The Psychological Context of Sexual Compulsivity Among Men Who Have Sex with Men

Among men who have sex with men (MSM), sexual compulsivity is associated with overlapping psychosocial and behavioral health problems. Because difficulties with emotion regulation are thought to be one important feature, this study examined whether affective states and traumatic stress symptoms were independently associated with key dimensions of sexual compulsivity. Data were collected in San Francisco for the Urban Men’s Health Study-2002 from May 24, 2002 to January 19, 2003. In total, 711 MSM recruited via probability-based sampling completed a mail-in questionnaire that assessed psychological factors and substance use. Dissociation related to traumatic stress and any stimulant use in the past 6 months were independently associated with more frequent sexual thoughts or urges. Increased anger and HIV-positive serostatus were independently associated with a greater perception that sexual behavior is difficult to control. Clinical research is needed to examine if interventions targeting emotion regulation and traumatic stress can boost the effectiveness of HIV prevention efforts among MSM who experience difficulties related to managing sexual behaviors.