Introduction: Group sex among gay men has been associated with other HIV risk behaviours. Gay men who engage in group sex may be at increased risk of infection with HIV and other sexually transmitted infections (STI).
Methods: The Three or More Study (TOMS) of group sex among gay men utilised an anonymous, self-completed survey about participants’ most recent occasion of group sex with other men and in-depth interviews with a small number of these survey participants. The 436 men who reported having engaged in group sex within the previous month were included in these analyses.
Results: Among 436 men who engaged in group sex within the previous month, 32.5% reported unprotected anal intercourse (UAI) with non-regular, mostly HIV non-seroconcordant partners at this recent group sex encounter (GSE) and the majority reported other sex practices that are risk factors for STI other than HIV. Over one-third reported having been tested for HIV or other STI since their last GSE; those who had engaged in UAI at the GSE were more likely to have been tested (p = 0.008). Men who had a doctor with whom they were able to discuss their group sex activities had received a broader range of STI tests (p = 0.003).
Conclusion: Sex practices that risk the transmission of STI were common within this high-risk sample, whereas awareness of risk and the need for testing was high but not universal. Frank discussion with doctors of patients’ group sex behaviour also enhanced decisions about adequate testing. Gay men in group sex networks are an appropriate priority for sexual health screening.
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Funding: Supported by the New South Wales Health Department (Sydney). The National Centre in HIV Epidemiology and Clinical Research and the Australian Research Centre in Sex Health and Society receive funding from the Commonwealth Department of Health and Ageing. The Three or More Study was partly supported by the New South Wales Health Department. This funding agency had no further role in the study design, in the collection, analysis and interpretation of data, in the writing of the report or in the decision to submit the paper for publication.
Competing interests: None.
Ethics approval: Ethics approval was obtained.
Contributors: GPP and JH designed the TOMS study and wrote the protocol. GPP managed the literature searches and summaries of previous related work. GPP undertook the statistical analysis and wrote the first draft of the manuscript. All authors contributed to and have approved the final manuscript.