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Less understood, particularly in the experiences of gay and bisexual men, are the relational or interpersonal variables that may affect condom use [ 23 ]. Studies of heterosexual partners have demonstrated that the use of condoms has relational significance; specifically, heterosexual partners report that the use of condoms may signify a lack of trust, a lack of emotional bond or a lack of intimacy during sex acts [ 16 ]. Evidence suggests that gay and bisexual men similarly view condoms as a barrier to intimacy, preventing the emotional experiences of closeness and bonding that are afforded by condomless sex [ 26 — 29 ]; however, the effect of relational variables on the use of condoms amongst gay and bisexual men has received scant attention in the literature; this may be due, in part, to stereotypic attitudes toward sexual behavior in this population—namely that relational elements are secondary or insignificant to gay or bisexual men.
The present study is designed to examine the role of condom-related attitudes along these three dimensions—risk reduction, pleasure reduction, and intimacy interference—in predicting condom use among a sample of sexually risky, substance-using gay and bisexual men. Specifically, we were interested in comparing the importance of intimacy interference to that of the two other more widely studied predictors, in order to examine the relative contributions of each of the three condom-related attitudes in predicting unprotected sex acts in this population, as well as their potential utility in prevention intervention development.
This article presents baseline data collected from gay and bisexual men recruited in the New York City metropolitan area for a study focused on substance use and sexual risk. Between September and September , participants completed a quantitative survey.
The Critical Role of Intimacy in the Sexual Risk Behaviors of Gay and Bisexual Men
To be eligible, participants had to be men, at least 18 years of age, self-report a negative or unknown HIV serostatus, and report at least 5 days of substance use including cocaine, methamphetamine, gamma hydroxybutyrate, ecstasy, ketamine, or poppers and at least one incident of unprotected anal intercourse with a casual or serodiscordant main male partner in the last 90 days.
Men completed baseline assessments consisting of psychosocial measures via audio computer-assisted self-interview ACASI software and an interviewer-administered timeline followback of recent 30 day substance use and sexual behavior, as described more fully below. Participants were recruited through a multimethod approach implemented in diverse geographic areas in the New York City metropolitan area using techniques previously effective in the recruitment and enrollment of substance-using MSM [ 30 ].
Both active and passive recruitment strategies were used. Potential participants were recruited for a study focused on substance use and sexual behavior among MSM, and then, upon the completion of the baseline assessment, were offered the option to enroll in a randomized controlled trial of a behavioral intervention.
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Thirteen items assessing attitudes toward condom use were adapted from the Decisional Balance for Unsafe Sex Scale [ 31 ] and a measure of situational temptation for unprotected sex [ 32 ]. These items formed the basis for three condom attitude subscales, each assessing a different aspect of motivation or barriers to condom use. The timeline followback TLFB semi-structured interview [ 33 ], modified for the assessment of sexual risk behavior and substance use [ 34 , 35 ], was used to collect data for the previous 30 days.
Critical life events i. The TLFB has demonstrated good test—retest reliability, convergent validity, and agreement with collateral reports for sexual behavior and substance use [ 36 , 37 ]. Interviewers for this project received extensive training in the administration of the TLFB, and demonstrated skills as evidenced through ongoing review of audiotapes of the TLFB interview and supervision in the development of rapport with participants and remaining non-judgmental and sex-positive in order to facilitate honest self-reports and to respect the values and behaviors of all participants.
Using a calendar, interviewers asked participants to report the type of sexual activity anal or oral intercourse; protected or unprotected by partner type main or casual on each day of the preceding 30 days. For each sexual behavior, participants also reported whether they were sober or under the influence of drugs.
Participants also reported days of drug use when sexual activity did not occur. Because the interaction of condom-related attitudes and behavior are likely to operate differently by partner type even within a given individual , we decided to focus this analysis on the impact of condom-related attitudes on sexual risk with casual partners. Excluded participants did not differ from the study sample on demographic variables or condom-related attitudes. Demographic data on study participants are presented in Table 1.
Over half the sample In subsequent analyses, this variable was log-transformed to correct for skew. Both the Pleasure Reduction and Intimacy Interference subscales were adequately and normally distributed. Table 1 also presents mean endorsement of each of the three condom attitudes subscales by demographic variables. Participants reported an average of 8. An average of The results of this regression are presented in Table 2. Because of the high correlation between the Pleasure Reduction and Intimacy Interference subscales, we conducted an evaluation of multicollinearity through criteria provided by Belsely, Kuh and Welsch [ 38 ].
The last root had a condition index equal to 6. The coefficients for both the Risk Reduction and Intimacy Interference subscales were significant in this step. Higher scores on the Intimacy Interference subscale—i. Scores on the Pleasure Reduction subscale—i. Findings from this study suggest a pivotal role for beliefs about condoms reducing intimacy in predicting unprotected sex with casual partners among a group of substance-using, sexually risky gay and bisexual men.
Beliefs that condoms reduce intimacy were strongly associated with beliefs that condoms reduce pleasure; however, in the multivariate model, only intimacy emerged as a significant predictor of percentage of sex acts that were unprotected. This paper is among the first to compare the relative importance of pleasure- versus intimacy-related attitudes in predicting unprotected sex among gay and bisexual men.
Our findings complement those of other studies suggesting that intimacy is a powerful motive in sexual decision-making among gay and bisexual men [ 39 ]. Many gay and bisexual men report being reluctant to give up the sexual and emotional intimacy associated with unprotected sex [ 40 , 41 ], and in one study of Latino gay men, participants reported that sex with condoms was incompatible with intimacy and trust [ 42 ]. An enhanced understanding of intimacy concerns and motives among gay, bisexual, and other MSM must acknowledge that intimacy includes not only physical or sexual closeness, but also emotional connectedness, self-disclosure, acceptance, and trust [ 43 ].
MSM report that their interest in establishing intimate connections may come into conflict with their desire to reduce sexual risk, and studies have found intimacy to be a motivating factor in partner selection practices or other risk-reduction strategies such as serosorting [ 39 ]. Past studies of motivations for barebacking have linked pleasure and emotional connection as a single factor associated with unprotected anal sex [ 26 ]. Our findings suggest that while pleasure and intimacy may be correlated, intimacy plays a greater role in predicting condom-use.
However, the fact that intimacy plays such a powerful role in condom use even in casual sexual encounters for gay and bisexual men suggests a fundamental need to revaluate prevention messages, including the extent to which men may privilege intimacy motives over risk reduction. More research is needed into the ways in which condom use may disrupt processes of intimacy among gay and bisexual men and the extent to which men may forgo condom use for the explicit purpose of communicating to a casual partner that they want to alter their relationship status toward romantic commitment.
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These data are subject to several limitations. The Risk Reduction, Pleasure Reduction, and Intimacy Interference subscales were not originally designed to tap into these constructs. It is possible that participants were subject to demand characteristics that biased their responses, especially those who had reported the most high-risk behavior.
However, we would hypothesize that this type of demand would result in an overestimate of the role of the Pleasure Reduction subscale, rather than the Intimacy Interference subscale, and our data demonstrated the opposite pattern. Because of the nature of the study from which these data are drawn, participants are active substance users living in an urban setting, and may not generalize to other populations of gay and bisexual men. However, this population is considered at highest risk for HIV infection, and can be argued to be those most in need of innovative intervention strategies.
In this study, we used percentage of sex acts that were high-risk, rather than a raw score of number of unprotected sex acts as our variable of interest. In other words, we examined the extent to which condom attitudes influenced the percent of the time in which an individual had unprotected sex, such that a man had unprotected sex in two out of two encounters is considered more strongly influenced than a man who had unprotected sex in three out of ten encounters. However, this analytic strategy does not control for overall number of sex acts or partners in its analysis.
It seems reasonable to assume that risk reduction and intimacy interference attitudes might operate differently to influence condom use as the number of repeat sex acts with the same casual partner increases. An act-by-partner analysis was beyond the scope of the present paper; however, future analyses should consider analytic approaches that can take such issues into account.
These data provide an important call for further investigation into the meaning and role of intimacy in the sexual decision-making of gay, bisexual, and other MSM. Further research should distinguish between different types of intimacy—e. In fact, the study says, non-monogamous couples can actually be closer than their more faithful counterparts.
He conducted minute, individual interviews with each of these men and their partners, who ranged in age from 19 to So far, Stults says his finding is that non-monogamous relationships can lead to a happier, more fulfilling relationship. So what makes an open relationship work? For McIntyre and Allen, two rules are key: For David Sotomayor, a year-old financial planner from New York, sticking to specific rules is fundamental to the success of his open marriage.
Sotomayor has broken them multiple times, which has caused conflict. There is emotion at play, and even in the most transactional experience someone can get attached. The anorgasmia occurs in women with psychological disorders such as guilt and anxiety that was caused by sexual assault. The last sexual disorder is the painful intercourse. The sexual disorder can be result of pelvic mass, scar tissue, sexually transmitted disease and more.
The lack of sexual desire in men is because of loss of libido, low testosterone. There are also psychological factors such as anxiety, and depression. The erectile dysfunction is a disability to have and maintain an erection during intercourse. Sexuality in humans generates profound emotional and psychological responses. Some theorists identify sexuality as the central source of human personality.
He also proposed the concepts of psychosexual development and the Oedipus complex , among other theories. Gender identity is a person's sense of self-identification as female, male, both, neither, or somewhere in between.
The social construction of gender has been discussed by many scholars, including Judith Butler. More recent research has focused upon the influence of feminist theory and courtship.
Human sexuality - Wikipedia
Sexual behavior and intimate relationships are strongly influenced by a person's sexual orientation. Before the High Middle Ages , homosexual acts appear to have been ignored or tolerated by the Christian church. By the end of the 19th century, it was viewed as a pathology. He said male homosexuality resulted when a young boy had an authoritarian, rejecting mother and turned to his father for love and affection, and later to men in general. He said female homosexuality developed when a girl loved her mother and identified with her father, and became fixated at that stage.
Sleeping with other people: how gay men are making open relationships work
Freud and Ellis said homosexuality resulted from reversed gender roles. In the early 21st century, this view is reinforced by the media's portrayal of male homosexuals as effeminate and female homosexuals as masculine. Society believes that if a man is masculine he is heterosexual, and if a man is feminine he is homosexual. There is no strong evidence that a homosexual or bisexual orientation must be associated with atypical gender roles. By the early 21st century, homosexuality was no longer considered to be a pathology.
Theories have linked many factors, including genetic, anatomical, birth order, and hormones in the prenatal environment, to homosexuality. Other than the need to procreate, there are many other reasons people have sex. In the past [ when? Sigmund Freud was one of the first researchers to take child sexuality seriously.