In the dark: Young men's stories of sexual initiation in the absence of relevant sexual health information

There has been increased attention to the consequences of poor sexual health education among heterosexual adolescents. Similarly, limited research has shown that “gay-sensitive” HIV instruction in schools is related to lower rates of HIV risk behaviors among gay, lesbian and bisexual (GLB) youth. However, there remains a dearth of relevant sexual health information available to GLB youth. Drawing on a mixed methods study with an ethnically diverse cohort of 526 young men who have sex with men (YMSM), this presentation explores how and where YMSM receive information on sexual health and behavior. The mean age for initiating anal sex was seventeen, and the choice to use a condom during that debut was associated with recent condom use. During qualitative interviews, respondents reported having limited knowledge and/or misconceptions about HIV and other sexually transmitted infections at the time of their sexual initiation. These findings indicate a limited availability of information related to gay men's sexuality from family, friends or schools. The information YMSM did access from older or more experienced partners, the Internet and pornography was often incomplete or misleading. For example, some believed that unprotected sex was “low risk”. Additional challenges at sexual debut included a lack of knowledge of the mechanics of anal sex, resulting in painful and/or unpleasant experiences with varying levels of risk. Findings are discussed in relation to how educators can increase knowledge of GLB sexuality to build solid foundations of sexual health education to reduce STI and HIV infections.