Viewing of internet-based sexually explicit media as a risk factor for condomless sex among men who have sex with men

Background: The last decade has seen a dramatic increase in the availability of sexually explicit media (SEM). The greatly expanded access to SEM afforded by the Internet has perhaps had the greatest impact on men who have sex with men (MSM). Although many MSM view SEM positively, widespread use of SEM among MSM may not be without adverse consequences. Method: An Internet-administered survey of 265 MSM who reported viewing Internet-based SEM in the past three months recruited via advertisements on Craigslist and Facebook in 2012. Results:  Participants viewed, on average, five hours of Internet SEM per week and nearly all reported viewing SEM featuring anal sex with (91%) or without (92%) condoms in the past three months. Even after controlling for relationship status, sexual sensation seeking, number of hours spent viewing SEM per week, and compulsive Internet SEM use, viewing a greater proportion of SEM containing condomless anal sex was associated with engaging in more condomless anal sex encounters (AOR = 1.19, 95% CI = 1.02 – 1.40) and viewing a greater proportion of SEM containing anal sex where condoms were used was associated with fewer condomless anal sex encounters (AOR = 0.60, 95% CI = 0.51 – 0.70).  Discussion: These findings provide further evidence that the viewing of bareback SEM is associated with greater sexual risk behaviors and suggest that policies requiring condom use by actors in the SEM industry may benefit not only actor health, but also have health implications for SEM viewers.