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 3 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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
The complete questionnaire is available from the corresponding author.
Responses to this question were used for inclusion/exclusion.
References
Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior (Facsimile ed.). Upper Saddle River, NJ: Prentice Hall.
Atwood, F. (2005). What do people do with porn? Qualitative research into the consumption, use and experience of pornography and other sexually explicit media. Sexuality and Culture, 9, 65–86.
Babor, T. (Ed.). (2007). Substance use disorders measures (2nd ed.). Arlington, VA: American Psychiatric Publishing.
Babor, T., de la Fuente, J., & Saunders, J. (1992). AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for use in primary healthcare (WHO Pub. No. PSA/92.4). Geneva: World Health Organization.
Bauermeister, J. A., Carballo-Dieguez, A., Ventuneac, A., & Dolezal, C. (2009). Assessing motivations to engage in intentional condomless anal intercourse in HIV risk contexts (“bareback sex”) among men who have sex with men. AIDS Education and Prevention, 21, 156–168.
Brown, J. D., & Strasburger, V. C. (2007). From Calvin Klein to Paris Hilton and MySpace: Adolescents, sex, and the media. Adolescent Medicine: State of the Art Reviews, 18, 484–507.
Carey, J. W., Mejia, R., Bingham, T., Ciesielski, C., Gelaude, D., & Herbst, J. H. (2009). Drug use, high-risk sex behaviors, and increased risk for recent HIV infection among men who have sex with men in Chicago and Los Angeles. AIDS and Behavior, 6, 1084–1096.
Colfax, G., Coates, T. J., Husnik, M. J., Huang, Y., Buchbinder, S., & Koblin, B. (2005). Longitudinal patterns of methamphetamine, popper (amyl nitrite), and cocaine use and high-risk sexual behavior among a cohort of San Francisco men who have sex with men. Journal of Urban Health, 82(1 Suppl. 1), i62–i70.
Dilley, J. W., Woods, W. J., Sabatino, J., Lihatsh, T., Adler, B., & Casey, S. (2002). Changing sexual behavior among gay male repeat testers for HIV: A randomized, controlled trial of a single-session intervention. Journal of Acquired Immune Deficiency Syndrome, 30, 177–186.
Duggan, S. J., & McCreary, D. R. (2004). Body image, eating disorders, and the drive for muscularity in gay and heterosexual men: The influence of media images. Journal of Homosexuality, 47(3–4), 45–58.
Duncan, D. F., & Donnelly, W. (1991). Pornography as a source of sex information for students at a private northeastern university. Psychological Reports, 68, 782.
Duncan, D. F., & Nicholson, T. (1991). Pornography as a source of sex information for students at the Southeastern State University. Psychological Reports, 68, 802.
Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention, and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley Publishing. Co.
Flynn, N. M., Forthal, D. N., Harro, C. D., Judson, F. N., Mayer, K. H., & Para, M. F. (2005). Placebo-controlled phase 3 trial of a recombinant glycoprotein 120 vaccine to prevent HIV-1 infection. Journal of Infectious Diseases, 191, 654–665.
Hald, G. M., & Malamuth, N. M. (2008). Self-perceived effects of pornography consumption. Archives of Sexual Behavior, 37, 614–625.
Hale, J., Householder, B., & Greene, K. (Eds.). (2002). The theory of reasoned action. Thousand Oaks, CA: Sage Publications.
Halkitis, P. N., Parsons, J. T., & Wilton, L. (2003). Barebacking among gay and bisexual men in New York City: Explanations for the emergence of intentional unsafe behavior. Archives of Sexual Behavior, 32, 351–357.
Hart, T., Roberts, K., James, C., Myers, T., Calzavara, L., & Loutfy, M. (2009, August). Social anxiety predicts later risky sex: Mediation by fear of being rejected by one’s partner. Paper presented at the National HIV Prevention Conference, Atlanta, GA.
Hays, R. B., Paul, J., Ekstrand, M., Kegeles, S. M., Stall, R., & Coates, T. J. (1997). Actual versus perceived HIV status, sexual behaviors and predictors of unprotected sex among young gay and bisexual men who identify as HIV-negative, HIV-positive and untested. AIDS, 11, 1495–1502.
HIV prevalence estimates–United States, 2006. (2008). MMWR. Morbidity and Mortality Weekly Report, 57(39), 1073–1076.
Keller, S. N., & Brown, J. D. (2002). Media interventions to promote responsible sexual behavior. Journal of Sex Research, 39, 67–72.
Kelly, J. A., Amirkhanian, Y. A., Seal, D. W., Galletly, C. M., Difranceisco, W., Glasman, L. R., et al. (2010). Levels and predictors of sexual HIV risk in social networks of men who have sex with men in the Midwest. AIDS Education and Prevention, 22, 483–495.
Kendall, C. N. (2004). Educating gay male youth: Since when is pornography a path towards self-respect? Journal of Homosexuality, 47, 83–128.
Kingston, D. A., Malamuth, N. M., Fedoroff, P., & Marshall, W. L. (2009). The importance of individual differences in pornography use: Theoretical perspectives and implications for treating sexual offenders. Journal of Sex Research, 46, 216–232.
Kleinbaum, D. G., & Klein, M. (2002). Logistic regression: A self-learning text (2nd ed.). New York: Springer.
Koblin, B. A., Chesney, M. A., Husnik, M. J., Bozeman, S., Celum, C. L., & Buchbinder, S. (2003). High-risk behaviors among men who have sex with men in 6 US cities: Baseline data from the EXPLORE study. American Journal of Public Health, 93, 926–932.
Kubicek, K., Beyer, W. J., Weiss, G., Iverson, E., & Kipke, M. D. (2010). In the dark: Young men’s stories of sexual initiation in the absence of relevant sexual health information. Health Education & Behavior, 2, 243–263.
Li, Q., & Davey, M. R. (1996). Pornography as a source of sex information for college students in fraternities and sororities. Journal of Health Education, 27, 165–169.
Loftus, D. (2002). Watching sex: How men really respond to pornography. New York: Thunder’s Mouth Press.
Malamuth, N., & Huppin, M. (2005). Pornography and teenagers: The importance of individual differences. Adolescent Medicine Clinics, 16, 315–326.
Mansergh, G., Marks, G., Colfax, G. N., Guzman, R., Rader, M., & Buchbinder, S. (2002). “Barebacking” in a diverse sample of men who have sex with men. AIDS, 16, 653–659.
Morrison, T. G., Morrison, M. A., & Bradley, B. A. (2007). Correlates of gay men’s self-reported exposure to pornography. International Journal of Sexual Health, 19, 33–43.
Ostrow, D. G., Silverberg, M. J., Cook, R. L., Chmiel, J. S., Johnson, L., & Li, X. (2008). Prospective study of attitudinal and relationship predictors of sexual risk in the multicenter AIDS cohort study. AIDS and Behavior, 12, 127–138.
Parsons, J. T., Kelly, B. C., Bimbi, D. S., Muench, F., & Morgenstern, J. (2007). Accounting for the social triggers of sexual compulsivity. Journal of Addictive Diseases, 26, 5–16.
Paul, P. (2005). Pornified: How pornography is transforming our lives our relationships, and our families. New York: Holt.
Prestage, G., Mao, L., Fogarty, A., Van de Ven, P., Kippax, S., & Crawford, J. (2005). How has the sexual behaviour of gay men changed since the onset of AIDS?: 1986–2003. Australian and New Zealand Journal of Public Health, 29, 530–535.
Romanelli, F., Smith, K. M., Thornton, A. C., & Pomeroy, C. (2004). Poppers: Epidemiology and clinical management of inhaled nitrite abuse. Pharmacotherapy, 24, 69–78.
Siegel, M. (2009). Business before pleasure? The Advocate. Retrieved from http://www.advocate.com/Health_and_Fitness/Health_and_Treatments/HIV/Business_Before_Pleasure_/
Skinner, H. A. (1982a). The Drug Abuse Screening Test. Addictive Behaviors, 7, 363–371.
Skinner, H. A. (1982b). Guide for using the drug abuse screening test (DAST). Toronto: Centre for Addiction and Mental Health.
Snowden, J. M., Raymond, H. F., & McFarland, W. (2009). Prevalence of seroadaptive behaviours of men who have sex with men, San Francisco, 2004. Sexually Transmitted Infections, 85, 469–476.
Subpopulation estimates from the HIV incidence surveillance system–United States, 2006. (2008). MMWR: Morbidity and Mortality Weekly Report, 57(36), 985–989.
Thomas, J. A. (2000). Gay male video pornography: Past, present, and future. In R. Weitzer (Ed.), Sex for sale: Prostitution, pornography and the sex industry (pp. 49–66). New York: Routledge.
Vanable, P. A., Ostrow, D. G., McKirnan, D. J., Taywaditep, K. J., & Hope, B. A. (2000). Impact of combination therapies on HIV risk perceptions and sexual risk among HIV-positive and HIV-negative gay and bisexual men. Health Psychology, 19, 134–145.
Wainberg, M. L., Muench, F., Morgenstern, J., Hollander, E., Irwin, T. W., & Parsons, J. T. (2006). A double-blind study of citalopram versus placebo in the treatment of compulsive sexual behaviors in gay and bisexual men. Journal of Clinical Psychiatry, 67, 1968–1973.
Whittier, D. (2009). Methamphetamine and HIV risk among men who have sex with men Retrieved September 23, 2009, from http://www.effectiveinterventions.org/files/Meth___HIV.pdf
Wolitski, R. J., Valdiserri, R. O., Denning, P. H., & Levine, W. C. (2001). Are we headed for a resurgence of the HIV epidemic among men who have sex with men? American Journal of Public Health, 91, 883–888.
Acknowledgments
The authors would like to thank the volunteers who mentioned this phenomenon for inspiring this project, the bloggers who were kind enough to support this research and the NYU/Bellevue AIDS Clinical Trials Unit Community Advisory Board for their feedback. This work was supported in part by NYU Center for AIDS Research grant AI27742 and grant 1P01 AI057127 from the National Institute of Allergy and Infectious Diseases, National Institutes of Health. A portion of this research was presented as a poster at the 2009 National HIV Prevention Conference, August 23–26, 2009, Atlanta, GA. The work has not otherwise been published.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Stein, D., Silvera, R., Hagerty, R. et al. Viewing Pornography Depicting Unprotected Anal Intercourse: Are There Implications for HIV Prevention Among Men Who Have Sex with Men?. Arch Sex Behav 41, 411–419 (2012). https://doi.org/10.1007/s10508-011-9789-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10508-011-9789-2