Sexual compulsivity and sexual risk in gay and bisexual men.

Much of our understanding of the association between the Sexual Compulsivity Scale (SCS) and sexual risk behavior among men who have sex with men (MSM) has been limited to samples of HIV positive MSM only. Using data from a community-based survey of gay and bisexual men (n = 1214), this analysis sought to further evaluate the association between the SCS and sexual risk behavior. The SCS was significantly associated with a variety of sexual risk behaviors, including having sex under the influence of club drugs, engaging in unprotected anal sex (receptive or insertive) with partners of the same and/or different HIV serostatus, identity as a barebacker, intentions to have bareback sex, number of recent sex partners, and temptation for unsafe sex. The SCS was also significantly associated with having engaged in a variety of specialized sexual behaviors (i.e., fetishes), many of which can increase HIV transmission risks. Finally, in multivariate analyses, the SCS significantly predicted unprotected sex with a non-main partner even when controlling for race, HIV serostatus, age, identity as a barebacker, and club drug use. These data indicate that the SCS may be able to serve as an indicator to detect HIV-associated sexual risk behavior in community-based samples of gay and bisexual men.