Skip to main content
SpringerLink
Log in

Other-Sensitive Motivation for Safer Sex Among Gay Men: Expanding Paradigms for HIV Prevention

  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Self-interest is not the only motivator to sexual safety among sexually active gay men. Indeed, limits to a self-interest prevention paradigm are significant, and growing. Semi-structured qualitative interviews in two cities with an ethnically diverse cohort of mixed-status, sexually active gay men reveal a wide range of other-sensitive motivators beyond self-interest whose roles in men's HIV safety decisions have not been recognized. Other-sensitive motivations fall into several categories: altruistic concern for sex partners, personal ethical/moral values, expressed desire for communal/collective survival, concerns about self-definition, and elaborate concerns over the effects of potential HIV infection on family and friends. Other-focused concerns seem to operate as key motivators among these men, lowering risk. Implications of other-sensitive concerns for a new generation of prevention strategies are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • Aronfreed, J. (1970). The socialization of altruistic and sympathetic behavior: Some theoretical and experimental analyses. In J. Macaulay and L. Berkowitz (Eds.), Altruism and helping behavior, (pp. 103–126). New York: Academic Press.

    Google Scholar 

  • Badgett, M. V. L., and Cunningham, N. (1998). Creating communities: Giving and volunteering by gay, lesbian, bisexual and transgender people. Working Group on Funding Lesbian & Gay Issues and Institute for Gay and Lesbian Strategic Studies, New York, NY, Amherst, MA. [Monograph].

    Google Scholar 

  • Batson, C. D., and Shaw, L. L. (1991). Encouraging words concerning the evidence for altruism. Psychological Inquiry, 2, 159–168.

    Google Scholar 

  • Binson, D., Michaels, S., Stall, R., Coates, T. J., Gagnon, J. H., and Catania, J. H. (1995). Prevalence and social distribution of men who have sex with men: United States and its urban centers. Journal of Sex Research, 32, 245–254.

    Google Scholar 

  • Bochow, M. F., Chiarotti, Davies, P., Dubois-Arber, F., Dur, W., Fouchard, J., Gruet, F., Manus, T., Markert, S., and Sandfort, T. (1994). Sexual behaviour of gay and bisexual men in eight European countries. AIDS Care, 6, 533–549.

    Google Scholar 

  • Cassel, J. B., and Ouellette, S. (1995). A typology of AIDS volunteers. AIDS Education and Prevention, 7, 80–90.

    Google Scholar 

  • Catania, J. A., Kegeles, S. M., and Coates, T. J. (1990). Towards an understanding of risk behavior: An AIDS risk reduction model (ARRM). Health Education Quarterly, 17, 381–399.

    Google Scholar 

  • Coates, T. J., Stall, R. D., Kegeles, S. M., Lo, B. Morin, S. F., and McKusick, L. (1988). AIDS antibody testing. Will it stop the AIDS epidemic? Will it help people infected with HIV? American Psychologist, 43, 859–864.

    Google Scholar 

  • Davies, P., Hickson, F. C. I., Weatherburn, P., and Hunt, A. J. (1993). Sex, gay men and AIDS. London: The Falmer Press.

    Google Scholar 

  • Davies, P. M., Weatherburn, P., Hunt, A. J., Hickson, F. C., McManus, T. J., and Coxon, A. P. (1992). The sexual behaviour of young gay men in England and Wales. AIDS Care, 4, 259–272.

    Google Scholar 

  • Dawson, J., Fitzpatrick, R., McLean, J., Hart, G., and Boulton, M. (1991). The HIV test and sexual behaviour in a sample of homosexually active men. Social Science and Medicine, 32, 683–688.

    Google Scholar 

  • Fishbein, M., and Azjen, F. (1975). Belief, attitude and behavior: An introduction to theory and research. Reading, MA: Addison-Wesley.

    Google Scholar 

  • Frazer, I. H., McCamish, M., Hay, I., and North, P. (1988). Influence of human immunodeficiency virus antibody testing on sexual behaviour in a “high-risk” population from a “low-risk” city. Medical Journal of Australia, 149, 365–368.

    Google Scholar 

  • Gayle, H. (1998). Treatment advances present new challenges for HIV prevention: Combating complacency may be greatest challenge. 12th World AIDS Conference, June 27, 1998, Geneva.

  • Gold, R. S., Skinner, M., Grant, P., and Plummer, D. (1991). Situational factors and thought processes associated with unprotected intercourse in gay men. Psychology and Health, 5, 259–278.

    Google Scholar 

  • Grusec, J. E. (1981). Socialization processes and the development of altruism. In J. Rushton and R. Sorrentino (Eds.), Altruism and helping behavior: Social, personality, and developmental perspectives (pp. 65–90). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Hays, R., Kegeles, S., and Coates, T. (1990). High HIV risk-taking among young gay men. AIDS, 4, 901–907.

    Google Scholar 

  • Hays, R., and Kegeles, S. (in press). Factors related to willingness of young gay men to participate in preventive HIV vaccine trials. Journal of AIDS and Human Retroviruses.

  • Hays, R., and Kegeles, S. (1997). Unprotected sex and HIV risk taking among young gay men within boyfriend relationships. AIDS Education and Prevention, 9, 314–329.

    Google Scholar 

  • Hickson, F. C., Reid, D. S., Davies, P. M., Weatherburn, P., Beardsell, S., and Keogh, P. G. (1996). No aggregate change in homosexual HIV risk behaviour among gay men attending the gay pride festivals, United Kingdom, 1993–1995. AIDS, 10, 771–774.

    Google Scholar 

  • Hickson, F. C. I., Davies, P., Hunt, A. J., and Weatherburn, P. (1992). Maintenance of open gay relationships: Some strategies for protection against HIV. AIDS Care, 4, 409–419.

    Google Scholar 

  • Higgins, D. L., Galavotti, C., O'Reilly K. R., Schnell, D. J., Moore, M., Rugg, D. L., and Johnson, R. (1991). Evidence for the effects of HIV antibody counseling and testing on risk behaviors. Journal of the American Medical Association, 266, 2419–2429.

    Google Scholar 

  • Hoff, C., Coates, T. J., Barrett, D. C., Collette, L., and Ekstrand, M. (1996). Differences between gay men in primary relationships and single men: Implications for prevention. AIDS Education and Prevention, 8, 546–559.

    Google Scholar 

  • Hoover, D. R., Munoz, A., Carey, V., Chmiel, J. S., Taylor, J. M., Margolick, J. B., Kingsley, L., and Vermund, S. H. (1991). Estimating the 1978–1990 and future spread of human immunodeficiency virus type 1 in subgroups of homosexual men. American Journal of Epidemiology, 134, 1190–1205.

    Google Scholar 

  • Hunt, A. J., Weatherburn, P., Hickson, F. C., Davies, P. M., McManus, T. J., and Coxon, A. P. (1993). Changes in condom use by gay men. AIDS Care, 5, 439–448.

    Google Scholar 

  • Kalichman, S. C., Roffman, R. A., Picciano, J. F., and Bolan, M. (1998). Risk for HIV infection among bisexual men seeking HIV-prevention services and risks posed to their female partners. Health Psychology, 17, 320–327.

    Google Scholar 

  • Katz, M. H. (1997). AIDS epidemic in San Francisco among men who report sex with men: Successes and challenges of HIV prevention. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 14, S38-S46.

    Google Scholar 

  • Kelly, J. A., St. Lawrence, J. S., and Brasfield, T. L. (1991a). Predictors of vulnerability to AIDS risk behavior relapse. Journal of Consulting and Clinical Psychology, 59, 163–166.

    Google Scholar 

  • Kelly, J. A., Kalichman, S. C., Kauth, M. R., Kilgore, H. G., Hood, H., Campos, P. E., Rao, S., Brasfield, T. L., and St. Lawrence, J. S. (1991b). Situational factors associated with AIDS risk behavior lapses and coping strategies used by gay men who successfully avoid lapses. American Journal of Public Health, 18, 1335–1338.

    Google Scholar 

  • Kippax, S., Crawford, J., Davis, M., Rodden, P., and Dowsett, G. (1993). Sustaining safe sex: A longitudinal study of a sample of homosexual men. AIDS, 7, 257–263.

    Google Scholar 

  • Kunda, Z., and Schwartz, S. (1983). Undermining intrinsic moral motivation: External reward and self-presentation. Journal of Personality and Social Psychology, 45, 763–771.

    Google Scholar 

  • Lemp, G. F. P., Hirozawa, A., Givertz, D., Nierei, G., and Anderson, L. (1994). Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men: The San Francisco/Berkeley young men's survey. Journal of the American Medical Association, 272, 449–454.

    Google Scholar 

  • Marks, G., Ruiz, M. S., Richardson, J. L., Reed, D., Mason, H. R., Sotelo, M., and Turner, P. A. (1994). Anal intercourse and disclosure of HIV infection among seropositive gay and bisexual men. Journal of Acquired Immune Deficiency Syndrome, 7, 866–869.

    Google Scholar 

  • McCusick, L., Coates, T., and Morin, S. (1990). Longitudinal predictors of reductions in UAI among gay men in San Francisco. American Journal of Public Health, 80, 978–983.

    Google Scholar 

  • McCusker, J., Stoddard, A. M., Mayer, K. H., Zapka, J., Morrison, C., and Saltzman, S. P. (1988). Effects of HIV antibody test knowledge on subsequent sexual behaviors in a cohort of homosexually active men. American Journal of Public Health, 78, 462–467.

    Google Scholar 

  • McLean, J., Boulton, M., Brookes, M., Lakhani, D., Fitzpatrick, R., Dawson, J., McKechnie, R., and Hart, G. (1994). Regular partners and risky behaviour: Why do gay men have unprotected intercourse? AIDS Care, 6, 331–341.

    Google Scholar 

  • Meyer, I. H., and Dean, L. (1995). Patterns of sexual behavior and risk taking among young New York City gay men. AIDS Education and Prevention, 7,(Suppl.), 13–23.

    Google Scholar 

  • Moreau-Gruet, F., and Dubois-Arber F. (1996). AIDS prevention in homosexuals in Switzerland: Adaptation to risks according to type of partner. Sozial-und Praventivmedizin, 41, 1–10.

    Google Scholar 

  • Myers, T., Godin, G., Lambert, J. Calzavara L., and Locker, D. (1996). Sexual risk and HIV-testing behavior by gay and bisexual men in Canada. AIDS Care, 8, 297–309.

    Google Scholar 

  • Nimmons, D. (1998). In this together: The limits of prevention based on self-interest and the role of altruism in HIV safety. Journal of Psychology and Human Sexuality, 10, 108–126.

    Google Scholar 

  • Nimmons, D., Folkman, S., and Acree, M. (in preparation). Talking beyond ourselves: Quantitative support for other-sensitive motivation to safer sex among gay men.

  • Osmond, D. H., Page, K., Wiley, J., Garrett, K., Sheppard, H., and Moss, A. (1994). HIV infection in homosexual and bisexual men 18 to 29 years of age: The San Francisco young men's study. American Journal of Public Health, 84, 1933–1937.

    Google Scholar 

  • Ouellette, S. C., Cassel, J. B., Maslanka, H., and Wong, L. M. (1995). GMHC volunteers and the challenges and hopes for the second decade of AIDS. AIDS Education and Prevention, 7, 64–79.

    Google Scholar 

  • Perkins, D. O., Leserman, J., Murphy, C., and Evans, D. (1993). Psychosocial predictors of high-risk sexual behavior among HIV-negative homosexual men. AIDS Education and Prevention, 5, 141–152.

    Google Scholar 

  • Prieur, A. (1990). Norwegian gay men: Reasons for continued practice of unsafe sex. AIDS Education and Prevention, 2, 109–115.

    Google Scholar 

  • Prochaska, J. O., Redding, C. A., Harlow, L. L., Rossi, J. S., and Velicer, W. F. (1994). The transtheoretical model of behavior change and HIV prevention: A review. Health Education Quarterly, 21, 471–486.

    Google Scholar 

  • Remien, R., Carballo-Dieguez, A., and Wagner, G. (1995). Intimacy and sexual risk behavior in serodiscordant male couples. AIDS Care, 7, 429–438.

    Google Scholar 

  • Roffman, R. A., Kalichman, S. C., and Kelly, J. A. (1995). HIV antibody testing of gay men in smaller U.S. cities. AIDS Care, 7, 405–413.

    Google Scholar 

  • Rosenstock, I. M. (1994). The health belief model and HIV risk behavior change. In R. J. DiClemente and J. L. Peterson (Eds.), Preventing AIDS: Theories and methods of behavioral interventions (pp. 5–24). New York: Plenum Press.

    Google Scholar 

  • Rushton, J. P. (1981). The altruistic personality. In J. Rushton and R. Sorrentino, (Eds.), Altruism and helping behavior: Social, personality, and developmental perspectives (pp. 251–266). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Sacco, W. P., and Rickman, R. L. (1996). AIDS-relevant condom use by gay and bisexual men: The role of person variables and the interpersonal situation. AIDS Education and Prevention, 8, 430–443.

    Google Scholar 

  • Service, S., and Blower S. M. (1995). HIV transmission in sexual networks: An empirical analysis. Proceedings of the Royal Society of London Biological Sciences, 260, 237–244.

    Google Scholar 

  • Snyder, M., and Omoto, A. M. (1992). Volunteerism and society's response to the HIV epidemic. Current Directions in Psychological Science, 1, 113–116.

    Google Scholar 

  • Torian, L., Weisfuse, I. B., Makki, H. A., Benson, D. A., DiCamillo, L. M., Patel, P. R., and Toribio, F. E. (1996). Trends in HIV seroprevalence in men who have sex with men: New York City Department of Health Sexually Transmitted Disease Clinics, 1988–1993. AIDS, 10, 187–192.

    Google Scholar 

  • Turner, H. A., Catania, J. A., and Gagnon, J. (1994). The prevalence of informal caregiving to persons with AIDS in the United States: Caregiver characteristics and their implications. Social Science and Medicine, 38, 1543–1552.

    Google Scholar 

  • van Griensven, G., J. de Vroome E. M., Tielman R. A., Goudsmit, J., van der Noordaa, J., deWolf, F., and Cutinho, R. A. (1988). Impact of HIV antibody testing on changes in sexual behavior among homosexual men in the Netherlands. American Journal of Public Health, 78, 1575–1577.

    Google Scholar 

  • Wainberg, M. F., and Friedland, G. (1998). Public health implications of antiretroviral therapy and HIV drug resistance. Journal of the American Medical Association, 279, 1977–1983.

    Google Scholar 

  • Waldo, C. R., and Coates, T. J. (in press). A call for multiple levels of analysis and intervention in HIV prevention science: Examples and directions for new research.

  • Zahn-Waxler, C., Cummings, E. M., and Iannotti, R. (1986). Altruism and aggression: Biological and social origins. Cambridge: Cambridge University Press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California

    David Nimmons

  2. Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California

    Susan Folkman

Authors
  1. David Nimmons
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Susan Folkman
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nimmons, D., Folkman, S. Other-Sensitive Motivation for Safer Sex Among Gay Men: Expanding Paradigms for HIV Prevention. AIDS Behav 3, 313–324 (1999). https://doi.org/10.1023/A:1025437418276

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1025437418276

Search

Navigation