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When pornography uses condoms, those watching have safer sex

Men who view more sexually explicit pornography where condoms were used were less likely to have anal sex without a condom themselves. A study by Eric Schrimshaw, PhD, at Columbia University’s Mailman School of Public Health, and Martin J. Downing, Jr., PhD, of the Public Health Solutions shows evidence that suggests pornography can have an important protective function by encouraging men to use condoms. Findings are published online in the journal PLOS ONE.

The research is among the first to examine the relationship between sexually explicit media and the frequency of condomless anal encounters.

According to Schrimshaw, who is an associate professor of Sociomedical Sciences at the Mailman School of Public Health and the paper’s first author, the findings showed no evidence of a public health problem stemming from watching most internet-based sexually explicit media. “Actually one type of pornography was associated with higher rates of condom use — men who viewed more pornography containing condom use engaged in fewer condomless anal sex encounters. Even those who took part in compulsive pornography viewing were not more likely to engage in condomless anal sex,” noted Schrimshaw.

However, watching pornography containing condomless anal sex was associated with more condomless anal sex behaviors. “These findings have important policy and HIV prevention implications,” said Downing.

Results were based on an online survey of 265 men who have sex with men and who had viewed sexually explicit media in the past three months. Participants were recruited via ads on Craigslist and Facebook and asked about the amount, compulsivity, and proportion of condomless anal sex and anal sex with condoms. Eligible men for the survey were at least 18 years of age and resided within 50 miles of New York City, Philadelphia, Baltimore, or Washington, D.C.

Nearly all (92 percent) of the men having sex with men reported viewing sexually explicit media containing condomless anal sex, and 48 percent agreed that seeing this had contributed to them engaging in riskier sex. Viewing the explicit material led to acting out the things they saw for 70 percent; 55 percent reported that viewing sexually explicit media led them to seek out sex afterwards.

The men surveyed were also asked to comment on how they perceived the effects of viewing sexually explicit media. Respondents agreed that pornography containing condomless anal sex contributed to their engaging in riskier sex, which the study authors say suggests that pornography can encourage men to engage in more sexual risk behaviors. This perception lends support to the argument for greater availability of sexually explicit media that contains anal sex in which condoms are clearly used by actors, noted Schrimshaw. “The potentially negative consequences on behavior, therefore, has policy implications for pornography directors, producers, distributors, performers, and viewers.”

Historically, condom use within the sexually explicit media industry has been self-imposed for the purpose of HIV/STD transmission prevention among the performers. However, with the increase in the prevalence of condomless anal sex in Internet-based porn, the Los Angeles City Council passed regulations mandating condom use among adult film performers for occupational safety purposes. A similar ballot initiative will be voted on statewide in California in November 2016.

Even more extreme, a bill has been passed by the State Assembly of Utah that labeled all sexually explicit media, regardless of condomless content, a “public health crisis.” Downing responds, saying, “Our findings run counter to Utah’s recent legislation since we now know that most pornography is not associated with more sexual risk behaviors.”

“Indeed, our finding that viewing pornography that contains condom use is associated with fewer condomless anal sex encounters suggests that pornography may have a potentially important protective function by encouraging men to use condoms,” noted the authors. However, future research will be needed to test whether safer sex interventions using sexually explicit media in which condoms are used by performers will result in changes in condom use behavior.

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. Eric W. Schrimshaw, Nadav Antebi-Gruszka, Martin J. Downing Jr. PLOS ONE. DOI:10.1371/journal.pone.0154439. Published online April 27, 2016.