Using Community-Based Participatory Research to assess HIV risk and sexual compulsivity among rural MSM

Background: It has been reported that rural men who have sex with men (MSM) are less likely than urban MSM to report their sexual behavior and to practice safer sex given their geographic isolation from supportive gay communities in which most HIV/AIDS interventions are found. Community-based participatory research (CBPR) has been shown to be effective in reaching populations historically neglected by mainstream methodologies. Method: Using CBPR, researchers and rural HIV service providers collected data using an Internet-based survey from 270 MSM. Measures included sociodemographics, health status, sexual behaviors, sexual compulsivity, and those related to sexual partner seeking. Results: Of the 270 participants, the majority identified as gay/homosexual, white, single, and currently sexually active. The mean sexual compulsivity score among men was 1.65 [SD = 0.66]. Nearly all participants (85.7%) had visited gay-related Internet sites, 42.2% had sex with someone met online and of those individuals 51.7% scored above the mean on the Sexual Compulsivity Scale (SCS). Further, participants with higher SCS scores were more likely to not use condoms during receptive (p = 0.035) or insertive anal sex (p = 0.044). Conclusions: MSM in this sample differed from other urban samples in both the nature of the venues in which they have sought sexual partners and also scored higher on the sexual compulsivity measure compared to those reported from recent urban samples. Internet-based interventions may be effective in reaching rural MSM and the sexual compulsivity measure may be a helpful tool to include in interventions that reach these populations.