The San Francisco Examiner;
Keay Davidson, Examiner Science Writer

Surveying 302 young gay men in three medium-sized cities on the West Coast, UC-San Francisco researcher Craig Waldo and his colleagues sought their reaction to statements like these:

* "I am glad to be gay."

* "My gay male friends are good at helping me solve personal problems."

* "At times I think I'm no good at all."

Those who responded affirmatively to the first two questions, and negatively to the third, were more likely to practice safe sex, said Waldo, who was scheduled to report his team's findings at the 12th World AIDS Conference in Geneva on Monday.

In the study, "if you look at the guys who accept themselves as gay the most, 30 percent had engaged in sexual risk behavior," for example, not using condoms for anal sex, Waldo said.

Whereas "if you look at those who accept themselves the least as gay, 46 percent had engaged in unsafe sex."

Waldo concludes that "young gay men who are comfortable with their gayness are more psychologically healthy and are more likely to practice safe sex. It's a good idea to help gay men accept themselves because it makes them less risky sexually."

Waldo suggests gays could "unlearn" self-dislike by becoming involved in the gay community, for example, in its clubs, religious groups and other activities.

"What we're seeing is a cross section of these young men's lives," Waldo adds. "It's a snapshot of a process unfolding. As time passes, if they get more support for their identities, it will ultimately have a favorable effect on their health."

Waldo's speech is one of four chosen by the International AIDS Society for presentation at the Geneva congress.

Study in 3 cities

The Waldo team surveyed 302 gay men, ages 18 to 29, in Santa Cruz and Santa Barbara and Eugene, Ore. Just a few of the men appeared to have been infected by HIV, the AIDS virus.

They were surveyed via a questionnaire developed by Waldo's colleagues at UCSF's Center for AIDS Prevention Studies and the UCSF AIDS Research Institute - Susan Kegeles and Robert Hays.

The findings don't surprise Benjamin Schatz, executive director of the Gay and Lesbian Medical Association in San Francisco.

"One of our slogans is that homophobia is a health hazard," Schatz said. "The fact is that if people are made to feel bad about themselves, then they don't necessarily view their own lives as worth protecting, or the (lives of their) sexual partners.

"If the (societal) message is, "Gay men are worthless,' why should he protect himself or his partner?"

Not a guarantee

However, high self-esteem does not ensure that a gay man will practice safe sex, warns Stephen LeBlanc, an activist with ACT UP Golden Gate. "My general impression is that it's a lot more complex than that," LeBlanc said. "I personally know six people in the last three years who have gone from being HIV negative to HIV positive (seroconverting). All of them were very well-educated, financially well off, professionally successful gay men."

These are presumably people "who would have high self-esteem," LeBlanc said. "Two of the six people seroconverted by having unsafe sex with a lover in what they thought was a serious relationship," LeBlanc added.

Sometimes a partner doesn't realize he is carrying the virus, while "in other cases the partner was clearly lying," LeBlanc says. "The "partner lying' business I've heard about many times from many people. A lot of unsafe sex occurs in loving relationships."

Kegeles, of the UCSF study, agrees these findings don't guarantee that a gay man with high self-esteem will practice safe sex. The three cities surveyed already have programs that advocate safe sexual behavior, she noted. "Where the gay communities are less supportive of safer sex, the findings may be different," Kegeles said.

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