Sex Transm Infect doi:10.1136/sti.2009.041954
  • Health services research

Older and swinging; need to identify hidden and emerging risk groups at STI clinics

Press Release
  1. Christian J P A Hoebe1,2
  1. 1Department of Infectious Diseases, South Limburg Public Health Service, Geleen, The Netherlands
  2. 2Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
  1. Correspondence to Dr Nicole H T M Dukers-Muijrers, Department of Infectious Diseases, South Limburg Public Health Service, PO Box 2022, 6160 HA Geleen, The Netherlands; nicole.dukers{at}
  1. Contributors ND analysed the data and wrote the manuscript; EB and AN contributed to the data collection; AN and CH organised STI clinic procedures; all authors contributed to the final draft of the manuscript.

  • Accepted 7 April 2010
  • Published Online First 24 June 2010


Background Identification of STI risk groups is essential for optimal prevention and medical care. Until now, swingers—that is, heterosexual couples who are practising mate swapping, group sex, visit sex clubs for couples, are not considered as a specific risk group for STI in healthcare services and prevention.

Objective To compare STI prevalence rates in swingers with that in other risk groups.

Methods At the STI clinic, South Limburg, The Netherlands, whether an attendee is a swinger has been systematically registered since 2007. STI clinic surveillance data were analysed to assess the swingers' share of consultations and STI diagnoses—here Chlamydia trachomatis (CT) and/or Neisseria gonorrhoea (NG).

Results Of 8971 consultations, 12% comprised swingers (median age 43 years, IQR 38–48). Overall, STI prevalence was highest in youth, men who have sex with men (MSM) and swingers. Older swingers had a CT prevalence of 10% and an NG prevalence of 4%. The share in STI diagnoses in the older age group (>45 years) comprised 55% for swingers and 31% for MSM.

Conclusions Swingers comprise a substantial proportion of STI consultations. They are a mainly older age group and form an important part of STI diagnoses. While other risk groups for STI, such as young heterosexuals and MSM, are systematically identified at STI healthcare facilities and provided with appropriate services, this is generally not the case for swingers. Swingers, like other groups with risk behaviours, need to be identified and treated as a risk group in STI prevention and care.


  • This paper has, in part, been presented at the 18th ISSTDR in conjunction with BASHH Congress in London, 28 June—1 July 2009 (P3.143).

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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