Men, Multiple Sexual Partners, and Young Adults’ Sexual Relationships: Understanding the Role of Gender in the Study of Risk

Heterosexual transmission of HIV and other sexually transmitted infections has become a primary health concern worldwide. Gender roles for heterosexual interactions appear to sanction men’s sexual risk-taking, especially the pursuit of multiple sexual partners. Using measures developed in this study, the current study assessed the associations between men’s and women’s relationship attitudes and experiences and their sexual risk encounters. Participants were 104 men and 103 women (18–24 years) from a large, urban college located in a high HIV risk neighborhood of New York City. All completed a survey assessing HIV risk and the battery of relationship measures assessing traditional sexual roles, sexual conflicts, significance of sex, relationship investment, need for relationship, and unwanted sex. For men, greater sexual conflict in their primary relationships was associated with more sexual partners and fewer unprotected vaginal intercourse encounters with a primary partner and across sex partners overall. In addition, men’s endorsement of more traditional sexual roles and lower relationship investment were associated with higher numbers of sexual partners. Among women, compliance with men to engage in unwanted sex was associated with higher levels of participation in unprotected sex. For both men and women, greater significance given to sex in a relationship was associated with fewer extradyadic partners. This study demonstrates the utility of measures of relationship attitudes and experiences to characterize sexual risk, especially among men. Findings are discussed in terms of implications for prevention program targeting young urban adults.O’Sullivan is with the Department of Family & Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Mazer 100, Bronx, NY 10461, USA; O’Sullivan, Hoffman, and Dolezal are with the HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA; Hoffman is with the Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA; Harrison is with the Department of Medicine, Division of Infectious Diseases and Population Studies and Training Center, Brown University, Providence, RI 02912, USA.     

Timing of Puberty and Sexuality in Men and Women

We examined the relations among timing of puberty, timing of first experience of sexual arousal, strength of sex drive, and sexual attitudes and behaviors in 277 men (M age, 22.4 years) and women (M age, 21.8 years). Kinsey had suggested that earlier maturers have a stronger sex drive and, therefore, engage in a higher frequency of sexual behaviors (including same-sex contacts) than do later maturers. The purpose of this study was to test Kinseys claim. Participants completed questionnaires on pubertal timing, timing of first experience of sexual arousal, sex drive in adulthood, sexual attitudes (e.g., sociosexuality or degree of comfort with casual sex), and sexual behaviors (e.g., lifetime number of sexual partners). Timing of puberty (i.e., emergence of secondary sex characteristics) was related to these variables for men but not for women. Timing of first sexual arousal was related to several aspects of adult sexuality in both sexes, but particularly in women. Earlier first sexual arousal was associated with having a higher sex drive, a less restricted sociosexual orientation, and with having had more sexual partners than was later first sexual arousal. Earlier first sexual arousal, but not timing of puberty, was related to sexual orientation for women only. We discuss classes of explanations for these results.     

Sex without emotional involvement: An evolutionary interpretation of sex differences

Two samples of male (n= 243) and female (n= 298) college students completed sexual surveys, and in-depth, oral interviews were conducted with 28 highly sexually active female college students. Findings supported five predictions derived from evolutionary (parental-investment) theory. Even when females voluntarily engaged in low-investment copulation, coitus typically caused them to feel emotionally vulnerable, and to have thoughts expressing anxiety about partners' willingness to invest. For females, increasing numbers of partners correlated positively with the incidence of these feelings and thoughts; for males, these correlations were negative. Females' attempts to continue regular coitus when they desired more investment than partners were willing to give produced feelings of distress, degradation, and exploitation despite acceptance of liberal sexual morality. Increasing numbers of partners did not mitigate these reactions in females and may exacerbate them. Multiple-partner females developed techniques for dealing with their emotional reactions to low-investment copulation: They frequently tested their partners for signs of ability and willingness to invest (e.g., dominance, prowess, jealousy, nurturance), and they limited or terminated sexual relations when they perceived partners' investment as inadequate. Results were consistent with the view that the emotional-motivational mechanisms that mediate sexual arousal and attraction are sexually dimorphic.     

Sexual Abuse in Childhood and Sexual Dysfunction in Adulthood: An Australian Population-Based Study

This study examined self-reported adult sexual functioning in individuals reporting a history of childhood sexual abuse (CSA) in a representative sample of the Australian population. A sample of 1793 persons, aged 18–59 years, were randomly selected from the electoral roll for Australian states and territories in April 2000. Respondents were interviewed about their health status and sexual experiences, including unwanted sexual experiences before the age of 16 years. More than one-third of women and approximately one-sixth of men reported a history of CSA. Women were more likely than men to report both non-penetrative and penetrative experiences of CSA. For both sexes, there was a significant association between CSA and symptoms of sexual dysfunction. In assessing the specific nature of the relationship between sexual abuse and sexual dysfunction, statistically significant associations were, in general, evident for women only. CSA was not associated with the level of physical or emotional satisfaction respondents experienced with their sexual activity. The total number of lifetime sexual partners was significantly and positively associated with CSA for females, but not for males; however, the number of sexual partners in the last year was not related to CSA. CSA in the Australian population is common and contributes to significant impairment in the sexual functioning of adults, especially women. These consequences appear not to extend to the other areas of sexual activity considered in this study.     

Sexual Behaviors of Non-gay Identified Non-disclosing Men Who Have Sex with Men and Women

The sexual behaviors of non-gay identified men who have sex with men and women (MSMW) who do not disclose their same-sex behavior to their female partners (referred to by some as men "on the down low") were examined, including the potential for these men to serve as a "bisexual bridge" for HIV and STD acquisition and transmission. Self-reported sexual behavior data were collected as part of an exploratory study of an ethnically diverse (41% African American, 35% Latino, 22% White, and 2% Asian) sample of 46 non-gay identified, non-disclosing MSMW in New York City. Men reported significantly more male than female sexual partners, but more frequent sex with females. The prevalence and frequency of unprotected sex did not differ significantly between male and female partners in the past 3 months. Men reported risk behavior more often with steady female and steady male partners (e.g., wives, girlfriends, boyfriends) than with more casual male and female partners (regular uncommitted partners, one-night stands). Men, especially African American/Black men, were significantly less likely to report receptive sexual behaviors with men than insertive behaviors. Unprotected sex was common with male and female partners in the past 3 months (e.g., 35% of anal sex with men; 50% of vaginal sex). Indeed, 22% of the sample (38% of those who had both recent males and female partners) reported both unprotected vaginal sex and unprotected anal sex with a male partner during the past 3 months. Although the study was limited by a small convenience sample, the findings suggest that non-gay identified non-disclosing MSMW are at risk for the acquisition and transmission of HIV and STDs, and may serve as a potential bridge, suggesting the need for further research and intervention targeting this unique population.     

Sex Differences in Sexual Psychology Produce Sex-Similar Preferences for a Short-Term Mate

We explored aspects of men's and women's short-term sexual psychology as a function of a potential short-term partner's relationship status. A total of 209 men and 288 women reported how likely they would be to pursue a casual sexual relationship with an attractive member of the opposite sex who was (1) married, (2) not married but has casual sexual partners, or (3) not married and has no casual sexual partners. Guided by sperm competition theory, we predicted and found that men prefer short-term sex partners who are not already involved in relationships and hence present a relatively low risk of sperm competition. Because women sometimes use short-term sexual relationships to acquire long-term partners, we predicted and found that women prefer short-term sexual partners who are not already involved in relationships and hence present relatively greater promise as a potential long-term partner. Finally, across each of the three levels of the imagined partner's relationship status, men reported a greater likelihood than did women of pursuing a casual sexual relationship. Discussion addressed methodological limitations and directions for future work.     

Adult Attachment Among Partnered Gay Men: Patterns and Associations with Sexual Relationship Quality

Previous research has found secure adult attachment to be associated positively with dimensions of main partner relationship quality and negatively with sexual risk taking and sex with casual partners among heterosexuals in primary relationships. Potential associations between adult attachment and aspects of relationship functioning have received limited attention among gay men. Data were collected from both members of 344 gay male couples as part of a community survey (M _age = 38.6, SD = 9.4). Participants completed a shortened version of the Adult Attachment Inventory (Collins & Read, 1990) and the Dyadic Sexual Communication Scale (Catania, 1998). They reported the frequency of sex with main partners and the number of casual male unprotected sex partners. Data were analyzed using the Actor-Partner Interdependence Model. Securely attached individuals reported the highest levels of sexual communication and men with securely attached partners were the most likely to report having sex with their partners as least once per week. Avoidantly attached men reported significantly more casual unprotected anal intercourse (UAI) partners compared to other attachment styles. Having an avoidantly attached partner was also associated with an increase in the number of UAI partners reported. Attachment style is relevant to the sexual relationship quality and sexual safety of partnered gay men. Cognitive-interpersonal intervention approaches developed to target attachment-related cognitions and behaviors may be relevant to HIV prevention efforts in this population.     

Characteristics of male and female injecting drug users of the AjUDE-Brasil II Project

The object of this study is to compare female and male injection drug users (IDUs) in terms of sociodemographic profile and aspects of their initiation to the use of injection drugs. It was a cross-sectional and multicentric study realized in 2000-2001 in six Brazilian syringe-exchange programs. 146 women and 709 men were interviewed, with average ages of 29.5 and 28.3 years, respectively. Both began injection drug use at similar ages, 18.6 and 19.3, for women and men, respectively, although women report more frequently than men that they were initiated by a sexual partner to acquiring drugs and syringes, and to the act of injection. Compared to men, women report significantly more regular sexual partners (83% versus 72%); fewer casual partners (39% versus 58%), more use of injection drugs with their partners, as well as more "exchange" of sex for drugs. Among HIV-seropositive individuals, women show less education, had more chance of their sexual partners participating in their initiation to injection drugs, and report sexual partners that used injection drugs more frequently. Female IDUs exhibit aspects of behavior indicating greater vulnerability to HIV infection than do males.     

Correlates of partner-specific condom use intentions among incarcerated women in Rhode Island

CONTEXT: Few studies of incarcerated women have examined potential associations between risky sexual behavior and relationship context factors; thus, little is known about the correlates of intentions to use condoms with main and casual partners in this underserved population. METHODS: A sample of 221 women incarcerated in a Rhode Island Department of Corrections facility in 2002-2003 were interviewed. Multiple linear regression analysis was performed to assess associations between selected demographic, psychosocial and behavioral variables and participants' reported intentions to use condoms with main and casual sexual partners in the first six months after their release. RESULTS: Condom use at last sex with a main partner, sexually transmitted disease (STD) history, no strong desire to currently be pregnant, belief that others influence one's health and perceived STD risk were positively associated with women's intention to use condoms with main partners. Pregnancy history was negatively associated with intention to use condoms with a main partner. Condom use at last sex with a casual partner was positively associated with intention to use condoms with casual partners, whereas binge drinking and believing in the role of chance in determining one's health were negatively associated with intention to use condoms with casual partners. CONCLUSIONS: Whether incarcerated women define a partner as main or casual may influence their decisions about the need to protect themselves by using condoms. Programs that focus on the importance of condom use with all partners could greatly benefit incarcerated women and the communities to which they return.     

Differences between males and females in motives for engaging in sexual intercourse

In a test of the hypothesis that a difference exists between males and females in motives for participating in sexual intercourse, a random sample of 249 college students was given a questionnaire containing questions about sexual behavior and attitudes, focusing on motives for having intercourse. There were significant differences between males and females in approval of casual sexual intercourse, number of premarital sexual partners, most important part of sexual behavior, and whether an emotional involvement was a prerequisite for participating in sexual intercourse. Effect-size analyses indicated that these differences are large, with a median ² = 0.24. Both males and females approved of premarital sexual intercourse in a serious relationship and stressed the importance of feeling loved and needed. However, males found it easier to participate in sexual intercourse without an emotional commitment, whereas females were unlikely to want intercourse for physical pleasure in the absence of psychological involvement.     

Predictors of unprotected male-to-male anal intercourse with casual partners in a national sample

Abstract: The focus of the paper is the predictors of unprotected anal intercourse with casual partners among a national Australian sample of homosexually active men. We interviewed by telephone 2583 homosexually active men (sex with a man within the last five years) about their sexual practice, type of sexual partners, human immunodeficiency virus (HIV) test status, attachment to the gay community, knowledge of HIV and acquired immune deficiency syndrome (AIDS) and a range of demographic variables. Logistic regression analyses were used to distinguish men who practised unprotected anal intercourse with casual partners from those who practised safe sex with casual partners. Men who practised unprotected anal intercourse with casual partners were less likely to have a regular male sexual partner than men who practised safe sex with their casual partners. They were less likely to be tertiary educated, more likely to be employed in trade and manual occupations and to live in Tasmania and the Northern Territory. They were less likely to be culturally or politically attached to the gay community. Knowledge of HIV/AIDS also distinguished the men: men with an accurate knowledge of HIV transmission were less likely to engage in unprotected anal intercourse with their casual partners. Several other variables, including age and HIV test status, did not distinguish those who practised safe sex with casual partners from those who practised unprotected anal intercourse with casual partners.     

Sex with Men Before Coming-Out: Relation to Sexual Activity and Sexual Risk-Taking Behavior

This study examined the difference in sequence of coming-out and first same-sex experience in relation to risk-taking behavior in a sample of Dutch gay and bisexual men. A questionnaire assessed age of disclosure (coming-out) and age of first same-sex experience, and information on sexual history, sexual relationships, and sexual behavior. It was found that 68% of respondents engaged in their first same-sex experience before coming-out. This proportion increased with age. Men who had sex with men before coming-out reported more lifetime sex partners and more casual sex partners in the past 6 months than men in which this sequence was reversed. In addition, among this group a higher proportion of men reported STDs, engaging in anal intercourse with casual partners in the previous 6 months, and unprotected anal sex with casual sex partners in the recent past, compared to men who came out before having their first same-sex experience. The extent to which external factors (such as tolerance toward homosexuals) or internal factors (such as personality factors) can account for the difference in sexual behaviors in general and sexual risk-taking behavior in particular could be subject of further study.     

Casual Sex and Psychological Health Among Young Adults: Is Having “Friends with Benefits” Emotionally Damaging?

CONTEXT: Speculation in public discourse suggests that sexual encounters outside a committed romantic relationship may be emotionally damaging for young people, and federal abstinence education policy has required teaching that sexual activity outside of a marital relationship is likely to have harmful psychological consequences. METHODS: In 2003–2004, a diverse sample of 1,311 sexually active young adults (mean age, 20.5) participating in a longitudinal study in Minnesota completed a survey including measures of sexual behavior and psychological wellbeing. Chi‐square tests were used to compare the prevalence of recent casual partnerships by selected demographic and personal categories. General linear modeling was then used to compare mean levels of each psychological wellbeing measure between those reporting recent casual partners and those reporting committed partners; partner type was measured both dichotomously and categorically. RESULTS: One‐fifth of participants reported that their most recent sex partner was a casual partner (i.e., casual acquaintance or close but nonexclusive partner). Casual partnerships were more common among men than among women (29% vs. 14%), and the proportions of male and female respondents reporting a recent casual partner diff ered by race or ethnicity. Scores of psychological well‐being were generally consistent across sex partner categories, and no significant associations between partner type and well‐being were found in adjusted analyses. CONCLUSIONS: Young adults who engage in casual sexual encounters do not appear to be at greater risk for harmful psychological outcomes than sexually active young adults in more committed relationships.     

Les effets de la dépression sur l’activité sexuelle et la prise de risques parmi les gays français utilisateurs de sites de rencontre sur Internet

ObjectivesThe objective of this study was to analyse how depression influences sexual desires and activities of gay men to understand the co-occurrence of depressed mood, high sex drive and unprotected anal intercourse with casual partners (UAIC) among some individuals.MethodsIn 2004, French gay men visiting a major gay Internet site participated in an online survey assessing serological status, numbers of casual partners, sex drive and control over sex drive, UAIC, depression and its impact on sexual desire.ResultsOne thousand nine hundred (and) thirty-two men who had casual partners in the previous year were included in the analysis. HIV-negative men on average had 22 casual partners per annum, and 28% reported UAIC. Insertive UAIC was practised with 4.5 partners, and receptive UAIC with 4 partners. Sexual activity and risk-taking were substantially higher for HIV-positive men (M = 46 partners, 58% UAIC), and HIV+ men had UAIC with more partners (insertive M = 20, receptive M = 22). Whereas depression lowered sexual desire among most gay men, a minority of men (22%) experienced the reverse effect. HIV+ men more often reported that depression strongly increased their sexual desires. These depressive sexual urges were found to increase sexual activity and reduce men's control over their sex drive. The combined effects of depressed sexual urges, high level of sex-drive, and low control over sex drive, explained 34% of the variance in risk behaviour in HIV-negative men and 56% of the variance in risk behaviour in HIV-positive men.DiscussionIn some gay men, especially those who are HIV-positive, sexual activity seems to be seems to be used to cope with depressive moods. Sexual coping however significantly increases exposures to risk because it may result in sexual compulsivity and reduces the amount of control individuals have over their sex drive. Tackling the issue of mental health amongst gay men is therefore an important challenge for the prevention of HIV.     

The Contexts of Sexual Involvement And Concurrent Sexual Partnerships

CONTEXT: Concurrent sexual partnerships may facilitate the spread of STDs, but little is known about partnership concurrency and its association with the relationship contexts of sexual involvement.
METHODS: Data about demographic characteristics, sexual histories and the most recent opposite-sex partnership among 783 adults aged 18–59 were drawn from the 1995 Chicago Health and Social Life Survey. Wald chi-square tests assessed gender differences in the timing and type of sexual involvement and in concurrent partnerships; bivariate probit regression analyses examined associations between concurrent partnerships and sexual involvement and other characteristics.
RESULTS: One in 10 of both women and men reported that both they and their partners had had other partners. Men were more likely than women to have been nonmonogamous (17% vs. 5%), and women were more likely than men to report that their partner had been (17% vs. 8%). The probability of having been nonmonogamous was 44% higher among women who were sexually involved with a friend, and 30% higher among those with a casual partner, than among those in a serious relationship; the corresponding figures for their partners were 48% and 32%, respectively. For men, the probability of having been nonmonogamous was elevated by 25% among those who were sexually involved with a friend and by 43% among those with a casual partner; for their partners, the figures were 27% and 24%, respectively.
CONCLUSIONS: Increased awareness that nonromantic sexual involvement is associated with partnership concurrency may enhance individuals' understanding of the risks and rewards of their relationships.     

Understanding sex partner selection from the perspective of inner-city black adolescents

CONTEXT: Black adolescents in inner-city settings are at increased risk for HIV and other STDs. Sex partner characteristics, as well as individual behavior, influence individuals' STD risk, yet little is known about the process of sex partner selection for adolescents in this setting. METHODS: Semistructured in-depth interviews were conducted during the summer and fall of 2002 with 50 inner-city black adolescents (26 females and 24 males) who had been purposively recruited from an STD clinic. Content analysis was used to study interview texts. RESULTS: Young women desire a monogamous romantic partner, rather than a casual sex partner; however, to fulfill their desire for emotional intimacy, they often accept a relationship with a nonmonogamous partner. Young men seek both physical and emotional benefits from being in a relationship; having a partner helps them to feel wanted, and they gain social status among their peers when they have multiple partners. For men, these benefits may help compensate for an inability to obtain jobs that would improve their financial and, as a result, social status. Both women and men assess partners' STD risk on the basis of appearance. CONCLUSIONS: HIV and other STD prevention initiatives must go beyond the scope of traditional messages aimed at behavior change and address the need for social support and socioeconomic opportunities among at-risk, inner-city adolescents.     

Unprotected Sexual Behavior Among Heterosexual HIV-Positive Injection Drug Using Men: Associations by Partner Type and Partner Serostatus

Few studies have examined sexual risk behaviors of HIV-positive, heterosexual, injection drug using (IDU) men. We investigated such behaviors and associations with risk among sexually active, HIV-positive IDU men who reported only female sex partners in the 3 months prior to baseline interview. We examined associations separately for four non-exclusive groups of men by crossing partner type (main or casual) and partner serostatus (HIV-positive or HIV-negative/unknown). Of 732 male participants, 469 (64%) were sexually active with only female partners. Of these 469 men, 155 (33%) reported sex with HIV-positive main partners, 127 (27%) with HIV-negative or unknown serostatus main partners, 145 (31%) with HIV-positive casual partners, and 192 (41%) with HIV-negative/unknown serostatus casual partners. Significant multivariate associations for unprotected sex with HIV-negative or unknown serostatus main partners were less self-efficacy to use condoms, weaker partner norms supporting condoms, and more negative condom beliefs. Similar correlates were found for unprotected sex with HIV-positive main and casual partners. In addition, alcohol or drug use during sex was a significant correlate of unprotected sex with HIV-positive main partners, while depression was significant for HIV-positive casual partners. For unprotected sex with HIV-negative/unknown status casual partners, self-efficacy for condom use, sex trade, and education were significant multivariate correlates. A combination of broad and tailored intervention strategies based on the relationship pattern of men's lives may provide the most benefit for reducing unprotected sex with female partners.Purcell and Mizuno are with the Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA; Metsch is with the University of Miami, Miami, FL, USA; Garfein is with the Department of Family and Preventive Medicine, University of California at San Diego, San Diego, CA, USA; Tobin is with the Bloomberg School of Public Health, Baltimore, MD, USA; Knight is with the University of California at San Francisco, San Francisco, CA, USA; Latka is with the Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY, USA.The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.     

Age at first sex and HIV infection in rural Zimbabwe

Beginning sexual activity introduces an individual to the risk of acquiring sexually transmitted infections. In this study, cross-sectional behavioral data linked to HIV-status from 4,138 men and 4,948 women interviewed in rural Zimbabwe are analyzed to investigate the distribution and consequences of early first sex. We find that age at first sex (at a median age of 19 years for males and 18 years for females) has declined among males over the past 30 years but increased recently among females. Those in unskilled employment, those not associated with a church, and women without a primary education begin to have sex earlier than others. Early sexual debut before marriage precedes a lifetime of greater sexual activity but with more consistent condom use. Women who begin to have sex earlier than others of their age are more likely to be infected with HIV. This finding can be explained by their having a greater lifetime number of sexual partners than those whose first sexual experience occurs later.