Heterosexual Young Adults' Interest, Attitudes, and Experiences Related to Mixed-Gender, Multi-Person Sex

There has been little research on threesomes, a form of multi-person sex that involves sexual activity with two other people simultaneously. Therefore, we examined young adults' attitudes toward, interest in, and experiences with one form of threesome, mixed-gender threesomes (MGTs), defined as sexual activity involving three people where at least one member of each gender is present. 

Participants were 274 (202 women, 72 men) heterosexual young adults who completed an online survey. Overall, 13 % of participants (24 % of men and 8 % of women) reported experience and 64 % reported some interest in engaging in an MGT. However, the overall level of interest was quite low and varied according to contextual variables (i.e., what other persons were involved). 

Men's interest remained unaffected by third person status as long as the MGT involved familiar others (friends and acquaintances) rather than strangers, whereas women preferred familiar others only for MGTs with which they were the third person, not for those involving a romantic partner. 

Participants also reported fairly neutral attitudes toward MGTs. Compared to the women, the men reported significantly more positive attitudes and greater interest, and were more likely to report MGT experience. In addition, attitudes, interest, and experience were all positively associated with each other. 

Taken together, these results suggest that young people are not judgmental about others engaging in MGTs but are not highly motivated to do so themselves. Implications for researchers and sexual health educators are discussed.

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By:  Thompson AE1, Byers ES2.

• 1Department of Psychology, University of Wisconsin Oshkosh, 800 Algoma Blvd., Oshkosh, WI, 54901, USA. thompsae@uwosh.edu.
• 2Department of Psychology, University of New Brunswick, POB 4400, Fredericton, NB, E3B 3A1, Canada. 
• Arch Sex Behav. 2016 Mar 4. 

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Beyond Anal Sex: Sexual Practices of Men Who Have Sex with Men and Associations with HIV and Other Sexually Transmitted Infections

INTRODUCTION:

Unprotected anal intercourse is often used as a single indicator of risky behavior in men who have sex with men (MSM), yet MSM engage in a variety of behaviors that have unknown associations with sexually transmitted infection (STI) and HIV.

AIM:

To assess the prevalence of a wide range of sexual behaviors and their associations with prevalent STI and HIV.

METHODS:

We used a standardized, self-administered survey to collect behavioral data for this cross-sectional study of 235 MSM seeking care in a public clinic for sexually transmitted diseases.

MEAN OUTCOME MEASURES:

Using modified Poisson regression, we generated unadjusted and adjusted prevalence ratios (PRs) to characterize associations between recent participation in each behavior and prevalent STI and HIV.

RESULTS:

Participants' median age was 26 years. One third (35%) were positive for STI. STI prevalence was significantly associated with using sex slings, felching, group sex, fisting, anonymous sex, and sex toys. HIV prevalence was 17% and was significantly associated with fisting, felching, enemas, and group sex.

CONCLUSION:

Multiple behaviors were significantly associated with prevalent STI and HIV in adjusted analyses. To provide a more comprehensive understanding of sexual risk in MSM, prospective studies are needed to examine whether these behaviors are causally associated with HIV and STI acquisition.

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By:  Rice CE1, Maierhofer C2, Fields KS3, Ervin M3, Lanza ST4, Turner AN2.

• 1Department of Biobehavioral Health, The Methodology Center (https://methodology.psu.edu/), College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA. Electronic address: cer5374@psu.edu.
• 2Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, OH, USA.
• 3Sexual Health Clinic, Columbus Public Health, Columbus, OH, USA.
• 4Department of Biobehavioral Health, The Methodology Center, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA. 
• J Sex Med. 2016 Feb 4. pii: S1743-6095(16)00074-6. doi: 10.1016/j.jsxm.2016.01.001.

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Is Group Sex a Higher-Risk Setting for HIV and Other Sexually Transmitted Infections Compared with Dyadic Sex among Men Who Have Sex with Men?

BACKGROUND:

Group sex has been suggested as a potential high-risk setting for HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM). We investigated whether group sex is associated with lower condom use during anal sex and higher proportions of STIs compared with dyadic sex among HIV-negative MSM between 2009 and 2012.

METHODS:

Cross-sectional data from 7 data waves of the Amsterdam Cohort Studies were used. The sample consisted of 465 MSM who either reported both group and dyadic sex (at n = 706 visits) or dyadic sex only (at n = 1339 visits) in the preceding 6 months. Logistic regression with generalized estimating equations was used to investigate the association between sexual setting (group vs. dyadic sex), condomless anal sex, and STI.

RESULTS:

Group sex was reported at 35% (706/2045) of visits. Condomless sex was more often reported during dyadic than group sex (odds ratio, 3.64 95% confidence interval, 2.57-5.16). Men who had group sex were more likely diagnosed as having gonorrhea compared with men with dyadic sex (odds ratio, 1.71; 95% confidence interval, 1.08-2.97), but this effect was not retained in the multivariate model.

CONCLUSIONS:

Results demonstrate within-person differences in sexual behavior during group and dyadic sex among MSM. Men were more likely to use condoms during group sex than during dyadic sex. Thus, for some, group sex may not necessarily be risky for HIV infection compared with dyadic sex. However, group sex may be a higher-risk setting for acquiring STIs other than HIV, such as gonorrhea. Group sex encounters should be recognized as distinct sexual settings with specific risk characteristics that need to be addressed accordingly.

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By:  van den Boom W1, Davidovich U, Heuker J, Lambers F, Prins M, Sandfort T, Stolte IG.

• 1From the *Department of Infectious Diseases Research and Prevention, Public Health Service Amsterdam, Amsterdam, the Netherlands; †Department of Infectious Diseases, Tropical Medicine and AIDS, CINIMA, Academic Medical Center, Amsterdam, the Netherlands; and ‡HIV Center for Clinical and Behavioral Studies, Department of Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY. 

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Sexual Behaviours, Sex Toy & Sexual Safety Methods Reported by Women Who Have Sex with Women & Men

Background: 
Relative to women who engage in sex with exclusively men or women, women who have sex with women and men (WSWM) are more likely to report a history of sexually transmissible infections. Knowledge of the diversity and specificity of the sexual behaviours in which they engage may provide insight into the behavioural modes of infection. The present study sought to document a range of behaviours including concurrent multi-person sexual activity (e.g. orgy, threesome), anal sexual activity and sex toy use. Barrier use methods during specific behaviours were also assessed. 

Methods: Eighty women who reported recent genital contact with at least one man and one woman were recruited via targeted Internet, venue-based and snowball sampling methods. Consenting participants were directed to an online survey. During an in-person timeline follow-back interview (the SEQUENCE© calendar method), a subset of participants (n = 53) provided detailed sexual behaviour data for each sexual partner over the previous 12 months. 

Results: Almost three-quarters of the sample reported at least one concurrent multi-person sexual activity. Nearly two-thirds of participants reported engaging in sexual behaviour that involved their own (66.7%) or their partner's (49.4%) anus in the past year. Barrier use for sexual behaviours other than penile-vaginal intercourse was uncommon. Behaviours and safety strategies were similar with men and women regardless of partner gender. 

Conclusions: The sexual repertoires reported by participants in this study were diverse. Understanding the range of diverse sexual behaviours of the participants may enable the construction of tailored recommendations for sexual health maintenance among WSWM.

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By:   Vanessa Schick A E, Brian Dodge B, Barbara Van Der Pol C, Aleta Baldwin B and J. Dennis Fortenberry D 

A University of Texas Health Science Center at Houston, Division of Management, Policy, and Community Health, School of Public Health, 1200 Pressler Street, Rm E-917, Houston, TX 77030, USA. 

B Indiana University - Bloomington, Center for Sexual Health Promotion, 1025 E.7th Street SPH 116, Bloomington, IN 47405, USA. 

C University of Alabama at Birmingham, Division of Infectious Diseases, 1900 University Boulevard, Birmingham, AL 35294, USA. 

D Indiana University School of Medicine, Division of Adolescent Medicine, 410 West 10th Street, Indianapolis, IN 46202, USA. 

E Corresponding author. Email: Vanessa.Schick@uth.tmc.edu 

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Characteristics Associated with Group Sex Participation among Men & Women in the Club Drug Scene

This study examined the demographics, substance use and sexual risk behaviours associated with group sex (GS) participation among a sample of club drug users (n = 498) in Miami. 

Men and women reported histories of GS. Group sex participation among men and women was associated with heroin and injection drug use, trading or selling sex, and sex while high, compared with no GS participation. Moreover, among men, GS was associated with buying sex and sex with an injection drug user; among women, GS was associated with substance dependence, a history of sexually transmissible infections and crack cocaine use, compared with no GS participation.

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By: Buttram ME, Kurtz SP.
Center For Applied Research on Substance Use and Health Disparities, 2 NE 40th Street, Suite 404 Miami, FL 33137, USA.