To Have Sex or Not to Have Sex? An Online Focus Group Study of Sexual Decision Making Among Sexually Experienced and Inexperienced Gay and Bisexual Adolescent Men

• Published in: Archives of sexual behavior Vol. 44; no. 7; pp. 2027 - 2040
• Main Authors: DuBois, L. Zachary, Macapagal, Kathryn R., Rivera, Zenaida, Prescott, Tonya L., Ybarra, Michele L., Mustanski, Brian
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-10-2015; Springer Nature B.V
• Subjects: Adolescent; Adult; Behavioral Science and Psychology; Decision making; Focus Groups; HIV; Homosexuality, Male - psychology; Homosexuality, Male - statistics & numerical data; Human immunodeficiency virus; Humans; Internet; Male; Males; Original Paper; Prevention; Psychology; Public Health; Reproductive Health; Sexual Behavior; Sexual Behavior - psychology; Sexual Behavior - statistics & numerical data; Sexual orientation; Sexual Partners; Sexually Transmitted Diseases - prevention & control; Social Sciences; Teenagers; United States; Young Adult; United States; Sexual initiation; Young men who have sex with men (YMSM); HIV prevention; Male homosexuality; Abstinence; Lesbian, gay, bisexual youth
• ISSN: 0004-0002; 1573-2800
• DOI: 10.1007/s10508-015-0521-5

Adolescent gay and bisexual men (AGBM) are at disproportionately high risk for HIV and other sexually transmitted infections, yet healthy sexuality and HIV prevention programs grounded in experiences unique to AGBM (e.g., coming out) are lacking, as is the formative work necessary to inform such programs. A richer understanding of factors informing AGBM’s decisions to have or not have sex is needed. To fill this gap in the literature, we conducted qualitative and mixed-methods analyses of data collected in online focus groups with 75 ethnically diverse 14–18-year-old AGBM across the United States. Findings suggest that many reasons why AGBM choose to have or abstain from sex mirror those noted in the previous literature as influential for heterosexual adolescents (e.g., temptation, “horniness”). AGBM conveyed additional experiences/concerns that appeared unique to their sexual identity, particularly fears about pain during anal sex, and difficulties safely and accurately identifying same-sex partners. Both sexually experienced and inexperienced youth voiced reasons to wait or stop having sex. Sexually inexperienced youth said their motivations centered on wanting to avoid STIs and HIV, a desire to wait for the right partner, and the specialness of sex. On the other hand, sexually experienced AGBM said they stopped having sex if there was not an available partner they had interest in, or to improve their romantic relationship. Thus, while our findings suggest that there may be common factors across sexual identities that impact youth’s sexual decision making, healthy sexuality programs for AGBM also need to address issues specific to being gay and bisexual.