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Men who have sex with men (MSM) frequently use Internet-based Web sites to recruit sex partners. Although many MSM users of such sites advocate for safe sex practices in their personal profiles, some users actively recruit sexual partners who wish to participate in anal sexual intercourse without the use of condoms, also known as "bareback" sex. Participating in this sexual practice places both sexual partners at higher risk of HIV transmission. In addition, data indicate this behavior is associated with other high-risk activities such as drug use and communication of other sexually transmitted infections. This article summarizes the literature assessing this phenomenon on the Internet. Specific recommendations are provided for clinicians, health educators, and researchers.

Despite public health campaigns and safer sex messages, many men who have sex with men (MSM) continue to participate in high-risk sexual behaviors, which may make them vulnerable to HIV infection and sexually transmitted infections. The purpose of this study was to determine the relationship of depressive symptoms, self-esteem, and sexual behaviors in a predominantly Hispanic sample of MSM. This correlational study sampled 205 MSM (M = 37 years of age, SD = ±8) representing the diverse ethnic composition of South Florida. This sample consisted of ethnic minorities (79%) with a large number of foreign-born men (69%). Participants completed measures of depressive symptoms, self-esteem, and sexual behaviors. Results indicated that higher levels of depressive symptoms and higher levels of self-esteem had a statistically significant relationship to lower levels of safer sexual behaviors. Lower income, lower educational level, and preference for Spanish language were associated with higher levels of depressive symptoms; lower income was associated with lower levels of self-esteem; and foreign birth and a preference for Spanish language were associated with lower levels of safer sex behaviors. Higher levels of depressive symptoms and higher levels of self-esteem were associated with high-risk sexual behaviors in this sample of MSM. Further research needs to be directed at culturally specific mental health and HIV prevention strategies for these vulnerable MSM.

This study uses a mixed-method approach to examine the relationship between body image and sexual health among adolescent boys. In Study 1, eight 12th-grade boys participated in semistructured interviews focusing on dating and sexuality. Qualitative analyses revealed several differences between boys who were satisfied with their bodies and boys who were not. Specifically, boys who were satisfied with their bodies indicated that they were clear about what they wanted sexually and were comfortable communicating those wants with partners. In contrast, boys with low body satisfaction were often unclear about their sexual choices and resisted talking about sexuality with partners. Study 2 examined these same themes using quantitative data from 149 boys from the 12th grade who completed surveys assessing body image, sexual experiences, and sexual attitudes. Body satisfaction was significantly associated with sexual agency and with clarity of personal sexual values. Implications for promoting adolescent sexual health are discussed.

This study tested the research hypothesis that men's errors using condoms would be associated with having multiple sex partners. Specifically, men engaging in sex with three or more women were compared with those having sex with two or fewer women. Recruitment (N = 271) occurred in a publicly funded sexually transmitted disease (STD) clinic located in a metropolitan area of the Southern United States. All men were clinically diagnosed with an STD. They completed a self-reported questionnaire (using a 3-month recall period). Those reporting sex with men were excluded from the analysis. About one half of the men (48.5%) reported penetrative sex with three or more women. The authors found that among young African American men, newly diagnosed with an STD, reporting recent (past 3 months) sex with multiple partners may be emblematic of condom errors. These men may benefit from clinic-based, targeted counseling and education designed to foster improved quality of condom use.