Background: HIV number continues to increase, especially among the minority of men who have sex with men (MSM) due to the high risks of their sexual behavior. This study aims to identify the correlation between sexual violence experiences and pornography media exposure to sexual risk behavior among people with HIV/AIDS (PLWHA) MSM.
Design and Methods: The study employed a cross-sectional design with the consecutive sampling technique and involved 258 PLWHA MSM under the guidance of an NGO in Bandung, Jawa Barat, Indonesia. The data were collected by employing an online questionnaire.
Results: The results show that there is a significant correlation between sexual violence experiences and sexual risk behavior (p=0.000, α=0.05; OR=6.496), pornography media exposure and sexual risk behavior (p=0.000, α=0.05; OR=4.271). The multivariate analysis of multiple logistics regression results reveals that the sexual violence experience is the factor that mostly influences the sexual risk behavior among PLWHA MSM (p=0.000, α=0.05; OR=3.784).
Conclusions: The sexual violence experiences and pornography media exposure have a significant positive relationship to sexual risk behavior. Therefore, nurses need to improve a comprehensive assessment, counseling, and personal education to reduce sexual risk behavior that can transmit HIV and other sexually transmitted diseases and create innovations through positive activities to reduce pornography consumption.
UNAIDS. Global HIV & AIDS statisticts-fact sheet. 2019. Available from: https://www.unaids.org/en/resources/fact-sheet
Ministry of Health of the Republic of Indonesia. [infoDATIN: Situasi umum HIVAIDS dan tes HIV berdasarkan laporan SIHA tahun 2013-2017 (infoDATIN: General situation of HIVAIDS and HIV testing based on the 2013-2017 SIHA report)].[in Indonesian]. Jakarta: Ministry of Health of the Republic of Indonesia; 2018. Available from: https://pusdatin.kemkes.go.id/resources/download/pusdatin/infodatin/InfoDatin-HIV-AIDS-01.pdf
AIDS Prevention Commission. [Estimasi jumlah populasi kunci HIV di Indonesia 2016 (Estimates of the number of key HIV population in Indonesia 2016 t)].[in Indonesian].Bandung: AIDS Prevention Commission; 2017. Available from: https://kpakotabandung.or.id/book/estimasi-jumlah-populasi-kunci-hiv-di-indonesia-2016/
Hernandez I, Reina-Ortiz M, Johnson A, et al. Risk factors associated with HIV among men who have sex with men (MSM) in Ecuador. Am J Mens Health 2016;11:1331-41. DOI: https://doi.org/10.1177/1557988316646757
Nelson KM, Eaton LA, Gamarel KE. Preferences for condomless sex in sexually explicit media among Black/ African American men who have sex with men: implications for HIV prevention. Arch Sex Behav 2017;46:977-85. DOI: https://doi.org/10.1007/s10508-016-0878-0
Træen B, Noor SW, Hald GM, et al. Examining the relationship between use of sexually explicit media and sexual risk behavior in a sample of men who have sex with men in Norway. Scand J Psychol 2015;56:290–6. DOI: https://doi.org/10.1111/sjop.12203
Nelson KM, Leickly E, Yang JP, et al. The influence of sexually explicit online media on sex: do men who have sex with men believe they “do what they see”? AIDS Care 2014;26:931–4. DOI: https://doi.org/10.1080/09540121.2013.871219
Downing Jr MJ, Schrimshaw EW, Scheinmann R, et al. Sexually explicit media use by sexual identity: a comparative analysis of gay, bisexual, and heterosexual men in the United States. Arch Sex Behav 2017;46:1763-76. DOI: https://doi.org/10.1007/s10508-016-0837-9
Centers for Disease Control and Prevention [Internet]. Sexual violence is preventable. Atlanta: CDC; 2019. Available from: https://www.cdc.gov/injury/features/sexual-violence/index.html
Chakrapani V, Lakshmi PVM, Tsai AC, et al. The syndemic of violence victimisation, drug use, frequent alcohol use, and HIV transmission risk behaviour among men who have sex with men: cross-sectional, population-based study in India. SSM – Population Health 2019;7:100348. DOI: https://doi.org/10.1016/j.ssmph.2018.100348
Brown TNT, Herman J. Intimate partner violence and sexual abuse among LGBT people. UCLA: The Williams Institute;. 2015. Available from https://escholarship.org/uc/item/1qs269pk
Davis KC, Neilson EC, Wegner R, et al. The intersection of men’s sexual violence perpetration and sexual risk behavior: a literature review. Aggress Violent Behav 2018;40:83–90. DOI: https://doi.org/10.1016/j.avb.2018.04.001
Tomori C, McFall AM, Srikrishnan AK, et al. The prevalence and impact of childhood sexual abuse on HIV-risk behaviors among men who have sex with men (MSM) in India. BMC Public Health 2016;16:784. DOI: https://doi.org/10.1186/s12889-016-3446-6
Semple SJ, Stockman JK, Goodman-Meza D, et al. Correlates of sexual violence among men who have sex with men in Tijuana, Mexico. Arch Sex Behav 2017;46:1011-23. DOI: https://doi.org/10.1007/s10508-016-0747-x
Dunkle KL, Wong FY, Nehl EJ, et al. Male-on-male intimate partner violence and sexual risk behaviors among money boys and other men who have sex with men in Shanghai, China. Sex Transm Dis 2013;40:362–5. DOI: https://doi.org/10.1097/OLQ.0b013e318283d2af
Boroughs MS, Valentine SE, Ironson GH, et al. Complexity of childhood sexual abuse: predictors of current post-traumatic stress disorder, mood disorders, substance use, and sexual risk behavior among adult men who have sex with men. Arch Sex Behav 2015;44:1891–902. DOI: https://doi.org/10.1007/s10508-015-0546-9
Darmayanti YD, Sumitri S. [Faktor penyebab perilaku laki-laki suka berhubungan seks dengan laki- laki (LSL) di Kota Bukittinggi tahun 2016 (Factors causing male behavior like having sex with men (MSM) in Bukittinggi City in 2016)].[Article in Indonesian]. Jurnal Endurance: Kajian Ilmiah Problema Kesehatan 2018;3:213-25. DOI: https://doi.org/10.22216/jen.v3i2.2784
Sidjabat FN, Setyawan H, Setyawan SA. [Lelaki seks lelaki: aktivitas seksual dan bagaimana mereka memulaiknya? ( Male sex men: sexual activity and how do they get started?)].[Article in Indonesian]. IKESMA 2017;12:131–42.
Stults CB, Javdani S, Greenbaum CA, et al. Intimate partner violence and sex among young men who have sex with men. J Adolesc Health 2016;58:215–22. DOI: https://doi.org/10.1016/j.jadohealth.2015.10.008
Schrimshaw EW, Antebi-Gruszka N, Downing Jr MJ. Viewing of internet-based sexually explicit media as a risk factor for condomless anal sex among men who have sex with men in four U.S. Cities. PLoS One 2016;11:e0154439. DOI: https://doi.org/10.1371/journal.pone.0154439
Rosser BRS, Smolenski DJ, Erickson D, et al. The effects of gay sexually explicit media on the HIV risk behavior of men who have sex with men. AIDS Behav 2013;17:1488–98. DOI: https://doi.org/10.1007/s10461-013-0454-8
Xu Y, Zheng Y, Rahman Q. The relationship between self-reported sexually explicit media consumption and sexual risk behaviors among men who have sex with men in China. J Sex Med 2017;14:357–65. DOI: https://doi.org/10.1016/j.jsxm.2017.01.002
Khawcharoenporn T, Mongkolkaewsub S, Naijitra C, et al. HIV risk, risk perception and uptake of HIV testing and counseling among youth men who have sex with men attending a gay sauna. AIDS Res Ther 2019;16:13. DOI: https://doi.org/10.1186/s12981-019-0229-z
Boyer CB, Greenberg L, Korelitz J, et al. Sexual partner characteristics, relationship type, and HIV risk among a community venue–based sample of urban adolescent and young adult men who have sex with men. Youth Soc 2019;51:219–46. DOI: https://doi.org/10.1177/0044118X16669259
Rocha GM, Kerr LRFS, Kendall C, et al. Risk behavior score: a practical approach for assessing risk among men who have sex with men in Brazil. Braz J Infect Dis 2018;22:113–22. DOI: https://doi.org/10.1016/j.bjid.2018.02.008
Kramer SC, Drewes J, Kruspe M, et al. Factors associated with sexual risk behaviors with non-steady partners and lack of recent HIV testing among German men who have sex with men in steady relationships: results from a cross-sectional internet survey. BMC Public Health 2015;15:702. DOI: https://doi.org/10.1186/s12889-015-1987-8
Bengtsson L, Lu X, Liljeros F, et al. Strong propensity for HIV transmission among men who have sex with men in Vietnam: behavioural data and sexual network modelling. BMJ Open 2014;4:e003526. DOI: https://doi.org/10.1136/bmjopen-2013-003526