Male prostitution: pathology, paradigms and progress in research

The body of research on male sex workers (MSWs) in the social science literature has evolved concurrently with the research that de-pathologized homosexuality. Unfortunately, the majority of studies focusing on MSWs have been dominated by paradigms that dehumanize the researched. Psychopathology, social deviance and, with the advent of HIV, MSWs as "vectors of disease," framed research questions. Further, many researchers have focused on typologies of MSWs, reporting respective associated characteristics. However, the knowledge gained by past research was often a product of the places MSWs were sampled; social scientists relied heavily on street MSWs. although other places and venues for sex work existed. What has been learned through this narrow focus has often been generalized to all men engaged in sex work resulting in stigmatization, stereotyping, and demonization. In the past decade, two important developments related to the field of sex work have been introduced. First, researchers have embraced a new paradigm that respects MSWs' personal motivations for sex work. Dominant among these motivations is the view of sex work as a job and, hence, a valid source of income. Second, the Internet has emerged as a new venue for sex work; a venue to which researchers are just beginning to turn their gaze.     

Sexual Venue Selection and Strategies for Concealment of Same-Sex Behavior Among Non-Disclosing Men Who Have Sex with Men and Women

In order to conceal their same-sex behavior, men who have sex with men and women (MSMW) who do not disclose their same-sex behavior to female partners must be cautious in their attempts to find potential male partners. This study interviewed 46 non-gay-identified, non-disclosing MSMW to identify the venues where they meet male sexual partners and the strategies they use to reduce the likelihood of discovery when at such venues. Most (74%) reported meeting a male partner in a sexual venue (e.g., bar or club, park) in the past year. Strategies to reduce the risk of discovery while seeking male partners included: a) avoiding certain venues, b) attending venues away from home, c) meeting partners on the Internet, d) preferring venues that have potential nonsexual uses, e) having sex at the partner's place, and f) limiting their onsite sexual activities. These findings provide insight into the coping strategies these men use to manage the conflicting needs to conceal their behavior and meet sexual partners.     

Educating gay male youth: since when is pornography a path towards self-respect?

In 2000, in the case of Little Sisters Book and Art Emporium, the Canadian Supreme Court was asked to determine whether gay male pornography violated the sex equality protections guaranteed by the Canadian Charter of Rights and Freedoms. Throughout this case, gay male activists and academics emphasised the risk posed by antipornography legal strategies to the dissemination of materials intended to promote safer sexual behaviour. Other arguments were advanced that gay male pornography should not be restricted because it serves as a learning tool for young men and, in so doing, does much to reduce the alarming incidence of gay youth suicide. The author examines these assumptions within the context of the gay male pornography defended in Little Sisters. His conclusion is that the present gay male obsession with hyper-masculinity, best evidenced in the pornography now widely touted by some gay men as a source of gay male identity and freedom, undermines safer sexual practices and the self-respect needed to combat youth suicide. The author concludes that gay men must commit to a sexuality built on mutuality, respect and caring (i.e., an identity politic built around sex equality).     

Male sex workers in three Australian cities: socio-demographic and sex work characteristics

This article describes the socio-demographic and sex work characteristics of sex workers in Sydney, Melbourne, and Brisbane. A total of 185 male sex workers completed the questionnaire component of the study. The results of this study serve to debunk many of the myths surrounding the popular view of the male sex worker (MSW). The respondents in this study were on average 27 years old, and the majority had completed secondary education, with 30% having gained some form of tertiary qualification. Interestingly, those MSWs who had not completed secondary education were mostly street workers and were generally aged under 25 years. The majority of sex workers lived in rented accommodation, with only 6% reporting to be homeless. Half of all respondents identified as being "gay," 31% as "bisexual" and 5.5% as "straight." More than half of the respondents were in a permanent relationship. Only 7.3% of this group reported using heroin daily, although the majority consumed alcohol, tobacco, marijuana, and ecstasy. The majority of sex workers had been in the profession for less than six months, although some had been working in the industry for more than ten years. Most of the sex workers reported having taken an HIV test and a preference to offer safer sex. The article highlights ways in which the work context of MSW can be better understood and supported by education and public policy programs.     

Latino Gay and Bisexual Men's Relationships with Non-Gay-Identified Men Who Have Sex With Men

This study investigated relationships between Latino gay-identified men in metropolitan New York City and their non-gay-identified male partners. Phase 1 consisted of in-depth interviews (N = 33), and Phase 2 consisted of quantitative surveys (N = 120) with Brazilian, Colombian, and Dominican men who have sex with men (MSM). A majority of participants reported having had sex with heterosexually identified men, and in many cases, the relationship was sustained over time. We found mixed results concerning an attitude sometimes attributed to Latinos that sexual orientation is defined by sexual role, with receptive MSM seen as gay and insertive MSM seen as straight. Although there were no significant associations between partner sexual orientation and unprotected anal intercourse, gay men were less likely to take the insertive role in oral or anal sex with straight-identified male partners than with gay partners.     

Frequency of Sexual Activity With Most Recent Male Partner Among Young,Internet-Using Men Who Have Sex With Men in the United States

Sex frequency, defined here as the number of oral or anal sex acts with the most recent partner in the past year, is a potential driver of risk for sexually transmitted infections. However, few data on sex frequency have been reported for men who have sex with men (MSM). Data from an Internet survey of MSM were used to describe sex frequency with most recent main and casual male partners and to estimate factors associated with higher sex frequency. Among 5,193 MSM, higher sex frequency was associated with younger age, shorter relationship duration, and reporting a main (vs. casual) partner; and lower sex frequency with male partners was associated with heterosexual or bisexual (vs. homosexual) identity or Black race (vs. non-Hispanic White). Secondary analyses of estimates of sex frequency from 2 publicly available nationally representative datasets comprised of primarily heterosexual survey respondents (the 2008 General Social Survey and the 1992 National Health and Social Life Survey) were performed. Sex frequency among MSM respondents was similar to that reported by heterosexuals.     

"Nobody's ever going to make a fag pretty woman": stigma awareness and the putative effects of stigma among a sample of Canadian male sex workers

The purpose of this study was to examine male sex workers' awareness of the social stigma surrounding involvement in the sex industry and the possible effects of that stigma. Personal interviews were conducted with 21 men (9 independent escorts who advertised via the Internet and 12 escorts/erotic masseurs who were on contract with an agency). Results indicated that a majority of interviewees believed sex work was stigmatized but attributed this stigma to society's tendency to conflate escort/erotic masseur with street-based prostitute and society's negative view of human sexuality in general and homosexuality in particular. It should be noted that interviewees did not necessarily perceive the gay community as more tolerant than the heterosexual community of persons involved in the male sex industry. In terms of how participants saw the sex trade, both prior to and during their involvement, multifarious viewpoints emerged (i.e., some engaged in "whore mythologizing" while others reported having no clearly defined perception of male sex workers). Finally, results suggested that some participants believed their involvement in a stigmatized industry was deleterious to them personally whereas others maintained that the consequences of being an escort/ erotic masseur were largely positive.     

HIV Risk Among Men Who Have Sex with Men Only (MSMO) and Men Who Have Sex with Men and Women (MSMW) in Baltimore

Men who have sex with men and women (MSMW) are at high risk for HIV. However, the majority of research on populations of men who have sex with men (MSM) combines MSMW and men who have sex with men only (MSMO) samples, which limits our understanding of HIV risk behaviors and factors associated with HIV risk among MSMW populations. We used the BESURE-MSM2, a venue-based cross-sectional study of HIV risk behaviors among MSM in Baltimore, MD, to examine HIV risk among MSMW. MSMW were less likely to report unprotected receptive anal intercourse than MSMO (6.8% vs. 19.6%, p = .0024). Among MSMW, 43.0% reported unprotected sex with a woman in the past year, but only 19.4% reported unprotected sex with both men and women, representing only 5.0% of the total MSM sample. In multivariate analyses, we found that among MSMW having unprotected sex with women in the past year, disclosing same sex behavior and having a main female partner were associated with unprotected anal intercourse with male partners. HIV prevention programs for MSMW are needed that address the complex partnerships of MSMW and the social contextual factors within which relationships and behaviors are embedded.     

Exploring First Sexual Intercourse,Sexual Orientation,and Sexual Health in Men

In this study the characteristics of the sexual debut of men who have sex with men (MSM) and men who have sex with women (MSW) age 35 or younger (N = 1,201) were compared with one another. We investigated whether these characteristics were associated with sexual health and behavior, and to what extent. Compared to MSW, MSM tended to be older when they had their first sexual intercourse; their first sex partner was older, they felt less ready, and they experienced more pain. We also found that they reported a higher number of lifetime sexual partners and less condom use compared to MSW. Similarities were also ascertained, such as the fact that individuals from both groups do not differ significantly regarding how they experienced their first sexual intercourse emotionally. Many differences between these groups should not always be seen as problematic, whereas others still indicate a need for targeted interventions.     

On Holiday: A Risk Behavior Profile for Men Who Have Vacationed at Gay Resorts

Sexual risk behavior is higher when people vacation as compared to when they are at home. The current study uses survey data to compare sexual risk behavior of gay men who vacation at gay resorts to those who do not. Independent predictors of vacationing at gay resorts included income level, relationship status, ever having attended a circuit party, and HIV serostatus. For men who visit resorts to meet sex partners, independent predictors included relationship status, ever having attended a circuit party, HIV serostatus, number of male sex partners in the past six months, and number of anal insertive male partners using a condom. These results show a need for the development of structural interventions in the gay resort and hotel setting.     

Sexual Coercion Among Gay and Bisexual Men in Aotearoa/New Zealand

Until recently, sexual coercion among gay men has been regarded as virtually oxymoronic. Discourses of male sexuality as ever-present and driven, and discourses of masculinity that portray men as in control and invulnerable, converge to almost disavow the possibilities that sex could be unwanted by men, or that men could be vulnerable to being pressured into sex against their will. This article reports on interviews with 19 gay and bisexual men about their experiences of forced, coerced, or unwanted sex. We identified four general patterns in these accounts: (1) incidents involving physical force; (2) experiences in which a man's ability to refuse sex was compromised by intoxication; (3) dynamics where young and inexperienced men were coerced or pressured into unwanted sex; and (4) situations in which men felt obligated to engage in unwanted sex. Specific issues included barriers to reporting sexual assault, power dynamics in intergenerational sex, and the difficulty of refusing unwanted sex. Importantly, many of the factors identified as driving sexual coercion relate not to gay sexuality per se, but rather to masculine sexuality. Conversely, some of the factors relating to men's vulnerability to coercion were exacerbated by some features of gay sexual culture; in particular those aspects associated with existing in a marginalized territory within a wider heteronormative context.     

The Social Environmental Context of Resilience Among Substance-Using African American/Black Men Who Have Sex With Men

ABSTRACT

Resilience theory has been suggested as a framework for research on HIV prevention among men who have sex with men. Among this population, literature indicates that African American/Black men who have sex with men experience additional health disparities including elevated HIV incidence rates, victimization, and poor physical health. Conceptualizing resilience as a part of one’s social environment, this qualitative study investigates resilience processes and HIV transmission risk among a sample of 21 substance-using African American/Black men who have sex with men. Data from in-depth interviews describe the social environmental context in which resilience is exhibited and document the influence of homophobia, expressions of agency, and access to social, economic, and cultural capital on resilience processes. Central to this are expressions of hidden resilience, in which African American/Black men who have sex with men mitigate risk and experience their lives as subjectively successful, whether or not outsiders see it as such.     

Reaching African-American Men on the “Down Low”: Sampling Hidden Populations: Implications for HIV Prevention

ABSTRACT

Studies on the impact of the HIV epidemic among African-American men who have sex with men (MSM) have largely neglected men who self-identify as heterosexual but engage in same-sex behavior. These men, commonly referred to as men on the “down low,” pose formidable challenges to researchers conducting prevention studies. This article addresses the methodological issues that create limitations in sampling this population. It presents a novel approach to locate and access these men, describes the success in using this approach, and suggests implications for future research employing this sampling approach.     

“Fruits,” “Fags,” and “Dykes”: The Portrayal of Gay/Lesbian Identity in “Nance” Jokes of the ’50s and ’60s

ABSTRACT

What is humorous and how it is interpreted very much depends on the norms and values of a culture at a particular point in time, the characteristics of who is telling jokes, and the makeup of the audience. This article presents archival material and an analysis of an outsider's jokes about gays and lesbians. These were told to primarily heterosexual audiences by a heterosexual comic. They reveal the assumptions Americans held about gays and lesbians throughout the 1950s, 1960s, and a few years into the mid-1970s, when most of these jokes were compiled. Although generalizations about gay/lesbian humor in that period cannot be made from one person's private collection of nearly 1,000 jokes, they do reveal several clear patterns: Much of the humor about male homosexuality is used to debase men and their masculinity, by making them passive, feminine, or weak, except for their hypersexuality. The women are also depicted in the jokes as sexually eager, especially to give oral sex to possibly straight women or acting in the male insertor role. Rarely were the gay/lesbian jokes focused on political issues of discrimination, oppression, or romantic relationships.     

Rural Men,Sexual Identity and Community

The relationship between rurality and men's sexuality remain relatively unexplored. This study addresses the knowledge gap in the research literature by focusing on men who have sex with men in rural areas across Ontario, Canada. Employing a constructivist grounded theory methodology, interviews were conducted with 32 men across 28 geographic locales consisting of populations of less than 10,000 people. Men identified as gay, bisexual, queer/bisexual, or refused labels. These self-selected identifiers were then explored to determine how participants conceptualized and organized their sexual identities in relation to context. Participants held divergent management strategies that resulted in two general identity grouping: “natives” and “transplanters.”     

HIV disclosure and subsequent sexual behaviors among men who have sex with men who meet online

To assess HIV disclosure discussions and related sexual behaviors among men who have sex with men (MSM) who meet sex partners online, 28 qualitative interviews with Seattle-area MSM were analyzed using grounded theory methods and themes and behavior patterns were identified. MSM found a greater ease in communicating and could prescreen partners through the Internet. However, no consistent relationship was found between HIV disclosure and subsequent behaviors: some were safer based on disclosure while perceived HIV status led others to risky behaviors. Interventions need to promote accurate disclosure while acknowledging its limitations and the need for men to self-protect.     

Philippines: Association of Population Correspondents formed in the Philippines

2 major decisions were reached at the December 1979 National Workshop for ESCAP Population Correspondents in the Philippines. The first was to set up an Association of Population Correspondents in order to enhance sharing population information at the national level. A newsletter was identified as a priority. The second decision was to set up a task force under the leadership of the Executive Secretary of the Commission on Population. The task force will be responsible for the preparation of a project proposal to establish a national population information clearing-house. Associated tasks will be the organization of a baseline study of the existing agencies, their capabilities and potential roles in the future national clearing-house. Participants stated specific needs for information. Information is needed from Thailand on community-based family planning programs and Indonesia on community participation and evaluation studies on contraceptive technology. The special needs of each member nation should be identified and then fed back to them for obtaining the required information. Participants requested a list of trainers for community-based programs; listing of specific linkages between private and government agencies involved in population work; and listing of international funding agencies on research and action programs.     

Age of Onset of Alcohol Consumption and Subsequent Negative Health Outcomes in Gay and Bisexual Men Who Have Sex With Men

ABSTRACT

The correlation between current alcohol use and sexual risk behaviors among men who have sex with men (MSM) is well documented, but little is known about age of drinking onset and current risks among this population. Data from a 2008 Internet survey of 8,452 MSM in the United States were used to assess factors associated with age of onset of alcohol use. In a multivariable model, drinking onset before age 15 was significantly associated with a higher number of lifetime male anal sex partners and being behaviorally bisexual in the past 12 months. Men who reported depressive symptoms in the past two weeks or who screened positive for alcohol abuse in the past 60 days were more likely to have early age of drinking onset. Findings suggest the need for targeting younger adolescents for alcohol screening, particularly sexual minority youth, to prevent risk behaviors in adulthood.     

The relationship between homosexuality, internalized homo-negativity, and mental health in men who have sex with men

Whether homosexuality or internalized homo-negativity is the critical variable affecting the mental health of men who have sex with men has long been debated. As part of a larger study, 422 Midwestern homosexual men completed questionnaires examining degree of homosexuality, internalized homo-negativity, and depression. Logistic regression modeling identified internalized homo-negativity, but not degree of homosexuality, as significantly associated with greater adjustment depression (OR = 1.5), major depression (OR = 2.6), dysthymia (OR = 1.5), and likelihood of being in therapy (OR = 1.4). Internalized homo-negativity was also negatively associated with overall sexual health, psychosexual maturation, comfort with sexual orientation, "outness," and peer socialization. Internalized homo-negativity, not homosexuality, appears associated with negative health outcomes. Providers should promote sexual health and avoid interventions that reinforce internalized homo-negativity.     

Sexual orientation identification of men who have sex with men in public settings in Canada

The present study attempts to determine how men who have sex with men (MSM) identify in terms of their sexual orientation. The sexual identity of MSM has important implications for the spread of HIV. The literature suggests that gay or bisexual identifying MSM are more likely to practice safer sex than heterosexually-identified MSM. A significant number of the MSM in public settings, such as parks, are believed to be heterosexual identifying. MSM in bathhouses are presumed to be gay or bisexual identifying. Parks have been the focus of safer sex outreach efforts targeted towards heterosexually-identified MSM. Sexual orientation self-identification was ascertained from park and bathhouse users via one-on-one interactions with outreach workers from 1996 to 1998. Chi-square analysis revealed no significant difference in the expressed sexual orientation of bath and park users, with both populations consisting mostly of gay-identified men. Heterosexually-identified MSM are not found in significant numbers in public settings. The current micro educational approach used to target these men may not be cost-effective. Alternative strategies are discussed.