Different cohorts of gay/bisexual men experience unique developmental factors given their distinct socio-historical contexts. This study examined the moderating effects of age on three psychosocial predictors of HIV risk behavior and substance use. Analyses drew on data from a study of substance using HIV-negative and unknown status gay/bisexual men (N = 302) at risk for HIV infection. Anxiety was a strong independent predictor of sexual risk and substance use, and its effects on the sex risk outcomes were moderated by age, such that older and more anxious participants had more frequent instances of sexual risk. Identification with the gay community protected against HIV risk, and its effects on sex risk outcomes were moderated by age, such that younger participants who identified with the gay community reported less sexual risk. Understanding HIV risk within socio-historical contexts is essential in tailoring prevention by taking into account recipients’ ages.
Sexual compulsivity and the internet have been investigated separately among gay and bisexual men for their connection to sexual risk behaviour, yet little research has addressed the intersection. This analysis explored qualitative interview data from 111 gay and bisexual men experiencing out of control sexual thoughts and/or behaviours, about the role of the internet in their lives. For some it facilitated their problematic sexual thoughts and behaviours and, to some extent, was a distraction from important facets of their lives. Equally, men identified strategies to limit their internet use and reduce these negative consequences. For some, the internet was attributed to being less discriminating about partners. In contrast, other men compared the internet to other venues for meeting sex partners (e.g. bars) and described the internet as a medium for reducing physical (cruising online versus cruising a dark alley) and sexual (multiple partners at bathhouses versus cyber-sex only) risk. Clinically, service providers should conduct more thorough assessments regarding the role of the internet in the lives of patients who experience sexual compulsivity, as many individual differences exist, and there may be positive benefits that stem from internet use.
The practice of sex work or exchange sex (having sex in exchange for money, drugs, shelter, or other things) and the risks for HIV and sexually transmissible infections (STIs) associated with it differ based on the venues where partners meet (e.g., streets, agencies, or the Internet). Although there is evidence that gay, bisexual, and other men who have sex with men (MSM) use social media and dating/hookup applications and websites to find exchange sex, little is known about this phenomenon. We used online survey data collected among MSM in New York City recruited through social/sexual networking technologies to learn more about the practice of exchange sex in this population. Overall, 28.8% of participants had ever exchanged (sold) sex, including 8.4% who had done so in the prior three months. Almost half (46.4%) of those who had ever exchanged sex had met their first client through a social/sexual networking app/website (that was not a website dedicated to sex work), and the majority (88%) of those who had exchanged sex in the prior three months had done so with a client met through these technologies. In multivariable analyses, those who had exchanged sex in the prior three months reported at least twice the number of condomless anal sex partners in that period (compared to those who never exchanged sex) after controlling for covariates (incidence-rate ratio [IRR] = 2.08, 95% confidence interval [CI] 1.52–2.84). Social/sexual networking technologies are important venues for finding exchange sex among MSM, a practice that may present high risk for HIV and/or STI transmission.
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