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Obesity, Body Image, and Unsafe Sex in Men who have Sex with Men

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Abstract

Little is known about the relationship among body weight, body image, and HIV/AIDS sexual risk behaviors. We examined this issue in a midwestern U.S. metropolitan area community sample of 316 men who have sex with men, a group at relatively high risk for HIV/AIDS. All data were self-reported by questionnaire using standard items to assess current body image, height and weight, and HIV/AIDS sexual risk behaviors. Logistic regression models were used to estimate cross-sectional associations. Forty-nine (15%) of the 316 men were classified as obese, and 56 (18%) had unsafe sex in the past three months. Normal weight or overweight men were 3.6 times more likely than obese men to have had unsafe sex, after adjusting for differences in body image and age. Men with better body image were 1.4 times more likely than men with lower body image to have had anal sex, after adjusting for differences in body weight and age. Non-obese men were no more or less likely than were obese men to have engaged in anal sex or in any sex in the past three months. This is the first study showing a positive relationship between below-obese body weight and unsafe sex and between better body image and anal sex in men who have sex with men. Future research should investigate these novel findings, perhaps using other study designs and data collection tools with less measurement error. Advances in knowledge about HIV/AIDS risk factors, including body weight and body image, could potentially contribute to more effective approaches to reducing this risk.

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Acknowledgments

The Minnesota 500 Men’s Study was funded by the Division of HIV/AIDS Prevention – Intervention Research and Support, Centers for Disease Control and Prevention, Atlanta, GA, Grant #U62-CCU513272. All research was undertaken with the approval of the University of Minnesota Institutional Review Board, Human Subjects’ Committee, #9204S05165. Resources and assistance from the Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, contributed to innumerable aspects of this project. We thank the Program in Human Sexuality for its support of Chris Kraft as a post-doctoral fellow during the years 1999 to 2001 during which this research was performed. The authors thank Anne Marie Weber-Main for her critical review and editing of manuscript drafts, Mike Ross and Greta Bauer for their input on the study design and statistical analysis, Liz Greene for her meticulous work on the reference section, and Ross Johnson for his exhaustive literature searches. In addition, thanks go to Eli Coleman, Leonard DeRogatis, and Karen Scheltema for their input and suggestions.

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Authors and Affiliations

  1. Johns Hopkins Center for Sexual Health and Medicine, Sexual Behaviors Consultation Unit, Department of Psychiatry, Johns Hopkins Medical Institution, 2360 W. Joppa Road, Suite 200, Lutherville, Baltimore, Maryland, 21093, USA

    Chris Kraft

  2. Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA

    Beatrice “Bean” E. Robinson & Walter O. Bockting

  3. Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA

    David L. Nordstrom

  4. Division of Epidemiology, School of Public Health, University of Minnesota Medical School, Minneapolis, Minnesota, USA

    B. R. Simon Rosser

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  1. Chris Kraft
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  2. Beatrice “Bean” E. Robinson
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  3. David L. Nordstrom
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  4. Walter O. Bockting
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  5. B. R. Simon Rosser
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Correspondence to Chris Kraft.

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Kraft, C., Robinson, B.E., Nordstrom, D.L. et al. Obesity, Body Image, and Unsafe Sex in Men who have Sex with Men. Arch Sex Behav 35, 587–595 (2006). https://doi.org/10.1007/s10508-006-9059-x

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