title: Group Sex and Prevalent Sexually Transmitted Infections Among Men Who Have Sex with Men.
abstract: We evaluated the direct relation between group sex and prevalent sexually transmitted infections (STI) in a cross-sectional study of men who have sex with men (MSM) presenting at an urban STI clinic in the Midwestern US. Among 231 men who enrolled and reported that they have sex with men, we collected behavioral data using a combination of interviewer and self-administered surveys and extracted STI data from electronic health records. We used modified Poisson regression to examine the unadjusted and adjusted associations between group sex participation and prevalent STI. One-quarter of participants (n = 58) reported group sex participation in the last 3 months. Eighteen percent of participants (n = 42) had gonorrhea and 19 % (n = 45) had chlamydial infection. Men who reported recent group sex were more likely to be HIV-positive, to report recent drug use, and to report unprotected receptive anal intercourse in the past 3 months. After adjustment for age, race, and recent drug use, recent participation in group sex was associated with prevalent gonorrhea infection (prevalence ratio [PR] = 2.11, 95 % confidence interval [CI] = [1.13, 3.95]) but not chlamydia infection (PR = 1.03, 95 % CI = [0.58, 1.84]). We performed a sensitivity analysis in which we also adjusted for unprotected receptive anal intercourse and the results were not substantively changed. In summary, participation in group sex in the past 3 months was associated with a more than twofold increased prevalence of gonorrhea, but not with chlamydia. These findings support group sex participation as a potential contributor to increased STI prevalence.
authors.affiliation: Division of Epidemiology, College of Public Health, The Ohio State University, N1144 Doan Hall, 410 West 10th Ave., Columbus, OH, 43210, USA. rice.477@buckeyemail.osu.edu.
authors.forename: Cara E
authors.initials: CE
authors.lastname: Rice
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Courtney D
authors.initials: CD
authors.lastname: Lynch
authors.affiliation: Division of Epidemiology, College of Public Health, The Ohio State University, N1144 Doan Hall, 410 West 10th Ave., Columbus, OH, 43210, USA.|Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Alison H
authors.initials: AH
authors.lastname: Norris
authors.affiliation: Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Davis
authors.affiliation: Sexual Health Clinic, Columbus Public Health, Columbus, OH, USA.
authors.forename: Karen S
authors.initials: KS
authors.lastname: Fields
authors.affiliation: Sexual Health Clinic, Columbus Public Health, Columbus, OH, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Ervin
authors.affiliation: Division of Epidemiology, College of Public Health, The Ohio State University, N1144 Doan Hall, 410 West 10th Ave., Columbus, OH, 43210, USA.|Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Abigail Norris
authors.initials: AN
authors.lastname: Turner
mesh_terms: D000293:Adolescent; D000328:Adult; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D015995:Prevalence; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D055815:Young Adult
keywords: Chlamydia; Gonorrhea; Group sex; Men who have sex with men; Sexual orientation