Problematic Pornography Use, HIV Risk Factors, and Sexual Self-Schemas in a National Sample of Men who have Sex with Men (MSM)

Men who have sex with men continue to be disproportionately impacted by HIV/AIDS (CDC, 2020). HIV prevention research has explored multiple risk factors o interest including condomless sex, use of pre-exposure prophylaxis (PrEP), HIV testing rates, and number of sexual partners. Given the ubiquity of the Internet and relative ease of accessing sexually explicit media online, an understudied behavioral consideration of problematic pornography use (PPU) may provide additional information for understanding and ameliorating persistent health disparities affecting the MSM population. The study applied the theoretical lens of sexual self-schema (Andersen & Cyranowski, 1994) among a sample of men who have sex with men (MSM) to investigate the association of PPU with HIV risk behaviors and psychological components of male sexual self-schema through path analysis. In the study, I examined the association of PPU with HIV risk variables (e.g., condom use) and the association of PPU with sexual self-schema variables (e.g., heterosexual self-presentation). PPU was found to be associated with more frequent insertive/receptive anal sex, more HIV testing, and more condom use. Additionally, PPU was found to be associated with less positive attitudes toward condom use, higher levels of heterosexual self-presentation, greater desire for multiple sexual partners, lower levels of sexual identity commitment, and higher penis satisfaction. PPU was not found to be associated with number of sexual partners or PrEP use.