Men's Sexual Practices Research Articles

A meta-synthesis about the study of men’s sexual behavior through the lens of hegemonic masculinity

The aim of this study is to understand how men experience sexual behavior in relation to dominant masculine norms in heteronormative social organizations. After a systematic search and a careful study selection process, we analyzed 15 scientific qualitative studies on men's sexual practices that draw on hegemonic masculinity. We then carried out a thematic synthesis of the results that collectively covered 438 male narratives ranging in age from 11 to 71. The results include (hetero)sex as a signifier of manhood, male sexual collectivity; sexual hierarchies; sexual risk; and the invisibility of sexual diversity. This meta-synthesis emphasizes the complex relationship between male sexuality and the influence of hegemonic masculinity, revealing important health and well-being effects on men. Also, this highlights a dynamic relationship that affects not only men but also their partners in sexual relationships.

Protocol for a systematic review: Interventions addressing men, masculinities and gender equality in sexual and reproductive health: An evidence and gap map and systematic review of reviews.

Protocol for a systematic review: Interventions addressing men, masculinities and gender equality in sexual and reproductive health: An evidence and gap map and systematic review of reviews.

Flexibility in Men's Sexual Practices in Response to Iatrogenic Erectile Dysfunction after Prostate Cancer Treatment.

IntroductionProstate cancer (PCa) treatments are associated with a high incidence of erectile dysfunction (ED). Interventions to help men with iatrogenic ED have largely focused on penile tumescence adequate for vaginal penetration. Less research has been undertaken on sex practices other than penile/vaginal intercourse.AimThe aim of this study was to explore forms of sexual practice engaged in by men following treatment for PCa. We focused in particular on anal intercourse (AI) as practiced by both nonheterosexual (i.e., gay-identified men and other men who have sex with men) and heterosexual men. We sought to determine how common AI was subsequent to PCa treatment and how flexible AI practitioners were in their modes (e.g., from insertive to receptive) when faced with iatrogenic ED.MethodsAn international online survey was conducted in 2010–2011 of men treated for PCa, where participants (N = 558) were asked explicitly about their sexual practices before and after PCa treatment.Main Outcome MeasuresThe outcome measures were the numbers and percentages of men who practiced AI before and after PCa treatment as well as the percentage who changed AI practice after PCa treatment.ResultsFive hundred twenty-six men (90 nonheterosexual men; 436 heterosexual men) answered questions on AI practices. A proportion of nonheterosexual (47%) and heterosexual men (7%) practiced AI following PCa treatment, and did so in all modes (insertive, receptive, and “versatile”). Many nonheterosexual men continued to be sexually active in the face of iatrogenic ED by shifting from the insertive to receptive modes. A few men, both heterosexual and nonheterosexual, adopted AI for the first time post-PCa treatment.ConclusionsFlexibility in sexual practice is possible for some men, both nonheterosexual and heterosexual, in the face of iatrogenic ED. Advising PCa patients of the possibilities of sexual strategies that include AI may help them in reestablishing a sex life that is not erection dependent. Dowsett GW, Lyons A, Duncan D, and Wassersug RJ. Flexibility in men's sexual practices in response to iatrogenic erectile dysfunction after prostate cancer treatment. Sex Med 2014;2:115–120.

Social, structural and behavioral drivers of concurrent partnerships among African American men in Philadelphia

African Americans face disproportionately higher risks of HIV infection. Concurrent sexual relationships, or sexual partnerships that overlap in time, are more common among African Americans than individuals of other races and may contribute to racial disparities in HIV infection. However, little is known about attitudes, norms and practices among individuals engaged in concurrent partnerships. Little is also known about the processes through which structural, behavioral, and social factors influence concurrent sexual relationships. We recruited 24 heterosexual African American men involved in concurrent sexual relationships from a public health clinic in Philadelphia. We conducted in-depth interviews exploring these men's sexual practices; social norms and individual attitudes about concurrency; perceived sexual health risks with main and non-main partners; and the social, structural, and behavioral factors contributing to concurrent sexual relationships. Twenty-two men reported having one main and one or more non-main partners; two reported having no main partners. Respondents generally perceived sexual relationships with non-main partners as riskier than relationships with main partners and used condoms far less frequently with main than non-main partners. Most participants commented that it is acceptable and often expected for men and women to engage in concurrent sexual relationships. Social factors influencing participants’ concurrent partnerships included being unmarried and trusting neither main nor non-main partners. Structural factors influencing concurrent partnerships included economic dependence on one or more women, incarceration, unstable housing, and unemployment. Several men commented that individual behavioral factors such as alcohol and cocaine use contributed to their concurrent sexual partnerships. Future research and interventions related to sexual concurrency should address social and structural factors in addition to conventional HIV risk-taking behaviors.

Sociocultural facilitators and barriers to condom use during anal sex among men who have sex with men in Guangzhou, China: an ethnographic study

This ethnographic study explored how cultural belief systems shaped sexual risk practices among men who have sex with men (MSM) in Guangzhou, China. A specific focus was on how these men's sexual practices varied across sexual venues and among different partners in order to better understand sociocultural facilitators and barriers to condom use in the Guangzhou community. Qualitative data were obtained through semi-structured in-depth interviews with MSM and ethnographic observations in MSM sexual venues in the city. The thematic analysis focused specifically on the accounts of unprotected sex occasions. We found that an erotic idea of “rouyu” (desire of physical flesh) embedded in a subculture of MSM and a metaphor for condom use as being inferior and promoting distance posed a considerable barrier to condom use among these MSM. Some men reported gaining a positive self-concept related to same-sex identity through unprotected sex. These MSM's subjective evaluations of HIV risk were closely tied to the perceived characteristics of sex partners and sexual venues. We conclude by advocating specific sociocultural interventions in emerging risk venues, such as saunas/bathhouses, to better meet the needs of the MSM community in Guangzhou.

Australian men's sexual practices in saunas, sex clubs and other male sex on premises venues

Sex on premises venues (SOPVs) where men have sex with men have been implicated in the spread of sexually transmissible infections, but few studies have described men's sexual encounters in SOPVs, particularly the degree to which men from different backgrounds engage in risky sexual practices. Interviewer administered surveys were conducted with 186 Australian men who have sex with men (MSM) within 48 h of visiting an SOPV. They reported their sexual practices, the characteristics of their partners and other circumstances surrounding their sexual encounters. All analyses were based on the number of sexual encounters (n = 430). Oral sex was the most common practice, occurring in 74.9% of encounters, followed by massage, frottage or kissing (53.7%), solo or mutual masturbation (36.3%), and anal sex (32.1%). Multivariate analyses revealed age as a significant factor for having protected anal sex (P = 0.001), insertive anal sex (P = 0.004) and receptive anal sex (P < 0.001). These practices were more frequent in encounters among younger men, while masturbation (P = 0.03) was more frequent among older men. When men's sexual partners were affected by alcohol, encounters were less likely to involve unprotected anal intercourse (P = 0.006) and more likely to involve massage, frottage or kissing (P = 0.009). Men disclosed their HIV status in only 7.7% of encounters. With the likelihood of risky sexual practices varying according to background, results from this study should be used to guide interventions aiming to promote safer sex in SOPVs.

‘Mobile men with money’: the socio‐cultural and politico‐economic context of ‘high‐risk’ behaviour among wealthy businessmen and government officials in urban China

China's transition from an injection drug‐driven HIV epidemic to one primarily transmitted through sexual contact has triggered concern over the potential for HIV to move into the non‐drug‐injecting population. Much discussion has focused on the migrant men of China's vast ‘floating population’ who are considered a high‐risk group. As a result, many men who frequently engage in high‐risk behaviour but are not included in this especially vulnerable group are evading HIV prevention messages. This paper highlights the socio‐cultural and politico‐economic factors that motivate many of China's wealthy businessmen and government officials, sometimes referred to as ‘mobile men with money’, to engage in such behaviour. Examination of the activities related to the work of these men reveals a situation where the confluence of a market‐oriented economy operating within a socialist‐style political system under the influence of traditional networking practices has engendered a unique mode of patron‐clientelism that brings them together over shared social rituals including feasting, drinking and female‐centered entertainment that is often coupled with sexual services. As a result, consideration of the socio‐cultural factors influencing these men's sexual practices is important for responding to the newly emerging stage of China's HIV epidemic.

Freudian Slips and Coteries of Vice: The Sexual Offences Act of 1967*

The Sexual Offences Act 1967 made the first inroads to decriminalising men's homosexual sex since buggery was made a capital offence under Henry VIII. The act was drafted at the direction of the 1957 Wolfenden report, but bore the distinct hallmark of individuals of the 1967 parliament. More complex than the dictated product of Wolfenden, and more idiosyncratic than a simple reflection of the social climate of the 1960s, the private member's bill was a Labour initiative with bipartisan support, driven in the Commons by the bizarre motivations of its sponsor, Labour member for Pontypool, Leo Abse. Contrary to popular myths about the aims of decriminalisation, Abse's crusading Freudian motivation was concerned with discouraging, more than allowing, homosexual behaviour. Similarly, ‘privacy’– the gift of the house of lords to sexual regulation – was aimed largely at curtailing men's sexual practices, along with secreting them away. Thus, while the act is typically associated with a general ideal of freedom, much parliamentary motivation concerned control and the prevention of sexual activities.

A narrative exploration of gay men's sexual practices as a dialectical dialogue

This study aims to attain a comprehensive understanding of gay male sexual practices by means of a narrative research approach. More specifically, the study explores the subjective experience of gay males regarding role and self-label during anal sexual intercourse. The findings suggest that the subjective experience of gay men during sexual intercourse is a result of a continuous and dynamic intra- and inter-personal dialectical dialogue that attributes meaning to both their role and their self-label in the sexual act. These findings are in accord with the post-modernist relational psychoanalytic perspective, suggesting that any type of intercourse, including sexual, is an intra- and inter-subjective experience that provides both intra- and inter-personal dialectical meaning. This meaning is dynamic and exists so long as the dialectic is initiated and maintained. In such a case, both partners acquire the freedom to construct and reconstruct their experience and its meaning. The collapse of the dialectic, however, is likely to signify an experience of unsatisfying, meaningless sexual intercourse.

Time, relations and learning in gay men's experiences of adventurous sex

In 1998 social researchers reported that membership of a “culture of sexual adventurism and experimentation” was a predictor of HIV sero‐conversion among homosexually active men living in Sydney. In this paper, we explore how these researchers have understood sexual adventurism as referring to a set of sexual practices, to a subcultural network, and to a particular sexual context. We then present an analysis of the way participants in our study recounted experiences of adventurous sex, focusing on sexual occasions that feature men playing with piss. Ten men, recruited on the basis of self–identification as being into ‘adventurous sex’, were interviewed on two occasions. The first interview invited men to recount experiences of adventurous sex in detail. In the second interview we asked men to provide accounts of their sexual histories or trajectories, and to speculate about their sexual futures. The interviews, which averaged one hour in length, were recorded on audio–tape and subsequently transcribed. The 10 participants were recruited from a list of participants from the Sydney Gay Community Periodic Surveys who had indicated their willingness to participate in further research. The men ranged from 33 to 57 years old. All had had sex with casual male partners in the previous six months. Two had regular male partners. Four of them were HIV–positive, four were HIV–negative and two were serostatus unknown. In contrast with an approach to research that seeks to define clusters of sexual activity across surveys of gay men's sexual practices, our study analysed narratives of sexual occasions recounted by gay men in interviews. This approach produces an interactive and iterative perspective on sexual experience, which we develop in this paper by drawing on the affect theory of Sylvan Tomkins and by attending to aspects of momentum, time and relations as recounted in gay men's experiences of adventurous sex. Through our analysis of interview data, we develop an account of adventurous sex that focuses on how men learn in interaction with others during sexual occasions and over time. We find that approaches to sex research and health education that seek predictability in what men do sexually and rely on men to delimit the scope of their sexual repertoire are incompatible with the attitudes with which men in our study approached and recounted experiences of adventurous sex.

HIV-Positive Men's Sexual Practices in the Context of Self-Disclosure of HIV Status

Objective: Compare substance use among men who have sex with men (MSM) at high risk for HIV infection to a nationally representative sample of heterosexual men. Methods: Compare data from surveys of 3,212 MSM recruited for participation in a Vaccine Preparedness Study (VPS) with an age-standardized group of 2481 single, urban-dwelling men from the 1995 National Household Survey on Drug Abuse (NHSDA). Results: Except for alcohol, relative risk (RR [95% confidence interval (CI)]) for use of any substance was higher in the VPS than the National Household Survey on Drug Abuse (NHSDA) (3.64 [3.01-4.42]). Drugs with the highest relative risks were “poppers” (21.6 [15.2-30.8]), sedatives (6.98 [2.46-19.8]), hallucinogens (6.14 [4.61-8.17]), tranquilizers (4.99 [2.96-8.42]), and stimulants (4.47 [3.58-5.58]). RR was higher for weekly use of poppers (33.5 [12.5-89.6]), stimulants (2.75 [1.79-4.22]), marijuana (2.37 [1.93-2.92]), and cocaine (2.24 [1.32-3.79]); and for daily use of marijuana (1.49 [1.08-2.05]). Conclusions: Participants in the VPS used more substances than a group of agestandardized, single, urban-dwelling men from the NHSDA. In view of previous data showing that substance use can be associated with unprotected sex, assessing substance use among MSM at high risk for HIV infection is an important component of risk reduction efforts.

HIV-positive men's sexual practices in the context of self-disclosure of HIV status.

To examine whether disclosure of HIV-positive status to sex partners at risk for HIV infection is associated with safer sex practices and to examine the prevalence and correlates of specific disclosure/sexual behavior patterns. Cross-sectional assessment of 206 HIV-positive men (41% homosexual, 35% bisexual, 24% heterosexual) sampled randomly at an outpatient HIV clinic in Los Angeles, who reported that their most recent sex partner was HIV-negative or of unknown serostatus. Unsafe sex was defined as unprotected anal or vaginal intercourse with that partner. Twenty-five percent of the men engaged in unsafe sex, and 48% of the total sample withheld disclosure from the partner. The prevalence of safer sex was not significantly higher among disclosers than among nondisclosers (unadjusted odds ratio = 1.29; 95% confidence interval: 0.69-2.45), and disclosure was not significantly associated with safer sex in any of 25 demographic or partner subgroups examined in the study. In the full sample, 40% of the men disclosed and engaged in safer sex (informed protection), 35% withheld disclosure and engaged in safer sex (uninformed protection), 12% informed their partner and engaged in unsafe sexual behavior (informed exposure), and 13% withheld disclosure and engaged in unsafe sex (uninformed exposure). Risky behavior patterns were associated with using alcohol/drugs before sex, having an HIV-unknown partner, being less emotionally involved with one's partner, and testing seropositive in the previous 3 years. Interventions for seropositive men that focus primarily on increasing disclosure of serostatus to sex partners may not reduce the prevalence of unsafe sex. Interventions are needed to address the social and psychologic processes that give rise to risky behavior patterns in HIV-infected men. Improved substance abuse counseling also may be needed.

Fitting Fanny: Cleland's "Memoirs" and the Politics of Male Pleasure

In general, prostitutes in John Cleland's Memoirs of a Woman of Pleasure (1748), Fanny Hill included, have few individual characteristics. Different eye colors, degrees of plumpness, and beauty traits such as Emily's even white teeth hardly vary novel's depiction of what may be described as stereotypic prostitute (96). The repeated portraits of fair-skinned Englishwomen who are incapable of pregnancy, immune to disease, and responsive far beyond call of ... professional duty become the eighteenth-century version of centerfold (Markley 348), verbally airbrushing both prostitutes' looks and harsh realities of their working conditions in order to stimulate a male readership that has a libidinal investment in novel's sexual fantasy. The novel's prostitutes, then (with notable exception of Phoebe), possess a remarkable sameness, as Fanny herself notes about employees of Mrs. Cole's brothel, in terms of sex, age, profession, and views (93). On other hand, men in Cleland's novel present reader with a range of physical traits, class positions, and identities. The figure of standardized prostitute serves to mediate between these men, I argue, in order to calibrate them according to their penis size and sexual performance. Although Cleland principally aimed at sexually arousing his reader, and novel's purpose does not seem, in any marked way, to have been political (Trumbach, Erotic 253), Memoirs does combine its satirical and dramatic episodes with descriptions of sexual practices in order to praise or to denigrate men based on their treatment of idealized figure of English prostitute. The novel is so blithely unconcerned about depicting prostitutes or their working conditions with any verisimilitude, I think, not only because it serves erotic interests of male readers but also because it is far less concerned about effects of sexual pleasure and practices on women's than on men's bodies. In that sense, text combines sexual and political, in particular because it intently scrutinizes way that men's sexual practices at once reflect and influence their social status. Although Memoirs, first pornographic novel in English, is undoubtedly popular among eighteenth-century male readers because of its prurience, then, its subsidiary function as a classification system for various types of masculinity in era is equally interesting and important. Of course, Memoirs does not accurately depict men's involvement with prostitution any more than it does women's: even kind of polite, domesticated brothel that novel represents does not exist in England in 1750.1 The novel does, however, create a

Patterns of sexual risk‐taking among heterosexual men

Heterosexual male STD (sexually transmitted disease) clinic patients (N=146) were classified by cluster analysis into four groups based on their self-reported frequency of participation in eleven sexual behaviors that varied in risk for contracting an STD or HIV. Significant differences among the four groups were found in their participation in some sexual practices that were not used in the clustering, and men in the four groups differed significantly by ethnicity, education, type of relationship, and motivations for engaging in sex. Results of this study have implications for the design of effective AIDS prevention programs to encourage safer-sex among heterosexual men. Given the differences in men's sexual practices, safer-sex messages need to be tailored to reach subgroups of STD patients with similar risk-taking patterns.