1. Alex Parr & Carrie Llewellyn Brighton and Sussex Medical School, UK
A quantitative study to understand the sexual appetites of men who have sex with men (MSM)
Alex Parr & Carrie Llewellyn
Brighton and Sussex Medical School, UK

2. Introduction 3360 new MSM HIV diagnoses in 2014 (UK)
HIV prevention strategies
Behavioural interventions
Increasing risky behaviour – unprotected anal intercourse (UAI)
Libido, sexual compulsivity, hypersexuality…
14 % unaware
Alongside pharmacological interventions, non-drug interventions are important
Intrusive/overwhelming thoughts/desires
Lots of terminiology –getting at the same thing, thoughts becoming intrusive or disruptive

3. Research question
To what extent is libido associated with risk behaviour?
Hypotheses:
There would be a positive correlation between high libido and:
Low incidence of condom use
High number of sexual partners
High incidence of repeat prescription for post-exposure prophylaxis (PEP) within 1 year
High incidence of HIV/STI diagnosis within 1 year
Wanted to understand how much of a problem it is, and extent of association
Explain PEP

4. Methods Project PEPSE – paper survey
Participants: MSM, ≥16 years, PEPSE, Sexual Health clinic (6 centres across SE England)
10 items to assess libido
Risk behaviour measures
Psychological measures
Number of partners
Information
Inconsistent condom use
Motivation
Repeat PEP prescription in 1 year
Behavioural skills
HIV/STI diagnosis in 1 year
Univariate + multivariate statistical analyses
Introduce project PEPSE – 2ndary analysis of data
Baseline data (+follow up)
Cross sectional data
Recruitment info – who they are, entering into behavioural intervention study, but this was baseline data before intevention
Psychological measures based on a psy model

5. Results - demographics
N ( % )
Age mean (range)
34.5 (19-66)
Sexuality
Gay
Bisexual
Heterosexual / Rather not say
160 (92.5)
11 (6.4)
2 (1.2)
Ethnicity
White UK
White other
Black / Asian / Mixed / Other
80 (45.7)
61 (34.9)
34 (19.4)
Employment
(Self) Employed
Student
Unemployed / Retired / Other
141 (80.6)
20 (11.4)
14 (8.1)
Education
Below degree level
Degree / Post-graduate degree
48 (27.4)
127 (72.6)

6. Results - libido items
I find myself thinking about sex while at work or college
My sexual appetite gets in the way of my relationships
My sexual thoughts and behaviours are causing problems in my life
I think about sex more than I would like to
I sometimes get so horny I could lose control
I feel that my sexual thoughts and feelings are stronger than I am
My desires to have sex have disrupted my daily life
I sometimes fail to meet my commitments and responsibilities because of my sexual behaviour
I have to struggle to control my sexual thoughts and behaviours
It has been difficult for me to find sex partners who desire having as much sex as I want to

7. Results – univariate analysis
Inconsistent condom use
rs = p = .007
Libido
Number of sexual partners
rs = p < .001

8. Results – multivariate analysis
Lower levels of HIV information (OR = 0.73, p = .030, CI = .54 – .97)
Less intention of using risk reduction strategies (OR = 0.83, p = .008, CI = .73 – .95)
Inconsistent condom use (active)
Less likelihood of planning to have safer sex (OR = 0.8, p = .023, CI = .66 – .97)
Higher libido (OR = 1.69, p = .007, CI = 1.16 – 2.46)
Inconsistent condom use (passive)
Less intention of using risk reduction strategies (OR = 0.85, p = .014, CI = .75 – .97)
Higher libido (OR = 1.71, p = .003, CI = 1.21 – 2.43)
High number of sexual partners
Less likelihood of planning to have safer sex (OR = 0.68, p = .001,
CI = .53 – .86)
HIV/STI diagnosis in 1 year
Constructed 5 mathematical models… seeking to find significant factors for each of our surrogate meausres for risk

9. Discussion & Recommendations
Libido plays a role in risk taking sexual behaviour
Explore intentions or levels of knowledge within clinics
Target individuals
Identify high risk MSM
Libido assessment
We’ve shown associations b/w surrogates for risk outcomes libido and behavioural
Understanding knowledge and/or intentions within clinics then perhaps targeting
?libido scores could be used to identify high risk people
Information – information about condoms, using them
Motivation – inraesing willingness to use condoms – why important to do this
BS – having condoms with you, using them correctly
Corroborates previous work

10. Strengths & Limitations
First quantitative study assessing the role of libido on risk behaviour in UK
Self-reporting bias
Chemsex, drugs and alcohol
Specific sample of men

11. Acknowledgements
Thank you to: The participants Alex Pollard Dr Chris Jones Division of Public Health and Primary Care at BSMS