Sexual compulsivity among men in a decentralized MSM community of the Midwestern United States.

Among men who have sex with men (MSM), sexual compulsivity has been associated with higher frequencies of sexual behaviors that may increase risk for transmission of HIV and other sexually transmitted infections (STI). In a Midwestern region where social and community resources for MSM are relatively diffuse, the patterns of partner-seeking and sexual behavior, and their relations to sexual compulsivity, may be different than findings from most other assessments of men in large urban areas. Using a community-based participatory approach (CBPR) and a cross-sectional survey, quantitative data were collected between November 2006 and January 2007 from 504 men related to sexual compulsivity, sexual partner-seeking, and sexual behavior. We sought to explore sexual behaviors in venues where men reported meeting sexual partners, based on their level of compulsivity. Venues that could be characterized as "sexualized" were better predictors of higher sexual compulsivity scores among men than those that are "social" in nature. Men who were higher in compulsivity reported patterns of saturating sexualized venues in order to find sexual partners. Given the unique patterns of sexual partner-seeking in this area, interventions to decrease sexual risk-taking should take into account that men who have a higher propensity for sexual compulsivity are visiting multiple venues, and prevention messages need to be tailored to be consistent across these contexts. In addition, these may need to be differentially designed based on the specific environment in which they are to be delivered.