TY - JOUR
T1 - Attachment style, childhood adversity, and behavioral risk among young men who have sex with men
AU - Gwadz, Marya Viorst
AU - Clatts, Michael C.
AU - Leonard, Noelle R.
AU - Goldsamt, Lloyd
N1 - Funding Information:
This study was supported by a Grant from the National Institute on Drug Abuse (DA11596). We would like to thank the young men who participated in the study, as well as the project ethnographers and interviewers: Kyle Ayers, Carlos Cortez, Jorge Ignacio Cortiñas, Wil Edgar, Christian Kolarz, Kalil Vicioso, and Salvador Vidal-Ortiz. We would also like to express our appreciation to David Nish and the staff of the Streetwork Project/Safe Horizon, Carrie Steinman and Carl Siciliano of Safe Space, and Jennie Casciano of the New Neutral Zone/GVYC for help with recruitment, Peter Flom for statistical consultation, and Karla Gostnell, Steve Lankenau, Dorinda Welle and Huso Yi, as well as members of the New York Association on Homeless and Street-Involved Youth, for their assistance with the project.
PY - 2004/5
Y1 - 2004/5
N2 - Purpose To examine relationships among childhood adversity, attachment style (one's core beliefs regarding the self and others), and the following risk behaviors and contexts among young men who have sex with men (YMSM): homelessness, daily substance use, participation in sex work, involvement in the criminal justice system, and being out of school or work. Methods Using a targeted sampling approach, we recruited 569 YMSM aged 17-28 years from natural venues in New York City including bars, clubs, parks, and bus stations. Youth completed a structured interview assessing lifetime and current risk and protective contexts and behavior. Data were analyzed using univariate and multivariate statistical methods, including hierarchical logistic regression. Results After controlling for demographic characteristics and childhood adversity, YMSM with a fearful attachment style were more likely to have been homeless (OR 2.93, 95% CI 1.65-5.18), to have participated in sex work (OR 2.35, 95% CI 1.44-3.85), to use substances daily (OR 2.79, 95% CI 1.29-6.03), to have been involved in the criminal justice system (OR 2.04, 95% CI 1.38-3.01), and to be out of school/work (OR 2.47, 95% CI 1.47-4.15). Three subgroups were particularly vulnerable: YMSM who identified as heterosexual, or bisexual, and/or transgender. Conclusions A fearful attachment style contributes to some YMSM remaining outside of the protective systems of family, school, and work, and is associated with risky contexts where they are less likely to encounter prosocial peers and adults. Further, it is associated with risk behavior. Although gay-identified youth are generally found to have poor outcomes when compared with the general population of adolescents, in the present report, YMSM who identified as heterosexual were at particular risk. Attachment theory can guide interventions by informing how individuals experience relationships and manage developmental transitions.
AB - Purpose To examine relationships among childhood adversity, attachment style (one's core beliefs regarding the self and others), and the following risk behaviors and contexts among young men who have sex with men (YMSM): homelessness, daily substance use, participation in sex work, involvement in the criminal justice system, and being out of school or work. Methods Using a targeted sampling approach, we recruited 569 YMSM aged 17-28 years from natural venues in New York City including bars, clubs, parks, and bus stations. Youth completed a structured interview assessing lifetime and current risk and protective contexts and behavior. Data were analyzed using univariate and multivariate statistical methods, including hierarchical logistic regression. Results After controlling for demographic characteristics and childhood adversity, YMSM with a fearful attachment style were more likely to have been homeless (OR 2.93, 95% CI 1.65-5.18), to have participated in sex work (OR 2.35, 95% CI 1.44-3.85), to use substances daily (OR 2.79, 95% CI 1.29-6.03), to have been involved in the criminal justice system (OR 2.04, 95% CI 1.38-3.01), and to be out of school/work (OR 2.47, 95% CI 1.47-4.15). Three subgroups were particularly vulnerable: YMSM who identified as heterosexual, or bisexual, and/or transgender. Conclusions A fearful attachment style contributes to some YMSM remaining outside of the protective systems of family, school, and work, and is associated with risky contexts where they are less likely to encounter prosocial peers and adults. Further, it is associated with risk behavior. Although gay-identified youth are generally found to have poor outcomes when compared with the general population of adolescents, in the present report, YMSM who identified as heterosexual were at particular risk. Attachment theory can guide interventions by informing how individuals experience relationships and manage developmental transitions.
KW - Adolescence
KW - Attachment style
KW - Bisexuality
KW - Child abuse
KW - Criminal justice
KW - Foster care
KW - Homeless youth
KW - Homosexuality
KW - Prostitution
KW - Substance abuse
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U2 - 10.1016/S1054-139X(03)00329-X
DO - 10.1016/S1054-139X(03)00329-X
M3 - Article
C2 - 15093795
AN - SCOPUS:1942452742
SN - 1054-139X
VL - 34
SP - 402
EP - 413
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 5
ER -