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Our sample, like all opportunistic samples of MSM in England, was predominantly gay identified, well-educated and employed. This paper is among the first to compare the relative importance of pleasure- versus intimacy-related attitudes in predicting unprotected sex among gay and bisexual men. Self-reported sexual difficulties and their association with depression and other factors among gay men attending high HIV-caseload general practices in Australia. A small number of men 5. Quotes from respondents, shown in italics , are provided as theme exemplars. Past studies of motivations for barebacking have linked pleasure and emotional connection as a single factor associated with unprotected anal sex [ 26 ]. 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.
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