Men who have sex with men (MSM) are at high risk for contraction and transmission of Human Immunodeficiency Virus (HIV). Increased risk of infection has been linked to high risk behaviors, such as alcohol and drug use, as well as engaging in unsafe sexual behaviors. Experiences of discrimination related to sexual orientation often experienced in this population predict risky behavior outcomes, but little research has examined the mechanisms implicated in this model. The current study examined the effect of anxiety and depressive symptoms in the relationship between discrimination related to sexual orientation and high-risk behaviors of alcohol use, drug use, using sex to cope with negative emotions, frequency of sex without a condom, and frequency of sex with an HIV+ or unknown status partner. Three hundred and eighty-nine MSM were recruited to participate in a survey based study. Results indicated anxiety was maintained a significant indirect effect between discrimination related to sexual orientation and coping behaviors (using sex to cope, alcohol, substance use), but showed no significant indirect associations with risky sexual behavior. Overall, the current study provides novel empirical evidence that discrimination related to sexual orientation is associated with increased anxiety, which in turn, is associated with certain HIV risk behaviors. Importantly, it is possible that alcohol use, drug use, and using sex to cope with negative emotions may be precursors to more risky sexual behavior, such as engaging in anal sex without a condom or having sex with an HIV+ or unknown status partner. Clinically, reducing symptoms of anxiety in the context of discrimination related to sexual orientation may help reduce HIV risk behavior among MSM.
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