J Med Assoc Thai 2010; 93 (3):6

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Health Behaviors in the Development and Maintenance Process of Homosexual Identity
Patthum T Mail, Kessomboon P , Sinsuphan N , Ratanasiri A

Background: Health behaviors of men who have sex with men (MSM) affect their health status in many aspects. Rate of HIV
infection among Thai male prostitutes in 2005 was 15.4%. Among these, 28.3% were MSM. Thirty percent of youth suicides
were conducted by gays and lesbians.

Objective: To explore the health behaviors related to the development and maintenance process of men who have sex with
men.

Material and Method: This was a qualitative study. The study population was MSM in Mukdahan province. The subjects
were recruited gradually, by snowball sampling, until the required data were saturated. In-depth interviews and participant
observations were performed over a period of 17 months. A triangulation technique was applied to check reliability of the
data. Data were analyzed by content analysis and compared with the Troiden’s stages of development and maintenance
process of homosexual identity.

Results: Eleven Thai MSM were recruited and followed up. Health behaviors of them were different according to the stages
of development and maintenance process regarding Troiden’s theory. Physical, psychological, social and sexual aspects of
health behaviors were identified in various stages. It was found that many factors affect health behaviors of MSM. These
include health promoting and undermining factors.

Conclusion:
Health behaviors of MSM varied in each stage of development and maintenance of homosexual identity. Health
promotion campaigns and policies for MSM should be designed accordingly.

Keywords:
Health behavior, Men who have sex with men, MSM, Development and maintenance process, Homosexual identity

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