Purpose Little research addresses sexual pleasure in young men who have sex with men (YMSM). In this qualitative study, we developed a sexual health focused conceptual framework to explore relationships that emerged between condom use and sexual pleasure in sexual relationships among a sample of gay, bisexual, and transgender males.

Methods 30 YMSM (ages 18–24 years) were recruited (through advertisements on social networking sites, participant referrals, and flyers posted at local venues frequented by YMSM) to complete a 90-minute, semi-structured interview seeking to better understand partner-seeking behaviours of YMSM. Interviews were transcribed verbatim. Analysis used inductive open coding such that emergent concepts were connected across interviews and major themes identified.

Results Median age was 22 years old (M = 21.96; SD = 1.75). Most (N = 18, 60%) of participants self-identified as White, and gay (N = 22, 73%). Over 90% (N = 28) reported having had sex with someone met on a dating website in the past 3 months. Five (17%) participants reported being HIV-positive and 12 (40%) reported a prior history of a sexually transmitted infection. Emotional effects (such as connectedness with others) and physical effects (loss of sensation and erectile difficulties) mediated the relationship between pleasure and condom use during insertive penile-anal intercourse. Specific characteristics of sexual events (e.g., use of lubricant), relationship with the partner, and of the specific sex act (including sexual position) moderated the relationship, with pleasure and satisfaction greater during receptive anal sex without a condom with emotionally intimate or regular partners.

Conclusion s Our findings suggest that relationship between sexual pleasure and condom use may be mediated by both emotional and sexual factors. Prevention work with YMSM need to acknowledge the centrality of pleasure in sexual health and focus on modifiable factors that may impact pleasure among YMSM.