title: What constitutes the best sex life for gay and bisexual men? Implications for HIV prevention.
abstract: BACKGROUND
  While a large body of research has sought to understand HIV transmission risk behaviours among gay men, bisexual men and other men who have sex with men (MSM), less attention has been paid to the wider sexual health and well-being of this population. While some community-based organisations aim to support a more holistic sense of sexual well-being there is little evidence to draw on to inform their interventions. The current study sought to explore gay and bisexual men's conceptions of what constitutes the 'best sex'.
  
  
  METHODS
  The EMIS survey of 2010 recruited more than 180,000 respondents from 38 European countries to complete an online questionnaire about sexual health and behaviour. The 12,942 English language, UK-based responses to the open ended question, "What's your idea of the best sex life?" were subjected to a detailed content analysis. A framework was devised to reflect and describe the key themes emerging from the data, which was then used to code all responses to one (or more) of these themes. Further statistical analysis sought to establish if and how responses differed according to key demographic variables.
  
  
  RESULTS
  Eight themes emerged that capture the diversity of gay and bisexual men's sexual desires. Most common among responses was a desire for sex within committed relationships, followed by a desire for sex which is emotionally or psychologically connected. Men also expressed a desire for volume and variety in their sexual lives, and for sex that is free from physical, social or psychological harm. Comparative analysis identified that older men were less likely to idealise a relationship or emotional connection, but were more likely to specify the sexual acts or behaviours they wished to engage in.
  
  
  CONCLUSIONS
  Attending to what men value or aspire to can help ensure interventions are engaging and meaningful to the target population. HIV prevention interventions need to attend to the broad range of sexual desires held by gay and bisexual men in delivery of holistic sexual health promotion that can help them to have the best sex with the least harm.
authors.affiliation: Sigma Research, Department of Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK. adam.bourne@lshtm.ac.uk.
authors.forename: Adam
authors.initials: A
authors.lastname: Bourne
authors.forename: Gary
authors.initials: G
authors.lastname: Hammond
authors.forename: Ford
authors.initials: F
authors.lastname: Hickson
authors.forename: David
authors.initials: D
authors.lastname: Reid
authors.forename: Axel J
authors.initials: AJ
authors.lastname: Schmidt
authors.forename: Peter
authors.initials: P
authors.lastname: Weatherburn
mesh_terms: D000328:Adult; D000367:Age Factors; D001727:Bisexuality / Q000523:psychology* / Q000706:statistics & numerical data; D015658:HIV Infections / Q000517:prevention & control; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D012725:Sexual Behavior / Q000523:psychology*; D012945:Social Values; D011795:Surveys and Questionnaires; D006113:United Kingdom; D055815:Young Adult