This study aimed to describe sexually explicit online media (SEOM) consumption among men who have sex with men (MSM) in the United States and examine associations between exposure to unprotected anal intercourse (UAI) in SEOM and engagement in both UAI and serodiscordant UAI. MSM in the U.S. who accessed a men-seeking-men website in the past year (N = 1,170) were recruited online for a cross-sectional, Internet-based survey of sexual risk and SEOM consumption. In the 3 months prior to interview, more than half (57 %) of the men reported viewing SEOM one or more times per day and almost half (45 %) reported that at least half of the SEOM they viewed portrayed UAI. Compared to participants who reported that 0–24 % of the SEOM they viewed showed UAI, participants who reported that 25–49, 50–74, or 75–100 % of the SEOM they viewed portrayed UAI had progressively increasing odds of engaging in UAI and serodiscordant UAI in the past 3 months. As SEOM has become more ubiquitous and accessible, research should examine causal relations between SEOM consumption and sexual risk-taking among MSM as well as ways to use SEOM for HIV prevention.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Bancroft, J. (2000). Individual differences in sexual risk taking: A biopsychosocial theoretical approach. In J. Bancroft (Ed.), The role of theory in sex research (pp. 177–212). Bloomington: Indiana University Press.
Brown, R. L., & Rounds, L. A. (1995). Conjoint screening questionnaires for alcohol and other drug abuse: Criterion validity in a primary care practice. Wisconsin Medical Journal, 94, 135–140.
Centers for Disease Control and Prevention. (2011). High-impact HIV prevention: CDC’s approach to reducing HIV infections in the United States. Atlanta, GA: Author. Retrieved April 24, 2013 from http://www.cdc.gov/hiv/strategy/dhap/pdf/nhas_booklet.pdf.
Centers for Disease Control and Prevention. (2012a). HIV surveillance report, 2010 (Vol. 22). Retrieved February 12, 2013 from http://www.cdc.gov/hiv/topics/surveillance/recourses/reports/.
Centers for Disease Control and Prevention. (2012b). Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 U.S. dependent areas—2010. Retrieved February 13, 2013 from http://www.cdc.gov/hiv/surveillance/resources/reports/2010supp_vol17no3/index.htm.
Chaney, M. P., & Chang, C. Y. (2005). A trio of turmoil for Internet sexually addicted men who have sex with men: Boredom proneness, social connectedness, and dissociation. Sexual Addiction & Compulsivity, 12, 3–18. doi:10.1080/10720160590933671.
Clark, M., Milberg, S., & Ross, J. (1983). Arousal cues, arousal related material in memory: Implications for understanding effects of mood on memory. Journal of Verbal Learning and Verbal Behavior, 22, 633–649.
Crepaz, N., Marks, G., Liau, A., Mullins, M. M., Aupont, L. W., Marshall, K. J., … HIV/AIDS Prevention Research Synthesis (PRS) Team. (2009). Prevalence of unprotected anal intercourse among HIV-diagnosed MSM in the United States: A meta-analysis. AIDS, 23, 1617–1629. doi:10.1097/QAD.0b013e32832effae.
Crooks, R. L., & Baur, K. (2010). Our sexuality (11th ed.). Belmont, CA: Cengage Learning.
Czaja, R. (1998). Questionnaire pretesting comes of age. Marketing Bulletin, 9, 52–66.
Downing, M. J., Schrimshaw, E. W., Antebi, N., & Siegel, K. (2013). Sexually explicit media on the Internet: A content analysis of sexual behaviors, risk, and media characteristics in gay male adult videos. Archives of Sexual Behavior. doi:10.1007/s10508-013-0121-1.
Duggan, S. J., & McCreary, D. R. (2004). Body image, eating disorders, and the drive for muscularity in gay and heterosexual men: The influence of media images. Journal of Homosexuality, 47, 45–58. doi:10.1300/J082v47n03_03.
Eaton, L., Cain, D., Pope, H., Garcia, J., & Cherry, C. (2012). The relationship between pornography use and sexual behaviours among at-risk HIV-negative men who have sex with men. Sexual Health, 9, 166–170. doi:10.1071/SH10092.
Finlayson, T. J., Le, B., Smith, A., Bowles, K., Cribbin, M., Miles, I., … Division of HIV/AIDS National Center for HIV/AIDS Prevention. (2011). HIV risk, prevention, and testing behaviors among men who have sex with men—National HIV Behavioral Surveillance System, 21 U.S. Cities, United States, 2008. Morbidity and Mortality Weekly Report Surveillance Summaries, 60, 1–34.
George, W. H., Davis, K. C., Norris, J., Heiman, J. R., Stoner, S. A., Schacht, R. L., … Kajumulo, K. F. (2009). Indirect effects of acute alcohol intoxication on sexual risk-taking: The roles of subjective and physiological sexual arousal. Archives of Sexual Behavior, 38, 498–513. doi:10.1007/s10508-008-9346-9.
Gold, R. (2000). AIDS education for gay men: Towards a more cognitive approach. AIDS Care, 12, 267–272.
Gold, R., & Skinner, M. (1992). Situational factors and thought processes associated with unprotected intercourse in young gay men. AIDS, 6, 1021–1030.
Gold, R., Skinner, M., & Ross, M. (1994). Unprotected anal intercourse in HIV-infected and non-HIV-infected gay men. Journal of Sex Research, 31, 59–77.
Grov, C., Hirshfield, S., Remien, R. H., Humberstone, M., & Chiasson, M. A. (2013). Exploring the venue’s role in risky sexual behavior among gay and bisexual men: An event-level analysis from a national online survey in the U.S. Archives of Sexual Behavior, 42, 291–302. doi:10.1007/s10508-011-9854-x.
Grudzen, C. R., Elliott, M. N., Kerndt, P. R., Schuster, M. A., Brook, R. H., & Gelberg, L. (2009). Condom use and high-risk sexual acts in adult films: A comparison of heterosexual and homosexual films. American Journal of Public Health, 99, S152–S156.
Guy, R. J., Wand, H., Wilson, D. P., Prestage, G., Jin, F., Templeton, D. J., … Kaldor, J. M. (2011). Using population attributable risk to choose HIV prevention strategies in men who have sex with men. BMC Public Health, 11, 247. doi:10.1186/1471-2458-11-247.
Hald, G. M., Smolenski, D., & Rosser, B. R. S. (2013). Perceived effects of sexually explicit media among men who have sex with men and psychometric properties of the Pornography Consumption Effects Scale (PCES). Journal of Sexual Medicine, 10, 757–767. doi:10.1111/j.1743-6109.2012.02988.x.
Halkitis, P., & Parsons, J. (2003). Intentional unsafe sex (barebacking) among HIV-positive gay men who seek sexual partners on the internet. AIDS Care, 15, 367–378.
Hatzenbuehler, M. L., O’Cleirigh, C., Mayer, K. H., Mimiaga, M. J., & Safren, S. A. (2011). Prospective associations between HIV-related stigma, transmission risk behaviors, and adverse mental health outcomes in men who have sex with men. Annals of Behavioral Medicine, 42, 227–234. doi:10.1007/s12160-011-9275-z.
Hurley, R. (2009). Bareback to basics: How gay porn undermines safe sex campaigns. British Medical Journal, 338, b910.
Kubicek, K., Beyer, W. J., Weiss, G., Iverson, E., & Kipke, M. D. (2010). In the dark: Young men’s stories of sexual initiation in the absence of relevant sexual health information. Health Education & Behavior, 37, 243–263. doi:10.1177/1090198109339993.
Liau, A., Millett, G., & Marks, G. (2006). Meta-analytic examination of online sex-seeking and sexual risk behavior among men who have sex with men. Sexually Transmitted Diseases, 33, 576–584.
Loewenstein, G., Weber, E., Hsee, C., & Welch, N. (2001). Risk as feelings. Psychological Bulletin, 127, 267–286.
Maisto, S. A., Palfai, T., Vanable, P. A., Heath, J., & Woolf-King, S. E. (2012). The effects of alcohol and sexual arousal on determinants of sexual risk in men who have sex with men. Archives of Sexual Behavior, 41, 971–986. doi:10.1007/s10508-011-9846-x.
Mayer, K. H., Wheeler, D. P., Bekker, L.-G., Grinsztejn, B., Remien, R. H., Sandfort, T. G. M., & Beyrer, C. (2013). Overcoming biological, behavioral, and structural vulnerabilities: New directions in research to decrease HIV transmission in men who have sex with men. Journal of Acquired Immune Deficiency Syndromes, 63(Suppl. 2), S161–S167. doi:10.1097/QAI.0b013e318298700e.
McNeil, D. G. (2012, November 5). Unlikely model for H.I.V. prevention: Adult film industry. The New York Times. Retrieved April 23, 2013 from http://www.nytimes.com/2012/11/06/health/unlikely-model-for-hiv-prevention-porn-industry.html.
Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis : An expanded sourcebook (2nd ed.). Thousand Oaks, CA: Sage.
Morrison, T., Morrison, M., & Bradley, B. (2007). Correlates of gay men’s self-reported exposure to pornography. International Journal of Sexual Health, 19(2), 33–43.
Muhr, T. (2004). ATLAS.ti 5.2 [computer software]. Berlin: Scientific Software Development.
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. doi:10.1300/J069v26n03_02.
Rich, F. (2001, May 20). Naked capitalists. New York Times Magazine, 51–55, 80–81, 92.
Rosenberger, J. G. (2012, November). Event-level examination of online pornography consumption among gay and bisexual men. Paper presented at the meeting of the Society for the Scientific Study of Sexuality, Tampa, FL.
Rosser, B. R. S., Grey, J. A., Wilkerson, J. M., Iantaffi, A., Brady, S. S., Smolenski, D. J., & Horvath, K. J. (2012). A commentary on the role of sexually explicit media (SEM) in the transmission and prevention of HIV among men who have sex with men (MSM). AIDS and Behavior, 16, 1373–1381. doi:10.1007/s10461-012-0135-z.
Rosser, B., Hatfield, L., Miner, M., Ghiselli, M., Lee, B., Welles, S., & Positive Connections Team. (2010). Effects of a behavioral intervention to reduce serodiscordant unsafe sex among HIV positive men who have sex with men: The Positive Connections randomized controlled trial study. Journal of Behavioral Medicine, 33, 147–158. doi:10.1007/s10865-009-9244-1.
Rosser, B. R. S., Miner, M. H., Bockting, W. O., Ross, M. W., Konstan, J., Gurak, L., … Coleman, E. (2009a). HIV risk and the Internet: Results of the Men’s INTernet Sex (MINTS) Study. AIDS and Behavior, 13, 746–756. doi:10.1007/s10461-008-9399-8.
Rosser, B. R. S., Oakes, J. M., Horvath, K. J., Konstan, J. A., Danilenko, G. P., & Peterson, J. L. (2009b). HIV sexual risk behavior by men who use the Internet to seek sex with men: Results of the Men’s INTernet Sex Study-II (MINTS-II). AIDS and Behavior, 13, 488–498. doi:10.1007/s10461-009-9524-3.
Rosser, B. R. S., Smolenski, D. J., Erickson, D., Iantaffi, A., Brady, S. S., Grey, J. A., … Wilkerson, J. M. (2013). The effects of gay sexually explicit media on the HIV risk behavior of men who have sex with men. AIDS and Behavior, 17, 1488–1498. doi:10.1007/s10461-013-0454-8.
Rural Health Research Center. (2005). Rural urban commuting area codes data. Retrieved March 13, 2013 from http://depts.washington.edu/uwruca/ruca-approx.php.
Schramke, C. J., & Bauer, R. M. (1997). State-dependent learning in older and younger adults. Psychology and Aging, 12, 255–262.
Shuper, P. A., & Fisher, W. A. (2008). The role of sexual arousal and sexual partner characteristics in HIV + MSM’s intentions to engage in unprotected sexual intercourse. Health Psychology, 27, 445–454. doi:10.1037/0278-6188.8.131.525.
Sidat, M. M., Mijch, A. M., Lewin, S. R., Hoy, J. F., Hocking, J., & Fairley, C. K. (2008). Incidence of putative HIV superinfection and sexual practices among HIV-infected men who have sex with men. Sexual Health, 5, 61–67.
StataCorp. (2011). Stata statistical software: Release 12. College Station, TX: StataCorp LP.
Stein, D., Silvera, R., Hagerty, R., & Marmor, M. (2012). Viewing pornography depicting unprotected anal intercourse: Are there implications for HIV prevention among men who have sex with men? Archives of Sexual Behavior, 41, 411–419. doi:10.1007/s10508-011-9789-2.
Thomas, J. (2000). Gay male video pornography: Past, present and future. In R. Weitzer (Ed.), Sex for sale: Prostitution, pornography, and the sex industry (pp. 49–66). New York: Routledge.
van Kesteren, N., Hospers, H., & Kok, G. (2007). Sexual risk behavior among HIV-positive men who have sex with men: A literature review. Patient Education and Counseling, 65, 5–20.
Weinberg, M. S., Williams, C. J., Kleiner, S., & Irizarry, Y. (2010). Pornography, normalization, and empowerment. Archives of Sexual Behavior, 39, 1389–1401. doi:10.1007/s10508-009-9592-5.
Weitzer, R. J. (Ed.). (2010). Sex for sale: Prostitution, pornography, and the sex industry. New York: Routledge.
Ybarra, M. L., & Bull, S. S. (2007). Current trends in Internet- and cell phone-based HIV prevention and intervention programs. Current HIV/AIDS Reports, 4, 201–207.
We would like to thank our participants, as well as the Simoni Lab for their help with this project. Research reported in this publication was supported by NIMH of the National Institutes of Health under award numbers F31MH088851 and K24MH093243. Additional support was provided by the Department of Psychology at the University of Washington, the American Psychological Association of Graduate Students, and the University of Washington Center for AIDS Research (CFAR), an NIH-funded program (P30AI27757) which is supported by the following NIH Institutes and Centers (NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA). The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other sources of support.
About this article
Cite this article
Nelson, K.M., Simoni, J.M., Morrison, D.M. et al. Sexually Explicit Online Media and Sexual Risk Among Men Who Have Sex with Men in the United States. Arch Sex Behav 43, 833–843 (2014). https://doi.org/10.1007/s10508-013-0238-2
- Men who have sex with men (MSM)
- Sexually explicit media
- Sexual risk-taking