Sexual Compulsivity and Sexual Risk in Gay and Bisexual Men
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.
KeywordsSexual 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.
- American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
- 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
- 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
- Black, D. W. (1998). Compulsive sexual behavior: A review. Journal of Practical Psychology and Behavioral Health, 4, 219–229.Google Scholar
- 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.
- Carnes, P. (1991). Don’t call it love: Recovery from sexual addiction. New York: Bantam Books.Google Scholar
- 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 http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/transmission.htm.
- CDC (Centers for Disease Control and Prevention). (2008b). HIV prevalence estimates––United States, 2006. Morbidity and Mortality Weekly Report, 57, 1073–1076.Google Scholar
- 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
- 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
- Coleman, E. (1992). Is your patient suffering from compulsive sexual behavior? Psychiatric Annals, 22, 320–325.Google Scholar
- Comp Care. (1987). Hope and recovery: A twelve-step guide for healing from compulsive sexual behavior. Minneapolis, MN: Author.Google Scholar
- 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
- Menard, S. (2002). Applied logistic regression analysis. Thousand Oaks, CA: Sage.Google Scholar
- 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
- 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
- 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
- Saghir, M. T., & Robins, E. (1973). Male and female homosexuality: A comprehensive investigation. Baltimore, MD: Williams & Wilkins.Google Scholar
- SASH (The Society for the Advancement of Sexual Health). (2003). Homosexuality and sexual addiction. Retrieved December 29, 2008, from http://www.ncsac.org/general/papers_homosexuality.aspx.
- 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.
- Tabachnick, B., & Fidell, L. (2001). Using multivariate statistics (4th ed.). Boston, MA: Allyn and Bacon.Google Scholar