Sexually Explicit Online Media and Sexual Risk Among Men Who Have Sex with Men in the United States

Abstract

This study aimed to describe sexually explicit online media (SEOM) consumption among men who have sex with men (MSM) in the United States and examine associations between exposure to unprotected anal intercourse (UAI) in SEOM and engagement in both UAI and serodiscordant UAI. MSM in the U.S. who accessed a men-seeking-men website in the past year (N = 1,170) were recruited online for a cross-sectional, Internet-based survey of sexual risk and SEOM consumption. In the three months prior to interview, more than half (57%) of the men reported viewing SEOM one or more times per day and almost half (45%) reported that at least half of the SEOM they viewed portrayed UA. Compared to participants who reported that 0–24% of the SEOM they viewed showed UAI, participants who reported that 25–49%, 50–74%, or 75–100% of the SEOM they viewed portrayed UAI had progressively increasing odds of engaging in UAI and serodiscordant UAI in the past three months. As SEOM has become more ubiquitous and accessible, research should examine causal relations between SEOM consumption and sexual risk-taking among MSM as well as ways to use SEOM for HIV prevention.

Association Between Pornography Use and Sexual Risk Behaviors in Adult Consumers: A Systematic Review

“…Overall, unmarried males who consumed pornography were more likely to use condoms than unmarried nonconsumers, even after controlling for relevant demographic variables. This result contrasts with Nelson et al, 35 Eaton et al, 23 and Stein et al, 32 although this association was weak and inconsistent across time frames. In addition, this study did not differentiate participants based upon sexuality, whereas the above studies examined only MSM.…”

“…In a community sample of HIV-negative men who have sex with men (MSM), Eaton et al 23 found that time spent viewing pornography was associated with the number of unprotected insertive anal acts, but not the number of unprotected receptive anal sex acts in the previous month. In a similar study, Stein 35 found that the odds of engaging in unprotected anal intercourse were higher as the amount of unprotected anal intercourse viewed in pornography increased. In addition, the odds of having knowingly engaged in serodiscordant unprotected anal intercourse were also higher for greater amounts of unprotected anal intercourse viewed in pornography.…”

“…In addition, many studies examined very specific populations. For example, four studies examined only MSM, 23,32,33,35 and a further four studies restricted their participants to males. 34,39,41,47 Poor replication does not lend confidence to the existing findings, and further replication, both within specific and broader community populations, is required.…”

“…Seven studies, 23,[30][31][32][33][34][35] including the two Internet pornography studies, investigated the association between pornography use and safer sex practices. All seven studies found evidence of an association.…”

“…It is of note that these findings represented a small effect size, and contrasted with the results of the comparative sample reported in Sinkovic et al 31 Despite this, the findings appear to be consistent with MSM samples. 23,32,33,35 Number of sexual partners Ten studies 23,34,[36][37][38][39][40][41][42][43] examined the association between pornography use and number of sexual partners. The overall results suggested that there is a robust association between pornography use and a higher number of sexual partners.…”