Date of Award


Degree Name

Master of Arts




John S. Wiebe


The objective of the present study was to assess whether sexual self-esteem -- an individual's tendency to feel sexually pleased, attractive, and in control of their sexual thoughts, feelings, and behaviors -- influences the relationship between substance use and sexual risk behavior in a sample of men who have sex with men (MSM) and who are living with HIV. We sampled 106 Latino adult MSM living with HIV who were being treated at a clinic in El Paso, Texas that offers comprehensive HIV/AIDS services. We assessed demographic variables, as well as two domains of sexual self-esteem (i.e., overall feeling of attractiveness and sexual control), substance use patterns, and sexual risk behavior, with a series of survey measures.

In comparison to other research investigating the sexual self-esteem of MSM living with HIV, we observed moderate levels of perceived physical attractiveness with higher levels of perceived sexual control. We also observed moderate levels of substance use. Of the 106 MSM surveyed 30.5% reported illicit drug use in the past 30 days and 24% reported problem drinking. Additionally, 12.9% of the sample engaged in unprotected sex in the past six months with an HIV-negative or a partner whose HIV status was unknown. As hypothesized, perceived physical attractiveness positively correlated with sexual control. Also, although alcohol use was positively correlated with having more sexual partners it did not correlate with any other measure of sexual risk. Additionally, illicit drug use did not significantly predict number of sexual partners in the past six months nor did it predict other sexual risk. We also did not find support for our hypotheses that perceived physical attractiveness and sexual control would moderate the relationship between substance use and sexual risk.

Results from this sample differed substantially from those obtained with other samples. The absence of consistent links between sexual risk behaviors and measures for appearance-related distress and substance use is an encouraging finding that warrants further study. In general, these results suggest that large subgroups of Latino MSM living with HIV report safer sexual behavior even in the context of substance use and related mental health conditions such as appearance-related distress.




Received from ProQuest

File Size

130 pages

File Format


Rights Holder

Miriam Pando

Included in

Psychology Commons