A Worldwide Internet Study Based on Implicit Association Test Revealed a Higher Prevalence of Adult Males' Androphilia than Ever Reported Before

Background: Social constrictions or the lack of a clear awareness about one's sexual orientation may influence the ability of individuals to explicitly declare their sexual preferences. Thus, the actual prevalence of males’ sexual attraction toward adult males, which is estimated by studies relying only on explicit questionnaires, may be biased. Conversely, the implicit measurement of androphilia may be a promising method to obtain more reliable data. Aim: In the present work, explicit and implicit methods have been used to investigate the rates of explicit nonheterosexuality and implicit androphilia in a large sample of adult males from all around the world. For implicit androphilia, a rate consistent across the continents and close to that predicted by recent genetic models (about 15%) was expected. In contrast, for self-declared homosexuality, a lower and more variable rate was expected. Methods: A sample of 1,050 participants was recruited through an online platform. All participants completed a short biographical questionnaire, an Autobiographical-Implicit Association Test, the Sexual Preference-Implicit Association Test, and an explicit measure of sexual orientation. The answers to these measures were used to explore explicit sexual orientation and implicit androphilia across six main geographical areas (Middle East and Africa, South America, North America, Asia, Europe, and Oceania). Outcomes: The main outcome measures were the D score at the Sexual Preference-Implicit Association Test and the scores at the explicit measure of sexual orientation. Results: The rate of nonheterosexuality, which can be found using explicit measures, is rather low, variable (from 6.3% to 11.4%), and influenced by cultural factors. In contrast, the prevalence of androphilia resulting from implicit methods is higher and consistent across geographical areas (from 14.4% to 17.6%). Clinical Implications: Studying the diffusion of adult males’ androphilia may be useful to better understand sexual behaviors and preferences and to develop effective health promotion programs among males who have sex with males. Strengths & Limitations: The large and cross-cultural sample and the use of both implicit and explicit measures allowed for obtaining a detailed picture of adult males’ sexual orientation and androphilia. The main limitations were the Web-based characteristics of the protocol and the lack of an investigation of actual sexual behaviors. Conclusion: Compared with the explicit measurement of nonheterosexuality, the implicit measurement of sexual preferences showed a prevalence of androphilia among adult males that is higher, more stable across continents, and more consistent with the predictions of recent genetic models. Colledani D, A. Camperio Ciani Worldwide Internet Study Based on Implicit Association Test Revealed a Higher Prevalence of Adult Males' Androphilia than Ever Reported Before. J Sex Med 2021;18:4–16.