BURIED PLEASURES:
Childhood Environment Predicts Preferences for Certain Safe and Unsafe Sexual Acts

Poster Tu.D.2714, presented 9 July 1996 at the XI International AIDS Conference, Vancouver BC, Canada (abstracts book page 387)

James D. Weinrich, Ph.D.
J. Hampton Atkinson, M.D.
J. Allen McCutchan, M.D.
Igor Grant, M.D.
The HNRC Group

HIV Neurobehavioral Research Center
University of California
2760 Fifth Avenue #200
San Diego, California, 92103 USA

Telephone: 619-543-5025
<jweinrich@ucsd.edu> <http://math.ucsd.edu/~weinrich/>

Centering thought
Where are the independent erotic variables in AIDS research?
Qualifications
Questions asked
Results
A hypothetical ad campaign based upon similar findings

Abstract

Issue: Too little attention has been given to erotic variables in AIDS research. Models typically presume that heterosexual (HT) and homosexual (HM) men's erotic preferences are completely different, and then treat each kind of man as a uniform "type." We strongly disagree, and present new data and a new model to understand such preferences.

Objectives: We sought: (1) to identify childhood and other antecedents for both HM and HT men associated with sexual identification; (2) to ascertain erotic subgroups of these men relevant to HIV transmission; and (3) to suggest strategies based on this erotic typology which would help fight transmission (e.g., by devising appeals to particular subgroups).

Methods: We studied 123 men using questionnaires and a 90-minute clinically-oriented interview to ascertain each man's lovemap: his image of an ideal, optimally arousing sexual partner and a maximally arousing interaction with that partner. We added data on personality, and coping skills from a larger study in which the men took part.

Results: One typical result: childhood physical abuse, neglect, and parental alcoholism (but not sexual abuse) are associated with submissive sexual lovemaps in adulthood for HM and HT men. Sexual orientation per se is not predicted by parental factors. Among HM men, such fantasies (as well as childhood gender nonconformity) are associated with receptive anal sex.

Conclusions: Even when preferences for particular sexual acts seem fixed, interventions may increase effectiveness by taking account of the deeper reasons why men prefer the acts they do. We need to appreciate men's erotic variability, understand how deeply buried pleasures trigger erotic value in sexual scenarios, and use that understanding to personalize messages for change.

NOTE: Above text has been updated slightly from abstract published in the official program.

Centering thought

One of the main reasons HIV prevention efforts to date have ... only been partially successful, [Rofes] asserts, is that prevention activists have failed to consider the meaning that certain sexual acts might hold for certain individuals.... Gay men are recognizing in growing numbers that sex is more complicated than reading a checklist in a prevention brochure....

"When you're trying to deal with mass change in the area of sexual activity," says Rofes, "the problem is you adopt approaches that pretend these acts are meaningless, that they're easily exchangeable, that they're not loaded and inscribed deeply with meanings that resonate ..., and then you wonder why your work isn't successful.... Those of us [who] ... function primarily from the head expect the rest of the world to do likewise.... the idea that things are more complex than that is something we resist."

--Eric Rofes, interviewed in the Washington Blade, 7 June 1996, page 63.

Where are the independent erotic variables in AIDS research?

Conspicuous by their absence in the overwhelming majority of social-psychological research on AIDS prevention and safer sex are the independent erotic variables that common sense would suggest are important in determining which individuals quickly adopt safer-sex guidelines and which continue performing unsafe sexual acts. The Health Beliefs Model, Theory of Reasoned Action, and countless other models simply ignore the special power of sexual fantasies in motivating people's wishes and actions. Presumably this came about because researchers want to study things that they can change, and no one really knows how to change people's sexual fantasies (although condom eroticization campaigns are at least trying to do so).

Accordingly, we are using a completely different model in our attempts to understand the deeper, psychodynamic reasons why people prefer the sexual behaviors they do. Sexual fantasies are central to this model; social-psychological concepts (such as AIDS awareness, self-efficacy, etc.) are deemed peripheral. We made this choice not because such factors are in fact peripheral, but because most targeted individuals are now aware of how HIV is transmitted and how to avoid AIDS, or because such variables are probably subsequent to those we do include. For example, a sense of self-efficacy in controlling one's sexual behavior in the face of AIDS is probably a function of what and how strong one's fantasies are: if receptive anal intercourse (RAI) is not pleasurable, one's self-efficacy to control it is probably high; if RAI is extremely arousing, one's self-efficacy may not be so high.

Important Qualifications to the Model

The model does not presume that homosexuality, childhood femininity, or a preference for submissive or receptive sex in adulthood are pathological. To the contrary, we consider all of these to be part of a normal spectrum of human sexuality.
Of course, we do consider physical and verbal abuse in childhood to be pathological, but that does not imply that their consequences are.
For example, if people who are abused in childhood are more likely to become psychologists or mental health professionals in adulthood, that does not imply that such choices are pathological!
We only have enough data to address physical and verbal abuse, not sexual abuse. Sexual abuse by a parent is very uncommon in our sample.
The model describes part of the processes resulting in unsafe sex, not all of them. It describes two factors which may influence a preference for receptive anal sex -- but not the only such factors.
Although our results come mostly from a sample of homosexual men, preliminary analyses suggest that similar relationships hold for heterosexual men. Our reading of the literature suggests that some may hold also for women.
We do not believe that there is anything inevitable or uncontrollable about these relationships -- although they should help us understand why people behave the way they do. Even if we explain why people have an itch, we must acknowledge that humans have the ability to consciously overrule such feelings and impulses. Yet practically speaking, we observe that most people scratch most itches.
At this meeting, we only present data pertaining to one of the components of the model; other components have been previously published or are under continuing investigation.

The Questions

Participants were asked a series of open-ended questions about an ideal sexual partnership, beginning with:

Our final set of questions has to do with your perfect sexual and romantic fantasy. Start by telling me what your perfect sexual and romantic partner would be like. Describe that person in any way you wish.

Later, they were asked:

Now [assume] that you've met your partner, [and so] tell me what an ideal sexual and/or romantic encounter with them would be like. Describe that encounter in any way you wish. Pretend that there is no such thing as AIDS or any other sexually transmitted disease, so that you can do whatever you want to with that person sexually.

The interviewer marked checkboxes to indicate which scenarios or acts were mentioned spontaneously. Among these were:

Spanking partner               Being spanked
Dominating partner sexually    Being dominated sexually
Tying partner up               Being tied up

Thus, the numbers reported in the tables reflect respondents who mentioned an act or scenario without specific prompting.

Results

We begin with a sexual behavior with no specific relevance to HIV transmission, to illustrate the principle and the generality of the finding -- namely, arousal by being spanked.

Getting Spanked

Parental abuse or alcoholism?  No    Yes
Aroused by being spanked        1      9
Not aroused                    39     42

n = 91; p < 0.03, Fisher's Exact test

Although only 10 respondents reported that their ideal sexual interaction with an ideal partner would involve their being spanked, 9 of the 10 had had an abusive or alcoholic parent. It's as if children's brains are pre-wired to learn that parental care equals love (even if the parents are abusive or incapacitated due to alcoholism). In adulthood they discover that erotically transformed versions of that care are arousing (even if the care was abusive).

Submissive and/or Masochistic

Maternal abuse or alcoholism?  No    Yes
Submissive or masochistic      16     15
Not subm. or masochistic       46     18

n = 95; p < 0.05, Fisher's Exact test

Note that this finding pertains to maternal abuse and/or alcoholism; the situation for father is different (see below).

Paternal abuse or alcoholism?   No    Yes
Submissive or masochistic        8     23
Not subm. or masochistic        25     39

Although this result is in the correct direction, it is only a weak trend (p < 0.15, Fisher's Exact test).

Dominant and/or Sadistic

Maternal abuse or alcoholism?   No    Yes
Dominant or sadistic             6      9
Not dominant or sadistic        57     23

n = 95, p < 0.03, Fisher's Exact Test

This relationship is not statistically significant for paternal abuse/alcoholism.

Tie partner up

Parental abuse or alcoholism?   No    Yes
Enjoys tying up partner          2     10
Does not enjoy tying up         38     43

n = 93, p < 0.05, Fisher's Exact Test

Not predicted by the theory (but not necessarily contradicting it) is the finding that childhood abuse/parental alcoholism is associated with an increased likelihood of wanting to tie up a sexual partner.

Get tied up

Parental abuse or alcoholism?   No    Yes
Enjoys being tied up             5     12
Does not enjoy being tied up    35     40

n = 92, p = 0.15, Fisher's Exact Test

For the corresponding submissive act (getting tied up), results are in the same direction for both mother and father -- although they are not statistically significant.

A sample campaign based on these findings

[For illustration purposes only.]

This storyboard demonstrates why it is useful to understand the deeper reasons why people do what they do, even if we cannot change those underlying fantasies or aspects of personality. Many researchers prefer not to investigate such topics because they don't think anything can be done with such knowledge (except, perhaps, to use it to blame the victim).

To see the storyboard, click here.

What is the research upon which this storyboard is based?
Our research identified a group of gay men who resist safer-sex messages because they interpret them as attempts to control their behavior (authoritarian) rather than attempts to help them (authoritative).
Why would acts like receptive anal sex be attractive to anti-authoritarian men?
Men who experienced extremely authoritarian (abusive) childrearing were more likely to be sexually aroused by fantasies of erotic submission in adulthood (see charts). In some instances, these two findings combined in a lethal mix. Mistrust of authority would lead such a man to discount safer-sex messages. His attraction to dominant male figures would lead him to leave the choice of sexual activity and condom use to his partner. With an uncaring partner, this is a recipe for seroconversion.
How can we deliver authoritative safer-sex messages to people who mistrust authority?
One way would be to appeal to their desire to be free of moralistic controls. That is, use a technique tailored to the group which addresses emotions and cognitions salient for that group. This storyboard depicts such an appeal in a hypothetical safer-sex campaign.

<jweinrich@ucsd.edu>

<http://math.ucsd.edu/~weinrich/>

BURIED PLEASURES: Childhood Environment Predicts Preferences for Certain Safe and Unsafe Sexual Acts

James D. Weinrich, Ph.D. J. Hampton Atkinson, M.D. J. Allen McCutchan, M.D. Igor Grant, M.D. The HNRC Group

HIV Neurobehavioral Research Center University of California 2760 Fifth Avenue #200 San Diego, California, 92103 USA

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