Hypersexual, Sexually Compulsive, or Just Highly Sexually Active? Investigating Three Distinct Groups of Gay and Bisexual Men and Their Profiles of HIV-Related Sexual Risk


Emerging research supports the notion that sexual compulsivity (SC) and hypersexual disorder (HD) among gay and bisexual men (GBM) might be conceptualized as comprising three groups—Neither SC nor HD; SC only, and Both SC and HD—that capture distinct levels of severity across the SC/HD continuum. We examined data from 370 highly sexually active GBM to assess how the three groups compare across a range of risk factors for HIV infection. Comparisons focused on psychosexual measures—temptation for condomless anal sex (CAS), self-efficacy for avoiding CAS, sexual excitation and inhibition—as well as reports of actual sexual behavior. Nearly half (48.9 %) of this highly sexually active sample was classified as Neither SC nor HD, 30 % as SC Only, and 21.1 % as Both SC and HD. While we found no significant differences between the three groups on reported number of male partners, anal sex acts, or anal sex acts with serodiscordant partners, the Both SC and HD group reported higher numbers of CAS acts and CAS acts with serodiscordant partners and also had a higher proportion of their anal sex acts without condoms compared to the SC Only group. Our findings support the validity of a three-group classification system of SC/HD severity in differentiating psychosexual and HIV-related sexual risk behavior outcomes in a sample of GBM who report similarly high levels of sexual activity. Notwithstanding the need for sex positive HIV prevention programs, interventions that attempt to help Both SC and HD men deal with distress and address their psychosexual needs specifically may derive HIV prevention benefits.


Investigaciones recientes apoyan la noción que la compulsividad sexual (CS) y el trastorno hipersexual (DH) entre los hombres gay y bisexuales (HGB) pueden ser conceptualizados en tres grupos – ni CS o DH; solamente CS, o ambos CS y DH – que captura niveles distintos sobre la severidad dentro del continuo CS/DH. Hemos examinado datos recibidos de 370 HGB que son altamente activos sexualmente para evaluar como los tres grupos se comparan en términos de riesgo para contraer el VIH. Las comparaciones se enfocaron en medidas psicosociales – tentación para tener sexo sin condón (SSC), autoeficacia para evitar SSC, excitación e inhibición sexual – en conjunto con reportajes de los comportamientos sexuales actuales. Casi la mitad (48.9 %) de esta muestra altamente activa sexualmente fue clasificada ni como CS o DH, 30 % solo como CS, y 21.1 % como ambos CS y DH. Aunque no hemos encontrado diferencias significativas entre los tres grupos sobre la cantidad de parejas sexuales varones, sexo anal, o sexo anal entre parejas serodiscordantes, el grupo con ambos CS y DH reportaron un alto número de SSC y SSC con parejas serodiscordantes y también tuvieron una proporción alta de sus acciones de sexo anal sin condones comparado con el grupo de solamente CS. Nuestros descubrimientos apoyan la validez de un sistema de clasificación de los tres grupos sobre CS/DH, mirando a la severidad en diferenciar los resultados (psicosexuales y comportamientos arriesgosos para contraer el VIH) en una muestra de HGB que reportan niveles similares de actividad sexual alta. A pesar de la necesidad para programas de prevención para el VIH que declaran una perspectiva de sexo positiva, intervenciones que intentan ayudar ahombres que tienen ambos CS y DH a lidiar con la angustia y hablar sobre las necesidades psicosexuales que tienen pueden tener beneficios para prevenir el VIH.

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This project was supported by a research Grant from the National Institute of Mental Health (R01-MH087714; Jeffrey T. Parsons, Principal Investigator). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to acknowledge the contributions of the Pillow Talk Research Team: Brian Mustanski, John Pachankis, Ruben Jimenez, Demetria Cain, and Sitaji Gurung. We would also like to thank the CHEST staff who played important roles in the implementation of the project: Chris Hietikko, Chloe Mirzayi, Anita Viswanath, Arjee Restar, and Thomas Whitfield, as well as our team of recruiters and interns. Finally, we thank Chris Ryan, Daniel Nardicio and the participants who volunteered their time for this study.

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Parsons, J.T., Rendina, H.J., Ventuneac, A. et al. Hypersexual, Sexually Compulsive, or Just Highly Sexually Active? Investigating Three Distinct Groups of Gay and Bisexual Men and Their Profiles of HIV-Related Sexual Risk. AIDS Behav 20, 262–272 (2016). https://doi.org/10.1007/s10461-015-1029-7

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  • Gay and bisexual men
  • Sexual compulsivity
  • Hypersexuality
  • Condomless anal sex
  • HIV