Gay sexual practices

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This article is about sexual practices between males. For sexual practices between females, see Lesbian sexual practices.
19th-century erotic interpretation of Hadrian and Antinous (detail), by Paul Avril

Gay sexual practices are sexual activities involving men who have sex with men (MSM), regardless of their sexual orientation or sexual identity. The Kinsey Reports state that 37% of its male subjects had at least one homosexual experience.[1] However, more recent studies assert that at least 3% of men worldwide – and perhaps as high as 16% of men – have had sex at least once with a man. These people fall under the category of MSM.[2]


Frot: two men rubbing their penises together

Historically, anal sex has been popularly associated with male homosexuality and MSM. However, many MSM do not engage in anal sex, and may engage in oral sex, frottage or frot, or mutual masturbation instead.[3][4][5][6] Wellings et al. reported that "the equation of 'homosexual' with 'anal' sex among men is common among lay and health professionals alike," whereas an online survey of 18,000 MSM in Europe "showed that oral sex was most commonly practised, followed by mutual masturbation, with anal intercourse in third place."[3] A 2011 survey by The Journal of Sexual Medicine found similar results for U.S. gay and bisexual men.[7] However, reports with regard to the prevalence of anal sex among MSM have varied over time, with some percentages higher than others.[8][9][10][11]

Among men who have anal sex with other men, the insertive partner may be referred to as the top, the one being penetrated may be referred to as the bottom, and those who enjoy either role may be referred to as versatile.[10] MSM may also have greater risks in that they can switch sex roles.[12] An orgasm may be achieved through receptive anal penetration by indirect stimulation of the prostate.[13][14][15] Some men who have sex with men, however, believe that being a receptive partner during anal sex questions their masculinity.[16][17]

Frot is a non-penetrative form of male-male sexual activity that usually involves direct penis-to-penis contact.[18][19] It is a form of frottage. Frot can be enjoyable because it mutually and simultaneously stimulates the genitals of both partners as it tends to produce pleasurable friction against the frenulum nerve bundle on the underside of each man's penile shaft, just below the urinary opening (meatus) of the penis head (glans penis). Intercrural sex is another form of non-penetrative sex that can be practiced between MSM. Docking (the insertion of one man's penis into another man's foreskin) is also practiced. MSM may engage in different forms of oral sex such as fellatio, tea bagging, and anilingus.

Health risks[edit]

A 2007 study reported that two large population surveys found "the majority of gay men had similar numbers of unprotected sexual partners annually as straight men and women."[20][21] Since frot is a non-penetrative sex act, the risk of passing a sexually transmitted infection (STI/STD) that requires direct contact between the mucous membranes and pre-ejaculate or semen is reduced. HIV is among the infections that require such direct contact, and research indicates that there is no risk of HIV transmission via frot.[22][23] However, frot can still transmit other sexually transmitted infections, such as HPV, pubic lice (crabs) and genital warts.[22][24] Other sexual acts such as oral sex pose health risks as well.

Acquired immune deficiency syndrome (AIDS) is a disease of the human immune system caused by the human immunodeficiency virus (HIV).[25][26][27] HIV can infect anybody, regardless of sex, ethnicity, or sexual orientation.[28] Worldwide, an estimated 5–10% of HIV infections are the result of men having sex with men.[29] However in many developed countries, including the United States, Canada, Australia, New Zealand and most of Western Europe, more HIV infections are transmitted by men having sex with men than by any other transmission route.[28] In the United States, "men who have had sex with men since 1977 have an HIV prevalence (the total number of cases of a disease that are present in a population at a specific point in time) 60 times higher than the general population".[30]

Hepatitis B is a disease caused by hepatitis B virus (HBV) which infects the liver of hominoidea, including humans, and causes an inflammation called hepatitis.[31] Transmission of HBV results from exposure to infectious blood or body fluids containing blood.[32][33] Hepatitis C is a co-infection risk factor for hepatitis B, making it prudent for persons with hepatitis C to be immunized against hepatitis B.[34][35] However the level of sexual transmission risk for hepatitis C remains uncertain except for association between infection rate and high-risk sexual practices such as multiple sexual partners and penetrative anal sex.[36]

Syphilis (caused by infection with Treponema pallidum) is passed from person to person through direct contact with a syphilis sore; these occur mainly on the external genitals, or in the vagina, anus, or rectum.[37] Sores also can occur on the lips and in the mouth.[37] Transmission of the organism occurs during vaginal, anal, or oral sex.[37] In 2006, 64% of the reported cases in the United States were among men who have sex with men.[37] This is consistent with a rise in the incidence of syphilis among MSM in other developed nations, attributed by Australian and UK authors to increased rates of sex without a condom among MSM.[38][39]

Genital human papillomavirus (HPV) is a common virus that most sexually active people in the U.S. will have at some time in their lives.[40] It is passed on through genital contact and is also found on areas that condoms do not cover.[40] Most men who get HPV of any type never develop any symptoms or health problems.[40] Some types of HPV can cause genital warts, penile cancer, or anal cancer.[40] MSM and men with compromised immune systems are more likely than other men to develop anal cancer.[40] Men with HIV are also more likely to get severe cases of genital warts that are hard to treat.[40][41][42]

See also[edit]


  1. ^ Sexual Behavior in the Human Male, p. 656
  2. ^ "Between Men: HIV/STI prevention for men who have sex with men" (PDF). World Health Organization (WHO). Retrieved 10 May 2015. 
  3. ^ a b Kaye Wellings, Kirstin Mitchell, Martine Collumbien (2012). Sexual Health: A Public Health Perspective. McGraw-Hill International. p. 91. ISBN 0335244815. Retrieved August 29, 2013. 
  4. ^ "Not all gay men have anal sex". Go Ask Alice!. June 13, 2008. Retrieved August 19, 2015. 
  5. ^ Goldstone, Stephen E.; Welton, Mark L. (2004). "Sexually Transmitted Diseases of the Colon, Rectum, and Anus". Clin Colon Rectal Surg 17 (4): 235–239. PMC 2780055. PMID 20011265. 
  6. ^ Edwin Clark Johnson, Toby Johnson (2008). Gay Perspective: Things Our Homosexuality Tells Us about the Nature of God & the Universe. Lethe Press. p. 139. ISBN 978-1-59021-015-4. Retrieved February 12, 2011. 
  7. ^ Sexual Behaviors and Situational Characteristics of Most Recent Male-Partnered Sexual Event among Gay and Bisexually Identified Men in the United States Retrieved 2-13-2014
  8. ^ Laumann, E., Gagnon, J.H., Michael, R.T., and Michaels, S. The Social Organization of Sexuality: Sexual Practices in the United States. 1994. Chicago: University of Chicago Press (Also reported in the companion volume, Michael et al., Sex in America: A Definitive Survey, 1994).
  9. ^ Center for Disease Control, Increases in Unsafe Sex and Rectal Gonorrhea Among Men Who Have Sex With Men – San Francisco, California, 1994–1997[1]. Retrieved April 29, 2007.
  10. ^ a b Steven Gregory Underwood (2003). Gay Men and Anal Eroticism: Tops, Bottoms, and Versatiles. Harrington Park Press. ISBN 978-1-56023-375-6. Retrieved February 12, 2011. 
  11. ^ "Anal Sex Safety and Health Concerns". WebMD. Retrieved August 19, 2013. 
  12. ^ "Sexual Behavior Does Not Explain Varying HIV Rates Among Gay And Straight Men - Medical News Today". Retrieved February 10, 2015. 
  13. ^ "The male hot spot — Massaging the prostate". Go Ask Alice!. 2002-09-27 (Last Updated/Reviewed on 2008-03-28). Retrieved April 21, 2010.  Check date values in: |date= (help)
  14. ^ Rosenthal, Martha (2012). Human Sexuality: From Cells to Society. Cengage Learning. pp. 133–135. ISBN 0618755713. Retrieved September 17, 2012. 
  15. ^ Komisaruk, Barry R.; Whipple, Beverly; Nasserzadeh, Sara and Beyer-Flores, Carlos (2009). The Orgasm Answer Guide. JHU Press. pp. 108–109. ISBN 0-8018-9396-8. Retrieved November 6, 2011. 
  16. ^ John H. Harvey, Amy Wenzel, Susan Sprecher (2004). The handbook of sexuality in close relationships. Routledge. pp. 355–356. ISBN 0805845488. Retrieved March 12, 2011. 
  17. ^ Odets, Walt (1995). In the Shadow of the Epidemic: Being Hiv-negative in the Age of AIDS. Duke University Press. pp. 191–192. ISBN 0822316382. Retrieved July 6, 2013. 
  18. ^ Joe Perez (2006). Rising Up. pp. 190–192. ISBN 1411691733. Retrieved March 24, 2011. 
  19. ^ "The New Sex Police". The Advocate. 2005-04-12. pp. 39–40, 42. Retrieved February 12, 2011. 
  20. ^ "Sexual Behavior Does Not Explain Varying HIV Rates Among Gay And Straight Men - Medical News Today". Retrieved February 10, 2015. 
  21. ^ Goodreau SM, Golden MR (October 2007). "Biological and demographic causes of high HIV and sexually transmitted disease prevalence in men who have sex with men". Sex Transm Infect 83 (6): 458–462. doi:10.1136/sti.2007.025627. PMC 2598698. PMID 17855487. 
  22. ^ a b "Lower Your Sexual Risk of HIV". Retrieved February 10, 2015. 
  23. ^ Kelly, Jeffrey A (October 1995). "Advances in HIV/AIDS education and prevention". Family Relationship (National Council on Family Relations) 44 (4): 345–352. doi:10.2307/584989. ISSN 0197-6664. JSTOR 584989. 
  24. ^ Hales, D. (2008). An Invitation to Health, Brief Edition. Cengage Learning. p. 269. ISBN 9780495391920. Retrieved February 10, 2015. 
  25. ^ Sepkowitz KA (June 2001). "AIDS—the first 20 years". N. Engl. J. Med. 344 (23): 1764–1772. doi:10.1056/NEJM200106073442306. PMID 11396444. 
  26. ^ Weiss RA (May 1993). "How does HIV cause AIDS?". Science 260 (5112): 1273–1279. doi:10.1126/science.8493571. PMID 8493571. 
  27. ^ Cecil, Russell (1988). Textbook of Medicine. Philadelphia: Saunders. pp. 1523, 1799. ISBN 0-7216-1848-0. 
  28. ^ a b "2009 AIDS epidemic update". Joint United Nations Programme on HIV/AIDS and World Health Organization. November 2009. Retrieved September 28, 2011. 
  29. ^ "Men who have sex with men (MSM) and HIV/AIDS | AVERT". Retrieved February 10, 2015. 
  30. ^ Consumer Affairs Branch (CBER) (2013-03-18). "Blood Donations from Men Who Have Sex with Other Men Questions and Answers". Retrieved May 17, 2013. 
  31. ^ Williams R (2006). "Global challenges in liver disease". Hepatology 44 (3): 521–526. doi:10.1002/hep.21347. PMID 16941687. 
  32. ^ Petersen NJ, Barrett DH, Bond WW, Berquist KR, Favero MS, Bender TR, Maynard JE (1976). "Hepatitis B surface antigen in saliva, impetiginous lesions, and the environment in two remote Alaskan villages". Appl. Environ. Microbiol. 32 (4): 572–4. PMC 170308. PMID 791124. 
  33. ^ "Hepatitis B – the facts". 
  34. ^ Nelson, PK; Mathers BM; Cowie B; Hagan H; Des Jarlais D; Horyniak D; Degenhardt L (2011-08-13). "Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews". Lancet 378 (9791): 571–83. doi:10.1016/S0140-6736(11)61097-0. PMC 3285467. PMID 21802134. 
  35. ^ Wilkins, T; Malcolm JK; Raina D; Schade RR (2010-06-01). "Hepatitis C: diagnosis and treatment" (PDF). American family physician 81 (11): 1351–7. PMID 20521755. 
  36. ^ Tohme RA, Holmberg SD (June 2010). "Is sexual contact a major mode of hepatitis C virus transmission?". Hepatology 52 (4): 1497–505. doi:10.1002/hep.23808. PMID 20635398. 
  37. ^ a b c d Syphilis & MSM (Men Who Have Sex With Men) – CDC Fact Sheet, Centers for Disease Control and Prevention
  38. ^ Christopher K Fairley, Jane S Hocking and Nicholas Medland. "Syphilis: back on the rise, but not unstoppable". Medical Journal of Australia 2005; 183 (4): 172–173. 
  39. ^ M Hourihan, H Wheeler, R Houghton, B T Goh (2004). "Lessons from the syphilis outbreak in homosexual men in east London". Sex Transm Infect 80 (6): 509–511. doi:10.1136/sti.2004.011023. PMC 1744940. PMID 15572625. 
  40. ^ a b c d e f "STD Facts – HPV and Men". Retrieved August 17, 2007. 
  41. ^ Frisch M, Smith E, Grulich A, Johansen C (2003). "Cancer in a population-based cohort of men and women in registered homosexual partnerships". Am. J. Epidemiol. 157 (11): 966–972. doi:10.1093/aje/kwg067. PMID 12777359. However, the risk for invasive anal squamous carcinoma, which is believed to be caused by certain types of sexually transmitted human papilloma viruses, notably type 16, was significantly 31-fold elevated at a crude incidence of 25.6 per 100,000 person-years. 
  42. ^ Chin-Hong PV, Vittinghoff E, Cranston RD et al. (2005). "Age-related prevalence of anal cancer precursors in homosexual men: the EXPLORE study". J. Natl. Cancer Inst. 97 (12): 896–905. doi:10.1093/jnci/dji163. PMID 15956651.