Preferences for Condomless Sex in Sexually Explicit Media Among Black/African American Men Who Have Sex with Men: Implications for HIV Prevention

Risk factors of HIV/AIDS among men who have sex with men in Akwa Ibom State, Nigeria

Introduction

Men who have sex with men (MSM) belong to the key population group which contributes to the high burden of human immunodeficiency viruses (HIV)/acquired immunodeficiency syndrome (AIDS) despite the ongoing HIV prevention programs in Nigeria. The current study assessed the risk factors of HIV/AIDS among men who have sex with men in Akwa-Ibom State, Nigeria.

Methods

This study was a cross-sectional study of 400 men who have sex with men selected from three senatorial zones in Akwa Ibom. A statistical package for service solution version 23 was used to analyze the data. Descriptive statistics, Relative risk and Binary logistic regression were used to compare proportions between risk factors and HIV/AIDS among the MSM.

Results

More than half (50.5%) of the respondents were between the ages of 20-29 years. Above 66% of the respondents made their debut into MSM at the age bracket of 13-19 years. 50% of the respondents preferred unprotected sex with fellow men. About 99% of the respondents have multiple sexual partners. More than 72% of the respondents had engaged in group sex. About 64% of the respondents use tramadol before sex. Greater than half (54%) of the respondents have shared injection needles. Averagely, 97% of the respondent engaged in transactional sex in the past 3 months. 11.8% of the 400 respondents tested positive for HIV. There was a significant association between risk factors and HIV among the MSM studied.

Conclusions

MSM in Akwa Ibom State engage in high-risk behaviors, therefore, a risk reduction program targeted at each specific identified risk is highly recommended.

Sexual Orientation, HIV Vulnerability-Enhancing Behaviors and HIV Status Neutral Care Among Black Cisgender Sexual Minority Men in the Deep South: The N2 Cohort Study

Black sexual minority men (SMM) in the Deep South are heavily impacted by HIV; yet studies fail to consider discordance across aspects of sexual orientation (i.e., identity, attraction, behavior) or how a lack of concordance enhances vulnerability to HIV. We sought to explore the overlap across aspects of sexual orientation and examine associations between each aspect and the number of sexual partners who engaged in HIV vulnerability-enhancing behaviors, and HIV prevention and care outcomes. A total of 204 Black SMM completed surveys, reporting their sexual identity, attraction, and behavior (i.e., sex with men only vs. sex with men and women), number of condomless sex or transactional sex (e.g., buyers vs. sellers) partners in the past 6 months, and adherence to pre-exposure prophylaxis (PrEP) or antiretroviral therapy (ART) among users. Less than one in four participants (22.5%) reported overlap in same-sex sexual orientations, while 17.1% of bisexual men reported overlap across aspects. In multivariable models, differences were found in how aspects of sexual orientation were associated with the number of partners who bought or sold sex; as well as how often participants tested for HIV in the past 12 months. Results suggest different aspects of sexual orientation have implications for addressing HIV among Black SMM in the Deep South.

"I wish I actually had known what the heck sex was:" What adolescent sexual minority males knew and wish they knew prior to sexual debut with a male partner

Introduction

Understanding the sexual health needs of adolescent sexual minority males (ASMM) at the time of sexual debut will inform programs seeking to decrease sexual health inequities experienced by ASMM.

Methods

In 2020, sexually active, cisgender ASMM (n=102, age 14-17) in the United States completed the baseline assessment of an online sexual health intervention pilot trial. Participants responded to closed- and open-ended questions about their sexual debut with a male partner, including sexual behavior, skills and knowledge they knew and wish they knew at the time of their debut, and sources of said skills and knowledge.

Results

On average, participants were 14.5 years old (SD=1.4) at their debut. Participants reported knowing how to say no to sex (80%) and wishing they knew how to talk with partners about what they would (50%) and would not (52%) like to do sexually. Open-ended responses indicated that participants desired sexual communication skills at sexual debut. Personal research (67%) was the most common knowledge source prior to debut, and open-ended responses suggest that Google, pornography, and social media were the most frequently used websites and phone applications to find information about sex.

Conclusions

Results suggest sexual health programs for ASMM should occur prior to sexual debut, teach sexual communication skills, and teach media literacy skills to help youth deduce credible sexual health resources.

Policy Implications

Incorporating the sexual health needs and wants of ASMM into sexual health programs will likely improve acceptability and efficacy, and ultimately decrease sexual health inequities experienced by ASMM.

Sexually Explicit Internet Media Consumption and Sexual Risk Behaviors Among Chinese Male Sexual Minorities: The Moderating Role of Perceived Realism

Western research has suggested that viewing sexually explicit internet media (SEIM) may result in sexual risk behaviors (SRBs) among gay, bisexual, and other men who have sex with men. This study explored the relationship between SEIM consumption and SRBs and whether perceived realism could moderate this relationship among Chinese male sexual minorities. We assessed SEIM consumption from two aspects: consumption frequency and preference for specific content (condomless and group sex). This study recruited 360 participants from various online channels. Consistent with the sexual script acquisition, activation, application model (₃AM), we found that both SEIM consumption frequency and content preference were related to SRBs, and that perceived realism moderated the relationship between SEIM consumption and SRBs. Preference for group sex SEIM was significantly associated with an increased likelihood of casual sex when perceived realism was higher. SEIM use frequency was significantly associated with an increased likelihood of unprotected anal intercourse when perceived realism was higher. These findings may be used to promote HIV prevention, which necessitates joint effort from multiple stakeholders.

Parent-Child Sex Communication Prompts, Approaches, Reactions, and Functions According to Gay, Bisexual, and Queer Sons

Minimal research on parent-child sex communication between parents and gay, bisexual, and queer (GBQ) adolescent sons prevents the formulation of interventions that would buffer or brake this youth population's risks for HIV/STI. We sought to describe the perspectives of GBQ adolescent males on this process and the potential ways they think parents can address their sons' informational needs, including countering youth access of sexually explicit media. We conducted 30 semi-structured interviews with GBQ male youth aged 15-20 years. Thematic and content analysis revealed four central themes: prompts and triggers, parents' approaches, sons' reactions, and the functions assigned to sex communication. Parents can be sources of reliable sexual health information and may be leveraged for future HIV/STI risk reduction work.

Consumption of sexually explicit media and unprotected anal sex in men who have sex with men

This study aimed to evaluate the influence of bareback sexually explicit media (SEM) consumption on anal sex without a condom by men who have sex with men (MSM). To this end, a page was created on the Facebook® social network with a link that directed interested parties to a questionnaire. Cisgender men, aged 18 years and over, who had sex with other men in the last 12 months, were included. Data were collected in 2017 and analyzed using univariate and bivariate inferential statistics and multivariate logistic regression. A total of 2,248 MSM participated in the research, with a mean age of 24.4 years and a mean number of 3.9 partners in the last 30 days. Having multiple sexual partners (ORa: 9.4; 95% CI 3.9-22.4), preferring movies with bareback scenes (ORa: 2.6; 95% CI 1.5-4.6), considering this practice a fetish and realizing it (ORa: 3.52; 95% CI 2.3-5.4), having casual partnerships (ORa: 1.8; 95% CI 1.5-1.9) and being aware of the partner's negative serological status for HIV (ORa: 1.4; 95% CI 1.1-2.3) were factors that increased the likelihood of engaging in anal sex without a condom. Thus, we found an association between the consumption of bareback SEM and sex without a condom among MSM.

Factors associated with unprotected sex in people who consume sexually explicit media

OBJECTIVE

To analyze the factors associated with sex without the use of condoms in consumers of sexually explicit media (SEM).

METHODS

Cross-sectional study, with a sample of 172 participants selected and collected through social media. To assess the predictors of unprotected sexual practices, the Poisson regression model was used. Values were expressed as a robust prevalence ratio (PR) with their respective confidence intervals.

RESULTS

There was a statistically significant association between, the use of condoms and the type of scenes that the participants prefer (p = 0.03), the preference for films with scenes involving unprotected sex or even those that do not care about protection (p = 0.02), the type of pornography watched influencing sexual relations (p = 0.017), and the number of scenes seen per week (p = 0.05).

CONCLUSIONS

The lack of condom use was associated with the access to erotic scenes.

Sexual violence experiences and pornography media exposure with sexual risk behavior among PLWHA MSM in Bandung, Indonesia

Background

HIV number continues to increase, especially among the minority of Men who have Sex with Men (MSM) due to the high risks of their sexual behavior. This study aims to identify the correlation between sexual violence experiences and pornography media exposure to sexual risk behavior among people with HIV/AIDS (PLWHA) MSM.

Design and Method

The study employed a cross-sectional design with the consecutive sampling technique and involved 258 PLWHA MSM under the guidance of an NGO in Bandung, Jawa Barat, Indonesia. The data were collected by employing an online questionnaire.

Result

The results show that there is a significant correlation between sexual violence experiences and sexual risk behavior (p-value = 0.000, α = 0.05; OR = 6.496), pornography media exposure and sexual risk behavior (p-value = 0.000, α = 0.05; OR = 4.271). The multivariate analysis of multiple logistics regression results reveals that the sexual violence experience is the factor that mostly influences the sexual risk behavior among PLWHA MSM (p-value = 0.000, α = 0.05; OR = 3.784).

Conclusions

The sexual violence experiences and pornography media exposure have a significant positive relationship to sexual risk behavior. Therefore, nurses need to improve a comprehensive assessment, counseling, and personal education to reduce sexual risk behavior that can transmit HIV and other sexually transmitted diseases and create innovations through positive activities to reduce pornography consumption.

Adolescent Condom Use, Parent-adolescent Sexual Health Communication, and Pornography: Findings from a U.S. Probability Sample

Sexual scripts in pornography rarely include condoms. Many teenagers in the U.S. are exposed to pornography and have unprotected sex. Despite this, only a few studies have investigated whether greater pornography exposure is associated with condomless sex among U.S. teenagers, and these were conducted using clinical, convenience samples, many years ago, with data collections at a single location. This paper reports contemporary results on U.S. teenagers' exposure to pornography, parent-adolescent sexual health communication, and condom use from the National Survey of Porn Use, Relationships, and Sexual Socialization (NSPRSS), a U.S. population-based probability study. Although the correlations were in the expected direction, neither pornography exposure nor parent-adolescent sexual health communication were related at the bivariate level to teenagers' use of condoms. However, consistent with the sexual script acquisition, activation, application model (₃AM) of sexual media socialization, pornography exposure interacted with parent-adolescent sexual health communication to predict condomless sex. Pornography exposure was associated with an increased probability of condomless sex only when parents engaged in little to no sexual health communication with their children. When parent-adolescent sexual health communication was high, pornography use was unrelated to teenagers' engagement in condomless sex. These results are consistent with the public health position that pornography can be a risk factor for condomless sex, the theoretical position that the socializing impact of sexual media depends on consumers' existing sexual scripts, and the pedagogical position that parent-adolescent sexual health communication can buffer youth against detrimental effects of sexual media.

Use of Sexually Explicit Materials as Sex Education Tools to Reduce the Number of Recurrences of Urinary Tract Infection in Sexually Active Women

Context: As sexual intercourse is a known risk factor for recurrent urinary tract infection (UTI) in women, we decided to evaluate a novel method of sex education using sexually explicit materials (SEM) to reduce the number of recurrences of UTI in sexually active women, when the other preventive measures fail to reduce the number of recurrences of UTI in these women.

Methods: After obtaining written informed consent and ethical committee approval, sexually active women with a single sexual partner, who presented for recurrent symptomatic UTI following sexual intercourse, were included in this study. The absence of recurrence for 6 months, successful postcoital drug prophylaxis, the presence of comorbidities, anatomical abnormalities of the genitourinary tract (GUT), history of instrumentation of GUT, and use of contraception were exclusion criteria. Their demographic profile, socioeconomic status, imaging studies, pre- and post-intervention urine culture profile and pre- and post-intervention sexual practices were recorded. During every visit, all these women along with their male partners were given sex education sessions about healthy sexual practices using SEM. Data is analyzed.

Results: Study period was January 2012 to June 2018. A total of 107 women with the mean age of 30.11 years were included in the study. A total of 82% of UTI were due to Escherichia coli, whereas the other cases were attributable to Klebsiella, Proteus, and Staphylococcus saprophyticus. Their preintervention yearly incidence of documented UTI was 4.04 episodes which reduced to 1.91 episodes post intervention.

Conclusions: Sex education with SEM can be an option to treat recurrent UTI in sexually active women.

Understanding What Influences Sexual Health Behaviors among Black Males in College

Using the Health Belief Model as a guide, focus groups and interviews (n=35) were conducted with Black males at a Historically Black College and University. Findings suggest that norms around the expectations of men and sex relates to their sexual behavior. The study also indicates that while Black college men know they should engage in protected sex (perceived benefits), they are inclined to engage in unprotected sex if their partner is on the pill (cues to action), they don't believe the consequences are immediate (perceived severity), and they like the feel of not using a condom (perceived barriers).

Sexually explicit media exposure as a sexual milestone among gay, bisexual, and other men who have sex with men

OBJECTIVE

Gay, bisexual, and other men who have sex with men (GBMSM) remain at high risk of HIV infection via condomless anal sex. Sexually explicit media (SEM) likely influences GBMSM's sexual behavior and has been associated with condomless anal sex. SEM messages may be especially potent during formative developmental periods.

METHOD

We examined the association between age of first SEM exposure and condomless anal sex in a sample of adult GBMSM (N = 1,114) recruited using the Internet.

RESULTS

Every 1-year delay in age of first SEM exposure resulted in a 3% decrease in the odds of engaging in condomless anal sex as an adult (odds ratio = .97, 95% CI [.95, .99], p = .01). This association remained significant in 3 separate multivariable models that controlled for age of sexual debut, age of anal sex debut, and current age, respectively. This association was moderated by ethnicity such that the effect was stronger among Latino men.

CONCLUSIONS

GBMSM who were exposed to SEM earlier in their lives report more sexual risk behavior as adults. SEM exposure in GBMSM is an important sexual development milestone deserving further research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

If You Film It Will They Watch? Factors Associated with Willingness to View Safer Sex Messaging in Internet-Based Sexually Explicit Media

Research on the association between viewing condomless sex in sexually explicit media (SEM) and engaging in risk behavior suggests the need for SEM-based safer sex messaging (e.g., PrEP, condom use), though few studies have considered viewer willingness to watch SEM containing HIV/STI prevention messages. Online survey data from a racially diverse sample of 859 men and women were used to investigate factors associated with willingness to watch SEM with safer sex messaging. Analyses were conducted separately for three groups: heterosexual men and other men who only report sex with women, heterosexual women and other women who only report sex with men, and gay, bisexual, and other men who have sex with men. All three groups expressed some willingness to view safer sex messages in SEM and a majority viewed the SEM industry as having some responsibility to provide this type of messaging. Factors associated with greater willingness varied across the three groups. These findings have implications for the design and implementation of safer sex messaging in SEM.