Assessing relational cognitions among young gay and bisexual men on health outcomes of HIV and mental health

Sang, Jordan (2019) Assessing relational cognitions among young gay and bisexual men on health outcomes of HIV and mental health. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Young gay and bisexual men (YGBM) face multiple health disparities compared to heterosexual youth, including HIV risk and poor mental health outcomes. Relational cognitions (relational beliefs and expectations) may provide nuanced understanding of these disparities, but have not been fully explored among YGBM. In our first analysis, we identified six subscales on relational expectations (restrictions, masculine and gender norms, negative breakups, cheating, optimism, and immediacy) and two subscales on relational beliefs (sex beliefs and equality). In our second analysis, we tested these subscales on outcomes of receptive and insertive condomless anal sex (R-CAS and I-CAS). We found that YGBM with greater expectations of negative breakups were negatively associated with I-CAS (AOR=0.91; 95% CI: 0.85, 0.97) and R-CAS (AOR=0.92; 95% CI: 0.87, 0.97). YGBM with greater expectations of optimism were negatively associated with R-CAS (AOR=0.93; 95% CI: 0.88, 0.97), and positively associated with I-CAS (AOR=1.22; 95% CI: 1.15, 1.30). YGBM with greater expectations of cheating were positively associated with R-CAS (AOR=1.20; 95% CI: 1.14, 1.26) and immediacy was negatively associated with R-CAS (AOR=0.92; 95% CI: 0.88, 0.97). Among relational beliefs, YGBM with greater endorsement of sex beliefs had a negative association with R-CAS (AOR=0.81; 95% CI: 0.74, 0.89), and beliefs about equality (AOR=0.74; 95% CI: 0.67, 0.82) were negatively associated with R-CAS. In our third analysis, we utilized the developed subscales from paper 1 to test for associations to outcomes of anxiety and depression. We found that YGBM with greater relational restrictions (β= -.06) had a negative association with depression, while expectations of negative break ups (β= .34) and optimism (β= .05) were positively associated with higher depressive scores. Among relational beliefs, beliefs about equality (β= .06) were positively associated with higher depressive scores. For anxiety, expectations of restrictions (β= -.17) were negatively associated with higher anxiety scores. Alternatively, we found the constructs of negative break ups (β= .31), and immediacy (β= .06) positively associated with higher anxiety scores. The public health significance of these analyses illustrates the importance of relational cognitions on health and well-being among YGBM. We support future interventions that focus on relational cognitions to reduce health disparities.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Sang, Jordanjms567@pitt.edujms5670000-0001-5649-0326
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairEgan, Jamesjee48@pitt.edujee48
Committee MemberHawk, Marymary.hawk@pitt.edumeh96
Committee MemberBear, Toddtobst2@pitt.edutobst2
Committee MemberMarkovic, Ninaninam@pitt.eduninam
Committee MemberMatthews, Derrickderrick.matthews@unc.edu
Committee MemberBauermeister, Josébjose@nursing.upenn.edu
Date: 27 June 2019
Date Type: Publication
Defense Date: 29 March 2019
Approval Date: 27 June 2019
Submission Date: 20 March 2019
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 149
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Behavioral and Community Health Sciences
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Relational Cognitions, YGBM, HIV, Mental Health
Date Deposited: 27 Jun 2019 17:09
Last Modified: 27 Jun 2019 17:09
URI: http://d-scholarship.pitt.edu/id/eprint/36084

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