Sexual behaviours of homosexual and bisexual men in France: a generational approach

Abstract

Objective: In high-income countries, the social and epidemiological contexts surrounding homosexuality and AIDS have changed profoundly in recent decades. This work sought to examine key indicators of the long-term sexual trajectories of successive generations of men who have sex with men (MSM) in France.

Methods: We performed a longitudinal analysis of the French Gay Press surveys, which were self-administered socio-behavioural questionnaires, repeated from 1985 to 2011 in the gay press, and on the internet in 2004 and 2011. An age-cohort analysis using graphical representations and multivariate logistic regressions was conducted among participants aged 18-59 (N = 38 821).

Results: First sexual intercourse occurred more often with a male partner in younger generations than in older ones: 76.0% in MSM who turned 18 in 1956-1959, 75.6% in 1980-1983, 83.7% in 2008-2011, p(overall) = 0.0002). Every generation showed the same pattern of sexual trajectory between 1985 and 2011: globally, the frequency of masturbation increased from the 1985 survey to the early 1990s and then decreased from the late 1990s to the end of the study period. Inversely, the frequency of oral and anal sex decreased in the mid-1980s and increased from 1990 to 2011. The frequency of both oral sex and anal intercourse is currently quite high, regardless of generation (>95% and around 80%, respectively). Compared to their predecessors, recent generations of young MSM reported more frequent oral and anal sex, but fewer male partners in the previous 12 months.

Discussion: While the increased frequency of first intercourse with a man over successive generations since the 1970s may be related to reduced social pressure for heterosexuality, there is evidence that sexual norms among MSM are widespread, with practices spreading across age groups and generations. Although AIDS profoundly affected sexual practices in the 1980s, further AIDS-related events (discovery of HIV antiretroviral drugs and their use in prevention) do not appear to have accentuated ongoing trends in sexual practices.

Fig 1. Percentages of respondents reporting that their first sexual intercourse was with a male partner, adjusted for age, and corresponding fit curve.

Surveys in 1995–2011, respondents aged 18–59.

Fig 2. Median age at first sexual intercourse with a man.

Surveys in 1995–2011, respondents aged 18–59. Reading: Respondents aged 25–29 surveyed in 1995 had turned 18 in 1986 on average and had a median age at first intercourse with a man equal to 17.8. Lines are drawn only when the generation is composed of at least 30 respondents.

Fig 3. Percentage of participants reporting more than 10 male partners in the previous 12 months.

Surveys in 1991–2011, respondents aged 18–59. Reading: 22.5% of the respondents from the 1996–1999 generation reported more than 10 male partners in the previous 12 months when their mean age was 18.6 years (i.e., when they were surveyed in 1997). Lines are drawn only when the generation is composed of at least 30 respondents.

Fig 4. Percentage of participants reporting (a) masturbation, (b) oral sex, and (c) anal intercourse as frequent practices.

Surveys in 1985–2011, respondents aged 18–59. Reading: 61.5% of the respondents from the 1996–1999 generation reported frequent anal intercourse when their mean aged was 18.6 years (i.e., when they were surveyed in 1997).Lines are drawn only when the generation is composed of at least 30 respondents.