The cognitive structure of the domain of safe and unsafe gay sexual behaviour in Belgium.

This study compares the cognitive structure of sexual techniques of safe versus unsafe gay men older than 30 years. Subjects rated 25 sexual techniques by six bipolar adjective scales making up a short version of the semantic differential. Scales measured subjects' perception of the safety and gratification potential of the sexual techniques. We used cluster analysis, multidimensional scaling and factor analysis. Subjects reporting no unprotected anal sex with non-steady partners (N = 312) differ from men reporting unsafe behaviour (N = 19). Safe and unsafe men used different main categories to structure the domain of sexual behaviour. Within the group of safe men, the domain of sexual behaviour structured by perceptions of gratification and safety seem to mirror the epidemiological structuring of sexual techniques using the non-penetration versus penetration, and transmission of body fluids versus no transmission of fluids dimension. Among risky men, this structuring is not that clearly present. We found different estimations of the level of risk associated with unprotected insertive versus receptive anal sex in combination with a higher perception of the gratification potential of the former. Unsafe men seem to make a noticeable difference between their own and their partner's risk and gratification.