The Role of Maladaptive Cognitions in Hypersexuality Among Highly Sexually Active Gay and Bisexual Men

Cognitive appraisals about sex may represent an important component of the maintenance and treatment of hypersexuality, but they are not currently represented in conceptual models of hypersexuality. Therefore, we validated a measure of maladaptive cognitions about sex and examined its unique ability to predict hypersexuality. Qualitative interviews with a pilot sample of 60 highly sexually active gay and bisexual men and expert review of items yielded a pool of 17 items regarding maladaptive cognitions about sex. A separate sample of 202 highly sexually active gay and bisexual men completed measures of sexual inhibition and excitation, impulsivity, emotional dysregulation, depression and anxiety, sexual compulsivity, and a measure of problematic hypersexuality. Factor analysis confirmed the presence of three subscales: perceived sexual needs, sexual costs, and sexual control efficacy. Structural equation modeling results were consistent with a cognitive model of hypersexuality whereby magnifying the necessity of sex and disqualifying the benefits of sex partially predicted minimized self-efficacy for controlling one’s sexual behavior, all of which predicted problematic hypersexuality. In multivariate logistic regression, disqualifying the benefits of sex predicted unique variance in hypersexuality, even after adjusting for the role of core constructs of existing research on hypersexuality, AOR = 1.78, 95 % CI 1.02, 3.10. Results suggest the utility of a cognitive approach for better understanding hypersexuality and the importance of developing treatment approaches that encourage adaptive appraisals regarding the outcomes of sex and one’s ability to control his sexual behavior.     

HIV-Positive Men Sexually Active with Women: Sexual Behaviors and Sexual Risks

This study examines patterns of sexual behavior, sexual relating, and sexual risk among HIV-positive men sexually active with women. A total of 278 HIV-positive men were interviewed every 6–12 months between 1994 and 2002 and reported considerable variability in sexual behaviors over time. Many were not sexually active at all for months at a time; many continued to have multiple female and at times male partners. Over one-third of the cohort had one or more periods when they had engaged in unprotected sex with a female partner who was HIV-negative or status unknown (unsafe sex). Periods of unsafe sex alternated with periods of safer sex. Contextual factors such as partner relations, housing status, active drug use, and recently exchanging sex showed the strongest association with increased odds of unsafe sex. A number of predictors of unsafe sex among African American men were not significant among the Latino sub-population, suggesting race/ethnic differences in factors contributing to heterosexual transmission. Implications for prevention interventions are discussed.Aidala, Lee, Howard, Caban, Abramson, and Messeri are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 W. 168th St, Suite 1119, New York, NY 10032, USA.     

Explanations for the Origins of Sexual Compulsivity Among Gay and Bisexual Men

Sexual compulsivity (SC) is a condition characterized by sexual fantasies and behaviors that interfere with personal, interpersonal, or vocational pursuits. This article describes the ways in which gay and bisexual men with symptoms of SC understand and explain the origins of their condition. The data for this article were drawn from Project SPIN, a mixed-methods study of SC among 183 gay and bisexual men in New York City. The article provides an evaluation of how urban gay and bisexual men experience SC and describes how they think about it in their own words. These men articulated both intrinsic and extrinsic sources for the development of SC. Some participants endorsed a belief in a predisposition toward sexually compulsive behavior, whereas others identified factors such as emotional neglect, sexual abuse, or the availability and accessibility of sexual partners. These understandings may influence the ways in which SC can be treated, while also highlighting issues that may be critical in the identification and/or measurement of SC. Insights into the origins of SC may yield new therapeutic models that reduce not only the distress of contending with this condition but its negative health effects and impact on quality of life.     

Comparing Gay and Bisexual Men on Sexual Behavior, Condom Use, and Psychosocial Variables Related to HIV/AIDS

Interviews were conducted with 750 men, recruited from a variety of sources in Chicago, who reported sex with men in the past 3 years. Behavioral criteria were used to establish groups of gay and bisexual men. We predicted that gay men, compared to bisexual men, would report more male sexual partners, more experience with receptive sex, and more tolerant attitudes toward homosexuality. The only reliable difference between the gay and bisexual men with respect to number of partners was that gay men were more likely to have had a steady male partner or lover. Gay men were more likely than bisexual men to have engaged in receptive sex, including unprotected receptive anal sex. Bisexual men were more self-homophobic and saw other people as less accepting of same-sex activity. There were no differences between gay and bisexual men in other psychosocial variables. Interventions designed to reduce the transmission of HIV/AIDS need to consider differences in gay and bisexual men's sexual behavior and attitudes toward homosexual behavior.     

A National Study of Lesbian,Gay, Bisexual (LGB), and Non-LGB Youth Sexual Behavior Online and In-Person

Online and in-person sexual behaviors of cisgender lesbian, gay, queer, bisexual, heterosexual, questioning, unsure, and youth of other sexual identities were examined using data from the Teen Health and Technology study. Data were collected online between August 2010 and January 2011 from 5,078 youth 13–18 years old. Results suggested that, depending on sexual identity, between 4–35 % of youth had sexual conversations and 2–24 % shared sexual photos with someone online in the past year. Among the 22 % of youth who had oral, vaginal, and/or anal sex, between 5–30 % met one of their two most recent sexual partners online. Inconsistent condom use was associated with increased odds of meeting one’s most recent partner online for heterosexual adolescent men. For gay and queer adolescent men, having an older partner, a partner with a lifetime history of sexually transmitted infections (STI), and concurrent sex partners were each significantly associated with increased odds of having met one’s most recent sex partner online. None of the examined characteristics significantly predicted meeting one’s most recent sexual partner online versus in-person for heterosexual; bisexual; or gay, lesbian, and queer women. The Internet is not replacing in-person exploration and expression of one’s sexuality and meeting sexual partners online appears to be uncommon in adolescence across sexual identities. Healthy sexuality programming that acknowledges some youth are meeting partners online is warranted, but this should not be a main focal point. Instead, inclusive STI prevention programming that provides skills to reduce risk when engaging in all types of sex is critical.     

The Relation Between Sex Drive and Sexual Attraction to Men and Women: A Cross-National Study of Heterosexual,Bisexual, and Homosexual Men and Women

Recent research suggests that, for most women, high sex drive is associated with increased sexual attraction to both women and men. For men, however, high sex drive is associated with increased attraction to one sex or the other, but not to both, depending on men's sexual orientation (Lippa, R. A., 2006, Psychological Science, 17, 46–52). These findings were replicated in a very large BBC data set and were found to hold true in different nations, world regions, and age groups. Consistent with previous research, lesbians differed from other women in showing the male-typical pattern, that high sex drive is associated with attraction to one sex but not the other. Bisexual women and men were more similar to same-sex heterosexuals than to same-sex homosexuals in their pattern of results. The correlation between same-sex and other-sex attraction was consistently negative for men, was near zero for heterosexual and bisexual women, and negative for lesbians. Thus, same-sex and other-sex attractions were, in general, more bipolar and mutually exclusive for men than for women. The current findings add to evidence that sexual orientation is organized differently in women and men and suggest a biological component to this difference.     

Epidemiology of Early Monkeypox Virus Transmission in Sexual Networks of Gay and Bisexual Men,England, 2022

After community transmission of monkeypox virus was identified in Europe, interviews of 45 case-patients from England indicated transmission in international sexual networks of gay and bisexual men since April 2022. Interventions targeting sex-on-premises venues, geospatial dating applications, and sexual health services are likely to be critical for outbreak control.     

Sexual Health Screening Among Racially/Ethnically Diverse Young Gay,Bisexual, and Other Men Who Have Sex With Men

PurposeScreening for sexually transmitted infections (STIs) is a crucial element of improving health and reducing disparities, and young men who have sex with men (YMSM) face high rates of both STIs and human immunodeficiency virus. We examined sexual health screening among a diverse sample of adolescent YMSM living in New York City.MethodsBetween 2009 and 2011, cross-sectional data were collected from 590 YMSM in New York City. Separate multivariable logistic regression models were used to assess the relationship between sociodemographic, psychosocial, and health and healthcare related factors and two main outcomes: having sought a recent sexual health screening (past 6 months) and having a rectal sexual health screening (lifetime).ResultsOverall, 46% reported a sexual health screening in the prior 6 months, but only 16% reported ever having a rectal screening for STIs. Rates were higher among ethnic minority YMSM and men who accessed care at clinics. Multivariable results indicated that gay community affiliation, recent unprotected anal sex, and number of lifetime male partners were also associated with seeking a recent screening.ConclusionsThough half of the sample reported recent general screening, rates of lifetime rectal screening are low. Efforts to increase screening may focus on improving provider knowledge and guideline adherence, and educating and encouraging YMSM to access sexual health check-ups.     

A Latent Class Analysis of Seroadaptation Among Gay and Bisexual Men

Initial research into seroadaptive strategies suggests that, individually, they are potentially effective behavioral methods to reduce risk of HIV transmission. Combining strategies, therefore, has the potential to increase risk reduction. The aim of this study was to determine how gay and bisexual men (GBM) combine strategies. To this end, a total of 774 sexually active GBM, aged ≥16 years, in Metro Vancouver, Canada, were recruited. Grouped by self-reported HIV status, latent class analysis of self-reported condom use, strategic positioning, anal sex avoidance, serosorting, viral-load sorting, and withdrawal were conducted. Multinomial logistical regression identified explanatory variables of class membership (i.e., sensation seeking, treatment optimism, sexual altruism, relationship status, number of partners, anal sex preference). Four latent classes were identified: Condom Users, Multiple Prevention Users, Viral-Load Sorters, and Serosorters. The majority of HIV-negative/unknown men (72 %) and a large proportion of HIV-positive men (42 %) belonged to the Condom Users class. Class membership was associated with age, relationship status, treatment optimism, sexual altruism, sensation seeking, number of recent male anal sex partners, and recent condomless anal sex with a serodiscordant or unknown-status partner. Understanding these distinct patterns allows for tailored interventions addressing GBM’s sexual health needs.     

Well-Being Among Older Gay and Bisexual Men and Women in England: A Cross-sectional Population Study

ObjectivesLesbian, gay, and bisexual (LGB) older people present an under-represented population in research, with limited research citing higher prevelance of depression, loneliness, rejection, and overall poorer health and well-being outcomes. Our study compares well-being, defined as quality of life, life satisfaction, sexual satisfaction, and depression, among LGB people with their heterosexual peers'.DesignCross-sectional population study using data from the English Longitudinal Study of Aging (ELSA), a representative panel study of older adults aged 50 and older.Setting and ParticipantsData were from ELSA wave 6, collected 2012-2013. A total of 5691 participants were included in the analysis, with 326 (5.7%) self-identifying as LGB.MeasuresWell-being was measured using CASP-19, a quality of life questionnaire; the Satisfaction with Life Scale for life satisfaction; and the Center for Epidemiologic Studies Depression Scale for depressive symptoms. Sexual satisfaction was assessed using the question “During the past three months, how satisfied have you been with your overall sex life?” In addition, t test and chi-square tests were used to test differences in sociodemographic characteristics between LGB and heterosexual participants. Bivariate logistical regression and linear regression were used to test associations between sexual orientation and well-being outcomes.ResultsIn unadjusted models, LGB participants reported significantly lower mean quality of life and life satisfaction, and had significantly lower odds of reporting satisfaction with their overall sex life and higher odds of reporting depressive symptoms above threshold. After adjustment for sociodemographic and health-related covariates, there remained significant differences between LGB and heterosexual groups in mean quality of life scores (B = ?0.96, 95% confidence interval [CI] ?1.87 to ?0.06, P = .037) and odds of sexual satisfaction (odds ratio = 0.56, 95% CI 0.38-0.82, P = .003).Conclusions/ImplicationsLGB older people report lower quality of life and lower sexual satisfaction than their heterosexual counterparts, possibly associated with a number of unwanted social experiences.     

Sex Parties among Young Gay,Bisexual, and Other Men Who Have Sex with Men in New York City: Attendance and Behavior

Very little information exists with regard to sex party behaviors in young men who have sex with men (YMSM), often defined as men ranging in age from 13 to 29 years. The current analysis examines sex party attendance and behavior in a sample of 540 emergent adult gay, bisexual, and other YMSM in New York City, ages 18–29 years. Findings indicate that 8.7% (n = 47) of the sample had attended a sex party 3 months prior to assessment. Sex party attendees reported that parties included both HIV-positive and HIV-negative men; attendees also reported unprotected sex and limited access to condoms and lubricant. As compared with those who did not attend sex parties, those who did indicated significantly more lifetime and recent (last 3 months) casual sex partners, drug use (both number of different drugs used and total lifetime use), psychosocial burden (history of partner violence and number of arrests), and total syndemic burden (a composite of unprotected anal sex, drug use and psychosocial burden). These results indicate that while only a small percentage of the overall sample attended sex parties, the intersection of both individual risk factors coupled with risk factors engendered within the sex party environment itself has the potential to be a catalyst in the proliferation of the HIV/AIDS epidemic in urban settings. Lastly, given that sex parties are different than other sex environments, commercial and public, with regard to how they are accessed, public health strategies may need to become more tailored in order to reach this potentially highly risky group.     

Emotions During Sexual Activity: Differences Between Sexually Functional and Dysfunctional Men and Women

The present study investigated the differences in emotional response to automatic thoughts presented during sexual activity between sexually functional and dysfunctional men and women. A total of 376 participants (160 women and 120 men without sexual problems and 47 women and 49 men with a DSM-IV-TR diagnosis of sexual dysfunction) completed the Sexual Modes Questionnaire (SMQ male and female versions; P. J. Nobre & J. Pinto-Gouveia, 2000) and measures of sexual functioning: The International Index of Sexual Function (IIEF; R. C. Rosen et al., 1997), and The Female Sexual Function Index (FSFI; R. C. Rosen et al., 2000). The SMQ is a combined measure constituted by three interdependent subscales: Automatic Thought subscale (AT), Emotional Response subscale (ER), and Sexual Response subscale (SR). Emotions were assessed by the ER subscale, where participants endorsed emotional reactions (worry, sadness, disillusion, fear, guilt, shame, anger, hurt, pleasure, satisfaction) to a list of automatic thoughts (AT subscale) that may occur during sexual activity. Results showed that both men and women with sexual dysfunction had significantly less positive emotional reactions to automatic thoughts during sexual activity. Sexually dysfunctional men had significantly more emotions of sadness, disillusion, and fear, and less pleasure and satisfaction, compared to men without sexual problems. Women with sexual dysfunction had significantly less pleasure and satisfaction, and more sadness, disillusion, guilt, and anger. Findings were congruent with recent studies indicating that emotions related to depressed affect (sadness, disillusion, lack of pleasure) as opposed to negative emotions (mostly related to anxiety) were stronger correlates of sexual dysfunction.     

Perceived Partner Responsiveness Mediates the Association Between Sexual and Marital Satisfaction: A Daily Diary Study in Newlywed Couples

Sexuality is an integral part of intimate relationships, yet surprisingly little is known about how and for whom sexuality matters. The present research investigated the interplay of sexual and non-sexual factors that contribute to relationship satisfaction. Specifically, we tested the hypothesis that the association between sexual satisfaction and marital satisfaction is mediated by a non-sexual factor—namely, perceived partner responsiveness (PPR). Additionally, we tested the role of gender as a possible moderator of this mediated association. Thirty-four newlywed couples completed diaries with each spouse reporting their sexual satisfaction, marital satisfaction, and PPR every day for 30 days. We tested our predictions at both the person level (i.e., the mean level across 30 days) and the daily level. At the person level, we found that sexual satisfaction and PPR separately predicted marital satisfaction. Moreover, the effect of sexual satisfaction on marital satisfaction was partially mediated by PPR. No gender differences emerged at this level. At the daily level, we found similar support for partial mediation. However, at this level, gender did serve as a moderator. The stronger mediation found for women was driven by a stronger association between sexual satisfaction and PPR for women than for men. This study joins a growing literature highlighting the role of PPR in dyadic relationships.     

A Twin Study of Sexual Behavior in Men

The role of genetic and environmental influences on age of initiation of first sexual relations and engaging in sexual activity with multiple partners (10 or more partners in 1 year) was investigated in male twins (N = 6,744) from the Vietnam Era Twin Registry. Individual differences in both types of sexual behaviors were heritable, but only age of onset of sexual relations was significantly influenced by the environment shared by the twins. There was a moderate negative correlation between age of initiation of sexual relations and the multiple partners variable; initiating sexual relations earlier was associated with a higher probability of having multiple partners. The additive genetic influence on age of initiation also influenced the multiple partners variable. The substantial unique environmental influences on each variable were uncorrelated with each other. The data suggest that the observed association between age of initiation of sexual relations and having multiple partners is due to genetic influences common to both behaviors.