title: Sexual behaviours, sex toy and sexual safety methods reported by women who have sex with women and men.
abstract: 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.
authors.affiliation: 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.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Schick
authors.affiliation: Indiana University - Bloomington, Center for Sexual Health Promotion, 1025 E.7th Street SPH 116, Bloomington, IN 47405, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Dodge
authors.affiliation: University of Alabama at Birmingham, Division of Infectious Diseases, 1900 University Boulevard, Birmingham, AL 35294, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Van Der Pol
authors.affiliation: Indiana University - Bloomington, Center for Sexual Health Promotion, 1025 E.7th Street SPH 116, Bloomington, IN 47405, USA.
authors.forename: Aleta
authors.initials: A
authors.lastname: Baldwin
authors.affiliation: Indiana University School of Medicine, Division of Adolescent Medicine, 410 West 10th Street, Indianapolis, IN 46202, USA.
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry