Some gay men who have unprotected anal intercourse a avoid ejaculation-they
practise 'withdrawal'. Using data collected in 1997 from a sample of Sydne
y gay men (n=625), we explored the relation between men's practice of ejacu
lation and their use of condoms. We also investigated whether men who had u
nprotected withdrawal but not unprotected ejaculation were more likely to t
hink unprotected withdrawal was safe, liked condoms less, liked anal interc
ourse more, or were more sexually adventurous. Considering separately inser
tive and receptive anal intercourse with regular and with casual partners,
we found that the majority of men who practised unprotected withdrawal also
practised unprotected ejaculation. Of those whose only unprotected sex was
withdrawal ('true withdrawers'), most never used condoms (they did not als
o have protected sex with ejaculation). True withdrawers were compared with
men who had unprotected ejaculation, who always used condoms, who had no a
nal sex and who had no partners. Those who were true withdrawers with casua
l partners were more likely to believe withdrawal was safe; no group effect
s were found with regular partners. No significant differences in condom at
titudes were found. True withdrawers with regular partners liked anal inter
course less than other men, but true withdrawers with casual partners were
indistinguishable from those who had unprotected ejaculation. True withdraw
ers did not differ in sexual adventurousness from other men who had anal in
tercourse. Most withdrawers avoided anal sex with ejaculation rather than u
se condoms. Converting them into reliable condom users may be a considerabl
e challenge for health promotion.