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Negative affective states have been consistently associated with sexual risk behaviors among men who have sex with men (MSM). While research has focused on the influence of depression and anxiety on risk behavior, few studies have examined the effect of loneliness on HIV-related risk behavior. This article examines the Loneliness and Sexual Risk Model (LSRM) which postulates that loneliness is associated with sexual risk behavior and that this relationship is mediated by the influence of substance use and compulsive behavior. Therefore, successfully addressing loneliness and its underlying causes is likely to result in subsequent reductions in risk behaviors. Clinical practice considerations are discussed.
The preparation of this manuscript was supported, in part, by National Institute of Mental Health (NIMH) Center grant P30-MH52776 and NIMH National Research Service Award postdoctoral training grant T32-MH19985.