Multidimensional Patterns of Sexual Risk Behavior Among Young Men Who Have Sex with Men

Although much of the research on adolescent and young adult sexuality has focused on single predictors of sexual risk behavior, recent research has suggested that sexual risk may be better predicted by the intersection of multiple types of sexual behaviors, contraceptive use, and relationship factors (Vasilenko, Kugler, Butera, & Lanza, 2015). However, little is known about multidimensional patterns of sexual behavior among young gay, bisexual, and other men who have sex with men (MSM), who may be at higher risk of sexually transmitted infections, including HIV. This study uses latent class analysis (LCA) to identify patterns of sexual behavior in young MSM based on their sexual behaviors, partner factors, and protective behaviors.

Method. We used a subsample of 18-25 year-old HIV- men from a large national sample recruited from social and sexual networking websites for MSM (N = 5,965; 76% white, 11% Latino, 5% Black, 4% Asian, 4% other; 74% gay, 21% bisexual, 1% heterosexual, 3%, unsure/questioning 1% other). We modeled LCAs with 6 indicators of sexual behavior, 2 indicators of partner factors, and 2 indicators of protective behaviors (see Table 1). We then predicted class membership by race/ethnicity, sexual identity, age, religiosity, and level of “outness” to peers, family and coworkers.

Results. We selected a model with 8 classes: Multiple Same Sex Behaviors, Receptive Anal Intercourse, Insertive Anal Intercourse, Relationship, Non-Penetrative Sexual Behavior, Not Currently Sexually Active, Same and Opposite Sex Sexual Behavior, & Vaginal Only. Black participants were overrepresented in the Insertive Anal Intercourse class and underrepresented in the Relationship class whereas Asian participants were overrepresented in the Receptive Anal Intercourse, Relationship, and Non-Active classes. Bisexual and other sexual identity participants were underrepresented in the Multiple Same-Sex Behaviors class and were much more likely to be in classes engaging in vaginal sex. Individuals who were older, less religious, and more “out” were generally more likely to be in the Multiple Same Sex Behaviors and Relationship classes.

Discussion. Findings suggest a possible progression of patterns of behavior, in which individuals who are younger, more tied to institutions with conservative teachings about sexuality, and less open about their sexuality are less sexually active and engage in a smaller number of behaviors. Findings also suggest that individuals may alter their preventative behaviors based on their perceived level of risk, and HIV/STI prevention messages may be more effective if they are tailored to individuals’ patterns of sexual behavior, as well as demographic and social/contextual factors.