The purpose of this study was to use grounded theory methodology to explore the influence of loneliness in young men who have sex with men (YMSM) of HIV-negative or unknown status in regards to their HIV risk behaviors. Twenty-three YMSM, 18–29 years of age, of HIV-negative/unknown status who reside in Southern California were contacted and interviewed between February 2011 and March 2011. Main topics addressed during the course of the interview process included: (1) participants' definition of loneliness; (2) impact of loneliness on daily life; (3) perception of HIV risk; (4) exploration of participants' HIV risk in regards to their sexual and/or substance use behaviors; and (5) exploration of the impact of loneliness on sexual and/or substance use behaviors. The results of this study indicated that loneliness is defined in two ways: emotional and social. Participants presented a cyclical pattern of experience that included negative symptoms associated with loneliness, the self-treatment of loneliness symptoms, temporary relief of loneliness symptoms, perceived negative consequences related to engaging in HIV risk behaviors, and ultimately the reemergence of initial loneliness symptoms. The Model of Perpetual Loneliness and HIV Risk Behavior in YMSM was created by the author to better understand the cyclical pattern that emerged from the data.

The present study suggests that loneliness in YMSM plays a greater role in HIV-related behavior than previously understood. Implications of this study, as well as directions for future research, are discussed.