Behavioral Medicine

ISSN: 0896-4289 (Print) 1940-4026 (Online) Journal homepage: http://www.tandfonline.com/loi/vbmd20

Associations between Perceived Weight Status,

Body Dissatisfaction, and Self-Objectification
on Sexual Sensation Seeking and Sexual Risk
Behaviors Among Men Who Have Sex with Men
Using Grindr
William C. Goedel, Paul Krebs PhD, Richard E. Greene MD & Dustin T. Duncan
ScD
To cite this article: William C. Goedel, Paul Krebs PhD, Richard E. Greene MD & Dustin T.
Duncan ScD (2016): Associations between Perceived Weight Status, Body Dissatisfaction, and
Self-Objectification on Sexual Sensation Seeking and Sexual Risk Behaviors Among Men Who
Have Sex with Men Using Grindr, Behavioral Medicine, DOI: 10.1080/08964289.2015.1121130
To link to this article: http://dx.doi.org/10.1080/08964289.2015.1121130

Accepted author version posted online: 25

Jan 2016.

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Associations between Perceived Weight Status, Body Dissatisfaction, and SelfObjectification on Sexual Sensation Seeking and Sexual Risk Behaviors Among Men Who
Have Sex with Men Using Grindr
William C. Goedel 1, 2, 3
Paul Krebs, PhD 1, 4

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Richard E. Greene, MD 5, 6
Dustin T. Duncan, ScD 1, 2, 6, 7, 8, 9
1.

Department of Population Health, School of Medicine, New York University, New York, NY

2.

College of Global Public Health, New York University, New York, NY

3.

Department of Sociology, College of Arts and Science, New York University, New York, NY

4.

VA New York Harbor Healthcare System, New York, NY

5.

Department of Medicine, School of Medicine, New York University, New York, NY

6.

Center for Health, Identity, Behavior, and Prevention Studies, Steinhardt School of Culture,
Education, and Human Development, New York University, New York, NY

7.

Center for Drug Use and HIV Research, College of Nursing, New York University, New York,
NY

8.

Population Center, College of Arts and Science, New York University, New York, NY

9.

Center for Data Science, New York University, New York, NY

Address Correspondence to: William C. Goedel, New York University School of Medicine,
Department of Population Health, 227 East 30th Street, Cube 628A, New York, New York,
10016. Phone: (646) 501-2715. E-mail Address: william.goedel@nyu.edu

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ABSTRACT (Word Count: 150)

To date, various dimensions of body image and their associations with condom use have
not been studied among men who have sex with men (MSM) who use geosocial-networking
smartphone applications (apps) to meet new sexual partners. The purpose of the current study

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was to evaluate associations between weight perception, body dissatisfaction, and selfobjectification with sexual behaviors among a sample of MSM (n = 92) recruited from Grindr, an
app popular among MSM, to complete an online survey. Obese participants scored significantly
higher on measures of body dissatisfaction and lower on measures of sexual sensation seeking.
Decreased propensities to seek sexual sensations were associated with fewer sexual partners. By
assessing associations between dimensions of body dissatisfaction and sexual risk behaviors, this
study adds support to a theory of syndemics among MSM, which suggests that synergistically
related biological, psychological, social, and behavioral factors disproportionately affect health
and health-related behaviors in this population.
KEYWORDS
Men who have sex with men; body dissatisfaction; weight perception; self-objectification;
condom use

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INTRODUCTION
Safer sexual practices, including consistent and correct condom use, are important
strategies in preventing the spread of the human immunodeficiency virus (HIV) and other
sexually transmitted infections (STIs). 1 While the number of new HIV infections has remained

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relatively stable or decreased among the general population, the number of new infections
continues to increase among gay, bisexual, and other men who have sex with men (MSM), 2
suggesting that efforts to promote consistent condom use in the United States may be needed in
this population. Further studies examining psychosocial and behavioral variables (e.g. risk
perceptions, self-objectification, sexual sensation seeking) as they relate to condom use,
specifically condom use self-efficacy (defined as a confidence in ones ability to practice safer
sex in difficult situations), are still needed, as traditional efforts (e.g., one-on-one risk-reduction
counseling) are not achieving the desire reduction in HIV transmission. 3,4 Particularly, it is of
interest to investigate associations between body image and condom use self-efficacy, as body
image has been linked to overall self-efficacy5 and weight control self-efficacy.6
Various dimensions of body image including body dissatisfaction, weight and weight
perception, and self-objectification may impact condom use and condom use self-efficacy. First,
findings regarding the association between body mass index (BMI) and condom use have been
mixed. Moskowitz and Seal (2010)7 found that MSM with higher BMIs were less likely to use
condoms during anal intercourse. In contrast, Allensworth-Davies and colleagues (2008)8 found
that obesity was associated with decreases in condomless anal intercourse, while others have
found non-significant differences between BMI groups (e.g. underweight, normal weight,

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overweight, and obese) on condom use among MSM. 9-11 A recent meta-analysis concluded that
increased body dissatisfaction, defined as possessing negative evaluation about ones body or
appearance,12 is associated with decreased self-efficacy regarding the use of condoms. 13
Individuals who have concerns regarding their appearance report heightened worry about
receiving negative evaluations from others and that, in sexual encounters, these individuals may

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experience increased anxiety during discussions regarding condom use out of concern that this
negotiation will lead to rejection, leading to lower condom use self-efficacy.14
Self-objectification involves the internalization of cultural standards of attractiveness and
habitual body surveillance focusing on how the body looks rather than how it feels or
functions.15 This internalization and body surveillance can promote body shame because cultural
standards can be difficult or impossible to meet. 16 More specifically, experiences of sexual
objectification in particular may condition an individual to see their worth in terms of their
sexual desirability, which may be related to increased sexual risk behaviors. 17 To date,
objectification theory has been largely examined among samples of undergraduate, heterosexual,
White women.15,18 Recently, however, scholars have applied this theory to sexual minority men
given the emphasis placed on physical attractiveness in this community and society at large. 19-21
Compared with heterosexual men, sexual minority men often demonstrate more selfobjectification, body dissatisfaction, drive for thinness, and body shame. 20,22,23 In extending
objectification theory to the context of sexual risk behaviors in sexual minority men, higher
scores on the Sexual Minority Mens Body Objectification Experiences Scale, 24 indicating more
frequent experiences of sexual objectification, were directly related to more frequent condomless
anal intercourse in a sample of 216 sexual minority men.17

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Sexual minority men may utilize various technologies including geosocial-networking
applications (e.g. Grindr, Jackd, and Scruff) for the establishment of social and sexual
networks.25 Through the use of these technologies, sexual minority men have the option to
network and connect with other sexual minority men, but also have the opportunity to display
various provocative images of their bodies and solicit sexual activity. 26,27 A recent content

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analysis of profiles on one of these applications (Scruff) has indicated that their users tend to
privilege masculinity, to visually present themselves semi-clothed, and to mention fitness or
[description of their] bodies in the text of their profile, which may contribute to the creation of
an objectifying virtual environment.28 While various dimensions of body image (e.g. weight and
weight perception, body dissatisfaction, and self-objectification) and their associations with
condom use have been studied among MSM who use the Internet to seek sexual partners,7 this is
the first study, to our best knowledge, to evaluate these constructs among geosocial-networking
application-using MSM. The purpose of the current study is to evaluate associations between
each of these body image dimensions in a sample of MSM recruited from Grindr, a popular
geosocial-networking application among MSM.
METHODS
Study Design and Sample
Recruitment protocols for this study have been previously described. 25 Briefly, using a
method consistent with prior research recruiting MSM using Grindr in large urban centers, 29,30
Grindr users in the Atlanta metropolitan statistical area in Georgia, an area with an estimated
190,726 Grindr users in 2013,31 were shown broadcast advertisements on the application with
text encouraging them to click through the advertisement and complete the survey. Users were

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shown this advertisement the first time they logged into their account over the course of three
consecutive days in January 2015. At the end of this period, 604 users had clicked through the
advertisement, 143 users (23.7%) provided informed consent, and 92 users completed the survey.
Response rates have ranged widely using broadcast advertisements as a method of recruiting
Grindr users from 9.9%30 to 31.9%,29 where our overall response rate was 15.2%. Institutional

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review board approval was obtained prior to any data collection.

Survey Measures
Weight and Weight Perception: Individuals were asked to report their perception of their current
weight by answering an item previously utilized in the National Health and Nutrition
Examination Survey (NHANES)32,33 reading, Do you consider yourself to be with four
response options, underweight, overweight, obese, or about the right weight.
Participants also provided their current weight trajectory as trying to lose weight, trying to
gain weight, or trying to do nothing about their weight using an item previously used in the
NHANES.33,34 Individuals self-reported their current height (in feet and inches) and current
weight (in pounds). All height measurements were converted to meters and all weight
measurements were converted to kilograms to enable the calculation of BMI using the standard
formula of weight/height 2.35 BMIs were categorized using World Health Organization weight
categories and their corresponding BMI ranges: underweight (BMI < 18.50), normal weight
(BMI 18.51 to 24.99), overweight (BMI 25.00 to 29.99), and obese (BMI > 30.00).36
Body Dissatisfaction: Body dissatisfaction was measured with an adapted form of Male Body
Attitudes Scale, which is a 24-item self-report instrument measuring males attitudes toward
their bodies.37 Items were responded to on a five-point scale, with response options: always,

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often, sometimes, rarely, and never. The scale is scored by summing the individual items and
taking the average. Scores range from 1 to 5, where higher scores indicate higher levels of body
dissatisfaction. In this study, scales were truncated from their original six response options
(removing the usually option, between often and always) to enhance readability of the
items on Grindr users smartphone screens to increase the feasibility of application-based data

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collection. There are three subscales; all validated through confirmatory factor analysis in
samples of both heterosexual and non-heterosexual men.37,38 These three subscales assess body
dissatisfaction related to muscularity, body fat, and height. Excellent internal consistency was
observed in this sample for the full scale (Cronbachs = 0.92) with good to excellent internal
consistency observed for each of the subscales (Cronbachs = 0.87 for the muscularity
subscale, 0.92 for the low body fat subscale, and 0.82 for the height subscale). Despite changes
to the response options, these alpha values are consistent with those reported in previous
samples. For example, Bergeron and Tylka (2007) reported = 0.90 for muscularity scores, 0.94
for low body fat scores, and 0.85 for height scores in a sample of 368 male college students. 39
Self-Objectification: The Trait Self-Objectification Questionnaire was used to assess the extent
to which individuals view their bodies in objectified terms. The questionnaire requires
respondents to rank ten body features in order of importance to their physical self-concept, where
a rank of zero indicates an attribute that has the least impact on physical self-concept and a rank
of nine indicates an attribute that has the most impact on physical self-concept. Five of the bodily
attributes included in this measure are individual aspects of physical appearance (e.g. weight),
whereas the other five are composed of characteristics relevant to overall physical competence
(e.g. strength). The difference between the sum of the rankings of individual appearance

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attributes and the sum of the rankings of overall competence attributes provides the individuals
overall score. Scores range from -25 to 25, where higher scores indicate an increased importance
on individual physical attributes rather than overall physical competence. 18
Sexual Sensation Seeking Scale: The Sexual Sensation Seeking Scale was used to gauge an
individuals propensity to seek out novel or risky sexual stimulation.40,41 This 10-item instrument

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employs a four-point Likert-type scale with response options: not at all like me, slightly like me,
mainly like me, and very much like me. Scores range from 10 to 40, where higher scores indicate
a higher propensity to seek out sexual stimulation.40,41 The scale displayed acceptable internal
consistency (Cronbachs = 0.68) in this sample.
HIV Status and Recent Sexual Behaviors: HIV status was categorized based on self-reported as
negative, positive, and unknown/never tested. Sexual behaviors were assessed with six items
created by the authors. Respondents were asked whether or not they engaged in insertive and
receptive anal intercourse in the past six months (In the past 6 months, have you engaged in
insertive anal intercourse with another man? and In the past 6 months, have you engaged in
receptive anal intercourse with another man?). If insertive or receptive anal intercourse was
indicated, the respondent was asked with how many partners he engaged in the particular
behavior with in the past six months (How many partners have you engaged in insertive anal
intercourse with in the past 6 months? and How many partners have you engaged in receptive
anal intercourse with in the past 6 months?), and with how many partners he engaged in the
particular behavior without a condom (How many partners have you engaged in insertive anal
intercourse without a condom in the past 6 months? and How many partners have you engaged
in receptive anal intercourse without a condom in the past 6 months?).

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Demographic Characteristics: Age (categorized as 18-25 years old, 26-30 years old, 31-40 years
old, 41-50 years, and 51-60 years old), sexual orientation (categorized as gay/homosexual,
bisexual, straight/heterosexual, and other), relationship status (categorized as currently being in a
relationship and not currently being in a relationship), race/ethnicity (categorized as White or
Caucasian, Black or African American, Hispanic or Latino, Asian or Pacific Islander, or

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Multiracial or Other), educational attainment (categorized as less than 12 th grade, high school,
some college, technical/vocational training, Associate's degree, Bachelors degree, Master's
degree, or doctoral degree), employment status (categorized as working full time, working part
time, not working, student, and unable to work), and past year individual income (categorized as
under $25,000; $25,000 to $54,999; $55,000 to $84,999; $85,000 or higher) were recorded for
each participant. These items were based on items utilized in previous population- and
community-based health studies, including the Boston Youth Survey, 42 the National Health
Interview Survey,43 and the Health Information National Trends Survey.44
Data Analysis
Analyses were conducted using IBM SPSS Statistics 21.0. First, descriptive statistics
were computed for all variables. Scores for the Male Body Attitudes Scale, the Trait SelfObjectification Questionnaire, and the Sexual Sensation Seeking Scale were calculated based on
scoring instructions from the developer of the scale. Scores were not calculated for individuals
missing responses to one or more items. For the Trait Self-Objectification Questionnaire, scores
were not calculated for individuals assigning the same rank to one or more attributes. Across the
three scales, 5.4% of individuals (n = 5) were excluded from analyses involving the Male Body
Attitudes Scale, 6.5% of individuals (n = 6) were excluded from analyses involving the Trait

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Self-Objectification Questionnaire, and 2.2% of individuals (n = 2) were excluded from analyses
involving the Sexual Sensation Seeking Scale. Cohens kappa () coefficient was used to assess
agreement between current weight classification and perceived weight classification. 45 ANOVAs
were used to assess associations between demographic and weight-related variables and age,
BMI, scale scores, and sexual behavior variables. Statistical significance was determined at p <

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0.05.
RESULTS
Demographic Characteristics
Demographic characteristics for the sample are reported in Table 1. Participants ranged in
age from 18 years old to 66 years old with an average age of 31.73 years old (SD = 10.77),
where 37.0% were between 18 and 25 years old. Most (98.9%) identified as gay or bisexual.
Most participants (63.0%) were White/Caucasian; 19.6% were Black/African American, 9.8%
were Hispanic/Latino, 3.3% were Asian/Pacific Islander, and 4.3% were multiracial or identified
with some other racial/ethnic category. Most (97.8%) had completed at least high school, where
51.2% had completed a Bachelors degree or higher. Nearly three-fourths (72.8%) reported
working full- or part-time; 12.0% reported current status as a student, 13.0% reported not
working, and 2.2% reported being unable to work. Most participants (77.8%) reported earning
under $55,000 in the past year. One-fourth of the sample reported currently being a relationship.
Weight and Weight Perception
Participant BMI ranged from 15.78 to 38.34 with an average BMI of 25.79 (SD = 4.93),
where 4.3% were underweight, 40.2% were normal weight, 37.0% were overweight, and 17.4%
were obese. In contrast, 15.2% perceived themselves to be underweight, 39.1% perceived

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themselves to be a normal weight, 41.3% perceived themselves to be overweight, and 3.3%
perceived themselves to be obese. Just over half (53.3%) reported currently trying to lose weight,
while 18.5% reported currently trying to gain weight and 27.2% reported currently trying to do
nothing about their weight. There were no significant variations in BMI, weight classification,
perceived weight classification and weight trajectory observed across demographic variables.

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Table 2 shows perceptions of weight classification by BMI classification. Half of the

sample correctly perceived their weight classification, where all (100%) of underweight
participants, 54.1% of normal weight participants, 54.5% of overweight participants, and 18.8%
of obese participants reported concordant weight classifications and perceived weight
classifications, = 0.256, p < .001. There were no significant variations in the correctness of
perceived weight classifications observed across demographic variables.
Body Dissatisfaction
Scores on the Male Body Attitudes Scale ranged from 1.17 to 4.83 with an average score
of 3.03 (SD = 0.76). Scores on the height, body fat, and muscularity subscales ranged from 1.00
to 5.00 with average scores of 3.01 (SD = 0.91), 3.18 (SD = 1.08), and 3.06 (SD = 0.82)
respectively. Scores on the full scale, F(2, 84) = 3.82, p = 0.026, in addition to the muscularity
subscale, F(2, 84) = 4.49, p = 0.014, varied significantly with sexual orientation, where the
lowest average scores were observed in respondents identifying as gay and the highest average
scores were observed in respondents identifying as bisexual.
Variations in Male Body Attitudes Scale Scores based on perceived weight classification
are shown in Table 3. The lowest average scores for the full scale were observed in those who
perceived themselves to be normal weight and the highest average scores were observed in those

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who perceived themselves to be obese, F(3, 82) = 10.61, p = 0.000. The lowest average scores on
the height subscale were observed in those who perceived themselves to be obese and the highest
average scores were observed in those who perceived themselves to be overweight, F(3, 82) =
5.62, p = 0.001. The lowest average scores on the body fat subscale were observed in those who
perceived themselves to be underweight and the highest average scores were observed in those

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who perceived themselves to be obese, F(3, 82) = 34.22, p = 0.000. There were no significant
associations with these measures and objective measures of BMI.
Self-Objectification
Scores on the Trait Self-Objectification Questionnaire ranged from -23 to 25 with an
average score of 1.94 (SD = 11.71). There were no significant variations in Trait SelfObjectification Questionnaire scores across demographic variables, HIV status, or across weightrelated variables.
Sexual Sensation Seeking
Scores on the Sexual Sensation Seeking Scale ranged from 16 to 40 with an average
score of 30.32 (SD = 4.52). Variations in scores on the Sexual Sensation Seeking Scale by
perceived weight class are displayed in Table 4. Scores on the Sexual Sensation Seeking Scale
were associated with an individuals perceived weight classification, where the lowest average
scores were observed in those perceiving themselves to be obese and the highest average scores
were observed in those perceiving themselves to be overweight, F(3, 85) = 2.77, p = 0.046.
There were no significant variations in Sexual Sensation Seeking Scale scores across
demographic variables or objective measures of BMI.
HIV Status and Recent Sexual Behaviors

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A majority of the sample (84.8%) reported their HIV status as negative; 8.7% reported a
positive HIV status and 6.5% reported an unknown HIV status or having never been tested.
Nearly two-thirds (64.1%) engaged in insertive anal intercourse with at least one partner
in the past six months, with an average of 3.91 (SD = 5.68) partners. The number of partners for
insertive anal intercourse was positively associated with an individuals score on the Sexual

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Sensation Seeking Scale (r = 0.45, p = 0.000). With regard to condomless anal intercourse,
40.2% of participants engaged in condomless insertive anal intercourse with at least one partner
in the past six months, with an average of 1.85 (SD = 3.62) partners. The number of partners for
condomless insertive anal intercourse was positively associated with an individuals score on the
Sexual Sensation Seeking Scale (r = 0.34, p = 0.003). There were no significant variations in
insertive anal intercourse behaviors across demographic, HIV status, or weight-related variables.
A lesser percentage (56.5%) engaged in receptive anal intercourse with at least one
partner in the past six months, with an average of 2.96 (SD = 5.63) partners. The number of
partners for receptive anal intercourse was positively associated with an individuals score on the
Sexual Sensation Seeking Score (r = 0.320, p = 0.002). With regard to condomless anal
intercourse, 40.2% of participants engaged in condomless anal intercourse with at least one
partner in the past six months, with an average of 1.76 (SD = 4.50) partners. There were no
significant variations in receptive anal intercourse behaviors across demographic, HIV status, or
weight-related variables.
DISCUSSION
In this sample of MSM recruited from Grindr, a geosocial-networking application
commonly used by MSM, weight misperception was common whereby 50% of the sample

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misperceived their weight classification (e.g. underweight, normal weight, overweight, or obese).
Misperception was most common among currently obese men, where only 18.8% of obese
participants correctly perceived themselves as obese and about three-fourths (75.1%) of obese
participants instead perceived themselves to be normal weight or overweight. Misperception of
weight status has repeatedly been documented among overweight and obese adults32,46,47 and it

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has been hypothesized that weight misperception among overweight and obese individuals may
preclude the adoption of healthful attitudes and behaviors. 48
Perceived weight classification was associated with body dissatisfaction, whereby the
highest levels of body dissatisfaction overall and body dissatisfaction related to body fat were
observed in those perceiving themselves to be obese and the highest levels of body
dissatisfaction related to height were observed in those perceiving themselves to be overweight.
Height-related and muscularity-related body dissatisfaction (as measured by the height and
muscularity subscales of the Male Body Attitudes Scale) were significantly associated with
measures of self-objectification. Higher levels of body dissatisfaction were associated with more
positive (appearance-favoring) scores on the Trait Self-Objectification Questionnaire. Masculine
norms among gay men are often defined by the interplay of sexual experiences, social behavior,
and physical appearance49,50 and masculinity is closely linked to muscularity from childhood for
many young men.51 Height-related dissatisfaction may be linked to self- and sexual
objectification through masculine norms as well, where taller men are regarded as more
attractive52 and taller men are believed to have larger penises. 53 In Western gay culture, mens
penis size is stereotypically linked with notions of masculinity and sexual prowess. 54

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Perceived weight classification was also associated with sexual sensation seeking,
whereby the lowest average scores were observed in those perceiving themselves to be obese.
Using survey results from the 1998 Twin Cities Lesbian, Gay, Bisexual, and Transgender
(LGBT) Pride Festival (n = 535), Allensworth-Davies and colleagues (2008) assessed
associations between body image and condomless anal intercourse among MSM, where MSM

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reporting overweight/obese body image engaged in anal intercourse with fewer partners and also
indicated infrequent condom use compared to MSM reporting underweight and normal weight
perceptions.8 A lowered propensity to seek out sexual stimulation may be related to fewer sexual
partners. Ones tendency to seek out sexual stimulation (as measured by the Sexual Sensation
Seeking Scale) was positively associated with the number of partners for both insertive and
receptive anal intercourse and for condomless insertive anal intercourse in the past six months.
Findings from this study should be considered in light of their limitations. First, given the
small sample size, the localization of the sample to the Atlanta metropolitan statistical area in
Georgia, and the recruitment of these men from a single MSM-targeting geosocial-networking
application (Grindr), these findings may not be generalizable to larger application-using MSM
populations. Additionally, a substantial percentage of individuals (83.9%) who saw the
advertisement and clicked on it did not complete the survey, so the sample is likely to be biased
by some degree of self-selection. Additionally, the generalizability and comparatively of results
with regard to the Male Body Attitudes Scale is limited due to our changing of the scale to fit the
mobile display of the online survey.
The sample size and associated low statistical power may contribute to the lack of
significant findings concerning the influence of weight and weight perceptions and measures of

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body dissatisfaction of self-objectification on condomless sexual behaviors, but these
preliminary analyses are worthy of further study in larger samples of MSM in multiple locations
using multiple applications as more complex relationships may emerge from multivariable
analysis. In addition, our measures of sexual behaviors are relatively crude as the number of
sexual partners may not reflect the number of instances an individual engaged in a particular

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sexual behavior in the recall period (six months) which may contribute to potential
misclassification of sexual risk behaviors. These measures do not account for a respondent
engaging in two or more of these sexual behaviors with the same partner in the recall partner,
which also may contribute to misclassification of risk.
Furthermore, height and weight were self-reported measures in this study and are subject
to inaccurate reporting, as individuals have been shown to over-report height and under-report
weight,55 and sexual minority men have been shown to significantly under-report their BMI.56
However, we believe that the desire to report more socially acceptable measurements was
minimized given the anonymous nature of data collection. In addition, while BMI is commonly
used in population-based studies, previous research has noted that it is an imperfect measure of
body composition that does not take into account body fat distribution or the ratio of muscle to
fat.57 For this reason, lean persons with high muscle mass can have high BMI values, 58 which
may lead to an overestimating of the number of overweight and obese participants in the sample.
Given that BMI may improperly classify those with muscular body types, we note that the
apparent patterns in weight misperception may, in part, be due to measurement error rather than
the cognitive process of misperception. Future research should incorporate objectively measured

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height and weight, along with other measures such as waist circumference and body fat
percentage to ensure accurate calculation of weight related measures.
CONCLUSIONS
To our knowledge, this study is the first to explore the influences of various dimensions
of body image (e.g. weight perception, body dissatisfaction, and self-objectification) on sexual

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sensation seeking and sexual risk behaviors among a sample of geosocial-networking

application-using MSM. Through their associations with sexual sensation seeking, selfobjectification, and body image dissatisfaction may in turn impact sexual risk taking behaviors
and risk for acquiring HIV and other STIs. By assessing associations between body
dissatisfaction and sexual risk taking behavior, this study adds support to a theory of syndemics
among MSM, which suggests that multiple synergistically-related biological, psychological,
social, and behavioral factors that disproportionately affect the health and health-related
behaviors (e.g. condomless sexual behaviors) of this population.59,60

Acknowledgements: The authors wish to thank the participants for their contributions to this
study. This work was funded by the Wilfred L. and Ruth S.F. Peltz Research Scholarship
through the New York University College of Arts and Science Deans Undergraduate Research
Fund (Principal Investigator: William C. Goedel). Dr. Dustin T. Duncan was supported by his
New York University School of Medicine Start-Up Research Fund to work on this project. The
authors have no financial interests to disclose.

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Table 1 Sample Demographics

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n (%)
Age
18 to 25 years old
26 to 30 years old
31 to 40 years old
41 to 50 years old
51 to 60 years old
61 to 70 years old
Sexual Orientation
Gay
Bisexual
Other
Race/Ethnicity
White (Non-Hispanic/Latino)
Black (Non-Hispanic/Latino)
Hispanic/Latino (Any Race)
Asian/Pacific Islander
Multiracial
Education
Less than 12th Grade
High School, or Equivalent
Some College
Technical/Vocational Training
Associate's Degree
Bachelors Degree
Masters Degree
Doctoral Degree
Employment Status
Working full time
Working part time
Not working
Student
Unable to work
Relationship Status
Yes
No
Individual Yearly Income
Under $25,000
$25,000 to $54,999
$55,000 to $84,999

34 (37.0)
17 (18.5)
19 (20.7)
18 (19.6)
3 (3.3)
1 (1.1)
71 (77.2)
20 (21.7)
1 (1.1)
58 (63.0)
18 (19.6)
9 (9.8)
3 (3.3)
4 (4.3)
2 (2.2)
11 (12.0)
21 (22.8)
4 (4.3)
7 (7.6)
33 (35.9)
11 (12.0)
3 (3.3)
52 (56.5)
15 (16.3)
12 (13.0)
11 (12.0)
2 (2.2)
23 (25.0)
69 (75.0)
33 (35.9)
37 (40.2)
14 (15.2)

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6 (6.5)
2 (2.2)

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$85,000 or higher
Missing

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Table 2 Cohens Kappa, Association Between Weight Perception and Current Weight
Classification
Perceived
Perceived
Perceived
Perceived
Underweight
Normal
Overweight
Obese
[n (%)]
Weight [n (%)]
[n (%)]
[n (%)]
4 (100.0)
0 (0.0)
0 (0.0)
0 (0.0)
Underweight BMI
9 (24.3)
20 (54.1)
8 (21.6)
0 (0.0)
Normal Weight BMI
0 (0.0)
15 (45.5)
19 (54.5)
0 (0.0)
Overweight BMI
1 (6.3)
1 (6.3)
11 (68.8)
3 (18.8)
Obese BMI
Note: = 0.256, p < .001

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Table 3 ANOVA, Mean Male Body Attitudes Scale Scores by Perceived Weight Classification (n
= 87)

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M (SD)
Male Body Attitudes Scale***
Underweight
Normal Weight
Overweight
Obese
Height Satisfaction Subscale***
Underweight
Normal Weight
Overweight
Obese
Body Fat Satisfaction Subscale***
Underweight
Normal Weight
Overweight
Obese
Muscularity Satisfaction Subscale
Underweight
Normal Weight
Overweight
Obese
Note: *** p < 0.001

2.70 (0.53)
2.66 (0.77)
3.47 (0.59)
3.65 (0.38)
2.92 (0.67)
2.63 (0.88)
3.43 (0.87)
2.50 (0.71)
1.95 (0.63)
2.68 (0.88)
4.00 (0.63)
4.44 (1.09)
3.35 (0.76)
2.84 (0.91)
3.15 (0.75)
3.30 (0.28)

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Table 4 ANOVA, Mean Sexual Sensation Seeking Scale Scores and Numbers of Sexual Partners

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by Perceived Weight Classification

M (SD)
Sexual Sensation Seeking Scale* (n = 90)
Underweight
29.54 (3.97)
Normal Weight
29.61 (4.52)
Overweight
31.70 (4.37)
Obese
25.67 (5.51)
Overall Sample
30.32 (4.52)
Number of Receptive Anal Intercourse Partners (n = 52)
Underweight
1.14 (1.75)
Normal Weight
3.00 (4.54)
Overweight
3.84 (7.39)
Obese
0.00 (0.00)
Overall Sample
2.96 (5.63)
Number of Insertive Anal Intercourse Partners (n = 59)
Underweight
1.70 (2.06)
Normal Weight
3.69 (5.80)
Overweight
5.10 (6.39)
Obese
1.67 (2.89)
Overall Sample
3.91 (5.68)
Number of Condomless Receptive Anal Intercourse Partners (n = 52)
Underweight
0.79 (1.31)
Normal Weight
1.54 (3.34)
Overweight
2.46 (6.14)
Obese
0.00 (0.00)
Overall Sample
1.76 (4.50)
Number of Condomless Insertive Anal Intercourse Partners (n = 59)
Underweight
0.80 (0.79)
Normal Weight
1.74 (4.75)
Overweight
2.34 (2.84)
Obese
1.67 (2.89)
Overall Sample
1.85 (3.62)
Note: * p < 0.05

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