Exploring and Adapting a Conceptual Model of Sexual Positioning Practices and Sexual Risk Among HIV-Negative Black Men Who Have Sex With Men

Estimates show a 50% lifetime human immunodeficiency virus (HIV) risk among Black men who have sex with men (BMSM) in the United States(U.S.). Studying the dynamics of sexual positioning practices among BMSM could provide insights into the disparities observed among U.S. groups of men who have sex with men (MSM). This study explored sexual positioning dynamics among HIV-negative BMSM and how they aligned with a theoretical model of sexual positioning and HIV/sexually transmitted infection (STI) risk among MSM. In-depth qualitative interviews were conducted with 29 HIV-negative BMSM between ages 25 and 35 in Los Angeles. Comments related to sexual behaviors were reviewed for relevance regarding oral or anal sexual positioning practices. Data presented represent the range of themes related to decision making regarding sexual positioning. Personal preference, partner attraction, HIV avoidance, and feeling obligated to practice partner preferences influenced sexual positioning. Drug use also affected decision making and was sometimes preferred in order to practice receptive anal intercourse. These variables build on the conceptual model of sexual positioning practices and sexual risk, and add understanding to the relationship between preferences, practices, and risk management. Future research on risk among HIV-negative BMSM should quantify the relative impact of personal preferences, partner attraction, partner type, compromise, and substance use on sexual positioning practices and risk.     

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.     

Does subliminal exposure to sexual stimuli have the same effects on men and women?

Three studies explored gender differences in explicit and implicit components of sexual arousal following brief exposure to a sexual stimulus. Whereas Study 1 assessed reports of sexual arousal following subliminal exposure to a sexual or a neutral picture, Studies 2 and 3 examined the effects of the same priming procedure on accessibility of sex-related thoughts assessed with a pictorial judgment task and a lexical decision task. The subliminal sexual prime did not have an effect on men's reports of sexual arousal, but caused women to report lower levels of sexual arousal. In contrast, the same subliminal sexual prime led to higher accessibility of sex-related thoughts in both men and women. It is therefore suggested that the subliminal sexual prime causes women to activate sex-related mental contents but to experience the result as somewhat aversive.     

Understanding Condom Use Decision Making Among Homeless Youth Using Event-Level Data

This is one of the first qualitative event-based studies to understand the various mechanisms through which multiple factors influence condom use decision making among homeless youth. Event-level interviews that explore characteristics of the environment surrounding sexual events were conducted with 29 youth who were asked to describe two recent sexual encounters. In thematic analyses of data across events, reasons that youth gave for engaging in unprotected sex included the expectation of having sex and use of alternative methods of protection against pregnancy. Other nonevent factors that influenced condom use decision making were related to attributes of the partnership (e.g., testing, trust and love, and assessments of risk) and attributes of the youth (e.g., perceptions of diseases, concerns over pregnancy, and discomfort using condoms). Additional event analyses conducted within the same individuals found that decision making was influenced by multiple interacting factors, with different pathways operating for event and nonevent factors. Future interventions should consider taking a multilevel and individualized approach that focuses on event-based determinants of risky sex in this population.     

Sexual Risk Behaviors and Perceptions of Men Who Go to Gay Sex Parties in New York City: Comparisons Between Three HIV Groups

Men who have sex with men (MSM) who attend group-sex events often engage in risky sexual behaviors that contribute to the high human immunodeficiency virus (HIV) incidence among this population. We conducted an online survey with 211 New York City MSM who attended sex parties in the prior year and asked them to describe their behaviors and perceptions of risk. We compared responses from HIV-positive-undetectable men (n = 36), HIV-negative men on pre-exposure prophylaxis (PrEP; n = 62), and HIV-negative men never on PrEP (n = 113). In bivariate analyses, undetectable and on-PrEP men had been to more sex parties in the prior six months, had more anal sex partners there, and had higher rates of sexually transmitted infection (STI) diagnoses than men never on PrEP. Although less than the other groups, 43% of the presumably HIV-negative men never on PrEP reported condomless anal sex at a party in the prior six months. About half of participants agreed that, at sex parties, they made assumptions about others’ HIV status, that they sometimes took more risks than intended, and that the atmosphere of these events was conducive to risk taking. Most disagreed that there was discussion of HIV status at sex parties. Implications for sexual health interventions are discussed.     

Conscious Regulation of Sexual Arousal in Men

The goals of this study were to examine the effectiveness of emotional reappraisal in regulating male sexual arousal and to investigate a set of variables theoretically linked to sexual arousal regulation success. Participants first completed a series of online sexuality questionnaires. Subsequently, they were assessed for their success in regulating sexual arousal in the laboratory. Results showed that the ability to regulate emotion may cross emotional domains; those men best able to regulate sexual arousal were also the most skilled at regulating their level of amusement to humorous stimuli. Participants, on average, were somewhat able to regulate their physiological and cognitive sexual arousal, although there was a wide range of regulation success. Whereas some men were very adept at regulating their sexual arousal, others became more sexually aroused while trying to regulate. Age, sexual experience, and sexual compulsivity were unrelated to sexual arousal regulation. Conversely, sexual excitation, inhibition, and desire correlated with sexual arousal regulation success. Increased sexual excitation and desire were associated with poorer regulatory performance, whereas a propensity for sexual inhibition due to fear of performance consequences was related to regulatory success.     

Using the Dual Control Model to Investigate the Relationship Between Mood,Genital, and Self-Reported Sexual Arousal in Men and Women

Recent findings suggest that there is considerable interindividual variability in how mood affects sexual arousal and that the dual control model may be helpful in explaining this variation. The current research investigated whether mood interacted with sexual excitation and inhibition proneness to predict subjective and genital arousal. In this study, 33 participants (18 men; 15 women), ages 18 to 45, attended three laboratory sessions where they completed questionnaires assessing preexisting mood and propensity for sexual excitation and inhibition, then watched a series of neutral and sexually explicit films. Subjective sexual arousal was continuously indicated during each film, while genital temperature was measured using thermographic imaging. Sexual excitation and inhibition interacted with various mood scores to significantly predict both subjective and genital arousal in men and women. Several gender differences were found. For example, vigor scores interacted with sexual excitation proneness to significantly predict genital but not subjective arousal in women, while the same interaction significantly predicted subjective but not genital arousal in men. The findings supported the hypothesis that the dual control model is an important framework in understanding how mood influences both subjective and genital sexual arousal.     

Not All Men,Situations, and Actions Are Equal

SUMMARY

Since 1985, annual surveys conducted in the French gay press show that gay men in France have made considerable changes in their sexual behavior due to the AIDS epidemic. However, risky behavior still occurs. In this article, some ideas which have been assumed concerning residual risk among gay men are tested. The research questions were: (1) Should all unprotected acts of anal intercourse be considered risky? (2) Has a phenomenon of relapse really occurred among gay men in France? and, (3) Are risks only limited to men who are on the margin of the gay community? Before answering these questions, major landmarks in HIV prevention for gay men in France are reviewed. Then, on the basis of the results of the 1995 Gay Press Surrey, subjects' perception of the degree to which they are socially accepted, and the diversity of homosexual lifestyles are presented, finally, we describe how respondents have adjusted to HIV-risk at a time when there has been much talk about the re-emergence of risk behaviors and a resurgence of the AIDS epidemic among homosexual men.     

Affect and Sexual Responsivity in Men With and Without a History of Sexual Aggression

Despite increased attention to understanding risk factors for sexual aggression, knowledge regarding the emotional and sexual arousal patterns of sexually aggressive men remains limited. The current study examined whether sexually aggressive men exhibit unique profiles of affective responsivity, in particular to negatively valenced stimuli, as well as sexual arousal patterns that differentiate them from nonaggressive men. We presented 78 young men (38 sexually aggressive; 40 nonaggressive) with a series of videos designed to induce positive, sad, or anxious affect. Affect and subjective sexual arousal were assessed following each film and erectile responses were measured continuously. Sexually aggressive men reported significantly higher levels of sexual arousal following both the positive and negative conditions as compared to nonaggressive men. Erectile responses of sexually aggressive men were significantly greater than nonaggressive men’s following the positive affect induction. Self-reported positive affect, but not negative affect, was a significant predictor of subjective sexual arousal for both groups of men. Compared to nonaggressive men, sexually aggressive men showed significantly weaker correlations between subjective and physiological sexual arousal. Findings suggest that generalized heightened propensity for sexual arousal may be a risk factor for sexually aggressive behavior.     

Is risky sex rational?

Consideration of a simple model of sexual decision‐making suggests that many individuals who engage in risky sexual practices do so for “rational” reasons. Within a framework of subjective values and perceptions, risky sex may be rational in the sense that the benefits derived from sexual expression outweigh the threat of loss from AIDS. One implication of this conceptualization is that in order to understand risky behavior, primary consideration must be accorded the perceptions, attitudes, and desires of the individual.     

Automatic processes and the appraisal of sexual stimuli: Toward an information processing model of sexual arousal

A model of sexual arousal is presented that highlights the interaction between automatic and controlled cognitive processes and proposes that different levels of cognitive processing can differentially affect subjective and physiological sexual arousal. In addition, two studies are presented in which the role of automatic processes was explored using a priming paradigm. Subjects were sexually functional men. In the first study an effect of priming was found on penile erection. Unexpectedly, responses were lower in sexual than in neutral trials. In the second study support was found, using a behavioral measure (decision time), for the notion that the meaning of sexual stimuli can be perceived in a fast, automatic manner. Priming was most successful at lower levels of stimulus accessibility. The model and experimental approach presented in this article render starting points for new research on response discordance, gender differences in the processing of sexual stimuli, and inhibition of sexual response.     

Pornographic Picture Processing Interferes with Working Memory Performance

Some individuals report problems during and after Internet sex engagement, such as missing sleep and forgetting appointments, which are associated with negative life consequences. One mechanism potentially leading to these kinds of problems is that sexual arousal during Internet sex might interfere with working memory (WM) capacity, resulting in a neglect of relevant environmental information and therefore disadvantageous decision making. In this study, 28 healthy individuals performed 4 experimental manipulations of a pictorial 4-back WM task with neutral, negative, positive, or pornographic stimuli. Participants also rated 100 pornographic pictures with respect to sexual arousal and indicated masturbation urges previous to and following pornographic picture presentation. Results revealed worse WM performance in the pornographic picture condition of the 4-back task compared with the three remaining picture conditions. Furthermore, hierarchical regression analysis indicated an explanation of variance of the sensitivity in the pornographic picture condition by the subjective rating of the pornographic pictures as well as by a moderation effect of masturbation urges. Results contribute to the view that indicators of sexual arousal due to pornographic picture processing interfere with WM performance. Findings are discussed with respect to Internet sex addiction because WM interference by addiction-related cues is well known from substance dependencies.     

Heterosexual Anal Intercourse among Men in Long Beach,California

Anal intercourse poses a greater risk for human immunodeficiency virus (HIV) transmission than vaginal intercourse, and in recent years there has been a growing understanding that heterosexual anal intercourse (HAI) is not uncommon. However, the majority of the anal intercourse literature has focused on men who have sex with men. The little research on HAI has mostly looked at women, with limited work among men. This analysis examined the association between HAI and high-risk behaviors (N = 1,622) and sexual sensation seeking (N = 239) in a sample of men recruited from 2001 to 2012 in Long Beach, California. Almost half of the sample was non-Hispanic Black. The median age was 42 years, 42% were homeless, and 20% reported recent HAI. Men who reported HAI were likely to be Hispanic, were likely to be homeless, had a male partner, engaged in sex exchange, and used cocaine or amphetamines during sex. Men who reported HAI scored higher on the Sexual Sensation Seeking scale. This research supports other work showing the relationship between HAI and high-risk behaviors. More important, it contributes new knowledge by demonstrating the association between HAI and sexual sensation seeking. This research highlights the importance of personality traits when trying to understand sexual behavior and when developing HIV prevention interventions.     

How Ego Depletion Affects Sexual Self-Regulation: Is It More Than Resource Depletion?

Rational thinking and decision making are impacted when in a state of sexual arousal. The inability to self-regulate arousal can be linked to numerous problems, like sexual risk taking, infidelity, and sexual coercion. Studies have shown that most men are able to exert voluntary control over their sexual excitation with various levels of success. Both situational and dispositional factors can influence self-regulation achievement. The goal of this research was to investigate how ego depletion, a state of low self-control capacity, interacts with personality traits—propensities for sexual excitation and inhibition—and cognitive absorption, to cause sexual self-regulation failure. The sexual responses of 36 heterosexual males were assessed using penile plethysmography. They were asked to control their sexual arousal in two conditions, with and without ego depletion. Results suggest that ego depletion has opposite effects based on the trait sexual inhibition, as individuals moderately inhibited showed an increase in performance while highly inhibited ones showed a decrease. These results challenge the limited resource model of self-regulation and point to the importance of considering how people adapt to acute and high challenging conditions.     

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     

Orgasmic latency and subjective ratings of erotic stimuli in male and female subjects

There are few ways in which comparable measures of sexual arousal may be obtained from males and females. Because latency to orgasm is an objective measure that is equivalent for both sexes, it may be a useful dependent variable for the investigation of response patterns and differences in men and women. To explore this possibility 24 men and 18 women participated in experimental sessions during which they masturbated to orgasm while viewing sexually explicit films and then rated the film for its arousal value. Male orgasmic latency was not significantly different across rating categories, whereas female research participants showed a significant quadratic trend in which films perceived as being average in arousal quality resulted in the longest latencies. Possible reasons for this sex difference are discussed, and it is suggested that using latency to orgasm as the dependent variable may be a valuable technique in researching sex differences in response to psychosexual stimulation.     

Reconstructing the Sexuality of Men with Learning Disabilities: empirical evidence and theoretical interpretations of need

Research and practice in sexuality and learning disability has directly and indirectly highlighted the pathological sexual behaviour of men with learning disabilities, particularly their abuse and exploitation of women with learning disabilities, and relatively high HIV risk sexual behaviour with men without learning disabilities. It is consequently argued that there has been a relative neglect of their wider sexuality and sexual needs. This paper reconstructs this wider agenda, drawing on empirical evidence and theoretical interpretations of need from research and sex education in support of the observations made. In identifying a range of key issues for sexuality work with men with learning disabilities and arguing that they require greater recognition and attention, the paper also provides directional pointers for informing such work and for responding more widely.     

Recruitment Strategies of Indian Men Who Have Sex with Men in the State of Maharashtra Into an Online Survey

ABSTRACT

The authors reported lessons learned from their efforts to recruit Indian men and transgender women/hijras who have sex with men into an online cross sectional study. Between September 2013 and May 2014, we implemented a 7-phased recruitment strategy that included the use of online and offline strategies to enroll a total of 449 participants into an online survey about recent sexual behavior and various psychosocial measures. The phases were implemented sequentially and cost-per-eligible participant was calculated. Using social media and collaborating with organizers of community events proved the most effective strategies for recruiting Indian men who have sex with men into online research.     

The Sexual Health of Transgender Men: A Scoping Review

There is a general paucity of research concerning the sexual health of transgender individuals, and most existing research focuses on transgender women. A scoping review concerning the sexual health of transgender men was conducted to identify gaps in the literature and to highlight opportunities for future research and intervention. A comprehensive search of seven databases was conducted. The Joanna Briggs Institute Reviewers’ Manual was used as a framework. Some 7,485 articles were initially identified using a search strategy applied to seven online databases: 54 articles were identified as relevant to the research questions and reviewed in detail; of those, 33 were included in the final analysis. Studies were conceptualized into four broad themes: sexual behaviors, sexual identity, sexual pleasure and sexual function, and transactional sex. Besides an overall lack of research, existing studies were often characterized by small convenience samples that do not allow for generalization to the larger population of transgender men. Significant gaps in the literature regarding sexual coercion, sexual and intimate partner violence, and relationship quality and functioning among transgender men exist. There is a need to improve the scope and depth of research examining the sexual health of this population, especially concerning sexual risk behaviors and structural barriers to sexual health care access.