Viewing Pornography Depicting Unprotected Anal Intercourse: Are There Implications for HIV Prevention Among Men Who Have Sex with Men?

Abstract

We used an Internet-based questionnaire to investigate whether viewing pornography depicting unprotected anal intercourse (UAI) was associated with engaging in UAI in a sample of 821 non-monogamous men who have sex with men (MSM). In the three months prior to interview, 77.2% viewed pornography depicting UAI, 42.6% engaged in insertive UAI, and 38.9% engaged in receptive UAI. Polytomous logistic regression of the 751 subjects who provided data on pornography viewing showed significantly elevated odds ratios for having engaged in receptive UAI, insertive UAI, and both receptive and insertive UAI associated with increasing percentage of pornography viewed that depicted UAI. We also found independently significant associations of engaging in UAI with age, use of inhalant nitrites, and HIV status. Although the data cannot establish causality, our findings indicate that viewing pornography depicting UAI and engaging in UAI are correlated. Further research is needed to determine if this observation may have utility 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.…”

“…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.…”

Level of ‘outness’ and pornography use among men who have sex with men: results from an online survey

“…And, as indicated, men who watched pornography that depicted unprotected anal sex were less likely to indicate their sex life resembled the pornography they watched, compared to those who watched pornography depicting only safer sex. The potential association between viewed pornography and sexual practices have been described elsewhere (Stein et al, 2012). The present findings suggest the fantasy and instructive aspects of pornography may differ among MSM with varying degrees of outness.…”

“…In essence, the varying consumption of pornography among subgroups of MSM may play an important role in understanding its possible effects. Consumption of pornography depicting high-risk sex has been associated with reports of engaging in high-risk sex in multiple studies (Rosser et al, 2013;Stein et al, 2012), and Rosser et al, specifically, suggest factors other than real-life sexual practice may drive MSM's preferences for different types of pornography. Varying consumption among subgroups of MSM may help contextualise studies that have found varying rates of pornography consumption as well as differing relationships between pornography consumption and self-perception.…”

‘Cocked, locked and ready to fuck?’: a synthesis and review of the gay male pornography literature

“…bareback sex). Another recent online study of gay and bisexual men (N = 751) conducted by Stein, Silvera, Hagerty, and Marmor (2012) obtained congruent findings. Participants who reported viewing a greater proportion of gay pornography depicting bareback sex were more likely to engage in either receptive or insertive anal sex without condoms.…”