Archives of Sexual Behavior

, Volume 39, Issue 4, pp 940–949 | Cite as

Sexual Compulsivity and Sexual Risk in Gay and Bisexual Men

  • Christian Grov
  • Jeffrey T. Parsons
  • David S. Bimbi
Original Paper


Much of our understanding of the association between the Sexual Compulsivity Scale (SCS) and sexual risk behavior among men who have sex with men (MSM) has been limited to samples of HIV positive MSM only. Using data from a community-based survey of gay and bisexual men (n = 1214), this analysis sought to further evaluate the association between the SCS and sexual risk behavior. The SCS was significantly associated with a variety of sexual risk behaviors, including having sex under the influence of club drugs, engaging in unprotected anal sex (receptive or insertive) with partners of the same and/or different HIV serostatus, identity as a barebacker, intentions to have bareback sex, number of recent sex partners, and temptation for unsafe sex. The SCS was also significantly associated with having engaged in a variety of specialized sexual behaviors (i.e., fetishes), many of which can increase HIV transmission risks. Finally, in multivariate analyses, the SCS significantly predicted unprotected sex with a non-main partner even when controlling for race, HIV serostatus, age, identity as a barebacker, and club drug use. These data indicate that the SCS may be able to serve as an indicator to detect HIV-associated sexual risk behavior in community-based samples of gay and bisexual men.


Sexual compulsivity Gay and bisexual men Sexual risk behavior HIV Club drugs Fetishes 



The Sex and Love v3.0 Project was supported by CHEST, under the direction of Dr. Parsons. The authors acknowledge the contributions of the project team: Michael R. Adams, Anthony Bamonte, Leland R. Bardsley, Lorelei Bonet, Justin Brown, Lauren DiMaria, Gideon Feldstein, Catherine Holder, James P. Kelleher, Brian C. Kelly, Juline Koken, Jose E. Nanín, Joseph C. Punzalan, Elana Rosof, Joseph P. Severino, Brooke Wells, and Anna Levy-Warren. We also thank the anonymous reviewers for their helpful comments on earlier drafts of this manuscript. Christian Grov was supported in part as a postdoctoral fellow in the Behavioral Sciences training in Drug Abuse Research program sponsored by Public Health Solutions and the National Development and Research Institutes, Inc. (NDRI) with funding from the National Institute on Drug Abuse (T32 DA07233). An earlier version of this manuscript was presented at the 2006 annual meeting of the Society for the Scientific Study of Sexuality.


  1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
  2. Bancroft, J. (2000). Individual differences in sexual risk taking by men: A psycho-socio-biological approach. In J. Bancroft (Ed.), The role of theory in sex research (pp. 177–212). Bloomington, IN: Indiana University Press.Google Scholar
  3. Bancroft, J. (2008). Sexual behavior that is “out of control”: A theoretical conceptual approach. Psychiatric Clinics of North America, 31, 593–601.CrossRefPubMedGoogle Scholar
  4. Bancroft, J., Janssen, E., Strong, D., Carnes, L., Vukadinovic, Z., & Long, J. (2003). Sexual risk-taking in gay men: The relevance of sexual arousability, mood, and sensation seeking. Archives of Sexual Behavior, 32, 555–572.CrossRefPubMedGoogle Scholar
  5. Baum, M. D., & Fishman, J. M. (1994). AIDS, sexual compulsivity, and gay men: A group treatment approach. In S. A. Cadwell & R. A. Burnham (Eds.), Therapists on the front line: Psychotherapy with gay men in the age of AIDS (pp. 255–274). Washington, DC: American Psychiatric Press.Google Scholar
  6. Benotsch, E. G., Kalichman, S. C., & Cage, M. (2002). Men who have met sex partners via the Internet: Prevalence, predictors, and implications for HIV prevention. Archives of Sexual Behavior, 31, 177–183.CrossRefPubMedGoogle Scholar
  7. Benotsch, E. G., Kalichman, S. C., & Kelly, J. A. (1999). Sexual compulsivity and substance use in HIV seropositive men who have sex with men: Prevalence and predictors of high-risk behaviors. Addictive Behaviors, 24, 857–868.CrossRefPubMedGoogle Scholar
  8. Benotsch, E. G., Kalichman, S. C., & Pinkerton, S. D. (2001). Sexual compulsivity in HIV-positive men and women: Prevalence, predictors, and consequences of high-risk behaviors. Sexual Addiction and Compulsivity, 8, 83–99.CrossRefGoogle Scholar
  9. Black, D. W. (1998). Compulsive sexual behavior: A review. Journal of Practical Psychology and Behavioral Health, 4, 219–229.Google Scholar
  10. Carey, M. P., Braaten, L. S., Jaworski, B. C., Durant, L. E., & Forsyth, A. D. (1999). HIV and AIDS relative to other health, social, and relationship concerns among low-income women: A brief report. Journal of Women’s Health and Gender Based Medicine, 8, 657–661.PubMedGoogle Scholar
  11. Carey, J. W., Mejia, R., Bingham, T., Ciesielski, C., Gelaude, D., Herbst, J. H., et al. (2008). Drug use, high-risk sex behaviors, and increased risk for recent HIV infection among men who have sex with men in Chicago and Los Angeles. AIDS and Behavior. doi: 10.1007/s10461-008-9403-3.
  12. Carnes, P. (1991). Don’t call it love: Recovery from sexual addiction. New York: Bantam Books.Google Scholar
  13. CDC (Centers for Disease Control and Prevention). (2008a). Dramatic declines indicate success in U.S. HIV prevention. CDC HIV/AIDS Facts. Retrieved December 12, 2008, from
  14. CDC (Centers for Disease Control and Prevention). (2008b). HIV prevalence estimates––United States, 2006. Morbidity and Mortality Weekly Report, 57, 1073–1076.Google Scholar
  15. CDC (Centers for Disease Control and Prevention). (2008c). Subpopulation estimates from the HIV incidence surveillance system––United States, 2006. Morbidity and Mortality Weekly Report, 57, 985–989.Google Scholar
  16. CDC (Centers for Disease Control and Prevention). (2008d). Trends in HIV/AIDS diagnoses among men who have sex with men-33 States, 2001–2006. Morbidity and Mortality Weekly Report, 57, 681–686.Google Scholar
  17. Chen, J., Callahan, D., & Kerndt, P. (2002). Syphilis control among incarcerated men who have sex with men: Public health response to an outbreak. American Journal of Public Health, 92, 1473–1474.CrossRefPubMedGoogle Scholar
  18. Coleman, E. (1992). Is your patient suffering from compulsive sexual behavior? Psychiatric Annals, 22, 320–325.Google Scholar
  19. Comp Care. (1987). Hope and recovery: A twelve-step guide for healing from compulsive sexual behavior. Minneapolis, MN: Author.Google Scholar
  20. Cooper, A., Delmonico, D. L., & Burg, R. (2000). Cybersex users, abusers, and compulsives: New findings and implications. Sexual Addiction & Compulsivity, 7, 5–29.CrossRefGoogle Scholar
  21. Dodge, B., Reece, M., Cole, S. L., & Sandfort, T. G. M. (2004). Sexual compulsivity among heterosexual college students. Journal of Sex Research, 41, 343–350.CrossRefPubMedGoogle Scholar
  22. Goodman, A. (1992). Sexual addiction: Designation and treatment. Journal of Sex and Marital Therapy, 18, 303–314.PubMedGoogle Scholar
  23. Gullette, D. L., & Lyons, M. A. (2005). Sexual sensation seeking, compulsivity and HIV risk behaviors in college students. Journal of Community Health Nursing, 22, 47–60.CrossRefPubMedGoogle Scholar
  24. Halkitis, P. N., & Parsons, J. T. (2002). Recreational drug use and HIV-risk sexual behavior among men frequenting gay social venues. Journal of Gay & Lesbian Social Services, 14, 19–38.CrossRefGoogle Scholar
  25. Kafka, M. P., & Prentky, R. A. (1994). Preliminary observations of DSM-III-R Axis I comorbidity in men with paraphilias and paraphilia-related disorders. Journal of Clinial Psychiatry, 55, 481–487.Google Scholar
  26. Kalichman, S. C., Adair, V., Rompa, D., Multhauf, K., Johnson, J., & Kelly, J. (1994). Sexual sensation-seeking: Scale development and predicting AIDS-risk behavior among homosexually active men. Journal of Personality Assessment, 62, 385–387.CrossRefPubMedGoogle Scholar
  27. Kalichman, S. C., Benotsch, E., Rompa, D., Gore-Felton, C., Austin, J., Luke, W., et al. (2001). Unwanted sexual experiences and sexual risks in gay and bisexual men: Associations among revictimization, substance use and psychiatric symptoms. Journal of Sex Research, 28, 1–9.CrossRefGoogle Scholar
  28. Kalichman, S. C., & Cain, D. (2004). The relationship between indicators of sexual compulsivity and high-risk sexual practices among men and women receiving services from a sexually transmitted infection clinic. Journal of Sex Research, 41, 235–241.CrossRefPubMedGoogle Scholar
  29. Kalichman, S. C., Greenberg, J., & Abel, G. G. (1997). HIV-seropositive men who engage in high risk sexual behavior. Psychological characteristics and implications for prevention. AIDS Care, 9, 441–540.CrossRefPubMedGoogle Scholar
  30. Kalichman, S. C., & Rompa, D. (1995). Sexual sensation seeking and sexual compulsivity scales: Reliability, validity, and predicting HIV risk behavior. Journal of Personality Assessment, 65, 586–601.CrossRefPubMedGoogle Scholar
  31. Kalichman, S. C., & Rompa, D. (2001). The sexual compulsivity scale: Further development and use with HIV-positive persons. Journal of Personality Assessment, 76, 379–395.CrossRefPubMedGoogle Scholar
  32. Kalichman, S. C., & Simbaya, L. (2004a). Sexual assault history and risks for sexually transmitted infections among women in an African township in Cape Town, South Africa. AIDS Care, 16, 681–689.CrossRefPubMedGoogle Scholar
  33. Kalichman, S. C., & Simbaya, L. (2004b). Traditional beliefs about the cause of AIDS and AIDS-related stigma in South Africa. AIDS Care, 16, 572–580.CrossRefPubMedGoogle Scholar
  34. Kuzma, J. M., & Black, D. W. (2008). Epidemiology, prevalence, and natural history of compulsive sexual behavior. Psychiatric Clinics of North America, 31, 603–611.CrossRefPubMedGoogle Scholar
  35. Levine, M. P., & Troiden, R. R. (1988). The myth of sexual compulsivity. Journal of Sex research, 25, 347–363.CrossRefGoogle Scholar
  36. McBride, K., Reece, M., & Sanders, S. A. (2008). Using the sexual compulsivity scale to predict outcomes of sexual behavior in young adults. Sexual Addiction and Compulsivity, 15, 97–115.CrossRefGoogle Scholar
  37. Menard, S. (2002). Applied logistic regression analysis. Thousand Oaks, CA: Sage.Google Scholar
  38. Miller, K. W., Wilder, L. B., Stillman, F. A., & Becker, D. M. (1997). The feasibility of a street-intercept survey method in an African-American community. American Journal of Public Health, 87, 655–658.CrossRefPubMedGoogle Scholar
  39. Missildine, W., Feldstein, G., Punzalan, J. C., & Parsons, J. T. (2005). S/he loves me, s/he loves me not: Questioning heterosexist assumptions of gender differences and romantic attractions. Sexual Addiction & Compulsivity, 12, 1–11.CrossRefGoogle Scholar
  40. Moskowitz, D. A., & Roloff, M. E. (2007). The ultimate high: Sexual addiction and the bug chasing phenomenon. Sexual Addiction and Compulsivity, 14, 21–40.CrossRefGoogle Scholar
  41. Muench, F., & Parsons, J. T. (2004). Sexual compulsivity and HIV: Identification and treatment. Focus, 19, 1–4.PubMedGoogle Scholar
  42. Nanín, J. E., Bimbi, D. S., Brown, J., Severino, J., & Parsons, J. T. (2005, April). Profiles of gay/bisexual men who hengage in specialized sexual behavior. Paper presented at the Western Region Conference of the Society for the Scientific Study of Sexuality, San Francisco, CA.Google Scholar
  43. Nanín, J. E., Bimbi, D. S., & Parsons, J. T. (2006, November). Prevalence and psychosocial correlates of specialized sexual behavior (SSB) and “extreme” sexual behaviors among gay and bisexual men. Paper presented at the Society for the Scientific Study of Sexuality, Las Vegas, NV.Google Scholar
  44. Nanín, J. E., & Parsons, J. (2006). Club drug use and risky sex among gay and bisexual men in New York City. Journal of Gay and Lesbian Psychotherapy, 10, 111–122.CrossRefGoogle Scholar
  45. O’Leary, A., Wolitski, R. J., Remien, R. H., Woods, W., Parsons, J. T., Moss, S., et al. (2005). Psychosocial correlates of transmission risk behavior among HIV-seropositive gay and bisexual men. AIDS, 19, 1–9.CrossRefGoogle Scholar
  46. Parsons, J. T. (2005). HIV-positive gay and bisexual men. In S. C. Kalichman (Ed.), Positive prevention: Reducing HIV transmission among people living with HIV/AIDS (pp. 99–133). New York: Kluwer.Google Scholar
  47. Parsons, J. T., & Bimbi, D. S. (2007). Intentional unprotected anal intercourse among sex who have sex with men: Barebacking––from behavior to identity. AIDS and Behavior, 11, 277–287.CrossRefPubMedGoogle Scholar
  48. Parsons, J. T., Bimbi, D. S., & Halkitis, P. N. (2001). Sexual compulsivity among gay/bisexual male escorts who advertise on the Internet. Sexual Addiction & Compulsivity, 8, 101–112.CrossRefGoogle Scholar
  49. Parsons, J. T., Halkitis, P. N., Bimbi, D. S., & Borkowski, T. (2000). Perceptions of the benefits and costs associated with condom use and unprotected sex among late adolescent college students. Journal of Adolescence, 23, 377–397.CrossRefPubMedGoogle Scholar
  50. Parsons, J. T., Halkitis, P. N., Wolitski, R. J., & Gomez, C. A. (2003). Correlates of sexual risk behaviors among HIV-positive men who have sex with men. AIDS Education and Prevention, 15, 383–400.CrossRefPubMedGoogle Scholar
  51. Parsons, J. T., Kelly, B. C., Bimbi, D. S., DiMaria, L., Wainberg, M. L., & Morgenstern, J. (2008). Explanations for the origins of sexual compulsivity among gay and bisexual men. Archives of Sexual Behavior, 37, 817–826.CrossRefPubMedGoogle Scholar
  52. Parsons, J. T., Kelly, B. C., Bimbi, D. S., Muench, F., & Morgenstern, J. (2007). Accounting for the social triggers of sexual compulsivity. Journal of Addictive Diseases, 26, 5–16.CrossRefPubMedGoogle Scholar
  53. Quadland, M. C. (1985). Compulsive sexual behavior: Definition of a problem and an approach to treatment. Journal of Sex and Marital Therapy, 11, 121–132.PubMedGoogle Scholar
  54. Reece, M. (2003). Sexual compulsivity and HIV serostatus disclosure among men who have sex with men. Sexual Addiction and Compulsivity, 10, 1–11.CrossRefGoogle Scholar
  55. Reece, M., Plate, P. L., & Daughtry, M. (2001). HIV prevention and sexual compulsivity: The need for an integrated strategy of public health and mental health. Sexual Addiction & Compulsivity, 8, 157–167.CrossRefGoogle Scholar
  56. Rotheram-Borus, M. J., Lee, M., Zhou, S., O’Hara, P., Birnbaum, J. M., Swendeman, D., et al. (2001). Variation in health and risk behavior among youth living with HIV. AIDS Education and Prevention, 13, 42–54.CrossRefPubMedGoogle Scholar
  57. Saghir, M. T., & Robins, E. (1973). Male and female homosexuality: A comprehensive investigation. Baltimore, MD: Williams & Wilkins.Google Scholar
  58. SASH (The Society for the Advancement of Sexual Health). (2003). Homosexuality and sexual addiction. Retrieved December 29, 2008, from
  59. Semple, S. J., Zians, J., Strathdee, S. A., & Patterson, T. L. (2008). Sexual marathons and methamphetamine use among HIV-positive men who have sex with men. Archives of Sexual Behavior. doi: 10.1007/s10508-007-9292-y.
  60. Tabachnick, B., & Fidell, L. (2001). Using multivariate statistics (4th ed.). Boston, MA: Allyn and Bacon.Google Scholar
  61. Zuckerman, M., Eysenck, S. B. G., & Eysenck, H. J. (1978). Sensation seeking in England and America: Cross-cultural, age, and sex comparisons. Journal of Consulting and Clinical Psychology, 46, 139–149.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Christian Grov
    • 1
    • 2
  • Jeffrey T. Parsons
    • 2
    • 3
    • 4
  • David S. Bimbi
    • 2
    • 5
  1. 1.Department of Health and Nutrition SciencesBrooklyn College of the City University of New York (CUNY)BrooklynUSA
  2. 2.Center for HIV/AIDS Educational Studies and TrainingNew YorkUSA
  3. 3.Department of Social and Personality PsychologyThe Graduate Center of CUNYNew YorkUSA
  4. 4.Department of PsychologyHunter College of the City University of New YorkNew YorkUSA
  5. 5.Department of Natural and Applied SciencesLaGuardia Community College of CUNYLong Island CityUSA

Personalised recommendations