Beyond Risk: Examining Last Sexual Events among a Large US Sample of Men who have Sex with Men

MSM are disproportionately impacted by HIV and STIs. In attempting to understand sexual behavior most research utilizes subjective timeframes (e.g. past 90 days). While this measurement approach can provide a sexual profile, it fails to capture complex contextual factors associated with specific sexual events. The purpose of this study was to document the most recent sexual event among MSM.

Data were collected via an internet-based survey from 27,690 18-80 year MSM. Measures included sociodemographics, psychosocial indicators, condom use, and sexual behavior.

Participants' mean age was 39.0 years, ethnicities included white (84.6%), Latino (6.4%), African-American (3.5%), and most (79.9%) identified as homosexual. Over half of participants were single (54.2%) and nearly all (88.9%) had more than one sexual partner in the past year. The most recent sexual event for most men (60.1%) had occurred within the past 7 days. Common locations of sexual activity included participant's home (49.6%) and sexual partner's home (28.1%). The majority reported not engaging in receptive (63.0%) or insertive (64.8%) anal sex, and most common reported behaviors included performing oral sex (77.9%), kissing (77.1%), and receiving oral sex (76.4%). Regardless of anal sex behavior, 46.1% reported condom use, 95.7% used lubricant, and participants reported no ejaculation in their own (98.1%) or their partner's anus (98.1%).

These data provide one of the first large assessments of sexual behavior among MSM during their most recent sexual encounter. Findings highlight variation in sexual behavior and demonstrate the need for comprehensive HIV prevention messages that consider contextual sexual experiences of MSM.