Sönmez, İbrahimFolch Toda, CintaLorente Palacios, NicolásBerg, Rigmor C.Thurlby, NatalieSchmidt, Axel2022-05-232022-05-232022Sönmez İ, Folch C, Lorente N, Berg RC, Thurlby N, Schmidt AJ. Influence of internalised homonegativity on sexual risk behaviour of men who have sex with men in Spain. Sexuality & Culture. 2022 Jun;26(3):932-50. DOI: 10.1007/s12119-021-09925-71095-5143http://hdl.handle.net/10230/53202In a sample of men who have sex with men (MSM) (N=3436) in Spain who bear intrinsic HIV risk, we investigated how internalised homonegativity (IH) is associated with the number of non-steady male partners with condomless intercourse (as a proxy of sexual risk behaviour). Using structural equation modelling (SEM), we examined the relationship between IH and sexual risk behaviour, and mediating efects of HIV/PrEP knowledge and substance use during sex on this relationship. We found no direct association between IH and sexual risk behaviour, nor did IH infuence substance use during sex. In line with our hypothesis, association between IH and sexual risk behaviour was signifcant when mediated by HIV/PrEP knowledge. We found that as IH increased, sexual risk behaviour decreased, because higher IH was associated with lower HIV/PrEP knowledge while higher HIV/PrEP knowledge was associated with increased non-condom use with non-steady partners. Substance use during sex was signifcantly associated with sexual risk behaviour. Our results emphasize the continuing importance of prevention strategies focused on behavioural changes and community level interventions, especially targeting substance use.application/pdfeng© The Author(s) 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.info:eu-repo/semantics/articlehttp://dx.doi.org/10.1007/s12119-021-09925-7Internalised homonegativitySexual risk behaviourHIV knowledgeSubstance useMSMStructural equation modellinginfo:eu-repo/semantics/openAccess