[Explanation of risky sexual behaviors in men who have sex with men].

OBJECTIVE

To explore views about risky sexual behaviors and perceptions of HIV, and to propose interventions for preventing HIV infections in a group of men who have sex with men.

METHODS

We performed a qualitative study in a sample of 13 men who have sex with men, who were participating in an HIV-seronegative cohort, and who we contacted via saunas for the gay community in Barcelona (Spain). We performed in-depth semi-structured interviews, followed by content analysis.

RESULTS

Risky sexual behaviors were associated with masculinity related to strong sexual needs, certain sexual exchange venues (such as saunas, private parties and clubs), drug use, and a desire to experiment with risk and one's own sexuality. HIV infection was perceived as a normalized disease, although becoming infected was still associated with shame and guilt. Proposed interventions included raising awareness of what it is like to live with HIV, generating greater social alarm, incorporating new technologies in prevention, and intensifying activity at gay venues.

CONCLUSIONS

The concept of masculinity plays a fundamental role in sexual practices among men who have sex with men. We suggest renewed innovation in preventive programs and incorporating the perception of risk and HIV infection from a gender perspective.