HIV risk practices sought by men who have sex with other men, and who use internet websites to identify potential sexual partners
Hugh KleinA Kensington Research Institute, Silver Spring, MD 20910, USA.
B Drug Abuse Research Program and the Center for the Study and Prevention of Drug Use, Morgan State University, Baltimore, MD 21251, USA.
C Corresponding author. Email: hughk@aol.com
Sexual Health 5(3) 243-250 https://doi.org/10.1071/SH07051
Submitted: 9 July 2007 Accepted: 15 February 2008 Published: 6 August 2008
Abstract
Men who have sex with men (MSM) account for the largest number of persons diagnosed with AIDS in the USA, 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 websites specifically designed to promote unsafe sexual practices may be particularly common among MSM, thereby fostering their risky behaviours. In light of these findings, the present study is based on a content analysis of 1316 ads/profiles posted on one of the most popular MSM websites 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 behaviours were very high, particularly for oral sex involving ejaculation into the mouth (88.0% for receptive oral sex, 77.4% for insertive oral sex), anal sex involving ejaculation into the anus (79.7% for insertive anal sex, 69.4% for receptive anal sex), multiple partner sex (77.9%) and felching (16.5%). A multivariate analysis of the correlates of sexual risk preferences identified seven factors that were related to a propensity towards enhanced sexual risk: younger age (β = 0.12, P = 0.0001), not being African American (β = 0.05, P = 0.0341), self-identification as a sexual ‘bottom’ (β = 0.20, P = 0.0001), not caring about one’s potential sex partners’ HIV serostatus (β = 0.15, P = 0.0001), preferring to have sex while under the influence of drugs (β = 0.08, P = 0.0022), a greater involvement in and commitment to the use of the website to locate potential unprotected sex partners (β = 0.16, P = 0.0001) and not being HIV-negative (β = 0.08, P = 0.0081). The HIV intervention-related implications of these findings are discussed.
Additional keywords: content analysis, sexual risk practices.
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A AIn contrast, most other MSM-oriented websites impose fairly-stringent limitations on the length of members’ postings, thereby precluding people from describing themselves and/or their sexual ‘want list’ as completely as they might wish to do.
B BMost of this information was provided in different check-box formats on the website’s various pages. To make sure that errors of omission were minimised, only profiles containing at least some of the required information on each profile page were included in this research. This enables the researcher to have confidence that each person’s profile content is as true a reflection of his self-description and sexual wants/preferences as possible.
C CThese terms refer to the sexual acts that the men typically prefer doing with their partners. For example, ‘top’ men typically prefer to engage in insertive anal sex and to receive oral sex from their partners, whereas ‘bottom’ men typically prefer to engage in receptive anal sex and to perform oral sex on their partners. These same ‘top’ and ‘bottom’ labels also may be applied to other sexual acts. Men who self-identify as ‘versatile’ are usually willing to engage in sexual activities on a relatively even give-and-take basis.
D DEach day, the site reports the 20 members whose profiles were the most searched-for on the site the previous day. These ‘most active profiles’ are posted in a prominent place on the website, encouraging site users to visit these particular profiles and see for themselves what makes these profiles engaging for other site users.
E EThis would have limited the generalisability of findings derived from studying their ad/profile content greatly, because socioeconomic factors such as the ability to afford site membership would have influenced site membership. With the site used in this research, membership is free to all who wish to utilise the website, and additional membership features are available for purchase for persons wishing to upgrade their usage of the site.
