Need for social approval and fears about being sexually rejected predicts subsequent risky sex among men who have sex with men (MSM)

Published: July 22, 2010

Need for social approval and fears about being sexually rejected predicts subsequent risky sex among men who have sex with men (MSM)

M.R. Di Domenico1, A. Berindean-Coroiu1, T.A. Hart1,2, T. Myers2, L. Calzavara2, M. Loutfy3

1Ryerson University, Psychology, Toronto, Canada, 2University of Toronto, Dalla Lana School of Public Health, Toronto, Canada, 3Women’s College Hospital, Toronto, Canada

Background: Previous research has suggested a relationship between excessive Need for Social Approval and unprotected anal intercourse (UAI) among MSM through related constructs such as social anxiety (e.g., Hart et al., 2008). Excessive Need for Social Approval may lead to greater fear of being sexually rejected if one insists on condom use, which has been found to be associated with UAI (Offir et al., 1993). The current study explored Fear of being Sexually Rejected (FSR) for insisting on condom use as a mediator in the relationship between excessive need for social approval and UAI among MSM.
Methods: 157 sexually active MSM recruited from community medical clinics and gay media in Toronto, Canada completed Audio Computer Assisted Self-Interviews at baseline and 6-month follow-up. At baseline, participants reported Need for Social Approval and FSR. At follow-up, participants reported any UAI in the past 6-months, with 34.2% engaging in this behaviour. Using logistic regressions with UAI as the dependent variable, Social Approval was entered into Step 1, and FSR was entered into Step 2.
Results: In the multivariable regression, Social Approval (OR = 1.80, 95% CI [1.26, 2.58] and FSR (OR = 1.71, 95% CI [1.17, 2.50]) were associated with subsequent UAI. Social Approval was associated with FSR. FSR (Sobel test statistic = 2.20, p = .028) partially mediated the relationship between Social Approval and UAI.
Conclusions: This study extends previous research on social anxiety and UAI by indicating that those who have a high Need for Social Approval may be at higher risk for engaging in risky sex, partially because they may have higher FSR. Future HIV prevention should address FSR, especially for MSM who have a high need to be socially approved by others. Both Need for Social Approval and FSR may be highly amenable to HIV prevention counselling programs for MSM.

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