Substance use, sexual behaviour and prevention strategies of Vancouver gay and bisexual men who recently attended group sex events

Abstract

Group sex events are epidemiologically important part of some gay and bisexual men's sexual culture in Canada. Associated with condomless anal intercourse and polysubstance use, such events have been cited as disproportionally contributing to HIV infection rates. We analysed questionnaire data from the Momentum Health Study in Vancouver, Canada to understand substance use, sexual behaviour, psychosocial variables (Sexual Sensation Seeking, Sexual Escape Motivation, and Treatment Optimism), and HIV prevention strategies (sero-sorting, strategic positioning, avoiding anal sex, disclosure, treatment as prevention) of men attending such events, which were defined as group (n≥4 partners) sex parties, blackout events, and darkrooms. Analysis by multivariable logistic regression compared men attending group sex events within the past 6 months (n=180) with non-attendees (n=539). Results showed that attendees reported 1) significantly higher use of sex drugs and alcohol consumption, 2) higher scores on the Sexual Sensation Scale, more anal sex partners, greater odds of any condomless anal sex with sero-discordant partners, and greater odds of reporting fisting and sex toy use, and 3) different prevention practices that varied by HIV-serostatus. Findings are interpreted in light of the importance of pleasure, sociality, and HIV/STI prevention strategies associated with group sex events. Findings contribute to the development of appropriate education and intervention for attendees.

Sexual Sensation Seeking: A Validated Scale for Spanish Gay, Lesbian and Bisexual People

“…That is, weekly group sex events, developed in private houses, where drug consumption is common 41 . Participation in these group sexual encounters has been associated with higher scores in SSS, more substance use, higher number of anal intercourse, less predisposition to condom use during these encounters and more frequency of other sexual practices such as fisting or sexual toys use 42 .…”

Chemsex behaviours among men who have sex with men: A systematic review of the literature

“…Thirteen of the studies examined elements of the environments and related drug use patterns linked to chemsex related behaviors (Ober et al, 2009;Prestage et al, 2009;Grov et al, 2013;Bourne et al, 2015;Rich et al, 2016a;Rich et al, 2016b;Gilbart et al, 2015;Deimel et al, 2016;Melendez-Torres et al, 2016;Ahmed et al, 2017, Melendez-Torres, 2017Rusow et al, 2017, Bowden-Jones, 2017. Most of these studies involved specific samples of MSM; five focused on varying elements of drug using MSM and three on MSM who engaged in group sex or multi-partner sexual encounters.…”

“…In comparison, a more recent study from a UK club drug clinic highlighted that 75% of the MSM sample had used the primary chemsex related drugs (mephedrone, methamphetamine, GHB/GBL) to facilitate sex (Bowden-Jones et al, 2017). Three studies indicated that consumption of varying stimulants occured at group sex events, which could include methamphetamine, GHB/GBL, mephedrone, ecstacy, cocaine and ketamine (Grov et al, 2013;Rich et al, 2016a;Prestage et al, 2009). Three studies reported that between 14%-26% of MSM attending sex parties consumed erectile disorder drugs (EDDs) and within two studies EDDs were more likely to be associated with methamphetamine use (Gilbart et al, 2015;Melendez-Torres, 2016;Prestage et al, 2009).…”

“…Four studies reported that within chemsex related behaviour HIV positive MSM were more likely to sero-sort and engage in CAI with HIV positive partners (Gilbart et al, 2015;Bourne et al, 2015;Melendez-Torres et al, 2016;Rich et al, 2016a). One study found that there was less incidence of CAI at sexual encounters when partner HIV status was sero-discordant or unknown (Melendez-Torres et al, 2017).…”

Breakage is the norm: use of condoms and lubrication in anal sex among Black South African men who have sex with men

“…A study of young gay men in Hong Kong similarly found trust vs. mistrust and steady vs. casual partnership to be factors that worked both ways in terms of engaging in either condom use or having condomless anal sex (Yeo and Fung 2015). Lastly, a recent analysis of longitudinal data regarding gay and bisexual men in Western Canada acknowledge that group sex presents ‘a unique risk environment’, in which consistent condom use is increasingly difficult when men have multiple partners in one setting (Rich et al 2016). …”