142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Participant Observer Methodology in Assessing the Role of Attractiveness in MSM Sexual Risk Taking

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Jorge Figueroa, Ph.D. , Public Health Studies, School of Health & Applied Human Sciences, University of North Carolina Wilmington, Wilmington, NC
  • This study uses a modified participant-observer methodology to investigate the willingness of MSM to agree to unprotected anal intercourse (UAI).  Nearly all published research of sexual risk-behavior is based on self-report data. This study uses participant-observer methodology to reduce biases associated with self-report in estimating the prevalence of UAI. The study also expands previous research identifying the relationship of attractiveness in sexual risk-taking to include the attractiveness of both parties.


  • Using a well-known Internet networking site, ads were placed in cities throughout the US.  Half of the ads included a picture of an “attractive” male and half a picture of an “average-looking” male.  The ads instructed interested men to reply including pictures of themselves.   Respondents to the ads were invited to meet for a sexual encounter with an explicit stipulation of “bareback only.”  The respondents’ photographs were ranked on attractiveness, and the effects on willingness to engage in UAI were analyzed.


  • Eighty-two percent of respondents agreed to UAI. Respondents to the attractive male were 55 times more likely to agree to bareback than those responding to the average male. There was also a significant interaction where, as the respondents’ attractiveness decreased, their willingness to bareback with the attractive male significantly increased.  


  • This study supports the contribution that PO methodology can make in better understanding the dynamics of MSM sexual-risk behavior.  These findings are examined within a sexual-economics model where less attractive individuals exchange UAI as a way of increasing their value to a more attractive partner. 

Learning Areas:

Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the construct of sexual capital and how it may be used to understand sexual risk-taking. Discuss the potential advantages of participant observer methodology in understanding sexual risk behaviors among MSM. Explain how sexual capital theory explains the role of attractiveness in willingness to engage in unprotected anal intercourse among MSM.

Keyword(s): HIV Risk Behavior, Methodology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the past Coordinator of the Public Health Studies Program at the University Of North Carolina Wilmington. Prior to returning to Academia I was the Executive Director of the Northern Colorado AIDS Project; one of five regional ASOs in Colorado. I was appointed to the Governor's Council on AIDS, bringing clinical, applied and scientific expertise to address HIV/AIDS issues in Colorado.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.