Perceptions of sexual partners and associated sexual risk behavior among a national sample of men who have sex with men

Background: Transmission of Human Immunodeficiency Virus (HIV) and sexually transmitted infections (STIs) continues to be a major public health concern, with an emphasis on addressing the needs of men who have sex with men (MSM). Little is known about what sexual partners communicate about sexual histories, nor how partners weigh the pros and cons of sexual encounters based on partner perceptions, suggesting a need to understand interpersonal dynamics of sexual risk evaluation. Methods: We assessed perceptions of sexual partners and associated sexual risk behavior among a national sample of HIV-negative men who have sex with men (MSM) in the United States. Data were collected from U.S. HIV-negative MSM (n = 24, 672) through an online survey. Results: Participants' median age was 39.0 years; most were white (84.6%), and most (79.9%) identified as homosexual. The most commonly reported behavior was kissing on the mouth (74.5%), followed by oral sex (72.7%), partnered masturbation (68.4%), and anal intercourse (37.2%). Multivariate logistic regression analysis was conducted to determine three aspects of partner evaluation: knowledge of sexual partners' extra-relational sexual behavior, STI history, and affective relationship dynamics in relation to sexual practices. The majority of respondents were aware of partner sexual history (68%) and STI status (60%). Preliminary findings suggest multiple influences on partner and sexual risk evaluation. Conclusions: Existing research often ignores the affective dynamic of partner evaluation. Understanding how knowledge of sexual partner's extra-relational sexual history impacts sexual behaviors can help public health interventions formulate messages that resonate as realistic and applicable.