The Influence of Sexually Explicit Online Media on Sex: Do Men who have Sex with Men Believe they “Do What They See”?

Abstract

Over the past two decades, men who have sex with men (MSM) have engaged in increasing consumption of MSM-specific sexually explicit online media (i.e., online pornography). Furthermore, the amount of MSM-specific sexually explicit online media portraying unprotected anal intercourse (UAI) has increased, raising concerns about HIV transmission among the actors and the encouragement of risky sex among consumers. The influence of sexually explicit online media on sexual risk-taking, at present largely understudied, could lead to new avenues for innovative HIV prevention strategies targeting at-risk MSM. In this preliminary assessment, in-depth qualitative interviews were conducted with sixteen MSM in the Seattle area to elucidate MSM’s perceptions about the influence of sexually explicit online media on their own and other MSM’s sexual behaviors. Participants reported that sexually explicit online media: 1) plays an educational role; 2) increases comfort with sexuality; and 3) sets expectations about sexual behaviors. While participants overwhelmingly reported not feeling personally influenced by viewing UAI in sexually explicit online media, they believed viewing UAI increased sexual risk-taking among other MSM. Specifically, participants reported that the high prevalence of UAI in sexually explicit online media sends the message, at least to other MSM, that: 1) engaging in UAI is common; 2) UAI is acceptable and “ok” to engage in; and 3) future partners will desire or expect UAI. Overall, this preliminary assessment indicates that sexually explicit online media exposure may have both positive (e.g., helping MSM become more comfortable with their sexuality) and negative (e.g., normalizing UAI) impacts on the sexual health of MSM and may be useful in the development of novel HIV-prevention interventions.

Introduction

An urgent need exists for innovative HIV prevention methods specifically targeting at-risk men who have sex with men (MSM). One potential avenue for intervention among MSM that has been largely understudied is the influence of sexually explicit online media (i.e., online pornography) on sexual risk-taking. The Internet has provided an unrestricted medium for the consumption of sexually explicit media, allowing a greater proportion of MSM instantaneous and anonymous access to all forms of MSM-specific sexually explicit media (Rosser et al., 2012), likely shaping MSM’s sexual interactions and actions over time (McLuhan & Gordon, 2003). As the MSM-specific sexually explicit online media industry has grown, the portrayal of unprotected anal intercourse (UAI) has also increased (Downing, Schrimshaw, Antebi, & Siegel, 2013; Grudzen et al., 2009; Hurley, 2009). This has raised concerns about HIV transmission among the actors and the potential encouragement of unsafe sexual practices among sexually explicit online media consumers (Grudzen et al., 2009; Hurley, 2009; Rosser et al., 2012).

Little research has been done in this area. The few studies that have been conducted indicate that sexually explicit media likely has both positive (e.g., increased sexual knowledge, enjoyment of sex, and understanding of sexual orientation) and negative (e.g., sexually compulsive behavior) impacts on MSM sexual health (Hald, Smolenski, & Rosser, 2013; Rosser et al., 2012). Interestingly, although there is growing evidence indicating that exposure to UAI in sexually explicit media is positively associated with engagement in UAI among MSM (Nelson et al., in press; Rosser et al., 2013; Stein et al., 2012), MSM in recent research by Hald et al. (2013) felt that exposure to sexually explicit media had no effect on their desire for UAI, illustrating a potential disconnect between how MSM think sexually explicit online media influences them and the measurable influence on their behavior.

In the present study, we conducted a preliminary assessment of MSM’s perceptions about the impact of sexually explicit online media on sexual behavior. We explored how participants perceive the impact of sexually explicit online media on their own behavior in contrast to how they think sexually explicit online media may influence the sexual behavior of other MSM.

Method

In-depth, semi-structured, one-hour interviews were conducted between July and September 2011 with sixteen MSM in Seattle, Washington, USA. Participants were recruited via MSM-specific listservs, Facebook groups, and fliers at community organizations in the area. Eligibility criteria were: 1) self-identifying as male; 2) being at least 18 years old; 3) having had sex with a man in the past year; 4) having internet access; 5) having accessed an online men-seeking-men website in the past year; and 6) having accessed sexually explicit online media in the past year. Participants were asked open-ended questions covering online partner-seeking behaviors, sexually explicit online media consumption, and the perceived influence of sexually explicit online media on themselves and on other MSM in the community. All interviews were digitally recorded, transcribed verbatim, and coded in Atlas.ti 5.2 (Muhr, 2004) using a constant comparison analysis framework (Miles & Huberman, 1994). In the present paper we focus on predominant themes about the perceived influence of sexually explicit online media and use selected quotations to illustrate key points. Participants received $20 for participation. This study was approved by the Institutional Review Board of the University of Washington.

Results

The sixteen participants had a mean age of 42 (range = 24 – 73; standard deviation = 3.14). Twelve were Caucasian, eight had a household yearly income of more than $30,000, eleven had an Associate’s degree (approximately fourteen years of education) or higher level of education, twelve self-identified as gay, fourteen did not currently have a primary partner, and two reported being HIV-seropositive.

MSM in our sample reported that sexually explicit online media: 1) plays an educational role; 2) increases MSM’s comfort with their sexuality; and 3) sets expectations about sexual behaviors among MSM (see summary of themes and illustrative quotes in Table 1). Further, while none of the participants endorsed being personally influenced by viewing UAI in sexually explicit online media, all expressed feeling that viewing UAI in sexually explicit online media influenced the sexual behaviors of other MSM in the community (see summary of themes and illustrative quotes in Table 2). Specifically, participants reported that the high prevalence of UAI in sexually explicit online media sends the message, at least to other MSM, that: 1) engaging in UAI is common; 2) UAI is acceptable and “ok” to engage in; and 3) future partners will desire or expect UAI. Participants expressed particular concern about the potential negative influence of viewing UAI in sexually explicit online media upon young MSM (e.g., “I would assume that younger people are much more likely to pursue [UAI] in person if they’re consuming [UAI in sexually explicit online media].” [White, 47 year old]).

Table 1.

Themes and illustrative quotes related to the perceived influence of sexually explicit online media on participants’ own sexual behavior and the sexual behavior of other men who have sex with men (MSM) in the community.

Plays an educational role

Influence on themselves

You know, really, it’s a great instructional tool. And yes, there have been scenarios or moves I guess you would call them, or positions, thank you, that you kind of look at and go ‘Oh, that’d be really hot to try.’ (White, 42 y.o.)

Oh, that’s hot. Maybe I will go try that kind of a thing (White, 44 y.o.).

Influence on other MSM

I’m sure a lot of sex ed does happen through [sexually explicit online media]. Even more now than before. (White, 47 y.o.)

I know there are people who I’ve had sex with who try to imitate what they’re seeing (Latino, 24 y.o.)

It’s just a part of figuring out who we are. And seeing what we do. And what we can do. (White, 42 y.o.)

Increases comfort with sexuality

Influence on themselves

[Sexually explicit online media] made me feel a little bit more comfortable about myself…and feelings that I had. (White, 36 y.o.)

Influence on other MSM

[Sexually explicit online media] at least reminds people that there are –if there’s a whole website then that means there’s other people like you who want to do that. (White, 37 y.o.)

Hopefully it makes [other MSM] feel more comfortable with their sexuality. (White, 36 y.o.)

Sets expectations about sexual behaviors

Influence on themselves

I think sometimes it makes you think there’s things you should be doing. (White, 44 y.o.)

[Sexually explicit online media helps define] ‘What’s an acceptable behavior?’ ‘What should you expect?’(White, 42 y.o.)

Influence on other MSM

I just think there’s a component of [sexually explicit online media] getting everything so normalized, that some people are always looking for that next thing. (White, 44 y.o.)

Note. y.o. = years old.

Table 2.

Themes and illustrative quotes related to the perceived influence of viewing unprotected anal intercourse (UAI) in sexually explicit online media on the sexual behavior of other men who have sex with men (MSM) in the community.

UAI is common

There’s more of a concept of barebacking than there used to be…people are advertising for it more, and people are asking for it more. (White, 36 y.o.)

Well, I think you know, people do what they see. And I hate to say it but I think more young gay men are starting to do more barebacking. (White, 57 y.o.)

They see beautiful, professional people doing it all the time and therefore they can enjoy it. (White, 52 y.o.)

UAI is acceptable and “ok” to engage in

I think that by having it more readily available, of course it makes people want to do it more. So I think it, of course the more you see anything the more people are gonna be accepting of it. (Latino, 29 y.o.)

[UAI in sexually explicit online media] probably sends a message that it’s really ok… I would think that it’s kind of giving a message that “it’s ok to bareback.”(White, 57 y.o.)

Future partners will desire or expect UAI

It has really influenced my idea of what men out there are expecting. And so I end up thinking that a lot of men out there are going to be expecting riskier behavior than I’m willing to participate in. (White, 44 y.o.)

Note. Participants reported that viewing UAI in sexually explicit online media had no influence on their own behavior. “Bareback” and “barebacking” refer to UAI. y.o. = years old.

Discussion

The influence of sexually explicit online media on MSM’s sexual behaviors has not been well explored. Similar to previous research in this area, participants in this preliminary assessment endorsed that sexually explicit online media consumption may both positively and negatively influences the sexual health of MSM. Specifically, participants in our sample reported that sexually explicit online media played an educational role in their sexual development and helped them become more comfortable with their sexuality. These positive influences have been associated with better physical and mental health outcomes for MSM (Herek & Garnets, 2007; Wolitski, Stall, & Valdiserri, 2008).

MSM in this study simultaneously endorsed some less encouraging effects of sexually explicit online media. Perhaps most concerning is the message sexually explicit online media may be sending regarding UAI. Participants in our sample endorsed that the increased visibility of UAI in sexually explicit online media may send the message that UAI is common among MSM and that it is “ok” to engage in. Participants also reported that viewing UAI in sexually explicit online media may be related to an increased expectation for UAI in the MSM community. Additionally complicating the picture is the perception of the influence of these messages. While MSM in this study reported that they, as individuals, were not influenced by viewing UAI in sexually explicit online media, they reported that other MSM were definitely being influenced.

We suggest two pathways by which viewing UAI in sexually explicit online media may be impacting sexual risk-taking among MSM: norm formation and perceived personal immunity. In line with existing research on norm formation (Buhi & Goodson, 2007; Collins, Murphy, & Bierman, 2004; Rimal & Real, 2005), it is possible that increasingly prevalent portrayals of UAI in sexually explicit online media may lead MSM to perceive a sexual norm of high levels of engagement in UAI in the community (likely an over-estimation), which can then lead to their own increased UAI behavior in order to be closer to the norm. Further, viewing of UAI in sexually explicit online media may also be subject to a phenomenon called perceived personal immunity (Hansen & Malotte, 1986; Helweg-Larsen & Shepperd, 2001). MSM in our study overwhelmingly reported that they, personally, were not influenced by viewing UAI in sexually explicit online media, but that other MSM in the community were definitely being influenced. Perceived personal immunity would indicate that MSM who think they are less likely than other men to be affected by UAI portrayals in sexually explicit online media may become less vigilant about guarding against the potential influence of viewing UAI, placing them at higher risk for susceptibility to messages sexually explicit online media may be sending about the UAI, and potentially leading to decreased protective behaviors and increased risk-taking (Helweg-Larsen & Shepperd, 2001).

While there are significant limitations due to a small sample size and geographic constraints, we conducted interviews until we felt we had achieved data saturation and believe that these findings are a useful preliminary look into how MSM perceive sexually explicit online media influences their sexual health. Specifically, our findings, combined with previous research in this area, indicate that sexually explicit online media exposure may have both positive and negative influences on the sexual health of MSM. The reach and potential influence of sexually explicit online media on sexual risk-taking among MSM could provide an ideal opportunity for HIV prevention interventions on a large scale. Public health efforts seeking to increase the positive influences and decrease the negative influences of sexually explicit online media could have the potential to increase self-acceptance and sexual satisfaction, while decreasing sexual risk-taking among a large audience of MSM.