Redefining gay male anal intercourse behaviors: Implications for HIV prevention and research

Research on gay male HIV risk typically groups subjects by whether they report any unprotected anal intercourse (UAI). Recent research suggests that men who consistently withdraw without ejaculation during UAI may represent a distinct group. Correlates of sexual behavior are examined (n = 1001) for men who report: I) UAI to ejaculation (30% of subjects), 2) UAI with consistent withdrawal (24%), 3) protected anal intercourse only (23%), and 4) no anal intercourse (24%). UAI groups differed on minority status, education, relationship status, and sexual impulse control. Differences between UAI and safer groups, and between all anal intercourse and the no anal group were also observed. It is important to address these social status and psychological differences between risk groups that impact prevention and research.