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The multi-national European Men who have sex with men Internet Survey (EMIS) of over 180,00 men reported that 36.8% of respondents were not happy with their sex life, rising to 53.0% of those who were not ‘out’ to any of their friends, family or colleagues about their attraction to men. Most commonly these included a loss of libido, poor self-image or low self-esteem, too little or no sex or worries about passing HIV to sexual partners. Recently published data has explored sexual (un)happiness among MSM at a broader level, including a study of sexual problems experienced by gay and bisexual men with diagnosed HIV in the UK, which identified that 70.5% of 1119 men had experienced one or more problems with sex within the previous 12 months. A notable exception is the Pleasure and Sexual Health study 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. Where non risk-related research has been conducted it has tended to focus on exploring sexual dysfunction (including premature or delayed ejaculation, erectile difficulties or libido), satisfaction with monogamous or polygamous relationships or pleasure associated with specific sexual acts, such as unprotected anal intercourse. While research to better understand HIV risk behaviours has been widespread, comparatively little attention has been paid to the broader sexual health and well-being of MSM. With emerging understanding of how HIV treatments can limit onward transmission, a growing body of literature has also explored how MSM perceive and utilise these new HIV prevention options. Given this obvious public health priority, a significant number of studies have sought to understand specific sexual risk behaviours, predictive factors for transmission or acquisition of the virus, risk management techniques, and HIV prevention needs. Gay men, bisexual men and other men who have sex with men (MSM) remain the group at highest risk for contracting HIV in the UK, as in many other parts of the world. 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. ConclusionsĪttending to what men value or aspire to can help ensure interventions are engaging and meaningful to the target population. 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.
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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. Most common among responses was a desire for sex within committed relationships, followed by a desire for sex which is emotionally or psychologically connected.
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ResultsĮight themes emerged that capture the diversity of gay and bisexual men’s sexual desires. Further statistical analysis sought to establish if and how responses differed according to key demographic variables.
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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. 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.
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The 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 current study sought to explore gay and bisexual men’s conceptions of what constitutes the ‘best sex’. 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. 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.