Skip to main content

Advertisement

SpringerLink
Log in

Preferences for Condomless Sex in Sexually Explicit Media Among Black/African American Men Who Have Sex with Men: Implications for HIV Prevention

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

Accumulating evidence suggests that viewing sexually explicit media (SEM; i.e., pornography) may be related to the sexual behaviors of men who have sex with men (MSM). Furthermore, stereotypical depictions of Black/African American MSM engaging in sexual risk behaviors in SEM may serve to normalize condomless sex, reinforce low peer norms around condom use, and facilitate HIV risk taking among Black/African American MSM. Despite this evidence, very little is known about the correlates of SEM consumption among Black/African American MSM, including HIV risk behaviors and their relation to preferences for viewing condomless sex in SEM. Participants were 653 HIV-seronegative Black-identified MSM ages 18–62 (M 33.58, SD 11.01) who completed a cross-sectional survey as a part of a HIV prevention trial in Atlanta, Georgia. Over three-quarters of the men (n = 514) reported a preference for condomless sex in SEM. In multivariate models, engaging in serodiscordant condomless sex was not significantly associated with preferences for condomless sex in SEM; however, men who self-identified as bisexual, engaged in transactional sex, and reported greater agreement with sexual risk cognitions (i.e., heat-of-the-moment thoughts about condom use) had significantly greater odds of reporting a preference for condomless sex in SEM. Study findings highlight the need for future research exploring the role of SEM in the sexual health of Black/African American MSM, including the extent to which SEM exposure alters norms and expectations about sexual behaviors among Black/African American MSM and how this might be addressed in HIV prevention programs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Albury, K. (2014). Porn and sex education, porn as sex education. Porn Studies, 1(1–2), 172–181. doi:10.1080/23268743.2013.863654.

    Article  Google Scholar 

  • Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). American Journal of Preventive Medicine, 10(2), 77–84.

    PubMed  Google Scholar 

  • Arrington-Sanders, R., Harper, G. W., Morgan, A., Ogunbajo, A., Trent, M., & Fortenberry, J. D. (2015). The role of sexually explicit material in the sexual development of same-sex-attracted Black adolescent males. Archives of Sexual Behavior, 44(3), 597–608. doi:10.1007/s10508-014-0416-x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Beck, A., McNally, I., & Petrak, J. (2003). Psychosocial predictors of HIV/STI risk behaviours in a sample of homosexual men. Sexually Transmitted Infections, 79, 142–146.

    Article  PubMed  PubMed Central  Google Scholar 

  • Berg, R. C. (2009). Barebacking: A review of the literature. Archives of Sexual Behavior, 38(5), 754–764. doi:10.1007/s10508-008-9462-6.

    Article  PubMed  Google Scholar 

  • Biello, K. B., Colby, D., Closson, E., & Mimiaga, M. J. (2014). The syndemic condition of psychosocial problems and HIV risk among male sex workers in Ho Chi Minh City, Vietnam. AIDS and Behavior, 18(7), 1264–1271. doi:10.1007/s10461-013-0632-8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Brafford, L. J., & Beck, K. H. (1991). Development and validation of a condom self-efficacy scale for college students. Journal of American College Health, 39(5), 219–225. doi:10.1080/07448481.1991.9936238.

    Article  PubMed  Google Scholar 

  • Bush, K., Kivlahan, D. R., McDonell, M. B., Fihn, S. D., & Bradley, K. A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Archives of Internal Medicine, 158(16), 1789–1795.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2015a). HIV surveillance report, 2014 (Vol. 26). Atlanta, GA: Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/hiv/library/reports/surveillance/

  • Centers for Disease Control and Prevention. (2015b, October 27). HIV and substance use in the United States. Retrieved March 23, 2016, from http://www.cdc.gov/hiv/risk/substanceuese.html

  • Downing, M. J., Schrimshaw, E. W., Antebi, N., & Siegel, K. (2014). Sexually explicit media on the internet: A content analysis of sexual behaviors, risk, and media characteristics in gay male adult videos. Archives of Sexual Behavior, 43(4), 811–821. doi:10.1007/s10508-013-0121-1.

    Article  PubMed  Google Scholar 

  • Dyer, T. P., Shoptaw, S., Guadamuz, T. E., Plankey, M., Kao, U., Ostrow, D., … Stall, R. (2012). Application of syndemic theory to black men who have sex with men in the Multicenter AIDS Cohort Study. Journal of Urban Health, 89(4), 697–708. doi:10.1007/s11524-012-9674-x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Eaton, L. A., Driffin, D. D., Bauermeister, J., Smith, H., & Conway-Washington, C. (2015). Minimal awareness and stalled uptake of pre-exposure prophylaxis (PrEP) among at risk, HIV-negative, Black men who have sex with men. AIDS Patient Care and STDs, 29(8), 423–429. doi:10.1089/apc.2014.0303.

    Article  PubMed  PubMed Central  Google Scholar 

  • Eaton, L. A., Kalichman, S. C., Cain, D. N., Cherry, C., Stearns, H. L., Amaral, C. M., … Pope, H. L. (2007). Serosorting sexual partners and risk for HIV among men who have sex with men. American Journal of Preventive Medicine, 33(6), 479–485. doi:10.1016/j.amepre.2007.08.004.

    Article  PubMed  PubMed Central  Google Scholar 

  • Erickson, D. J., Galos, D. L., Smolenski, D. J., Iantaffi, A., & Rosser, B. R. S. (2015). Typologies of sexually explicit media use among MSM: An application of latent class analysis. Psychology and Sexuality, 6(1), 28–43. doi:10.1080/19419899.2014.984515.

    Article  PubMed  Google Scholar 

  • Gold, R. (1993). On the need to mind the gap: On-line versus off-line cognitions underlying sexual risk taking. In D. J. Terry, C. Gallois, & M. McCamish (Eds.), The theory of reasoned action: Its application to AIDS preventative behavior (pp. 227–252). Oxford: Pergamon Press.

    Google Scholar 

  • Gold, R. (2000). AIDS education for gay men: Towards a more cognitive approach. AIDS Care, 12, 267–272. doi:10.1080/09540120050042909.

    Article  PubMed  Google Scholar 

  • Gold, R., & Skinner, M. (1992). Situational factors and thought processes associated with unprotected intercourse in young gay men. AIDS, 6, 1021–1030.

    Article  PubMed  Google Scholar 

  • Grudzen, C., Elliott, M., Kerndt, P., Schuster, M., Brook, R., & Gelberg, L. (2009). Condom use and high-risk sexual acts in adult films: A comparison of heterosexual and homosexual films. American Journal of Public Health, 99, S152–S156.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hald, G. M., Smolenski, D., & Rosser, B. R. S. (2013). Perceived effects of sexually explicit media among men who have sex with men and psychometric properties of the Pornography Consumption Effects Scale (PCES). Journal of Sexual Medicine, 10(3), 757–767. doi:10.1111/j.1743-6109.2012.02988.x.

    Article  PubMed  Google Scholar 

  • Hurley, R. (2009). Bareback to basics: How gay porn undermines safe sex campaigns. British Medical Journal, 338, b910.

    Article  Google Scholar 

  • Imrie, J., Stephenson, J., Cowan, F., Wanigaratne, S., Billington, A., Copas, A., … Behavioural Intervention in Gay Men Project Study Group. (2001). A cognitive behavioural intervention to reduce sexually transmitted infections among gay men: Randomised trial. British Medical Journal, 322, 1451–1456.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kelly, J. A., DiFranceisco, W. J., St Lawrence, J. S., Amirkhanian, Y. A., & Anderson-Lamb, M. (2014). Situational, partner, and contextual factors associated with level of risk at most recent intercourse among Black men who have sex with men. AIDS and Behavior, 18(1), 26–35. doi:10.1007/s10461-013-0532-y.

    Article  PubMed  Google Scholar 

  • Kendall, C. (2004a). Gay male pornography: An issue of sex discrimination. Vancouver, BC: UBC Press.

    Google Scholar 

  • Kendall, C. N. (2004b). Educating gay male youth: Since when is pornography a path towards self-respect? Journal of Homosexuality, 47(3–4), 83–128. doi:10.1300/J082v47n03_06.

    Article  PubMed  Google Scholar 

  • Klein, H., & Tilley, D. L. (2012). Perceptions of HIV risk among internet-using, HIV-negative barebacking men. American Journal of Men’s Health, 6(4), 280–293. doi:10.1177/1557988311434825.

    Article  PubMed  Google Scholar 

  • Kubicek, K., Carpineto, J., McDavitt, B., Weiss, G., & Kipke, M. D. (2011). Use and perceptions of the internet for sexual information and partners: A study of young men who have sex with men. Archives of Sexual Behavior, 40(4), 803–816. doi:10.1007/s10508-010-9666-4.

    Article  PubMed  Google Scholar 

  • Levy, M. E., Wilton, L., Phillips, G., Glick, S. N., Kuo, I., Brewer, R. A., … Magnus, M. (2014). Understanding structural barriers to accessing HIV testing and prevention services among Black men who have sex with men (BMSM) in the United States. AIDS and Behavior, 18(5), 972–996. doi:10.1007/s10461-014-0719-x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Matthews, D. D., Herrick, A. L., Coulter, R. W. S., Friedman, M. R., Mills, T. C., Eaton, L. A., … POWER Study Team. (2016). Running backwards: Consequences of current HIV incidence rates for the next generation of Black MSM in the United States. AIDS and Behavior, 20(1), 7–16. doi:10.1007/s10461-015-1158-z.

    Article  PubMed  PubMed Central  Google Scholar 

  • McCormack, M., & Wignall, L. (2016). Enjoyment, exploration and education: Understanding the consumption of pornography among young men with non-exclusive sexual orientations. Sociology. doi:10.1177/0038038516629909.

    Google Scholar 

  • Morgan, E. M. (2011). Associations between young adults’ use of sexually explicit materials and their sexual preferences, behaviors, and satisfaction. Journal of Sex Research, 48(6), 520–530. doi:10.1080/00224499.2010.543960.

    Article  PubMed  Google Scholar 

  • Myers, H. F., Javanbakht, M., Martinez, M., & Obediah, S. (2003). Psychosocial predictors of risky sexual behaviors in African American men: implications for prevention. AIDS Education and Prevention, 15(1 Suppl. A), 66–79.

    Article  PubMed  Google Scholar 

  • Nelson, K. M., & Carey, M. P. (2016). Media literacy is an essential component of HIV prevention for young men who have sex with men [Letter to the Editor]. Archives of Sexual Behavior, 45(4), 787–788. doi:10.1007/s10508-016-0712-8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nelson, K. M., Leickly, E., Yang, J. P., Pereira, A., & Simoni, J. M. (2014a). The influence of sexually explicit online media on sex: Do men who have sex with men believe they “do what they see”? AIDS Care, 26(7), 931–934. doi:10.1080/09540121.2013.871219.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nelson, K. M., Pantalone, D. W., Gamarel, K. E., & Simoni, J. M. (2016). A new measure of the perceived influence of sexually explicit online media on the sexual behaviors of men who have sex with men. Journal of Sex Research, 53(4–5), 588–600. doi:10.1080/00224499.2015.1066744.

    Article  PubMed  Google Scholar 

  • Nelson, K. M., Simoni, J. M., Morrison, D. M., George, W. H., Leickly, E., Lengua, L. J., & Hawes, S. E. (2014b). Sexually explicit online media and sexual risk among men who have sex with men in the United States. Archives of Sexual Behavior, 43(4), 833–843. doi:10.1007/s10508-013-0238-2.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nelson, K. M., Simoni, J. M., Pearson, C. R., & Walters, K. L. (2011). “I”ve had unsafe sex so many times why bother being safe now?’: The role of cognitions in sexual risk among American Indian/Alaska Native men who have sex with men. Annals of Behavioral Medicine, 42(3), 370–380. doi:10.1007/s12160-011-9302-0.

    Article  PubMed  PubMed Central  Google Scholar 

  • Oldenburg, C. E., Perez-Brumer, A. G., Reisner, S. L., & Mimiaga, M. J. (2015). Transactional sex and the HIV epidemic among men who have sex with men (MSM): Results from a systematic review and meta-analysis. AIDS and Behavior, 19(12), 2177–2183. doi:10.1007/s10461-015-1010-5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Peterson, J. L., & Jones, K. T. (2009). HIV prevention for Black men who have sex with men in the United States. American Journal of Public Health, 99(6), 976–980. doi:10.2105/AJPH.2008.143214.

    Article  PubMed  PubMed Central  Google Scholar 

  • Potter, W. J. (2013). Media literacy (7th ed.). Thousand Oaks, CA: Sage Publications Inc.

    Google Scholar 

  • Purcell, D. W., Johnson, C. H., Lansky, A., Prejean, J., Stein, R., Denning, P., … Crepaz, N. (2012). Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. The Open AIDS Journal, 6, 98–107. doi:10.2174/1874613601206010098.

    Article  PubMed  PubMed Central  Google Scholar 

  • Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401. doi:10.1177/014662167700100306.

    Article  Google Scholar 

  • Reisner, S. L., Mimiaga, M. J., Skeer, M., Bright, D., Cranston, K., Isenberg, D., … Mayer, K. H. (2009). Clinically significant depressive symptoms as a risk factor for HIV infection among black MSM in Massachusetts. AIDS and Behavior, 13(4), 798–810. doi:10.1007/s10461-009-9571-9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rosser, B. R. S., Grey, J. A., Wilkerson, J. M., Iantaffi, A., Brady, S. S., Smolenski, D. J., & Horvath, K. J. (2012). A commentary on the role of sexually explicit media (SEM) in the transmission and prevention of HIV among men who have sex with men (MSM). AIDS and Behavior, 16(6), 1373–1381. doi:10.1007/s10461-012-0135-z.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rosser, B. R. S., Smolenski, D. J., Erickson, D., Iantaffi, A., Brady, S. S., Galos, D. L., … Wilkerson, J. M. (2013). The effects of gay sexually explicit media on the HIV risk behavior of men who have sex with men. AIDS and Behavior, 17(4), 1488–1498. doi:10.1007/s10461-013-0454-8.

    Article  PubMed  Google Scholar 

  • Rothman, E. F., Kaczmarsky, C., Burke, N., Jansen, E., & Baughman, A. (2015). “Without porn … I wouldn’t know half the things I know now”: A qualitative study of pornography use among a sample of urban, low-income, Black and Hispanic youth. Journal of Sex Research, 52(7), 736–746. doi:10.1080/00224499.2014.960908.

    Article  PubMed  Google Scholar 

  • Safren, S. A., Reisner, S. L., Herrick, A., Mimiaga, M. J., & Stall, R. D. (2010). Mental health and HIV risk in men who have sex with men. Journal of Acquired Immune Deficiency Syndromes, 55(Suppl. 2), S74–S77. doi:10.1097/QAI.0b013e3181fbc939.

    Article  PubMed  PubMed Central  Google Scholar 

  • Saleh, L. D., Operario, D., Smith, C. D., Arnold, E., & Kegeles, S. (2011). “We’re going to have to cut loose some of our personal beliefs”: Barriers and opportunities in providing HIV prevention to African American men who have sex with men and women. AIDS Education and Prevention, 23(6), 521–532. doi:10.1521/aeap.2011.23.6.521.

    Article  PubMed  Google Scholar 

  • Schrimshaw, E. W., Antebi-Gruszka, N., & Downing, M. J. (2016). Viewing of Internet-based sexually explicit media as a risk factor for condomless anal sex among men who have sex with men in four U.S. cities. PLoS ONE, 11(4), e0154439. doi:10.1371/journal.pone.0154439.

    Article  PubMed  PubMed Central  Google Scholar 

  • Scott, H. M., Vittinghoff, E., Irvin, R., Sachdev, D., Liu, A., Gurwith, M., & Buchbinder, S. P. (2014). Age, race/ethnicity, and behavioral risk factors associated with per contact risk of HIV infection among men who have sex with men in the United States. Journal of Acquired Immune Deficiency Syndromes, 65(1), 115–121. doi:10.1097/QAI.0b013e3182a98bae.

    Article  PubMed  PubMed Central  Google Scholar 

  • Scott-Sheldon, L. A. J., & Johnson, B. T. (2006). Eroticizing creates safer sex: A research synthesis. Journal of Primary Prevention, 27(6), 619–640. doi:10.1007/s10935-006-0059-3.

    Article  PubMed  Google Scholar 

  • Shah, D., Thornton, S., & Burgess, A. (1997). Sexual risk cognitions questionnaire: A reliability and validity study. AIDS Care, 9, 471–480.

    Article  PubMed  Google Scholar 

  • StataCorp. (2011). Stata Statistical Software: Release 12. College Station, TX: Author.

    Google Scholar 

  • Stein, D., Silvera, R., Hagerty, R., & Marmor, M. (2012). Viewing pornography depicting unprotected anal intercourse: Are there implications for HIV prevention among men who have sex with men? Archives of Sexual Behavior, 41(2), 411–419. doi:10.1007/s10508-011-9789-2.

    Article  PubMed  Google Scholar 

  • Sullivan, P. S., Carballo-Diéguez, A., Coates, T., Goodreau, S. M., McGowan, I., Sanders, E. J., … Sanchez, J. (2012). Successes and challenges of HIV prevention in men who have sex with men. Lancet, 380(9839), 388–399. doi:10.1016/S0140-6736(12)60955-6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sullivan, P. S., Rosenberg, E. S., Sanchez, T. H., Kelley, C. F., Luisi, N., Cooper, H. L., … Peterson, J. L. (2015). Explaining racial disparities in HIV incidence in black and white men who have sex with men in Atlanta, GA: A prospective observational cohort study. Annals of Epidemiology, 25(6), 445–454. doi:10.1016/j.annepidem.2015.03.006.

    Article  PubMed  PubMed Central  Google Scholar 

  • Træen, B., Hald, G. M., Noor, S. W., Iantaffi, A., Grey, J., & Rosser, B. R. S. (2014). The relationship between use of sexually explicit media and sexual risk behavior in men who have sex with men: Exploring the mediating effects of sexual self-esteem and condom use self-efficacy. International Journal of Sexual Health, 26(1), 13–24. doi:10.1080/19317611.2013.823900.

    Article  PubMed  Google Scholar 

  • Ward, H., & Rönn, M. (2010). Contribution of sexually transmitted infections to the sexual transmission of HIV. Current Opinion in HIV and AIDS, 5(4), 305–310. doi:10.1097/COH.0b013e32833a8844.

    Article  PubMed  PubMed Central  Google Scholar 

  • Weinberg, M. S., Williams, C. J., Kleiner, S., & Irizarry, Y. (2010). Pornography, normalization, and empowerment. Archives of Sexual Behavior, 39(6), 1389–1401. doi:10.1007/s10508-009-9592-5.

    Article  PubMed  Google Scholar 

  • Wheeler, D. P., Lauby, J. L., Liu, K., Van Sluytman, L. G., & Murrill, C. (2008). A comparative analysis of sexual risk characteristics of Black men who have sex with men or with men and women. Archives of Sexual Behavior, 37(5), 697–707. doi:10.1007/s10508-008-9372-7.

    Article  PubMed  Google Scholar 

  • White, J. M., Dunham, E., Rowley, B., Reisner, S. L., & Mimiaga, M. J. (2015). Sexually explicit racialised media targeting men who have sex with men online: A content analysis of high-risk behaviour depicted in online advertisements. Culture, Health & Sexuality, 17(8), 1021–1034. doi:10.1080/13691058.2015.1027738.

    Article  Google Scholar 

  • Wilkerson, J. M., Iantaffi, A., Smolenski, D. J., Horvath, K. J., & Rosser, B. R. S. (2013). Acceptability of HIV-prevention messages in sexually explicit media viewed by men who have sex with men. AIDS Education and Prevention, 25(4), 315–326. doi:10.1521/aeap.2013.25.4.315.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We would like to thank the participants for this help with this project. This work was supported by R01MH094230 and R01NR013865. Dr. Nelson was supported by T32MH078788 and K23MH109346. Dr. Gamarel was supported by training grant T32MH078788.

Funding

This work was supported by the National Institutes of Health (R01MH094230, R01NR013865, T32MH078788, and K23MH109346). The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA

    Kimberly M. Nelson

  2. Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA

    Kimberly M. Nelson & Kristi E. Gamarel

  3. Department of Human Development and Family Studies, University of Connecticut, Storrs, CT, USA

    Lisa A. Eaton

  4. Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA

    Kristi E. Gamarel

  5. Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA

    Kristi E. Gamarel

Authors
  1. Kimberly M. Nelson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisa A. Eaton
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kristi E. Gamarel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kimberly M. Nelson.

Ethics declarations

Conflict of interest

Drs. Nelson, Eaton, and Gamarel declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nelson, K.M., Eaton, L.A. & Gamarel, K.E. Preferences for Condomless Sex in Sexually Explicit Media Among Black/African American Men Who Have Sex with Men: Implications for HIV Prevention. Arch Sex Behav 46, 977–985 (2017). https://doi.org/10.1007/s10508-016-0878-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-016-0878-0

Keywords

Search

Navigation