Demographic and Sexual Behavior Comparisons of Indian and U.S. Internet Samples of Men who have Sex with Men

ABSTRACT

Data were collected via the Internet on sexual behaviors of Indian men who have sex with men (MSM; n = 171); these data were compared to online American MSM (n = 682). Among Indian MSM, 51% had never been tested for HIV, 100% believed themselves to be HIV-uninfected, and 22% (secondary Internet male partners) to 43% (primary male partners) reported not using condoms during last anal intercourse. While U.S. MSM were more likely to not use condoms (42% for secondary Internet partners to 67% for primary male partners), most (88%) had been tested for HIV (.0001 ≤ p ≤ .002, all comparisons). Low rates of HIV testing, beliefs about being HIV-uninfected, and significant levels of unsafe anal intercourse could fuel the spread of infection among Indian MSM.     

Correlates of Human Immunodeficiency Virus/Sexually Transmitted Infection (HIV/STI) Testing and Disclosure Among HIV-Negative Collegiate Men Who Have Sex With Men

Abstract

Objective: To determine the extent to which personal, behavioral, and environmental factors are associated with human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing and disclosure. Participants: Nine hundred thirty HIV-negative collegiate men who have sex with men (MSM) who completed an online survey about alcohol use and sexual behavior. Methods: Correlates of testing and disclosure significant in bivariate analyses (p < .05) were grouped into personal, behavioral, or environmental factors and entered into multivariable logistic regression models. Results: About half of participants tested for HIV (51.9%) and for STIs (45.8%) at least annually. Over half (57.8%) of participants always/almost always discussed HIV status with new sex partners; 61.1% with new unprotected sex partners. Personal and behavioral factors (age and outness) explained differences in testing, and the behavioral factor (routine testing) explained differences in disclosure. Conclusions: Collegiate MSM should be supported in coming out, encouraged to engage in routine testing, and counseled on discussing HIV/STI status with potential sex partners.     

Predictors of HIV Sexual Risk Behavior Among Men Who Have Sex with Men,Men Who Have Sex with Men and Women,and Transgender Women

ABSTRACT

Men who have sex with men, men who have sex with men and women, and transgender women are at high risk for HIV infection. This study seeks to clarify which known HIV risk factors (partner type, sex location, serodiscordance, multiple sex partners, substance use during sex) contribute to engagement in high-risk (unprotected receptive anal) sex in each population. Data collected from June 2005 through June 2008 indicate all three populations display different HIV sexual risk profiles. The data suggest that HIV-prevention interventions should be individually tailored to address the specific needs of these three highly vulnerable and impacted populations.     

Anal Cancer Screening: Barriers and Facilitators Among Ethnically Diverse Gay,Bisexual, Transgender,and Other Men Who Have Sex With Men

ABSTRACT

Knowledge and beliefs about anal cancer screening among gay and other men who have sex with men remains unclear, despite data that suggests significant risk for intra-anal HPV-related cancers. Nevertheless, community-based screening activities may be most effective when stakeholder perspectives are addressed. We conducted four focus groups among 16 male and 3 female health care advocates experienced in working with diverse gay and other men who have sex with men in Los Angeles. Barriers to anal cancer screening included lack of awareness, stigma, psychological and physical discomfort, the anus as hidden/private, primary concern with HIV, and men's lack of healthcare seeking. Facilitators were community screening sites, novel strategies such as home testing, health care system changes and targeted educational campaigns, which may increase anal cancer awareness and screening among ethnically diverse men who have sex with men.     

Sexual Desire Among an Online Sample of Men Sexually Attracted to Children

ABSTRACT

Sexual attraction to children occurs in roughly 3 to 9 percent of the population. However, most knowledge about such desires comes from forensic samples, and most studies fail to assess preferred sexual activity and sexual partner. A new multimodal assessment of sexual desire was used to investigate interest in consensual and nonconsensual sex with adults and children in an online sample of men sexually attracted to children (n = 101). Desires were compared across history of sex offending behavior and preferred gender of child victim. Men who have and have not acted on their sexual attractions to children reported similar levels of sexual desire. Men primarily attracted to girls reported greater desire for sex with adults than did men primarily attracted to boys. Results highlight the heterogeneity of men sexually attracted to children as well as possible distinctions across gender of children to whom they are primarily attracted.     

Masturbatory Behavior and Feelings: An Exploratory Study of Indian Immigrant Men in Australia

ABSTRACT

Objectives: Sexual problems associated with masturbation (especially intense negative feelings) are commonly reported among Indian subcontinental men. Yet there is a paucity of scientific information about masturbatory behavior and feelings. Much of the available information is either from clinic-based studies or from studies involving young Indians. Methods: The present study, using a community sample of Indian men in Australia, aimed to explore their masturbatory behavior and feelings. Results: Overall, 268 men took part in an online survey, and 221 of these men completed the section on masturbation. Some demographic characteristics of the study sample were comparable to those of the Indian community in Australia. A large proportion (n = 174, 79%) reported that they currently masturbate, while the rest said they never masturbated (n = 9, 4%) or did masturbate in the past but not at present (n = 38, 17%). Among those who currently masturbate, the mean age of onset of masturbation was 14.9 years. Married men tended to masturbate less frequently than unmarried men. The most common mode, source of stimuli, and reason for masturbation were using hands (n = 162, 95%), watching erotic material on the Internet (n = 136, 81%), and to gain pleasure (n = 137, 79%), respectively. A high proportion (n = 114, 66%) of Indian men who currently masturbate said that they experienced positive feelings when masturbating. Conclusions: Masturbatory feelings of Indian men were found to differ by length of residence in Australia but not by degree of acculturation or age. The present exploratory study has provided baseline information about masturbation among Indian men and indicates the need for further research.     

Gay Men and HIV

SUMMARY

This paper reports on the results of qualitative studies examining the personal experiences of sex and sexual negotiation for British gay men who are diagnosed HIV positive and those who know or presume themselves to be uninfected. These are contrasted with the results of a study of representations of HIV and AIDS within an international review of community health promotion literature aimed at gay men. The paper highlights the disparity between specific community responses to the epidemic as engendered in the cultural production of health promotion materials and the individual experience of HIV, suggesting a! paradigm for a community response to the epidemic which reflects the personal experience of gay men both infected and uninfected.     

A Novel,Self-guided,Home-Based Intervention to Improve Condom Use Among Young Men Who Have Sex With Men

Abstract

Objective: This pilot study tested the efficacy of a brief, novel, theory-driven, self-guided, home-based intervention designed to promote condom use among young men who have sex with men (YMSM). Participants: Thirty YMSM were recruited from a large public US midwestern university during spring of 2012. Methods: The intervention was tested using a repeated measures design with the primary follow-up assessment occurring 6 weeks after enrollment. Results: Forty-five percent of men reported a reduced frequency of unprotected insertive penile–anal intercourse in the past 30 days compared with baseline (p = .01). Consistency of condom use improved (p = .013), as did motivation to use condoms correctly, condom use self-efficacy, and condom attitudes. All participants indicated that they were glad they participated, would recommend the program, and that overall, they had liked the program. Conclusions: This pilot study supports an expanded trial of this intervention with MSM at high-risk of acquiring human immunodeficiency virus/sexually transmitted infections (HIV/STIs).     

Gay Men

Summary

This report presents the findings from four ethnographic studies of older gay men (Brown, 1997; Brown, Sarosy, Cook & Quarto, 1997; Cook, 1991; Quarto, 1996; Sarosy, 1996). There were 69 total participants who ranged in age from 36 to 79 years; most were from 50 to 65 years of age. The purpose of these studies was to examine how older gay men have adjusted, psychologically and socially, to their sexual orientation and aging process. Participants reported that they spend 50% time or more with gay friends within their own age cohorts. Many reported being involved with the gay community in some capacity, while about 15% had no involvement with the gay community. Most participants were in regular contact with their families. Most stated that their families were aware of their sexual orientation. Most of the participants reported experiencing discrimination due to sexual orientation, and one third had experienced discrimination within the gay community based on age or ethnicity. With regard to sex life, the studies found an overall lowered frequency of sexual activity. Participants felt that HIV/AIDS has had a devastating impact on older gay men, interrupting the normal aging process for those who have contracted it and prematurely aging those who care for them. The studies' findings identified the qualities of healthy adaptation to aging for older gay males: having satisfying relationship, self-acceptance as one ages, good health, an active life with a variety of interests, and financial security.     

HIV/AIDS Projects with and for Gay Men in Northern Thailand

Abstract

In this paper I look at three HIV/AIDS projects which were run by and for gay men, transsexuals and men who have sex with men (MSM) in northern Thailand in the early 1990s. These three projects were very different in format and in context, ranging from a rural village AIDS association to an urban drag beauty contest. The projects were located in settings as different as gay bars and cruising areas, shopping malls and rural villages. Aspects of the three Thai projects have important implications for those working in HIV/AIDS prevention and in the care and support of people living with HIV/AIDS (PLWHAs) across cultures, particularly in relation to education, outreach and counselling programs.     

South African Men Who Have Sex With Both Men and Women and How They Differ From Men Who Have Sex With Men Exclusively

The label “men who have sex with men” (MSM) is used to categorize a diverse population exclusively on the basis of its sexual behavior. Understanding the diversity that this label comprises is critical for the development of health interventions that effectively reach the various populations subsumed under this label. In this cross-sectional study of South African MSM (N = 480) recruited through respondent-driven sampling (RDS), we explored differences between men who had sex with both men and women (MSMW) and men who had sex with men exclusively (MSME). We found significant differences between these two groups in terms of sexual attraction, sexual identity, sexual preferences, sexual histories, and current sexual practices. MSMW were more likely to be confused about their same-sex attraction, to experience internalized homophobia, and to have paid for sex in the previous year, while MSME were more gender nonconforming and more likely to have been forced to have sex in the previous year. These findings underscore that the MSM label comprises a diverse population and that exclusive sexual engagement with other men is a critical distinction to take into account in understanding this diversity and fully grasping the lived experiences of men who have sex with men.     

Sexual Problems and Distress among Men and Women with Same-Sex and Opposite-Sex Sexual Partners: An Analysis of a Nationally Representative Sample of Adults in Great Britain

Abstract

Objective: This study aimed to examine differences in reporting sexual problems and distress among men and women with same-sex and opposite-sex sexual partners.

Methods: Multinomial regression was undertaken on risk of reporting sexual problems and/or distress using data from the third National Survey of Sexual Attitudes and Lifestyles.

Results: Differences were detected between men of different sexual behavior groups when considering the problems “lack of enjoyment in sex,” “felt anxious during sex,” “felt no excitement or arousal during sex,” “lack of interest in sex,” “did not reach/took a long time to reach climax,” and “getting or keeping an erection.” Fewer differences were detected among women.

Conclusions: Women reporting same sex sexual partners, and to a greater extent men reporting same sex sexual partners , have different sexual health needs and report sexual health problems and distress to a different extent than is the case for individuals who only have opposite-sex sexual partners     

Electronic Media Access and Use for Sexuality and Sexual Health Education Among Men Who Have Sex With Men in Four Cities in Tanzania

Abstract

Background: Electronic media use is an important avenue for reaching stigmatized populations. We examined Internet access and use of sexually related electronic media among men who have sex with men (MSM) in 4 cities in Tanzania. Methods: A questionnaire was administered to 231 MSM in Dar es Salaam, Mwanza, Arusha, and Tanga regarding electronic media type, times of use, type of use and frequency of use of sexually-related media. Results: Mean age was 25.7?years, and 52% had completed high school. Half had access to the internet through personal electronic devices, a further quarter had access through work, 10% through friends’ devices, and only 2% had no access to the internet. Most frequently used electronic devices were personal computer followed by work smartphone, with work computer a close third. These patterns were consistent for both seeking other men for sex and finding sexual health information. All respondents had accessed sexual material electronically at some time. Substantial logged-in time was reported each week seeking/chatting with potential sexual partners (median?=?48 hr), looking at “porn” (median?=?24 hr), and searching for health information (median?=?7 hr). Over 98% indicated that they would use an anonymous/confidential online service for HIV and sexually transmitted infection testing. The majority (79%) had found sexual partners throughout the Internet in the last 24?hours, and 52% sought sexual health education online 2–3 times per week. Peak search time was evenings, increasing during weekends. Discussion: For Tanzanian MSM in cities, sexual electronic media use is high and includes work devices. Sexual health information seeking, and openness to electronic counseling and testing was almost universal. Electronic sites for sexual health access should be explored and evaluated.     

Transactional Sex: Supply and Demand Among European Men Who have Sex with Men (MSM) in the Context of Local Laws

Objectives: Transactional sex (TS) is generally defined as the trading of sex for material goods. Cast within the broader context of prostitution laws, we examined variations in the sociodemographic profile of men who have sex with men engaging in TS by payment direction (buying/selling). Methods: The data were collected as part of the 38-country European Men who have sex with men Internet Survey project, conducted in 2010. Results: About 12% of respondents reported engaging in TS in the past year. TS was associated with laws, age, education, employment, and residence. Conclusions: The striking sociodemographic differences in TS by payment direction suggest a power differential and a leading role of socioeconomic factors in TS.     

Importance of Self-Forgiveness and Social Support in Potentially Reducing Loneliness in Men Who Have Sex with Men

Abstract

Higher levels of loneliness in men who have sex with men (MSM) are associated with negative outcomes such as depression, anxiety, and sexual impulsivity. By identifying what may reduce loneliness in MSM, counselors and public health professionals can alleviate the distress of their clients. A significant hierarchical multiple regression controlling for relationship status, F(9, 105)?=?16.36, p?<?0.001, R² = .62, indicated that higher levels of self-forgiveness (β?=??.19, p?=?.04) and perceived social support (β?=??.49, p?<?.001) predicted lower levels of loneliness in MSM. Implications and limitations are discussed.     

Silence and Assumptions: Narratives on the Disclosure of HIV Status to Casual Sexual Partners and Serosorting in a Group of Gay Men in Barcelona

ABSTRACT

Disclosing HIV status and seeking sexual partners with the same serostatus (serosorting) are strategies used by some gay and bisexual men to have unprotected anal intercourse (UAI). This study aims to gain an understanding of the occurrence of disclosure and serosorting with casual sexual partners. A grounded approach was used to analyze 22 interviews with gay men from Barcelona. The results reveal that disclosure of serostatus or the seeking of sexual partners of the same HIV status are not behaviors in the repertoire of most HIV-negative men and were not even taken into account when they engaged in UAI with casual sexual partners. The opposite was observed in HIV-positive respondents who did consider the possibility of revealing their serostatus. Some relied on intuition or subjective elements to evaluate the HIV status of their occasional partners.     

Men Who Cheer

Abstract

This study examines the maintenance of gender and sexuality within a female-dominated sport, focusing specifically on men who cheer. Data were collected at a northeastern Ohio university using focus group discussions and one-on-one interviews. The interviews and discussions provided themes regarding stigmatization of male cheerleaders, the need to project a heterosexual image, and methods of saving face. Findings indicate that the gender and sexuality of men who cheer are called into question. In order to affirm their gender and sexuality as masculine and heterosexual, the men engage in behavior that sexualizes women and desexualizes their relationships with men. Overall, the findings demonstrate how the patriarchal superstructure manifests in smaller institutions in society. Implications of these findings and areas of future research are further addressed within the study.     

Human Papillomavirus Vaccine Intention Among College Men: What's Oral Sex Got to Do With It?

Abstract

Objective: To identify associations between engaging in oral sex and perceived risk of oral cancer among college men. Also, to identify associations, and their moderating factors, between oral sex and human papillomavirus (HPV) vaccine acceptance. Methods: Young men were recruited from 2 university campuses in the South (N = 150). Men completed an audio computer-assisted self-administered interview. Results: With the exception of receiving fellatio, each measure of oral sex behavior was significantly associated with greater perceived risk of oral cancer. Four oral sex behaviors evidenced significant associations with vaccine acceptance. Men engaging in recent oral sex or reporting oral sex behaviors with more than 2 partners were more likely to indicate vaccine intent. African American/black race, communication with parents about sex-related topics, and HPV-related stigma/shame were identified as moderating factors. Conclusion: Young college men giving or receiving oral sex with multiple partners may be predisposed to HPV vaccination.