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However, even interventions such as these have a tendency to focus on more mechanical aspects of sex such as how to effectively perform fellatio or how to feel comfortable during receptive anal intercourse rather than the more psycho-social dimensions of emotional connection, intimacy and relationships to which men taking part in EMIS clearly aspired. While it does incorporate information about how to deal with confidence or self-esteem issues as they relate to sex, the extent to which it facilitates a broader sense of well-being and emotional connection with sexual partners is limited.

Of course, it is impossible for any single intervention to meet the diverse needs of an equally diverse population of gay and bisexual men. Psychosocial interventions to help individuals and couples to increase their capacity for intimacy and emotionally connected relationships do exist see, for example, PACE Health in London, UK [ 49 ] and ACON in New South Wales, Australia [ 50 ] , however these are often small-scale and lack the visibility of mass-media interventions, which tend to focus on HIV testing options and condom use e.

This approach facilitated the presentation and discussion of gay relationships, including associated thoughts and feelings of the characters, as well as articulating information about how to have safer sex that limits the possibility of HIV or other STI transmission. Further creative or innovative ways to help men achieve a broader sense of sexual well-being need to be identified, up-scaled and resourced.

The emergence of new HIV prevention options that utilise anti-retroviral therapy reinforces the need for early diagnoses of HIV and the urgency of increasing HIV testing among those sexually active in higher risk groups. However, with an ever increasing focus on prevention of infection by testing and medical treatment, it is possible that HIV prevention activity may move further still from the principles of health promotion that seek to achieve more than the absence of disease or infection.

Emerging medical technologies may have the potential to prevent many new infections, but these will only be successful if they take account of the lived experience and beliefs as well as community and broader social structures of individuals most at risk of contracting HIV, including what they value most in the context of their sexual lives. Interventions that utilise new medical HIV prevention technologies, as well as those that rely on condom use, need to take better account of the themes presented above to ensure that their translation from controlled trial to wider population is as efficacious as possible.

Future studies may wish to use the broad themes described in this paper as the basis of further quantitative enquiry, which may enable more sophisticated analysis of how constructions of the best sex life differ according to demographic groups, relationship status or HIV status, and how they correlate with current or recent feelings of sexual happiness. The themes may also assist in the future development of a scale to assess sexual aspirations or sexual satisfaction among gay and bisexual men, or in the development of more in-depth qualitative research that explores sexual well-being among this population.

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The findings described in this paper reflect the views of men resident in the United Kingdom who were completing the survey in English. There is a need to explore if and how constructions of the best sex differ among men from different social, cultural, national or linguistic backgrounds. Data described in this survey are diverse but cluster around several key themes which highlight the primacy of meaningful interaction with other men as a key component of the best sex life.

As HIV prevention activity becomes increasingly medicalised, with an associated focus on HIV testing and pharmaceuticals, it is important that the broader sexual well-being of gay and bisexual men is not forgotten. Sexual health does not begin and end with HIV and the extent of sexual unhappiness previously documented among this population should be a cause for concern for all those working across the clinical, health, human rights and social care spectrum.

By taking account of what men value or aspire to in the context of their sexual lives we may be able to develop interventions that are both engaging and valuable for them in achieving the best possible sex, while at the same time facilitating an environment in which HIV transmission may be less likely to occur.

Coding of the data was performed by GH, supported by AB. The manuscript was drafted by AB and commented on by all other authors. AB and FH prepared the revision. All authors approved the final manuscript. We begin by thanking all of the men who took part in EMIS We also thank the websites who placed the EMIS banner, and particularly to those who sent individual messages to their users: We also thank all NGOs who promoted the survey.

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University College Maastricht; UK: Aids-Hilfe Wien; BE: Vstrecha; CH: Positive Voice; HR: GenderDoc-M; MK: Safe Pulse of Youth; RU: OZ Odyseus; TR: We also wish to thank Catherine Dodds, Rebecca French and Paul Steinberg for their very helpful comments on earlier versions of this paper. The EMIS project was funded by: National Center for Biotechnology Information , U. BMC Public Health. Published online Nov Author information Article notes Copyright and License information Disclaimer.

Corresponding author. Adam Bourne: Received Jul 18; Accepted Nov This is an open access article distributed under the terms of the Creative Commons Attribution License http: This article has been cited by other articles in PMC. Abstract Background While a large body of research has sought to understand HIV transmission risk behaviours among gay men, bisexual men and other men who have sex with men MSM , less attention has been paid to the wider sexual health and well-being of this population. Method The EMIS survey of recruited more than , respondents from 38 European countries to complete an online questionnaire about sexual health and behaviour.

Conclusions Attending to what men value or aspire to can help ensure interventions are engaging and meaningful to the target population. Background Gay men, bisexual men and other men who have sex with men MSM remain the group at highest risk for contracting HIV in the UK [ 1 ], as in many other parts of the world [ 2 , 3 ]. Table 1 Key participant demographic information. Open in a separate window. Figure 1. Proportion of responses including each theme not mutually exclusive. Relationship formulations When asked what their idea of the best sex life was, the most common response by Sexual actions or behaviours Around one in six men Sex free from physical harm A relatively small proportion of men Overcoming psychological and social barriers For 9.

Physical attributes of sexual partner s A small number of men 5. Settings or physical spaces for sex For a very small number of men 1. Table 2 Demographic variation in best sex themes represented in each response. Figure 2. Age variation in best sex themes represented in each response. Discussion This paper describes an exploratory analysis of responses to one open question about what constitutes the best sex life, which were often only several words in length and occasionally ambiguous. Competing interests The authors declare that they have no competing interests.

Pre-publication history The pre-publication history for this paper can be accessed here: References Health Protection Agency. HIV in the United Kingdom: Collindale, London: Health Protection Agency; Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries — PLoS Med. Ann Epidemio. Relative safety II: Sigma Research; AIDS Care.

Internalised homonegativity predicts HIV-associated risk behavior in European men who have sex with men in a country cross-sectional study: BMJ Open. Recreational drug use and sexual risk practice among men who have sex with men in the United Kingdom. Sex Transm Infect.

Risk factors for HIV seroconversion in homosexual men in Australia. Sex Health. AIDS Behav. Gay community periodic surveys: Multiple chances: Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. Use of viral load to negotiate condom use among gay men in Sydney, Australia. This site complies with the HONcode standard for trustworthy health information: This content does not have an English version.


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Choose a degree. Get updates. Give today. Healthy Lifestyle Adult health. Products and services. Free E-newsletter Subscribe to Housecall Our general interest e-newsletter keeps you up to date on a wide variety of health topics. Sign up now. Health issues for gay men and men who have sex with men Understand important health issues for gay men and men who have sex with men — from sexually transmitted infections to depression — and get tips for taking charge of your health.

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By Mayo Clinic Staff. References Makadon HJ.

Primary care of gay men and men who have sex with men. Accessed Sept. Makadon HJ, et al. Philadelphia, Pa.: American College of Physicians; CDC fact sheet: What gay, bisexual and other men who have sex with men need to know about sexually transmitted diseases.

Background

Rather, gay sex is more like firing up your PlayStation and playing Fallout 4. To limit oneself to just a single flavor is to shut out a smorgasbord of new experiences. Of course, culturally and historically, gay men have been narrowed down where the act of sex itself defines us. But really, if we minimize anal sex and place it on the same shelf as oral or masturbation, how much pressure would that alleviate?