Diverse Sexual Behaviors among a Sample of over 25,000 Men who have Sex with Men

Purpose: Men who have sex with men (MSM) continue to be disproportionately impacted by HIV/STIs. Significant attention has been given to capturing sexual behavior among this population, however most research limits behavior to counts or oral, anal, or vaginal intercourse. The present study sought to better understand the sexual repertoires of MSM in a large sample of internet-using men.

Methods: Data were collected via an internet-based survey from 27,690 18-80 year MSM. Measures assessed sociodemographics, health-related indicators, recent/lifetime sexual behavior history and sexual experience items.

Results: Participants' mean age was 39.0 years, ethnicities included white (84.6%), Latino (6.4%), African American (3.5%), and most (79.9%) self identified as homosexual. Over half of participants were not in a romantic relationship (54.2%) and nearly all (88.9%) had engaged in sexual activity with more than one partner in the past year. The most commonly reported behavior was solo masturbation, with nearly all participants (97.4%) having done so in the past 30 days. While less than half of men reported engaging in receptive (42.5%) or insertive (46.1%) anal intercourse in the previous 30 days, a similar percentage reported oral-anal contact as the receiving (44.0%) and performing partner (39.9%). Lifetime rates of behavior included having female partners (48.5%), having group sex (81.3%), and engaging in virtual sex (86.0%).

Conclusions: These data provide one of the first large assessments of MSM lifetime sexual repertoire. Findings highlight diversity in sexual behavior and demonstrate a variety of sexual acts among MSM not limited to anal intercourse or male partners.