Abstract

BackgroundWhile a large body of research has sought to understand HIV transmission risk behaviours among gay men, bisexual men and other men who have sex with men (MSM), less attention has been paid to the wider sexual health and well-being of this population. While some community-based organisations aim to support a more holistic sense of sexual well-being there is little evidence to draw on to inform their interventions. The current study sought to explore gay and bisexual men’s conceptions of what constitutes the ‘best sex’.MethodThe EMIS survey of 2010 recruited more than 180,000 respondents from 38 European countries to complete an online questionnaire about sexual health and behaviour. The 12,942 English language, UK-based responses to the open ended question, “What’s your idea of the best sex life?” were subjected to a detailed content analysis. A framework was devised to reflect and describe the key themes emerging from the data, which was then used to code all responses to one (or more) of these themes. Further statistical analysis sought to establish if and how responses differed according to key demographic variables.ResultsEight themes emerged that capture the diversity of gay and bisexual men’s sexual desires. Most common among responses was a desire for sex within committed relationships, followed by a desire for sex which is emotionally or psychologically connected. Men also expressed a desire for volume and variety in their sexual lives, and for sex that is free from physical, social or psychological harm. Comparative analysis identified that older men were less likely to idealise a relationship or emotional connection, but were more likely to specify the sexual acts or behaviours they wished to engage in.ConclusionsAttending to what men value or aspire to can help ensure interventions are engaging and meaningful to the target population. HIV prevention interventions need to attend to the broad range of sexual desires held by gay and bisexual men in delivery of holistic sexual health promotion that can help them to have the best sex with the least harm.

Highlights

  • While a large body of research has sought to understand HIV transmission risk behaviours among gay men, bisexual men and other men who have sex with men (MSM), less attention has been paid to the wider sexual health and well-being of this population

  • HIV prevention interventions need to attend to the broad range of sexual desires held by gay and bisexual men in delivery of holistic sexual health promotion that can help them to have the best sex with the least harm

  • The current study suggests that the kind of sex lives MSM aspire to are varied and multifaceted

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Summary

Introduction

While a large body of research has sought to understand HIV transmission risk behaviours among gay men, bisexual men and other men who have sex with men (MSM), less attention has been paid to the wider sexual health and well-being of this population. Bisexual men and other men who have sex with men (MSM) remain the group at highest risk for contracting HIV in the UK [1], as in many other parts of the world [2,3] Given this obvious public health priority, a significant number of studies have sought to understand specific sexual risk behaviours [4,5,6], predictive factors for transmission or acquisition of the virus [7,8,9], risk management techniques [10,11], and HIV prevention needs [12,13]. A notable exception is the Pleasure and Sexual Health study [23] in Australia, which reports on how gay men weigh up their desire to avoid acquiring or transmitting HIV with a strong desire to have sex that is pleasurable

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