The influence of sexually explicit online media on sex: do men who have sex with men believe they "do what they see"?

Over the past two decades, men who have sex with men (MSM) have engaged in increasing consumption of MSM-specific sexually explicit online media (i.e., online pornography). Furthermore, the amount of MSM-specific sexually explicit online media portraying unprotected anal intercourse (UAI) has increased, raising concerns about HIV transmission among the actors and the potential encouragement of risky sex among consumers. The influence of sexually explicit online media on sexual risk-taking, at present largely understudied, could lead to new avenues for innovative HIV-prevention strategies targeting at-risk MSM. In this preliminary assessment, in-depth qualitative interviews were conducted with 16 MSM in the Seattle area to elucidate MSM's perceptions about the influence of sexually explicit online media on their own and other MSM's sexual behaviors. Participants reported that sexually explicit online media: (1) plays an educational role, (2) increases comfort with sexuality, and (3) sets expectations about sexual behaviors. While participants overwhelmingly reported not feeling personally influenced by viewing UAI in sexually explicit online media, they believed viewing UAI increased sexual risk-taking among other MSM. Specifically, participants reported that the high prevalence of UAI in sexually explicit online media sends the message, at least to other MSM, that (1) engaging in UAI is common, (2) UAI is acceptable and "ok" to engage in, and (3) future partners will desire or expect UAI. Overall, this preliminary assessment indicates that sexually explicit online media exposure may have both positive (e.g., helping MSM become more comfortable with their sexuality) and negative (e.g., normalizing UAI) impacts on the sexual health of MSM and may be useful in the development of novel HIV-prevention interventions.