Archives of Sexual Behavior

, 38:1000

First Anal Intercourse and Condom Use Among Men Who Have Sex with Men in Switzerland

  • Hugues Balthasar
  • André Jeannin
  • Françoise Dubois-Arber
Original Paper

Abstract

The aim of this study was to analyze the circumstances of first anal intercourse (FAI) among men who have sex with men (MSM) and to identify factors associated with condom use at this event. We conducted a cross-sectional survey among a convenience sample of MSM living in Switzerland (N = 2,200). Anonymous questionnaires were distributed using Swiss gay communication channels (newspapers, associations, websites) and gay bathhouses. We gathered data on age at FAI, age of the partner, degree of familiarity with him, place of first meeting, and sociodemographic indicators. We did not ask whether FAI was insertive, receptive, or both. Data were stratified by birth year classes (birth cohorts). The median age at FAI fell from 24.5 years among men born before 1965 to 20.0 years among those born between 1975 and 1984 (p < .001). In each birth cohort, between 20 and 30% reported a partner 10 years older or more. Of eight variables examined in multivariate analysis, two were positively associated with condom use: age of participants at FAI and low degree of familiarity between partners. Conversely, large age discrepancy between partners was negatively associated with condom use. In conclusion, our data showed that early initiation of anal intercourse and large age discrepancy were associated with risk taking: a pattern of initiation that may facilitate HIV transmission from older to younger cohorts of MSM. Since age at FAI is on the decrease, there is an urgent need to heighten awareness of prevention actions regarding sexual debut of MSM.

Keywords

HIV Homosexuality Sexual behavior Sexual intercourse Condoms 

References

  1. Balthasar, H., Jeannin, A., & Dubois-Arber, F. (2005). Augmentation des expositions au risque d’infection par le VIH chez les hommes ayant des rapports sexuels avec des hommes: premiers résultats de GAYSURVEY 04 [Increase in HIV risk exposure among men who have sex with men: Preliminary results from the GAYSURVEY 04]. Bulletin de l’Office Fédéral de la Santé Publique, 48, 891–895.Google Scholar
  2. Balthasar, H., Jeannin, A., & Dubois-Arber, F. (2007). Surveillance des comportements face au VIH/sida chez les hommes ayant des rapports sexuels avec des hommes en Suisse, 1992–2004 [Surveillance of HIV/AIDS-related behaviors among men who have sex with men Switzerland, 1992–2004]. International Journal of Public Health, 52, 27–38.CrossRefPubMedGoogle Scholar
  3. Blake, S. M., Ledsky, R., Lehman, T., Goodenow, C., Sawyer, R., & Hack, T. (2001). Preventing sexual risk behaviors among gay, lesbian, and bisexual adolescents: The benefits of gay-sensitive HIV instruction in schools. American Journal of Public Health, 91, 940–946.CrossRefPubMedGoogle Scholar
  4. Bochow, M., Chiarotti, F., Davies, P., Dubois-Arber, F., Dür, W., Fouchard, J., et al. (1994). Sexual behaviour of gay and bisexual men in eight European countries. AIDS Care, 6, 533–549.CrossRefPubMedGoogle Scholar
  5. Bozon, M. (2006). Reaching adult sexuality. First intercourse and its implications: From calendar to attitudes. In M. Bozon & H. Leridon (Eds.), Sexuality and the social sciences: A French survey on sexual behaviour (pp. 143–175). Aldershot, England: Dartmouth Publishing Company.Google Scholar
  6. Bozon, M., & Kontula, O. (1998). Sexual initiation and gender in Europe: A cross-cultural analysis of trends in the twentieth century. In M. Hubert, N. Bajos, & T. Sandfort (Eds.), Sexual behaviour and HIV/AIDS in Europe (pp. 37–67). London: UCL Press.Google Scholar
  7. Cochand, P., & Singy, P. (2001). Développement identitaire et risques de contamination par le VIH chez les jeunes homosexuels et bisexuels en Suisse romande. Lausanne: Département universitaire de psychiatrie adulte (DUPA) (Raisons de santé, 71).Google Scholar
  8. Davis, M., Hart, G., Bolding, G., Sherr, L., & Elford, J. (2006). Sex and the Internet: Gay men, risk reduction and serostatus. Culture, Health and Sexuality, 8, 161–174.CrossRefPubMedGoogle Scholar
  9. Delor, F., & Hubert, M. (2000). Revisiting the concept of ‘vulnerability’. Social Science & Medicine, 50, 1557–1570.CrossRefGoogle Scholar
  10. Dubois-Arber, F., Jeannin, A., Meystre-Agustoni, G., Spencer, B., Moreau-Gruet, F., Balthasar, H., et al. (2003). Evaluation of the HIV/AIDS prevention strategy in Switzerland: Abridged version of the seventh synthesis report 1999–2003. Lausanne: Institut universitaire de médecine sociale et préventive.Google Scholar
  11. Dubois-Arber, F., Jeannin, A., & Spencer, B. (1999). Long term global evaluation of a national AIDS prevention strategy: The case of Switzerland. AIDS, 13, 2571–2582.CrossRefPubMedGoogle Scholar
  12. Dubois-Arber, F., Masur, J. B., Hausser, D., Zimmermann, E., & Paccaud, F. (1993). Evaluation of AIDS prevention among homosexual and bisexual men in Switzerland. Social Science & Medicine, 37, 1539–1544.CrossRefGoogle Scholar
  13. European Centre for the Epidemiological Monitoring of AIDS. (2002). HIV/AIDS surveillance in Europe: Mid-year report, No. 67. Saint-Maurice: Institut de Veille Sanitaire.Google Scholar
  14. Fassin, E. (2000). “Out”: la métaphore paradoxale [Out: The paradoxical metaphor]. In L.-G. Tin & G. Pastre (Eds.), Homosexualités: expression/répression [Homosexualities: Expression/repression] (pp. 180–194). Paris: Stock.Google Scholar
  15. Flowers, P., & Buston, K. (2001). “I was terrified of being different”: Exploring gay men’s accounts of growing-up in a heterosexist society. Journal of Adolescence, 24, 51–65.CrossRefPubMedGoogle Scholar
  16. Goodenow, C., Netherland, J., & Szalacha, L. (2002). AIDS-related risk among adolescents males who have sex with males, females, or both: Evidence from a statewide survey. American Journal of Public Health, 92, 203–210.CrossRefPubMedGoogle Scholar
  17. Hefez, S. (2003). Adolescence et homophobie: regards d’un clinicien [Adolescence and homophobia: The perspective of a clinician]. In C. Broqua, F. Lert, & Y. Souteyrand (Eds.), Homosexualités au temps du sida: tensions sociales et identitaires [Homosexuality in the AIDS era: Social tensions and identity issues] (pp. 147–168). Paris: Agence nationale de recherches sur le sida.Google Scholar
  18. Hospers, H. J., Harterink, P., Van Den, H. K., & Veenstra, J. (2002). Chatters on the Internet: A special target group for HIV prevention. AIDS Care, 14, 539–544.CrossRefPubMedGoogle Scholar
  19. Hospers, H. J., Kok, G., Harterink, P., & de Zwart, O. (2005). A new meeting place: Chatting on the Internet, e-dating and sexual risk behaviour among Dutch men who have sex with men. AIDS, 19, 1097–1101.CrossRefPubMedGoogle Scholar
  20. Igartua, K. J., Gill, K., & Montoro, R. (2003). Internalized homophobia: A factor in depression, anxiety, and suicide in the gay and lesbian population. Canadian Journal of Community Mental Health, 22, 15–30.PubMedGoogle Scholar
  21. Jeannin, A., Konings, E., Dubois-Arber, F., Landert, C., & Van Melle, G. (1998). Validity and reliability in reporting sexual partners and condom use in a Swiss population survey. European Journal of Epidemiology, 14, 139–146.CrossRefPubMedGoogle Scholar
  22. Jinich, S., Paul, J. P., Stall, R., Acree, M., & Kegeles, S. (1998). Childhood sexual abuse and HIV risk-taking behavior among gay and bisexual men. AIDS and Behavior, 2, 41–51.CrossRefGoogle Scholar
  23. Kosofsky Sedgwick, E. (1990). Epistemology of the closet. Berkeley: University of California Press.Google Scholar
  24. Lawless, J. F. (2003). Statistical models and methods for lifetime data (2nd ed.). Hoboken, NJ: Wiley.Google Scholar
  25. Lhomond, B. (1997). Attirance et pratiques homosexuelles [Attraction and homosexual practices]. In H. Lagrange & B. Lhomond (Eds.), L’entrée dans la sexualité: le comportement des jeunes dans le contexte du sida [Sexual debut: Behaviour of the youth in the AIDS era] (pp. 183–226). Paris: La Découverte.Google Scholar
  26. Mercer, C. H., Wellings, K., Macdowall, W., Copas, A. J., McManus, S., Erens, B., et al. (2006). First sexual partnerships: Age differences and their significance: Empirical evidence from the 2000 British National Survey of Sexual Attitudes and Lifestyles (‘Natsal 2000’). Journal of Adolescent Health, 39, 87–95.CrossRefPubMedGoogle Scholar
  27. Messiah, A., & Mouret-Fourne, E. (1996). Homosexuality, bisexuality: Elements of sexual socio-biography. In M. Bozon & H. Leridon (Eds.), Sexuality and the social sciences: A French survey on sexual behaviour (pp. 177–202). Aldershot, England: Dartmouth Publishing Company.Google Scholar
  28. Miller, K. S., Clark, L. F., & Moore, J. S. (1997). Sexual initiation with older male partners and subsequent HIV risk behavior among female adolescents. Family Planning Perspectives, 29, 212–214.CrossRefPubMedGoogle Scholar
  29. Moreau-Gruet, F., Dubois-Arber, F., & Jeannin, A. (2006). Long-term HIV/AIDS-related prevention behaviours among men having sex with men: Switzerland 1992–2000. AIDS Care, 18, 35–43.CrossRefPubMedGoogle Scholar
  30. Moreau-Gruet, F., Jeannin, A., Dubois-Arber, F., & Spencer, B. (2001). Management of the risk of HIV infection in male homosexual couples. AIDS, 15, 1025–1035.CrossRefPubMedGoogle Scholar
  31. Narring, F., Stronski Huwiler, S. M., & Michaud, P. A. (2003). Prevalence and dimensions of sexual orientation in Swiss adolescents: A cross-sectional survey of 16 to 20-year-old students. Acta Paediatrica, 92, 233–239.PubMedGoogle Scholar
  32. Narring, F., Wydler, H., & Michaud, P. A. (2000). First sexual intercourse and contraception: A cross-sectional survey on the sexuality of 16–20-year-olds in Switzerland. Schweizerische Medizinische Wochenschrift, 130, 1389–1398.PubMedGoogle Scholar
  33. Office fédéral de la statistique. (2002). Annuaire statistique de la Suisse 2002: Version numérique [Swiss statistical directory 2002: Numerical version]. Neuchâtel: Author.Google Scholar
  34. Pollak, M. (1992). Assessing AIDS prevention among male homo- and bisexuals. In F. Paccaud, J. P. Vader, & F. Gutzwiller (Eds.), Assessing AIDS prevention (pp. 137–157). Basel: Birkhäuser Verlag.Google Scholar
  35. Pollack, L. M., Osmond, D. H., Paul, J. P., & Catania, J. (2005). Evaluation of the Center for Disease Control and Prevention’s HIV behavioural surveillance of men who have sex with men: Sampling issues. Sexually Transmitted Diseases, 32, 581–589.CrossRefPubMedGoogle Scholar
  36. Remafedi, G. (1999). Sexual orientation and youth suicide. Journal of the American Medical Association, 282, 1291–1292.CrossRefPubMedGoogle Scholar
  37. Remafedi, G. (2002). Suicidality in a venue-based sample of young men who have sex with men. Journal of Adolescent Health, 31, 305–310.CrossRefPubMedGoogle Scholar
  38. Richard, H., & Guillemot, D. (1996). Les jeunes hommes attirés par des relations sexuelles avec des partenaires de même sexe [Young men atttracted to sexual relations with partners of the same sex]. In M. Calvez, M.-A. Schiltz, & Y. Souteyrand (Eds.), Les homosexuels face au sida: rationalités et gestion des risques [Homosexuals and AIDS: Rationales and risk management] (pp. 43–53). Paris: Agence nationale de recherches sur le sida.Google Scholar
  39. Rind, B. (2001). Gay and bisexual adolescent boys’ sexual experiences with men: An empirical examination of psychological correlates in a nonclinical sample. Archives of Sexual Behavior, 30, 345–368.CrossRefPubMedGoogle Scholar
  40. Rosario, M., Meyer-Bahlburg, H. F. L., Hunter, J., & Gwadz, M. (1999). Sexual risk behaviors of gay, lesbian, and bisexual youths in New York City: Prevalence and correlates. AIDS Education and Prevention, 11, 476–496.PubMedGoogle Scholar
  41. Rosenbrock, R., Dubois-Arber, F., Moers, M., Pinell, P., Schaeffer, D., & Setbon, M. (2000). The normalization of AIDS in Western European countries. Social Science & Medicine, 50, 1607–1629.CrossRefGoogle Scholar
  42. Ross, M. W., Tikkanen, R., & Mansson, S. A. (2000). Differences between Internet samples and conventional samples of men who have sex with men: Implications for research and HIV interventions. Social Science & Medicine, 51, 749–758.CrossRefGoogle Scholar
  43. Sandfort, T. G. M. (1997). Sampling male homosexuality. In J. Bancroft (Ed.), Researching sexual behavior: Methodological issues (pp. 261–275). Bloomington: Indiana University Press.Google Scholar
  44. Sandfort, T. G. M. (1998). Homosexual and bisexual behaviour in European countries. In M. Hubert, N. Bajos, & T. Sandfort (Eds.), Sexual behaviour and HIV/AIDS in Europe (pp. 68–105). London: UCL Press.Google Scholar
  45. Schiltz, M.-A. (1998). Young homosexual itineraries in the context of HIV: Establishing lifestyles. Population, 10, 417–446.PubMedGoogle Scholar
  46. Spencer, B. (1996). The normative context of sexual behaviour and the choice of prevention strategies. In M. Bozon & H. Léridon (Eds.), Sexuality and the social sciences (pp. 229–252). Aldershot: Dartmouth Publishing Company.Google Scholar
  47. Varghese, B., Maher, J. E., Peterman, T. A., Branson, B. M., & Steketee, R. W. (2002). Reducing the risk of sexual HIV transmission: Quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use. Sexually Transmitted Diseases, 29, 38–43.CrossRefPubMedGoogle Scholar
  48. Vittinghoff, E., Douglas, J., Judson, F., McKirnan, D., MacQueen, K., & Buchbinder, S. P. (1999). Per-contact risk of human immunodeficiency virus transmission between male sexual partners. American Journal of Epidemiology, 150, 306–311.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Hugues Balthasar
    • 1
  • André Jeannin
    • 1
  • Françoise Dubois-Arber
    • 1
  1. 1.Institute of Social and Preventive Medicine, University Hospital CenterUniversity of LausanneLausanneSwitzerland

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