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Prostate cancer treatments disrupt receptive anal intercourse (RAI) for gay and bisexual men (GBM). Sexual dysfunction following prostate cancer treatment may include severe pain in the anorectum during RAI (i.e., anodyspareunia). The purpose of this study was to explore the impact of prostate cancer and its treatments on RAI among GBM. Data were from a cross-sectional online survey of 100 GBM prostate cancer survivors who reported pleasurable RAI prior to treatment. Approximately 47% of the sample reported recent RAI, which was more common among GBM in long-term relationships. RAI was also associated with engagement in other sexual behaviors (e.g., oral and insertive anal sex). Anodyspareunia was reported by 23% of the men who had attempted recent RAI. Anodyspareunia was negatively associated with mental health, performing oral sex on a partner, and bowel function. The overwhelming majority received no information from their healthcare providers about loss of RAI function prior to prostate cancer treatment. Culturally responsive cancer survivorship care may need to address the loss of RAI function for GBM prostate cancer survivors. [ABSTRACT FROM AUTHOR]

Male androphilia (i.e., male sexual attraction to adult males) is considered an evolutionary paradox because it is partially influenced by genes and associated with decreased reproduction. Traits associated with attachment to genetic relatives (i.e., kin) could prompt increased kin-directed altruism, thereby offsetting decreased reproduction by helping kin reproduce. These traits include childhood separation anxiety and adulthood neuroticism, which have been associated with feminine gender expression. In prior research, gay men with a receptive (Bottom or Versatile) anal sex role (ASR) reported greater childhood gender nonconformity (GNC) than those with an insertive (Top) ASR. We examined whether ASR groups also differed on recalled childhood separation anxiety and adulthood neuroticism. The Separation Anxiety Scale-Revised and Big-Five Personality Inventory - short form were completed by 350 gay and 146 heterosexual men. For neuroticism, ASR preference groups differed from heterosexual men but not from one another. Gay men who preferred a Bottom or Versatile ASR reported higher recalled childhood separation anxiety than Tops and heterosexual men. Recalled childhood GNC mediated ASR group differences with heterosexual men on childhood separation anxiety. These results indicate that subgroups of gay men delineated by ASR differ on an evolutionarily relevant developmental trait, childhood separation anxiety. [ABSTRACT FROM AUTHOR]

The International Index of Erectile Functioning (IIEF) has been widely used to measure gay men's erectile functioning. However, the IIEF was initially developed using a sample of men whose sexual orientation was unspecified. Using scales not validated for specific populations can result in inaccurate assessments. The purpose of the current study was to evaluate the dimensionality, reliability, and validity of the IIEF with a large sample of gay men. One thousand and eighteen men self-identifying as "exclusively gay" completed an online survey consisting of demographics, the IIEF, the Hospital Anxiety and Depression Scale (HADS), the Perceived Stress Scale 4 (PSS4), and the Gay Male Sexual Difficulties (GMSD) erectile difficulties sub-scale. The replicability of the IIEF factor structure with a gay male sample was determined using exploratory and confirmatory factor analyses. Additionally, the HADS, PSS4, and GMSD were used to determine the validity of the IIEF. The current study was unable to replicate the IIEF factor structure. Four items required deletion and the factor solution differed from the original. Thus, reinterpretation of the latent variables was deemed necessary. Although the resultant 12-item IIEF evidenced model fit, validity, and reliability, it is not recommended for use with gay men. The revised IIEF is unable to accurately measure gay men's erectile functioning as the content of the items fail to capture their sexual behaviors (i.e., insertive and receptive anal sex). [ABSTRACT FROM AUTHOR]

Gay men are underrepresented in research on sexual satisfaction. We examined sexual satisfaction and over 50 sexual practices in an online U.S. national survey of men in relationships. Coarsened exact matching created comparable samples of heterosexual (n = 3527) and gay (n = 452) men on six demographic factors, including relationship length. Results identified many similarities between the groups, including sexual frequency, orgasm frequency, duration of sex, and sexual satisfaction. The majority of heterosexual and gay men expressed physical or emotional affection during their last sexual encounter, reporting that they or their partner said "I love you" (66%; 57%) and engaged in deep kissing (69%; 75%) or gentle kissing (82%; 72%). Heterosexual men were less likely than gay men to usually-always receive (27%; 61%) or give (37%; 68%) oral sex when intimate in the past month; were less likely to view pornography with their partner (35%; 61%); but were more likely to give their partner massages in the past year to improve their sex lives (71%; 58%). Number of sexual communication behaviors was a strong predictor of sexual satisfaction, particularly for gay men (β =.36). These findings enhance our understanding of heterosexual and gay men's sexual lives. [ABSTRACT FROM AUTHOR]

Age of sexual debut is a critical health indicator for young sexual minority men (YSMM), associated with an increased likelihood of HIV acquisition, use of alcohol, tobacco, and other substances, and psychological distress. This study examined the age of same-sex sexual debut for five sexual behaviors in a sample of racially/ethnically and socioeconomically diverse gay-identified YSMM in New York City. The mean age of sexual debut of any behavior was 14.5 years old and 19% of the sample reported sexual debut prior to age 13. Overall, mutual masturbation occurred at the youngest mean age, followed by performed oral, received oral, receptive anal, and insertive anal intercourse. There were significant differences by race/ethnicity and perceived familial socioeconomic status (SES), such that Black and Hispanic/Latino men had earlier ages of debut for performed oral and receptive and insertive anal sex, while upper SES men had later ages of debut for receptive and insertive anal intercourse. These findings are relevant to trends in HIV incidence in the U.S., which are highest among Black and Hispanic/Latino YSMM and may be associated with earlier age of sexual debut. These findings also underscore a need for comprehensive and inclusive sex education at younger ages. [ABSTRACT FROM AUTHOR]

Androphilia refers to sexual attraction toward adult males. Androphilic males' female genetic relatives might offset the fitness cost of androphilia by having elevated numbers of offspring. Increased attractiveness relative to other women may enable these females to marry up the social hierarchy, providing greater access to resources to support more offspring. In Thailand, there is a marked status hierarchy and male androphiles are highly visible – identifying as gay men or as a third gender known as sao praphet song. Thus, a field experiment was conducted in which 208 heterosexual men rated the facial attractiveness of 25 sisters of Thai gay men or sao praphet song and 25 comparison women with no known same-sex attracted relatives. Contrary to the prediction, the comparison group was rated as more attractive than the sisters, casting doubt on hypotheses that posit greater attractiveness of female relatives of male androphiles as a proximate mechanism facilitating the evolutionary maintenance of genes influencing male androphilia. Also, men from rural areas rated the women, regardless of group, as more attractive than men from urban areas, consistent with some prior studies showing rural-urban differences in perceptions of attractiveness. [ABSTRACT FROM AUTHOR]

This study utilizes interview data and a communication accommodation framework to explore how early midlife gay men negotiate HIV infection risk vis-à-vis a younger gay male sexual culture that has evolved in terms of its regard for dangers associated with HIV infection. Analysis of face-to-face interviews with 33 gay men (aged 40–53) in four U.S. cities revealed a model of gay intergenerational sexual (non)accommodation. The model includes forms of communicative convergence and nonaccommodating behavior that serve some men's achievement or continuation of sexual vitality and/or positive generational distinctiveness. Similarities and extensions to communication accommodation theory are discussed, as are the model's implications for understanding some gay men's management of sexual health at midlife. [ABSTRACT FROM AUTHOR]

This paper compares data on gay men and lesbians' sexual life courses in Italy from repeated cross-sectional surveys in 1995–1996 and 2012–2013. Gay men and lesbians increasingly experience sexual developmental milestones at similar ages and rates across the gender divide. They decreasingly experience their first coming out and first same-sex sexual contact in conventionally gendered situations. The number of lesbians' sexual partners rises towards that of gay men's. Sexual exclusivity spreads in gay and lesbian couples and the places were gay men and lesbians meet sexual partners consistently differ, but gendered trends point to common underlying norms. Growing similarities in gay and lesbian sexual experience across the gender divide suggest that, in line with on-going transformations in the meanings of sexuality in contemporary Italy, norms centred on relational preoccupations and sexual pleasure spread at the expense of the once hegemonic procreational and naturalised perspective on sexuality. [ABSTRACT FROM AUTHOR]

Researchers have theorized about the role of sexual shame as a mechanism through which sexual minority stress manifests into mental health difficulties, such as sexual compulsivity for gay and bisexual men (GBM), and about the resilience-promoting effects of sexual pride. However, no validated measures to date have directly tapped into these constructs rather than using proxies for them, such as internalized homonegativity. We developed the Sexual Shame and Pride Scale (SSPS) and conducted a psychometric evaluation of it using a sample of 260 highly sexually active GBM. The scale had the expected structure in factor analysis and showed evidence of internal consistency and test–retest reliability. Correlational analyses demonstrated the convergent validity of sexual shame and sexual pride with relevant constructs. Regression analyses demonstrated the predictive validity of sexual shame in relation to sexual compulsivity, accounting for unique variability even after adjusting for previously demonstrated etiological factors, and the predictive validity of both shame and pride, which interacted to consistently predict four sexual behavior outcomes. Findings suggest the SSPS is a psychometrically valid and reliable measure that may be useful in future empirical work and highlight preliminary evidence for the role of these constructs in the sexual health of GBM. [ABSTRACT FROM AUTHOR]

Background: The needs of gay men after prostate cancer treatment are becoming visible. This patient group reports a more negative impact of treatment than heterosexual men. Yet, gay men's experiences of post-treatment sexual changes are still little explored. This study aims to determine specific concerns of gay men's post-treatment sexual practices. Methods: A qualitative study design was deployed using semi-structured interviews as data. Participants were purposefully sampled through advertisements and the snowball method. Eleven self-identifying gay men aged 58–81 years and treated for prostate cancer participated in interviews during 2016–2017. The interviews were transcribed, coded and thematically analysed. Results: The analysis highlights sexual changes in relation to the physical body, identity and relations. Problematic physical changes included loss of ejaculate and erectile dysfunction. Some respondents reported continued pleasure from anal stimulation and were uncertain about the role of the prostate. These physical changes prompted reflections on age and (dis)ability. Relationship status also impacted perception of physical changes, with temporary sexual contacts demanding more of the men in terms of erection and ejaculations. Conclusions: Gay prostate cancer survivors' narratives about sexual changes circle around similar bodily changes as heterosexual men's, such as erectile problems and weaker orgasms. The loss of ejaculate was experienced as more debilitating for gay men. Men who had anal sex were concerned about penetration difficulties as well as sensations of anal stimulation. Additional studies are required to better understand the role of the prostate among a diversity of men, regardless of sexuality. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Rather than individual preferences, examination of sexual fields demonstrates that what is considered desirable by a majority of gay men follows a predictable pattern and is embedded with larger social meaning that defines which characteristics have erotic worth and which do not. While there are many diverse sexual fields, with many different potentially desirable characteristics, we argue that race is a consistent gauge of desirability that spans across diverse sexual fields within the gay community leading to widespread incidences of “sexual racism.” While the idea of sexual racism has been widely discussed in the popular press, and academic studies have also documented the racial hierarchy in the gay community, there have been fewer attempts to systematically explore how such racialized hierarchies of desire are understood by gay men of color. In this article, we attempt to address sexual racism as it is experienced by gay men of color and examine the consequences that sexual racism has on members of these groups. At the same time, we show that gay men of color of color are not simply “victims” of sexual racism but actively confront racial hierarchies of desire. [ABSTRACT FROM AUTHOR]

Age is the predominant risk factor for developing prostate cancer, leading to its description as an “older man’s disease.” Changed sexual embodiment is a concern for men who develop prostate cancer, often compounding experiences of age-related sexual decline. Although research has examined heterosexual men’s experiences of aging in the context of sexual embodiment after prostate cancer, gay and bisexual men have received little attention. This qualitative study used a material-discursive analysis, drawing on positioning theory and intersectionality, to explore constructions of aging following prostate cancer in 46 gay or bisexual men. Thematic decomposition of one-to-one interviews identified three subject positions: “mastering youth,” involving maintaining an active sex life through biomedical interventions, accessing commercial sex venues, or having sex with younger men; “the lonely old recluse,” involving self-positioning as prematurely aged and withdrawal from a gay sexual scene; and “accepting embodied aging,” involving the incorporation of changed sexual function into intimate relationships and finding pleasure through nonsexual activities. These subject positions are conceptualized as the product of intersecting masculine and gay identities, interpreted in relation to broader cultural discourses of “new aging” and “sexual health,” in which sexual activity is conceptualized as a lifelong goal. [ABSTRACT FROM PUBLISHER]

Gay and bisexual men are at disproportionate risk for human immunodeficiency virus (HIV) infection. While prevention efforts often emphasize consistent condom use, there is growing evidence that men are using seroadaptive safer-sex strategies, such as serosorting and seropositioning. This qualitative analysis of 204 HIV-negative and HIV-positive gay and bisexual men explored the ways that a sexual partner’s HIV status can influence safer-sex strategies and sexual decisions. The majority of the respondents reported that they were influenced by their partners’ HIV status. Those respondents who reported no influence discussed adhering to safer-sex rules that were not dependent on partner status and a lack of concern about HIV. Conversely, respondents who reported influence identified three primary areas of influence: psychological impacts, partner preference and selection, and specific behavioral intentions and strategies. A conceptual model explicating a potential process by which respondents use partner serostatus information in shaping sexual decisions is presented. [ABSTRACT FROM PUBLISHER]

In predominantly isiXhosa-speaking township communities in South Africa, men who have sex with men negotiate their identities and sexual practices alongside heteronormative cultural scripts of what it means to be a man. Such idealised notions of masculinity are predicated on the selective appropriation of cultural practices that preserve (heterosexual) male privilege and power. In this paper, we explore the identity work done by men who have sex with men, with particular reference to male circumcision as a cultural practice widely drawn on to inform and regulate normative masculinity. Through a narrative-discursive analysis of the accounts provided by men who have sex with men from township communities, we highlight how participants’ dissident sexualities are constructed as compromising their masculine identities. Participating in cultural practices such as traditional circumcision aligns participants to the idealised forms of masculinity that afford men full citizenship in their communities. Study findings suggest that sexual dissidence is less troubling to participants than deviating from gendered markers of hegemonic masculinity, and point to ways in which marginalised men might have an interest in maintaining the dominant gendered order. We conclude with implications for research and programmatic work with gay, bisexual and other men who have sex with men. [ABSTRACT FROM PUBLISHER]

In this study, we examined the lived experiences of an understudied subgroup, Portuguese American gay men, within the context of sexual script theory. We employed a phenomenological study design with eight men to provide a more in-depth analysis of their sociocultural sexual behaviours. Recruitment was conducted through word of mouth and a snowball approach beginning with two well-known HIV education and prevention outreach centres in southeastern Massachusetts. In this study, the sexual scripts of the participants were conceptualised within the three domains of cultural, interpersonal and intrapsychic scripts. Our findings suggest the three scripts are constantly interacting and informing one another. This ongoing negotiation influences the way our participants position their sexuality within the broader context of their everyday life within the US Portuguese community. Participants script their sexuality while they navigate multiple but separate entities within their culture, their religion and their families. Learning from these experiences could have important implications for the development of HIV prevention programmes for specific subgroups of men who have sex with men. [ABSTRACT FROM PUBLISHER]

Studies with heterosexual samples have supported the role of cognitions on sexual functioning in men and women. However, there is no research on the impact of automatic thoughts on sexual functioning in sexual-minority samples. Therefore, the current study aimed to analyze the differences in automatic thoughts during sexual activity between gay and heterosexual men, and lesbian and heterosexual women, with and without distressing sexual symptoms, in order to establish similarities and differences between samples. A web survey was completed by 156 men and 168 women. A group of men and women with distressing sexual symptoms (78 men and 84 women) and a group without distressing sexual symptoms (78 men and 84 women) equally distributed in terms of sexual orientation and matched for sociodemographic variables were constituted. Participants answered a sociodemographic questionnaire, a questionnaire about sexual symptoms, and an automatic thoughts measure. Main findings suggested that men and women with distressing sexual symptoms reported significantly more negative automatic thoughts and fewer erotic thoughts during sexual activity, regardless of sexual orientation. Overall, current findings were consistent with previous research with heterosexual samples, suggesting a similar pattern in heterosexual samples, and gay men and lesbian women samples. [ABSTRACT FROM PUBLISHER]

Men who have sex with men (MSM) frequently consume sexually explicit online media (SEOM), yet little is known about its influence on their sexual behaviors. We describe a sequence of four studies to develop and psychometrically validate a measure of the perceived influence of sexually explicit online media (PI-SEOM) on the sexual behaviors of MSM. Study 1 involved qualitative interviews (N = 28) and a quantitative survey (N = 100) to develop a preliminary measure. Using an Internet sample of MSM (N = 1,170), we assessed its factor structure and reliability in Studies 2 and 3 as well as convergent validity and associations with HIV-related sexual risk in Study 4. Based on findings the measure was divided into two subscales: influences on (1) self and (2) other MSM. Factor analyses confirmed a two-factor model for each subscale, measuring perceived influences on (a) general sexual scripts and (b) condomless sex scripts. Survey results indicated that the more men perceived SEOM influencing their own condomless sex scripts, the more likely they were to report engaging in sexual risk behaviors. The developed measure holds promise for assessing the influence of SEOM on the sexual behaviors of MSM and may prove useful for HIV-prevention research. [ABSTRACT FROM PUBLISHER]

Young men who have sex with men are becoming the most at-risk subgroup for HIV incidence in Hong Kong. To understand how young gay men in Hong Kong interpret and implement safer sex and condom use, focus-group discussions and individual in-depth interviews were held. The 74 participants were nearly all ethnic Chinese gay men aged between 18 and 25 years. Findings indicate that the challenge for health intervention lies in young gay men’s inconsistent condom use despite their high level of HIV-related knowledge. Participants described using condoms, testing for HIV and abstaining from anal sex as measures undertaken to prevent HIV infection. However, sociocultural norms and expectations pertaining to ‘0’ (docile, bottom) and ‘1’ (assertive, top) roles and trust between partners complicate the consistent implementation of risk-reduction measures. Influenced by heteronormative and romantic beliefs, sexual behaviours such as condomless anal sex and internal ejaculation hold symbolic meanings – exclusivity, commitment, intimacy, possession – for young gay men in Hong Kong, which override health concerns. These findings support more empowerment-driven HIV programming for young gay men. [ABSTRACT FROM PUBLISHER]

This article argues that Michael Lucas’Men of Israelwas made in response to the rising popularity of Arab themes, performers and locations in recent gay male pornography, particularly American studio-based productions. The article explores how recent representations of Arab society, culture and men in gay male pornography employ varying degrees of performativity and authenticity in an attempt to break down differences, and bridge connections, between East and West, while Lucas and his film attempt to maintain that rigid imaginary border. I argue that the texts are a microcosm of the contentious and ongoing debates about homosexuality in the East and West and crystallise how gay identities are used as currency to push various cultural political agendas generally and through pornography subculturally. [ABSTRACT FROM AUTHOR]

Few studies have examined male clients who pay for sex with male escorts. In 2012, clients (n = 495) completed an online survey about their most recent hire. Most clients were White/Caucasian (87.7%), HIV negative (89.5%), employed full time (71.1%), single (58.6%), with a mean age of 54. Three-quarters of clients were gay identified, 18% bisexual, and 4% heterosexual. The median rate paid to escorts was $250 per hour with a modal appointment time of 1 to 2 hours (41.6%). Oral sex was common (80% gave, 69% received), 30% reported anal insertive sex, and 34% reported anal receptive sex. In total, few (12%) reported unprotected anal sex. Satisfaction with encounters was high. Receptive unprotected anal intercourse was associated with greater satisfaction in bivariate analyses but not in multivariable analyses. In a multivariable model, having receptive anal sex (whether protected or not) and rating the financial cost of the encounter as “worth it” were significantly associated with greater satisfaction. This study contributes to a scarce literature regarding clients of male sex workers and, in particular, provides information on the characteristics of men hiring men for sexual services, behavioral event-level data about their encounters, and analysis of factors directly associated with client satisfaction. [ABSTRACT FROM PUBLISHER]

This article offers ethnographic and autoethnographic vignettes from my research on cultures of public sex in Austin, Texas. It also tracks some of the ways my own racialization as a black queer man shaped the research project. My approach, which includes an experimental – ‘reparative’ – textual style, offers several interlocking registers of analysis. I bring together my informants' nostalgic remembrances of public sex in Austin; the legal and media circulation of queer sex in general, and public sex in particular, as specifically ‘public’ problems requiring surveillance, administration, and management; the impacts of HIV/AIDS; and the rise of the Internet as a means to connect. In this way, I not only aim to archive sites of desire and their transformation, but to also archive the everyday and intimate affects that animate, make sense of, and give meaning to queerspaces and sexpublics in Austin as elsewhere. In its eclectic mixes of voices and styles, as well as reality and fiction, my ethnography does not simply describe material geographies (men have sex in parks and hook up online) or linear timelines (first there was public sex and then there was AIDS), rather, gesturing as it does toward a psychic geography of intensities, remembrances, and longings, it tries to conjure an expansive affective archive into brief life. [ABSTRACT FROM PUBLISHER]

Research has shown that gay male couples’ sexual agreements may affect their risk for HIV. Few U.S. studies have collected dyadic data nationally from gay male couples to assess what sexual behaviors they allow to occur by agreement type and the sequence of when certain behaviors occur within their relationships. In our cross-sectional study, dyadic data from a convenience sample of 361 male couples were collected electronically throughout the United States by using paid Facebook ads. Findings revealed that couples discussed their HIV status before having unprotected anal intercourse (UAI) but established their agreement some time after having UAI. About half of the couples (N = 207) concurred about having an agreement. Among these couples, 58% concurred about explicitly discussing their agreement, 84% concurred about having the same type of agreement, and 54% had both men adhering to it. A variety of sexual behaviors were endorsed and varied by agreement type. Concordance about aspects of couples’ agreements varied, suggesting the need to engage couples to be more explicit and detailed when establishing and communicating about their agreements. The allowed behaviors and primary reasons for establishing and breaking sexual agreements further highlight the need to bolster HIV prevention for gay male couples. [ABSTRACT FROM PUBLISHER]

Many studies have examined the relations between drug use and sexual behaviors; however, few have utilized episodic data to examine the co-occurrence of both behaviors within the same episode. This study surveyed 403 racially and ethnically diverse gay, bisexual, and other young men who have sex with men (YMSM; ages 18–29) in New York City. Men were surveyed about their sexual behavior and concurrent use of illicit substances and alcohol during their most recent sexual encounter with their main and/or casual partner(s). Logistic regression models were built to analyze predictors of unprotected oral and anal intercourse with main and casual partners. Results suggest that use of inhalant nitrates and alcohol increased the odds of men engaging in unprotected receptive anal intercourse (URAI) and men who identified as middle or high socioeconomic status (SES) were at lower odds of engaging in URAI with their main partner. Use of other illicit substances was not associated with unprotected sexual intercourse. These findings indicate a need to further consider the role of licit substances used by YMSM as a means of further reducing the incidence of HIV infection in this population. In addition, the high rates of unprotected anal intercourse among men reporting a main partner has the potential to be a significant source of HIV risk, and should be further explored among YMSM. [ABSTRACT FROM PUBLISHER]

This study investigated the associations between sexual dysfunction and unprotected anal intercourse among adult Chinese men who have sex with men; 519 participants who had had anal sex (past 12 months) were recruited from gay venues (Hong Kong and Shenzhen) and from the Internet (Hong Kong). Respectively, 48.9% and 59.6% (p< .05) of the Hong Kong and Shenzhen participants had had at least one type of sexual dysfunction for 3 consecutive months (past 12 months); the difference may be explained by differential income levels or other factors. After adjustment for significant background variables, three variables related to sexual dysfunction (premature ejaculation, erectile dysfunction, and experienced at least one sexual dysfunction) were significantly associated with unprotected anal intercourse in the Hong Kong (adjusted odds ratio = 1.65–2.80) and Shenzhen samples (adjusted odds ratio = 5.46–6.41). Anxiety about sex was significant only in the Shenzhen sample (adjusted odds ratio = 8.67). The associations may be results of coping toward sexual dysfunction. Sexual dysfunction is prevalent and may contribute to unprotected anal intercourse among men who have sex with men in China. Physiological damages of receptive anal sex may contribute to some types of sexual dysfunction. However, one limitation is that participants were not asked about insertion/receptive anal sex. HIV interventions targeting men who have sex with men in China need to take counseling related to sexual dysfunction into account. [ABSTRACT FROM PUBLISHER]

Background: Men who have sex with men (MSM) in Vietnam are receiving increased attention in recognition of their high-risk behaviours and potential for human immunodeficiency virus (HIV) infection and transmission. Due to societal pressures, many MSM in Vietnam are also bisexually active, which ultimately increases the transmission risks beyond the MSM population. Evidence is emerging that indicates a greater proportion of women in Asia with low-risk sexual activities are contracting HIV from their male partners who have become HIV infected through male-male sex. Methodology: Fourteen focus group discussions exploring sexual and social networks were conducted in Hanoi between July 2010 and September 2010. A total of 96 individuals participated in these sessions. Findings: A risk environment approach was used to analyse the focus group themes of social stigma and marriage, sex with other men in closed settings and transactional sex in Hanoi, an increasingly urbanising and westernising city. Implications: Despite limited evidence globally that bisexual men act as a bridge for sexually transmitted diseases, there is particular concern in Vietnam about this potential risk. HIV rates amongst MSM are rapidly rising and there are reports of women contracting HIV from their male partners who are bisexually active. [ABSTRACT FROM AUTHOR]

The Food and Drug Administration may license OraQuick™, a rapid HIV test, for over-the-counter (OTC) sale. This study investigated whether HIV-uninfected, non-monogamous, gay and bisexual men who never or rarely use condoms would use the test with partners as a harm-reduction approach. Sixty participants responded to two computer-assisted self-interviews, underwent an in-depth interview, and chose whether to test themselves with OraQuick. Over 80% of the men said they would use the kit to test sexual partners or themselves if it became available OTC. Most participants understood that antibody tests have a window period in which the virus is undetectable, yet saw advantages to using the test to screen partners; 74% tested themselves in our offices. Participants offered several possible strategies to introduce the home-test idea to partners, frequently endorsed mutual testing, and highlighted that home testing could stimulate greater honesty in serostatus disclosure. Participants drew distinctions between testing regular versus occasional partners. Non-monogamous men who have sex with men, who never or rarely use condoms, may nevertheless seek to avoid HIV. Technologies that do not interfere with sexual pleasure are likely to be used when available. Studies are needed to evaluate the advantages and disadvantages of using OTC rapid HIV tests as one additional harm-reduction tool. [ABSTRACT FROM AUTHOR]

Recent research studies suggest increasingly widespread use of Internet sexual networking sites to initiate sexual relationships among men who have sex with men. Concerns are growing in regard to use of such sites in promoting participation in higher-risk sexual activities by providing easier access to partners who are willing to participate. One such activity surrounds substance abuse including using crystal methamphetamine and is commonly termed “party and play” (PNP) during sexual encounters, particularly unprotected anal sex. Current studies indicate conflicting results on PNP and the meeting of sexual partners from the Internet. A critical examination of these studies is presented along with recommendations designed to support future scholarly inquiry. [ABSTRACT FROM PUBLISHER]

Understanding the dynamics of sexual risks for HIV among men who have sex with men has been one of the ongoing challenges of HIV prevention. While the majority of HIV-prevention interventions target individual behaviour and decision making, multiple studies point to the importance of social context in shaping risk behaviour. Analysis of qualitative data from a study of men who have sex with men, drug use and sex found that sexual encounters were made up multiple contextual and interpersonal elements, which interacted to shape sexual practices and risk reduction strategies. Semi-structured interviews were conducted with 60 racially diverse men who have sex with men in NYC, recruited from multiple venues. The majority of respondents were gay-identified and half were 40 or older. Respondents described risk assessment and risk-reduction processes that develop throughout a sexual encounter, embedded in ongoing negotiations of sexual practices. Strategies of risk assessment and reduction draw on probability-based approaches to HIV prevention, presenting a challenge to health education. [ABSTRACT FROM AUTHOR]

This paper examines discourse on serodiscordant relationships in interviews with 16 HIV-positive and 3 HIV-negative gay men living in Scotland. Drawing on critiques concerning love, reason and HIV serostatus normativity, this paper supplies a much-needed insight into how gay men in serodiscordant relationships negotiate HIV prevention. Among other matters, some HIV-negative men were said to knowingly request risky sex with their HIV-positive partners as an expression of love. In some situations, the person without HIV claimed a normative serostatus that implied they could 'invest' more in the relationship by offering to have sexual intercourse that may expose them to HIV. Such dynamics expressed devotion on the part of the HIV-negative man, but implied obligation for the HIV-positive man. Based on these and other perspectives we argue for closer attention to gay men's subjectivity in the present circumstances of proliferating biomedical forms of HIV prevention; more thoroughly reflexive public health engagements with gay men's sexual cultures; and a research agenda for gay men that challenges HIV-serostatus normativity. [ABSTRACT FROM AUTHOR]

In the present study, using a nationwide online survey, we investigate preferences for a commitment ceremony and long-term partners among 114 single, young (ages 18 to 29 years old) gay men. We take into account market characteristics (age, location, education level) and self-perceptions of participants' bodies. We found notable diversity in participants' aspirations for a commitment ceremony and preferences for long-term partners. Men who were more preoccupied with their own appearance (i.e., higher rates of self-objectification and wanting to be muscular) were more likely to want to have a commitment ceremony. Furthermore, respondents who lived in large metropolitan cities were more likely than respondents in small cities to value attractiveness in a potential partner. We draw on objectification and market theories, situate our findings in contemporary cultural landscape, raise questions, and offer future directions for research. [ABSTRACT FROM AUTHOR]

Recently, there has been an increase in research dedicated to the topic of drug/alcohol use and unsafe sex among gay men. Findings of this work suggest that drug/alcohol use is particularly common within gay circuit parties (GCPs). More recently, this work has begun to suggest that further exploration is needed to understand the desires of gay men who use drugs and alcohol and who engage in unsafe sex. Based on the foregoing, an ethnographic study was undertaken with the goal of better understanding the role of desire in the sequence of drugs/alcohol and unsafe sex. This research was guided theoretically by Deleuze and Guattari's work on desire. Using this theoretical orientation, the results revealed that some GCP-goers intentionally use drugs/alcohol to form connections. [ABSTRACT FROM AUTHOR]

Responsibility for the practise of (un)safe sex, for taking or not taking risks in relation to HIV transmission and for the negotiation of (safe) sex have been concerns in HIV-prevention research for a long time. This paper presents the findings of a discourse analysis of interview texts collected as part of the Three or More Study. We examine what, in the discourse examined, constrains and enables 'response-ability' - the capacity to respond to others and one's self in light of the complex contingencies that operate to enliven sexual contexts. We identify three key aspects of these sexual contexts that impact on response-ability: that there is an absence of 'explicit' (verbally communicated) negotiation and the presence of action-perception links, which are understood as forms of negotiation; that some sexual contexts appear to involve the passivity of participants to the sexual event, interaction or to other men, but that there is agency in and as part of this passivity; and that there exists a social obligation to being individually responsible for sexual decision making, including the taking of risks. [ABSTRACT FROM AUTHOR]

Previous research found up to 14% of men who go to bathhouses engage in unprotected anal intercourse (UAI) and tend to have multiple sexual partners during their bathhouse visit, thus appearing to support concerns that such venues could foster acute outbreaks of new HIV infections. We conducted a two-stage probability sample of men exiting a gay bathhouse, and focused our analysis on whether the partnering patterns of the men who engaged in UAI present such a risk. Among patrons who had oral or anal sex during their visit (n = 758), 16.7% were HIV+, and 13.9% engaged in UAI. Although men had multiple sex partners during a visit, they had UAI with only one of those partners, on average, and withdrawal prior to ejaculation occurred in the vast majority of UAI incidences. Thus, the risk of sexual transmission of HIV during the bathhouse visit was typically within isolated dyads rather than patterns of multiple sexual encounters that might put many men at risk during a single visit, and men who did engage in UAI tended to withdraw prior to ejaculation, potentially mitigating the risk of HIV transmission. [ABSTRACT FROM AUTHOR]

The explosive growth in Internet use by men who have sex with men (MSM) to find sexual partners has been noted in the research literature. However, little attention has been given to the impact of participating in this online sexual marketplace for MSM of color, despite race and ethnicity as frequently used selection criterion in personal ads or profiles. Six focus group discussions (n = 50) and 35 in-depth qualitative interviews were conducted with African American, Latino, or Asian and Pacific Islander MSM in Los Angeles, which included discussion of their use of Internet sites to meet or interact with other MSM. Men reported race and ethnicity as a pervasive and powerful factor in facilitating or derailing Internet-mediated sexual encounters. The racialized interactions that MSM of color reported ranged from simple expressions of race-based preferences, to blatantly discriminatory or hostile interactions, and often demeaning race-based sexual objectification. Experiences of rejection and a perceived hierarchy of value in the sexual market based on race had definite costs for these MSM using these online sites. Furthermore, the private and solitary nature of seeking partners online meant that there was little to buffer the corrosive aspects of those negative experiences. These online dynamics have implications for the power balance in Internet-mediated sexual liaisons, including sexual decision making and sexual risk. [ABSTRACT FROM AUTHOR]

Experimental research on sexual decision making is limited, despite the public health importance of such work. We describe formative work conducted in advance of an experimental study designed to evaluate the effects of alcohol intoxication and sexual arousal on risky sexual decision making among men who have sex with men. In Study 1, we describe the procedures for selecting and validating erotic film clips (to be used for the experimental manipulation of arousal). In Study 2, we describe the tailoring of two interactive role-play videos to be used to measure risk perception and communication skills in an analog risky sex situation. Together, these studies illustrate a method for creating experimental stimuli to investigate sexual decision making in a laboratory setting. Research using this approach will support experimental research that affords a stronger basis for drawing causal inferences regarding sexual decision making. [ABSTRACT FROM AUTHOR]

Men who have sex with men remain largely absent from the health statistics of many Eastern European countries. This relative dearth compared to other parts of the world may be attributed to the generally hidden nature of this population. The tendency to employ Western sexual identity labels, rather than locally meaningful categories of identity, may also make it difficult to identify men who have sex with other men. In a pilot study of HIV risk in Tbilisi (Georgia), we used a suite of qualitative techniques - focus groups, individual semi-structured interviews and pile-sort exercises - to probe the opinions, knowledge and experiences of 65 Georgian men. We identified locally meaningful men-who-have-sex-with-men types, demonstrating a complex intersectionality of sexual preference, socio-economic status, behaviour and geography. Positioning within these types appeared to impact a man's exposure to the social stigma of homosexuality; the sexual, physical and mental health risks that he faced; and his access to treatment and counselling. Our results suggest the use of imported identity categories limits researchers' ability to identify men who have sex with other men in Georgia and that further research aimed at elucidating locally meaningful categories is needed - research likely to lead to more-effective group interventions and facilitate a better understanding of holistic individual health needs. [ABSTRACT FROM AUTHOR]

This study assessed the ability of a modified respondent-driven sampling (RDS) method to recruit racial and ethnic minority men who have sex with men (MSM) at risk for HIV and other sexually transmitted infections (STIs). We used a modified RDS technique, a relatively new method of chain-referral sampling, to recruit 50 MSM in Greater Boston for a behavioral survey and interview. Traditional recruitment methods used by Fenway Community Health, a community-based health care and research facility, yield samples comprised of 15% to 30% racial/ethnic minority MSM. The present study recruited a sample of 60% racial/ethnic minority MSM, a significant difference from these earlier studies (all p values < .0001). Forty-five percent of the sample reported an annual income of less than $12,000, and 17% did not always have a regular place to live in the past year. Sixty-six percent of respondents were HIV infected; 43% reported a prior STI diagnosis. This study provides evidence that a modified RDS strategy can effectively engage at-risk racial/ethnic minority MSM, which has important implications for the enrollment of these populations in HIV prevention interventions and other social services. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) account for the largest number of persons diagnosed with AIDS in the United States, with higher-than-average rates of drug use and unprotected sex being cited as the principal reasons underlying their high rates of HIV infection. Recent evidence has suggested that the use of Web sites specifically designed to promote unsafe sexual practices may be particularly common among MSM, thereby fostering their risky behaviors. In light of these findings, the present study, which compares HIV risk behaviors sought by men whose profiles are among the most frequently brought up in searches to those whose profiles are not as popular with other site users, is based on a content analysis of 1,316 ads/profiles posted on one of the most popular MSM Web sites that specifically fosters unprotected sex. Ads/profiles were selected randomly based on the American ZIP code of residence. Data were collected between September 2006 and January 2007. Rates of advertised-for high-risk sexual behaviors were very high both for men whose profiles were among the most popular and those whose profiles were not, particularly for oral sex involving ejaculation into the mouth, anal sex involving ejaculation into the anus, multiple partner sex, and felching. Analytical comparisons of these groups showed that the most searched for profiles were those promoting the highest levels of risky behaviors and the greatest propensity toward wanting to engage in high-risk activities. The HIV intervention-related implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Over the past few years, researchers have begun to explore the use of the personals section on Craigslist.org as it applies to the sexual behaviors and partner accrual of men who have sex with men (MSM). Yet, the exact ramifications of such a free sexual advertisement service on MSM's sexual health and sexual risk-taking behaviors are just being documented. As such, we surveyed 535 men by responding to their sexual ads placed on Craigslist.org to assess their sexual health and sexual health behaviors. Using Self-Efficacy Theory as our foundation, we posited that MSM who placed more ads and reported more success from these ads would also report more negative health behaviors (e.g., lowered condom use) and sexually transmitted diseases. Testing confirmed this hypothesis. This study has two important implications. (1) The behavior of Internet cruising, on its own, insufficiently impacted MSM health. It was the interaction of number of ads (self-efficacy) and the success of those ads (outcome-efficacy) that ultimately contributed to negative health behaviors. (2) MSM may have had different intentions for cruising. The anti-theoretical tendency for some men to continually place high numbers of ads while also reporting very low success suggested that the outcome of merely placing the ads might be sufficiently erotic for some men. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) have a high risk for acquiring some sexually transmitted infections, including HIV and viral hepatitis A and B. Little is known about how to design effective sexual health educational materials to reach MSM. As part of a project to develop online educational materials to increase MSM's readiness to get hepatitis A and B vaccinations, three health promotion campaigns were evaluated-using quantitative and qualitative methods-by 41 MSM. Preferences about content, layout, visuals, dissemination sites, motivational messages, and memorable materials were collected and then descriptively and content analyzed. This information is useful for social service professionals to reach their clients who are at risk. Also, understanding how to motivate vaccination among MSM will pave the way as HPV and HIV vaccinations become available. [ABSTRACT FROM AUTHOR]

Extradyadic sex is a significant source of risk for sexually transmitted infections (STIs) among men in same-sex relationships. Nonmonogamous sexual agreements are common among male same-sex couples and may serve as effective targets for risk reduction interventions; however, there is a dearth of research reporting on the social and cultural determinants of explicit nonmonogamous agreements. In this study, it was hypothesized that attitudes toward dominant cultural standards of masculinity (i.e., normative masculinity) would be associated with the types of sexual agreements negotiated among gay male couples. An Internet-based survey was used to collect data from 931 men for this analysis. Results indicated that men who reported high endorsement of normative masculinity were more likely to be in nonmonogamous relationships. Furthermore, high endorsement of normative masculinity was predictive of relationship agreements characterized as the most sexually permissive. These findings indicate that rather than simply predicting nonmonogamy in gay male couples, attitudes toward masculinity may be indirectly related to increased risk of STIs by influencing the types of sexual agreements negotiated. This is the first empirical study to emphasize the role of masculinity as an explanatory factor of same-sex relationship agreements. [ABSTRACT FROM AUTHOR]

In my response to commentaries by Hartman and Sedgwick, I examine the positions from which each chose to speak. Hartman's rather light approach performs a particular function: the mentalization of anal erotic and homoerotic desire through the introduction of surplus meaning. I explore the relationship of this approach to the absence of rigorous theoretical critique in his essay. I question Sedgwick's decision to limit her critique to the confines of queer theory; this results in a constriction of meaning rather than the expansion she purports to offer. I challenge her notion of growth through mutual recognition with a model of change that is based in psychoanalytic theory and practice. Contrary to her assertion, I do not jettison danger or gender destabilization from the discourse on anal eroticism between men, but I question these as obligatory or constitutive to its meaning. [ABSTRACT FROM AUTHOR]

This essay takes up the issue of anal sexuality among gay men in order to consider the relationship between bodily and psychic penetrability. The lack of recognition some gay men may experience with this aspect of their sexuality suggests the importance that feeling “mentalized” (e.g., Fonagy and Target, 1993) may play in adult life. Drawing on early gay liberation and ACT UP-era theorizing about anal sex and an extended clinical example, I explore the meanings of gay men's wishes to (and fears of) penetrate and be penetrated on both bodily and psychic levels as well as the consequences of feeling denied entry. My consideration of these matters becomes in turn an occasion for a critical assessment of the mentalization concept itself. [ABSTRACT FROM AUTHOR]

Following on a discussion of Botticelli's and Guss's (this issue) papers on anal sex and gay psychopolitical erotics, this paper takes up the questions: Do gay men, does anyone, experience their embodiment relationally? Is there an inter-embodiment to match intersubjectivity? [ABSTRACT FROM AUTHOR]