De Zwart O, Van Kerkhof MP, Sandfort TG; International Conference on AIDS.

Int Conf AIDS. 1996 Jul 7-12; 11: 386 (abstract no. Tu.D.2708).

Municipal Health Service Rotterdam, Rotterdam, the Netherlands. Fax: + 31 10 4339237.

Objective: To assess the various meanings anal sex has for gay men, and how these meanings could be included in the development of HIV prevention strategies. Methods: Based on the sexual script theory and using a grounded theory approach, 71 gay and bisexual men were interviewed in three data-waves. Interviewees varied according to age, relation status and personal significance they attach to anal sex. The in-depth, semi-structured interviews focused on concrete descriptions of actual sexual encounters during which anal sex had or could have taken place. Transcripts were then analyzed in order to identify, the various meanings anal sex has, and implicit and explicit decisions which are part of the process of anal sex. Results: Decisions whether to engage in anal sex and, if so, about the actual role taken (insertive or receptive) are not only related to individual preferences but also to those of the partner. HIV is one, but not the only factor influencing these decisions. Condom use is depending on risk assessments, perceived practical impediments and emotional factors, such as the trustworthiness of the partner and the significance attached to the exchange of semen. Four distinct scenarios have been identified which structure and give meaning to anal sex. Related to these scenarios are specific obstacles and stimuli to use condoms. The mere bodily arousal which anal sex triggers characterizes the physical scenario; the use of a condom can be a barrier to experience this pleasure. In the intimate scenario the closeness and emotional satisfaction of anal sex are important; condoms are perceived as a frustration of such closeness. In the reciprocal scenario both partners fulfill both roles during one encounter. In this scenario some men experience practical impediments to use condoms in both roles. A ritualized unbalance of power is characteristic of the power scenario; the ritualization and the use of objects during sex facilitate the integration of condom use. Conclusions: The effectiveness of HIV prevention can be improved when the various scenarios of anal sex and their specific obstacles and stimuli to use condoms are taken into account. Unprotected anal sex can have important symbolical and emotional meanings which should be acknowledged in prevention activities.

Publication Types:

• Meeting Abstracts

Keywords:

• Acquired Immunodeficiency Syndrome
• Bisexuality
• Condoms
• HIV Infections
• HIV Seropositivity
• Homosexuality
• Homosexuality, Male
• Humans
• Male
• Risk Assessment
• Sexual Behavior
• Sexual Dysfunctions, Psychological
• Unsafe Sex

Other ID:

• 96922878

UI: 102218777

From Meeting Abstracts