Differences in HIV Risk Practices Sought by Self-Identified Gay and Bisexual Men Who Use Internet Websites to Identify Potential Sexual Partners

Abstract

Men who have sex with men (MSM) account for the largest number of persons diagnosed with AIDS in the United States, 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 (e.g., Bareback.com, BarebackRT.com, Bare4ever.com) may be particularly common among MSM, thereby fostering their risky behaviors.

In light of these findings, the present study, which compares HIV risk behaviors sought by self-identified gay and bisexual men, is based on a content analysis of 1,316 ads/profiles posted on one of the most popular men who have sex with other men (MSM) Websites (namely, Bareback.com) 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 behaviors were very high for gay and bisexual men alike, particularly for oral sex involving ejaculation into the mouth, anal sex involving ejaculation into the anus, multiple partner sex, and felching (i.e., eating ejaculatory fluid out of an anus into which at least one person previously ejaculated). Analytical comparisons of gay and bisexual men showed that, on various dimensions, the bisexual men in this sample had either similar or lower levels of sexual risk compared to the gay men. The HIV intervention-related implications of these findings are discussed.

Keywords:

• Bisexuals
• gay men
• men who have sex with other men (MSM)
• Internet use
• HIV risk behaviors
• HIV risk preferences

Notes

1. For comparison purposes, the next-highest HIV transmission category is injection drug use, which accounts for 34% of all persons with AIDS and 24% of those who are currently HIV-positive.

2. Content analysis is a method of systematically examining the types of messages promulgated by any type of mass medium. It utilizes a quantitative approach to identify the types and frequency of messages that are being provided in the medium under study. Content analysis has become increasingly popular during the past two decades, and it has been used to study the messages provided to readers/viewers of such varied media forms as television, comic books, Internet Websites, health promotional brochures and pamphlets, popular song lyrics, magazines, and music videos among others. Readers who are interested in learning more about content analysis research are encouraged to consult Krippendorff (2003) and/or Neuendorf (2001).

3. In 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.

4. These 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 (such as fisting, oral-anal contact, among others). Men who self-identify as “versatile” are usually willing to engage in both “top” and “bottom” sexual activities.

5. Each 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.

6. Rough sex was defined operationally as profiles explicitly stating a preference for partners with whom one could engage in “rough sex,” mentioning a desire for any type of sex that involved “pounding,” indicating a desire “to get plowed,” and so forth. Rough sex is included in this article as a risk-enhancing preference (not explicitly as a risk behavior per se) because of the significantly elevated risk for internal tearing (especially anal tearing) that often results from engaging in intentionally aggressive sexual practices.

7. Long-lasting sexual encounters were coded whenever a person's profile indicated an interest in identifying partners with whom he could have “long sessions,” partners who were “long lasting,” partners who were capable (sexually speaking) of “going on for hours,” and so forth. This is included in the present research as an indicator of a risk preference because long-lasting sexual sessions are highly likely to lead to tearing of the penis and/or anus.

8. This would have limited the generalizability 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 utilize the Website, and additional membership features are available for purchase for persons wishing to upgrade their usage of the site.