1. Social isolation, substance use and sexual behaviors among high risk MSM SP Kurtz and HL Surratt Center for Drug and Alcohol Studies University of Delaware To examine the relationship between extreme social isolation (ESI) and other psychological states, substance use, and sex risk behaviors. ESI was measured by the UCLA Loneliness Scale, which was validated by strong correlations with dissatisfaction with family, friend and intimate relationships. The sample included ethnically-diverse substance-using MSM ages 18-55 (median = 39) from Miami / Ft. Lauderdale, USA who reported recent unprotected sex with casual partners. 45% were HIV+.

2. C ORRELATES OF SEVERE SOCIAL ISOLATION (SI) MULTIVARIATE MODEL Odds Ratio p Severe mental distress3.774.000 DSM-IVR substance dependence2.088.005 Severe victimization history2.126.002 Extreme personal shame2.375.001 High sexual escapism1.885.010

3. S EX RISK BEHAVIORS AND SOCIAL ISOLATION (SI) Past 90 day behaviors w/Severely Not SI casual partners (means)SI (N=174) (N=218) p Anal sex partners15.2 12.5 ns Anal sex partners - receptive10.0 6.3.032 Anal partners - rec. no condom6.7 4.0.040 Anal sex times32.5 35.9 ns Anal sex times - no condom20.6 25.0 ns Anal sex times - receptive16.3 9.1.004 Anal sex times - rec. no condom11.0 6.1.015 Anal sex times per partner3.37 6.1.004