Condom Use and HIV-Related Behaviors in Portuguese Men who have Sex with Men: A Study of Sexual Behavior and Sexual Pleasure

Abstract

Background: The purpose of this study is to assess the types of sexual behaviors among men who have sex with men (MSM), with and without a condom, and to assess the predictive relationship between sexual pleasure and risky sexual practices among MSM. Methods: A total 304 MSM (Mean age 32.30, SD=11.28) recruited through informal social networks and the Internet participated in this study. Most participants were single and self-identified as gay (70%). Sexual pleasure was operationalized using one measure with 8 items (reliability analysis was good α=0.76). Participants were asked to recall their sexual experiences and their sexual behaviors over the last two months. Results: Only 7.2% of participants reported being HIV positive and approximately 26% reported not knowing their status. All participants indicated that they would feel higher levels of sexual pleasure if they were not using a condom during their sexual interaction, and all differences were statistically significant. Differences were also found between the following scenarios: a) having sex with or without a condom for receptive anal sex (p=0.036), b) having sex with or without a condom for insertive anal sex (p=0.012), and c) having sex with or without a condom for oral sex (p<0.001). Linear regression indicated that pleasure is a predictor of how many times a man was penetrated without a condom (β=0.255; R2=0.084; p<0.05) and a predictor of how many times a man penetrated another man without a condom (β=0.291; R2=0.066; p<0.05). Conclusion: Sexual pleasure needs to be prioritized in the development of condoms and other sexual safety measures as well as in the promotion of their use when working with HIV prevention among MSM.