Abstract
Background
Sexually explicit media (SEM) consumption may contribute to sexual risk-taking among young men who have sex with men (YMSM).
Methods
We estimated the prevalence and frequency of SEM consumption as well as associations with contextual and sexual risk characteristics among 61 YMSM.
Results
All participants (n=61, 100%) reported viewing SEM; 45 (74%) in the past week. There were no significant associations between viewing SEM in the past week and measured characteristics.
Conclusion
SEM use among YMSM is extremely common. Future research should clarify potential relations between SEM and sexual risk-taking with larger samples of YMSM and specific measures, including SEM content and amount.
Keywords: YMSM, HIV, men who have sex with men
Introduction
Researchers have suggested that sexually explicit media (SEM; i.e., pornography) consumption may contribute to HIV risk among young men who have sex with men (YMSM).1–7 Although there is a growing literature showing positive associations between SEM consumption and sexual risk-taking among adult MSM8–11 and heterosexual youth,12 only one qualitative study examined the effects among YMSM, finding that YMSM report modeling their sexual experiences after SEM, including engaging in condomless anal sex.3 The goal of this study was to provide preliminary data on SEM consumption and its relation with sexual risk-taking and other contextual factors among YMSM.
Methods
Participants and Procedures
Study procedures are described in greater detail elsewhere.13 Briefly, 95 participants in the Seattle, WA area were recruited for a one-year study that included serial web-based surveys. Participants were eligible if they: were males ages 16–30 years, spoke English, intended to stay in the Seattle area for 1 year, had ever had sex with another male, and either reported ≤ 10 lifetime male partners or were within 5 years of their same-sex sexual debut. Sixty-one consecutive participants received questions about SEM consumption at their 12-month follow-up survey. The University of Washington Institutional Review Board approved all procedures.
Measures
We used a combination of data from the baseline (race, school-based sexual education attendance) and 12-month surveys (age, in school, employment, living situation, sexual-orientation, and current parental support of sexuality). Sexual risk behaviors included: total number of partners, number of new male partners, number of anal sex acts with a male partner, number of condomless anal sex acts with a male partner, any condomless anal sex with a male partner, and any non-concordant condomless anal sex with a male partner in the 3 months prior to the 12-month survey. SEM consumption was measured using two questions from the 12-month survey: “Have you ever watched pornography?” and “When was the last time you watched pornography?”
Analyses
We estimated prevalence and frequency of SEM consumption using frequency distributions. We used Fisher exact and t-tests to assess associations between frequency of SEM consumption, sexual risk-taking, and other contextual factors.
Results
All participants (n = 61, 100%) reported viewing SEM; 45 (74%) in the past week. There were no significant associations between viewing SEM in the past week and measured characteristics (Table 1).
Table 1.
Socio-demographic, caregiver support, sexual education, and sexual behavior of 61 young men who have sex with men (YMSM) in the Seattle, WA area by frequency of sexually explicit media (SEM) use, 2009–2010.
| Total | SEM use | |||
|---|---|---|---|---|
| N = 61 | Within the last week n = 45 | More than a week ago n = 16 | ||
|
| ||||
| Socio-demographics | n (%) | n (%) | n (%) | p-value |
| Age | 0.23 | |||
| 17–21 | 34 (57) | 23 (51) | 11 (73) | |
| 22–31 | 26 (43) | 22 (49) | 4 (27) | |
| White race | 44 (72) | 30 (67) | 14 (88) | 0.19 |
| Currently in school | 31 (51) | 22 (49) | 9 (57) | 0.77 |
| Currently working | 42 (70) | 32 (73) | 10 (63) | 0.53 |
| Currently living in own place | 40 (66) | 31 (69) | 9 (56) | 0.38 |
| Gay sexual orientation | 49 (83) | 35 (81) | 14 (88) | 0.71 |
|
| ||||
| Caregiver support of sexual orientation | ||||
|
| ||||
| Extremely supportive mother or mother figure | 40 (70) | 29 (67) | 11 (79) | 0.51 |
| Extremely supportive father or father figure | 26 (52) | 21 (54) | 5 (45) | 0.74 |
|
| ||||
| Attendance in sexual education courses | ||||
|
| ||||
| Middle School | 48 (79) | 37 (82) | 11 (68) | 0.30 |
| High School | 43 (70) | 32 (71) | 11 (69) | 1.00 |
|
| ||||
| Sexual behaviors in the prior 3 months | ||||
|
| ||||
| # of partners (mean [SD])* | 3 (3) | 3 (3) | 2 (1) | 0.07 |
| # of new male partners (mean [SD])* | 2 (3) | 2 (3) | 1 (1) | 0.22 |
| # of anal sex acts with a male partner (mean [SD])* | 11 (15) | 11 (15) | 9 (14) | 0.72 |
| # of condomless anal sex acts with a male partner (mean [SD])* | 7 (13) | 7 (14) | 7 (11) | 0.84 |
| Any condomless anal sex with a male partner | 30 (50) | 22 (50) | 8 (50) | 1.00 |
| Any non-concordant condomless anal sex with a male partner | 2 (3) | 1 (2) | 1 (6) | 0.46 |
Note. Fishers exact and t-tests were conducted on all categorical and continuous variables, respectively.
t-test.
Discussion
There has been a paucity of research investigating the impact of SEM exposure among YMSM. Consistent with the adult MSM literature on SEM consumption,8–10 in this pilot study, all YMSM reported consuming SEM, most within the last week. Furthermore, frequency of SEM consumption was not associated with increased sexual risk-taking in our sample. This is also consistent with the adult MSM literature, which has shown that it is not how often MSM view SEM,9,10 but instead the amount of exposure to condomless sex in SEM that is the key factor.8–10 Exposure to condomless sex in SEM was not measured in this pilot, so we could not test for such an association among YMSM.
Given the ubiquity of SEM consumption among YMSM, additional research to understand the influence of SEM on HIV risk-taking among YMSM as well as ways to leverage SEM consumption for HIV prevention purposes is needed. Given the rapidly shifting technological landscape–especially among youth–it is critical that researchers continue to conduct research that is grounded in contemporary, formative work to fully appreciate the potentially nuanced relationship between YMSM, SEM, and media use. This approach can help achieve the overall goal of helping YMSM enjoy and learn from SEM while maintaining their sexual safety.
Acknowledgments
We would like to thank the study participants. This work was supported by the National Institutes of Health (R03 AI074359, T32 AI007140, T32 MH078788, F31 MH088851) and the Royalty Research Fund at the University of Washington.
Footnotes
Conflicts of Interest
No conflicts of interest are declared.
Contributor Information
Kimberly Nelson, Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Providence, RI; Department of Psychiatry and Human Behavior, Brown University, Providence, RI; Department of Psychiatry, Rhode Island Hospital, Providence, RI.
Matthew R. Golden, Department of Medicine, University of Washington, and HIV/STD Program, Public Health – Seattle & King County, Seattle WA.
Sara Nelson Glick, Department of Medicine, University of Washington, Seattle WA.
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