AEGiS-14IAC: Sexual and safer sex scripts among young men who have sex with men.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Sexual and safer sex scripts among young men who have sex with men.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. TuOrE1241)

Stevenson LY, Seal DW, Peterson JL, Stokes JP, Guenther-Grey C, Choi K, O'Donnell L
Medical College of Wisconsin, Milwaukee, United States

BACKGROUND: Safer sex negotiation and condom use are rarely included in people's ideal sexual scripts (a term referring to patterns of behavior that lead to sex). Effective safer sex negotiation requires explicit talk about taboo sexual topics that reduce the pleasure and spontaneity of erotic, emotionally intimate, or romantic sexual encounters. This study examined sexual and safer sex scripts among young men who have sex with men (YMSM), a population with rapidly increasing HIV incidence.

METHOD: As part of an in-depth interview about HIV risk behavior, 368 YMSM (ages 15-25) were asked to provide detailed narratives about three sexual situations: last anal sex with a condom (AWC; n=320); last anal sex without a condom (AWOC; n=250); and last oral sex with a condom (OWC; n=177). Thematic content analyses were performed to identify key themes and contexts of protected and unprotected behavior.

RESULTS: (1) AWOC situations were most often characterized by high arousal and physical passion between casual partners or by expressions of emotional intimacy between steady partners. AWC or OWC situations were typically characterized by sexual experimentation or a desire for casual sex. (2) Safer sex discussion was more likely in AWC and OWC situations; among steady versus casual partners; and in situations that did not involve substance use. (3) The decision to use a condom typically involved a personal decision or an a priori agreement between partners to always use condoms; in contrast, condom non-use typically "just happened".

CONCLUSIONS: Our findings indicate that safer sex negotiation and behavior are not consistent components of the sexual script for YMSM, and highlight the continued need for HIV prevention programs that promote safer sex strategies which are responsive to motivational and situational influences on behavior (e.g., negotiating safety within steady relationships or in sexual situations characterized by high arousal).

Keywords: AEGIS, Safe Sex, Coitus, Sex Behavior, Condoms, Risk-Taking, HIV Infections, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Negotiating, Communication, Human, Male

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TuOrE1241