Positive thinking.

A study published in the December 2008 Journal of Health and Social Behavior found that gay men who feel sexually undesirable are more likely to engage in risky sexual practices, and their sexual partners are more apt to insist on not using condoms. Meanwhile, men who have a healthy body image are more likely to insist on safer sex. The study shows a clear link between mental states and sexual behavior. Given the emphasis many gay men place on physical appearance, this study demonstrates the vital importance of cultivating a strong sense of self-worth. If you feel you have knowingly put yourself at risk for HIV and other STDs because of low self-esteem, speak to a health care professional. The Gay and Lesbian Medical Association (GLMA.org) has a directory of gay-friendly medical providers and support groups.

DR. FRANK SPINELLI is a board-certified internist in New York City, To ask medical questions for future, e-mail [e-mail].