Oral, Vaginal and Anal Sexual Practices among Heterosexual Males and Females Attending a Sexual Health Clinic: A Cross-Sectional Survey in Melbourne, Australia

Sex practices among heterosexuals are not well studied. We aimed to explore sexual practices among heterosexuals attending a sexual health clinic. This cross-sectional survey was conducted at Melbourne Sexual Health Centre between March and April 2019. Data were collected on kissing, oral sex (fellatio or cunnilingus), vaginal sex, anal sex and rimming in the previous 3 months. Univariable and multivariable logistic regression analyses were performed to examine the associations between engaging in anal sex and other sex practices. There were 709 participants (333 men; 376 women) who were eligible and completed the survey (response rate was 24.6%). In the past 3 months, most participants had had vaginal sex (n = 677; 95.5%), with a mean of 3.0 (standard deviation (SD): 3.9) vaginal sex partners, and half reported engaging in condomless vaginal sex in the past 3 months (n = 358; 50.1%). A total of 135 (19.0%) participants had had anal sex, with a mean of 1.3 (SD: 1.0) anal sex partners, with 63.5% (n = 94) engaging in any condomless anal sex in the past 3 months. Most participants (n = 637, 89.8%) had received oral sex in the past 3 months; this proportion did not differ by age group or gender. Women (n = 351, 93.4%) were more likely to perform oral sex than men (n = 275; 82.6% men) (p < 0.001) and to have received rimming (26.6% women vs. 12.6% men; p < 0.001). Men were more likely to have performed rimming (25.5% men vs. 9.3% women; p < 0.001). After adjusting for age, number of partners and sexual practice, anal sex was associated with being ≥35 years (adjusted odds ratio (aOR): 2.3; 95% CI: 1.2–4.2), receiving rimming (aOR: 3.8; 95% CI: 2.4–6.0) and performing rimming (aOR: 2.8; 95% CI: 1.8–4.6). Rimming and anal sex are practiced by one-fifth or more of heterosexuals. Older heterosexuals were more likely to engage in anal sex and to perform rimming. Future research should consider the benefits of testing extragenital sites where appropriate.

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Early sexual experiences of teenage heterosexual males in Australia: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2017-016779 ◽

2017 ◽

Vol 7 (10) ◽

pp. e016779 ◽

Cited By ~ 4

Author(s):

Eric P F Chow ◽

Rebecca Wigan ◽

Anna McNulty ◽

Charlotte Bell ◽

Mandy Johnson ◽

...

Keyword(s):

Sexual Health ◽

Condom Use ◽

Sexual Debut ◽

Oral Sex ◽

Sexual Experiences ◽

Anal Sex ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Sexual Behaviours ◽

Vaginal Sex

ObjectiveThere are limited data on the patterns of early sexual behaviours among Australian teenage heterosexual boys. This study describes the nature and onset of early sexual experiences in this population through a cross-sectional survey.DesignA cross-sectional survey between 2014 and 2015SettingMajor sexual health clinics and community sources across AustraliaParticipantsHeterosexual men aged 17–19 yearsResultsThere were 191 men in the study with a median age of 19.1 years. Median age at first oral sex was 16.4 years (IQR: 15.5–17.7) and 16.9 years (IQR: 16.0–18.0) for first vaginal sex. Most men had engaged in oral sex (89.5%) and vaginal sex (91.6%) in the previous 12 months with 32.6% reporting condom use at last vaginal sex. Of the total lifetime female partners for vaginal sex reported by men as a group (n=1187): 54.3% (n=645) were the same age as the man, 28.3% (n=336) were a year or more younger and 17.4% (n=206) were a year or more older. Prior anal sex with females was reported by 22% with 47% reporting condom use at last anal sex. Median age at first anal sex was 18.2 years (IQR: 17.3–18.8). Anal sex with a female was associated with having five or more lifetime female sexual partners for oral and vaginal sex.ConclusionsThese data provide insights into the trajectory of sexual behaviours experienced by teenage heterosexual boys following sexual debut, findings which can inform programme promoting sexual health among teenage boys.

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Sexual practices of female sex workers in Melbourne, Australia: an anonymous cross-sectional questionnaire study in 2017–18

Sexual Health ◽

10.1071/sh19037 ◽

2020 ◽

Vol 17 (1) ◽

pp. 53 ◽

Cited By ~ 4

Author(s):

Annalisa Zappulla ◽

Christopher K. Fairley ◽

Basil Donovan ◽

Rebecca Guy ◽

Catriona S. Bradshaw ◽

...

Keyword(s):

Sexual Health ◽

Sex Workers ◽

Female Sex Workers ◽

Sexual Practices ◽

Consistent Condom ◽

Anal Sex ◽

Consistent Condom Use ◽

Cross Sectional ◽

Male Clients ◽

Vaginal Sex

Background Sexually transmissible infections (STIs) are rising among female sex workers (FSW) in Australia. The rise might be explained by changes in sexual practices; however, there is limited behavioural data available. This study aimed to explore the current sexual practices among FSW in Melbourne. Methods: This cross-sectional study was conducted among FSW at Melbourne Sexual Health Centre between September 2017 and March 2018. Participants were asked about current sexual practices with male clients in an average working week. The frequency and proportion of each sexual practice was calculated. Results: There were 180 questionnaires included in the analysis. The median age of the FSW was 28 years (interquartile range [IQR]: 25–34). Most FSW (80.6%) worked in brothels. In an average working week, FSW had a median of 10 (IQR: 7–20) male clients. The most common sexual practices included: vaginal sex (98.3%), fellatio (97.2%), cunnilingus (92.2%) and tongue-kissing (83.7%). FSW had a median number of 10 (IQR: 6–18) vaginal, 10 (IQR: 5–18) fellatio, 7 (IQR: 2–10) cunnilingus and 6 (IQR: 2–10) tongue-kissing clients. Consistent condom use with all clients was highest for vaginal sex (97.1%), followed by anal sex (92.3%), then fellatio (78.9%). Only 3.1% used dental dams consistently for cunnilingus. Conclusion: Consistent condom use with all clients was high among FSWs, especially for vaginal and anal sex. However, one-fifth of FSW had condomless fellatio during an average working week. Tongue-kissing was more common than previously published. Peer-led sexual health education on safe sex practice for FSW is of high importance.

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Age, ethnic and travel-related disparities in kissing and sexual practices among heterosexual men in Melbourne, Australia

Sexual Health ◽

10.1071/sh19230 ◽

2020 ◽

Vol 17 (3) ◽

pp. 279

Author(s):

Finley J. Charleson ◽

Christopher K. Fairley ◽

Jane S. Hocking ◽

Lenka A. Vodstrcil ◽

Catriona S. Bradshaw ◽

...

Keyword(s):

Negative Binomial ◽

Health Centre ◽

Significant Risk ◽

Significant Risk Factor ◽

Sexual Practices ◽

Transmission Risk ◽

Heterosexual Men ◽

Sex Partners ◽

Cross Sectional Survey ◽

Cross Sectional

Background The kissing practices of heterosexual men are not well understood, despite the potential of kissing to be a significant risk factor for gonorrhoea transmission. This study aimed to explore kissing and sex practices among heterosexual men. Methods: A cross-sectional survey among heterosexual men attending the Melbourne Sexual Health Centre in 2016–2017 was conducted. Men were asked to report their number of kissing-only (in the absence of sex), sex-only (in the absence of kissing) and kissing-with-sex partners in the last 3 months. The mean number of each partner type was calculated, and multivariable negative binomial regression was used to investigate associations between the number of different types of partners and demographic characteristics. Results: Of the 2351 heterosexual men, men reported a mean of 2.98 kissing-only, 0.54 sex-only and 2.64 kissing-with-sex partners in the last 3 months. Younger men had a mean higher number of kissing-only partners than older men (4.52 partners among men aged ≤24 years compared with 1.75 partners among men ≥35 years, P < 0.001). Men born in Europe had the most kissing-only partners (mean: 5.16 partners) and men born in Asia had the fewest kissing-only partners (mean: 1.61 partners). Men recently arrived in Australia, including travellers from overseas, had significantly more kissing-only partners (adjusted incidence rate ratio (aIRR): 1.53; 95% CI: 1.31–1.80) than local men. Conclusions: This study provides novel data about kissing practices of heterosexual men. Studies assessing oropharyngeal gonorrhoea should include measurements of kissing until studies can clarify its contribution to transmission risk.

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THE BUILT ENVIRONMENT INFLUENCED THE INCIDENCE OF FALLS IN OLDER ADULTS LIVING IN THE UNDERSERVED COMMUNITY

Innovation in Aging ◽

10.1093/geroni/igz038.1076 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S292-S292

Author(s):

Rie Suzuki ◽

Jennifer Blackwood ◽

Shailee Shah ◽

Sabah Ganai ◽

Kimberly Warden

Keyword(s):

Physical Activity ◽

Older Adults ◽

Built Environment ◽

Walking Distance ◽

Health Clinic ◽

Cross Sectional Survey ◽

Eligibility Criteria ◽

Cross Sectional ◽

The Past ◽

Underserved Community

Abstract The built environment is commonly cited as a facilitator to local walking. Although health promotion programs targeting physical activity are available, few studies have investigated the associations of the perceived neighborhoods with the incidence of falls in the minority communities. Hence, the purpose of this preliminary study was to understand whether the perceived built environment influenced the fall experiences in older adults living in the underserved community. The preliminary cross-sectional survey was conducted at the regional health clinic in Flint, MI. Descriptive statistics and analysis of variance (ANOVA) were performed using SAS v8.4. The eligibility criteria included over 65 years old and Flint residents. Of 132 participants, the mean age was 69.75 (SD=5.00). The majority were female (68%), African Americans (80%), single, divorced or widowed (80%), and > GED (84%). The ANOVAs supported that “had fallen in the past year” was associated with “stores are within easy walking distance,” “easy to walk to a transit stop” and “there is a dirt strip that separates the streets from the sidewalks.” The fall experience was more likely to associate with the sedentary lifestyle and the comorbidities such as diabetes, fatigues, muscle spasms, and chronic pain. To summarize, the built environment increased the incidence of falls in the past year. Those who had fallen had poor health conditions. Further studies are needed for older adults to engage in physical activity. It is essential to develop the age-friendly support systems and accommodations to local walking in this community.

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A Cross-Sectional Survey on Attitudes of Men Who Have Sex With Men Towards Anal Self-Examination for Detection of Anal Syphilis

10.21203/rs.3.rs-625835/v1 ◽

2021 ◽

Author(s):

Ei T Aung ◽

Christopher K Fairley ◽

Jason J Ong ◽

Tiffany P Phillips ◽

Marcus Y Chen ◽

...

Keyword(s):

Secondary Syphilis ◽

Health Clinic ◽

Median Frequency ◽

Anal Sex ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Future ◽

Receptive Anal Sex ◽

Sex With Men ◽

Self Examination

Abstract Studies suggest men who have sex with men (MSM) practising receptive anal sex are more likely to present with secondary syphilis, implying primary anorectal lesions are likely to be missed. If men could detect anorectal lesions in the primary stage by regular anal self-examination (ASE), transmission could be reduced by early diagnosis and treatment. We aimed to explore the attitudes of MSM on performing ASE to detect primary anorectal syphilis. An online anonymous cross-sectional survey among MSM over 18 years of age living in Australia, was conducted between July and November 2020 and recruitment was from a sexual health clinic and social media. A total of 574 MSM completed the survey (median age: 34 [IQR 27–45]): 32% (183) had previously performed ASE. Among 56% (374) who had never performed ASE, 68% (250) would consider performing ASE in the future with a preferred median frequency of 2 times per 4 weeks (IQR: 1–4), whilst men who were already performing ASE were performing it at median 1 per 4 weeks (IQR: 0.2-3). Almost two-thirds of MSM who had never performed ASE were willing to adopt ASE practice in the future. Studies are required to determine the effectiveness of ASE for syphilis detection.

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Sexual health and the Rugby World Cup 2011: a cross-sectional study of sexual health clinics in New Zealand

Sexual Health ◽

10.1071/sh12076 ◽

2012 ◽

Vol 9 (5) ◽

pp. 466 ◽

Cited By ~ 5

Author(s):

Rebecca Psutka ◽

Patricia Priest ◽

Nigel Dickson ◽

Jennie Connor ◽

Sunita Azariah ◽

...

Keyword(s):

New Zealand ◽

Sexual Health ◽

Chlamydial Infection ◽

Cross Sectional Study ◽

Health Clinic ◽

Cross Sectional Survey ◽

World Cup ◽

Cross Sectional ◽

Increased Risk ◽

Sexual Health Clinics

Background We aimed to describe the characteristics of sexual health clinic (SHC) attendance and sexually transmissible infection (STI) diagnoses during the Rugby World Cup (RWC) in New Zealand in 2011. Methods: SHC attendance and STI diagnoses around the time of the RWC were compared with the 5 preceding years. A cross-sectional survey conducted at SHCs in four New Zealand cities collected information from attendees having RWC-related sex. Results: Although there was no statistically significant increase in clinic attendance or STI diagnoses during the RWC compared with previous years, in these four cities, 151 individuals of 2079 attending SHCs for a new concern reported RWC-related sex. The most frequently diagnosed STIs were chlamydial infection (Chlamydia trachomatis), genital warts and genital herpes. Most attendees (74%) who had RWC-related sex had consumed three or more alcoholic drinks; 22% had used a condom. Seven percent of women reported nonconsensual sex. RWC-related sex was associated with an increased risk of STI diagnoses in men: gonorrhoea (Neisseria gonorrhoeae): relative risk (RR) = 4.9 (95% confidence interval (CI): 2.1–11.4); nonspecific urethritis: RR = 2.8 (95% CI: 1.3–5.9); chlamydial infection: RR = 1.8 (95% CI: 1.1–2.9). Using a condom was associated with a reduced risk (RR = 0.3, 95% CI: 0.1–0.9) of diagnosis with any STI among those having RWC-related sex. Conclusions: These findings highlight issues that are amenable to prevention. The continued promotion of condoms as well as a reduction in the promotion and availability of alcohol at such events may reduce sexual health risks as well as other harm.

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The prevalence of excessive alcohol consumption and the acceptability of brief advice in a sexual health clinic: cross sectional survey

Sexually Transmitted Infections ◽

10.1136/sti.2003.008938 ◽

2004 ◽

Vol 80 (5) ◽

pp. 416-417 ◽

Cited By ~ 9

Author(s):

M J Crawford

Keyword(s):

Alcohol Consumption ◽

Sexual Health ◽

Health Clinic ◽

Cross Sectional Survey ◽

Excessive Alcohol Consumption ◽

Cross Sectional ◽

Excessive Alcohol ◽

Brief Advice

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Do gay and bisexual men who conceal their same-sex behavior prefer different kinds of health services? Findings across four cities to inform client-centered HIV prevention in China

BMC Public Health ◽

10.1186/s12889-019-7990-8 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Rong Fu ◽

Bryan A. Kutner ◽

Yumeng Wu ◽

Lu Xie ◽

Siyan Meng ◽

...

Keyword(s):

Health Service ◽

Health Services ◽

Sexual Health ◽

Health Clinic ◽

Sex Behavior ◽

Bisexual Men ◽

Same Sex ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Sexual Health Service

Abstract Background In China, addressing disparities in the HIV epidemic among men who have sex with men (MSM) requires targeted efforts to increase their engagement and retention in prevention. In an effort to advance MSM-friendly HIV services within China, and informed by community-based partnerships, we tested whether MSM who have ever versus never disclosed their same-sex behavior to healthcare providers (HCP) differ in sociodemographic and behavioral characteristics as well as the qualities of sexual health services each group would prefer to access. Methods We conducted a cross-sectional survey among HIV-negative MSM who went to MSM-focused voluntary counseling and testing clinics in four cities in China. The survey was anonymous and collected information on sociodemographic characteristics, testing behaviors, sexual-health related behavior, and sexual health service model preferences. Results Of 357 respondents, 68.1% participants had ever disclosed same-sex behavior to HCPs when seeking advice for sexual health. Younger age (aOR = 1.04; 95% CI: 1.01-1.08), and worry of HIV acquisition (aOR = 1.39; 95% CI: 1.05–1.84) were associated with higher odds of past disclosure. The availability of comprehensive sexual health services was one of the most valued characteristics of the ideal sexual health clinic. Those who ever disclosed and never disclosed differed significantly in their ranking of the importance of three out of ten dimensions: sexual health counseling services available (M = 3.99 vs. M = 3.65, p = .002), gay identity support available (M = 3.91 vs. M = 3.62, p = .016) and clinic collaborates with a gay CBO (M = 3.81 vs. M = 3.56, p = .036). Conclusions Our hypothesis that MSM who had disclosed versus never disclosed same-sex behavior would differ in the value they placed on different dimensions of sexual health service was partially borne out. As health authorities in China decide on implementation models for pre-exposure prophylaxis (PrEP) delivery and specifically within which institutions to integrate PrEP services, the preferences of target populations should be considered to develop comprehensive, patient-centric and LGBT-friendly services.

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HIV risk practices sought by men who have sex with other men, and who use internet websites to identify potential sexual partners

Sexual Health ◽

10.1071/sh07051 ◽

2008 ◽

Vol 5 (3) ◽

pp. 243 ◽

Cited By ~ 15

Author(s):

Hugh Klein

Keyword(s):

Sexual Risk ◽

Unprotected Sex ◽

Sexual Practices ◽

Oral Sex ◽

Sex Partners ◽

Anal Sex ◽

Multiple Partner ◽

Hiv Intervention ◽

Risk Practices ◽

The Usa

Men who have sex with men (MSM) account for the largest number of persons diagnosed with AIDS in the USA, with higher than average rates of drug use and unprotected sex being cited as the principal reasons underlying their high rates of HIV infection. Recent evidence has suggested that the use of websites specifically designed to promote unsafe sexual practices may be particularly common among MSM, thereby fostering their risky behaviours. In light of these findings, the present study is based on a content analysis of 1316 ads/profiles posted on one of the most popular MSM websites that specifically fosters unprotected sex. Ads/profiles were selected randomly based on the American ZIP code of residence. Data were collected between September 2006 and January 2007. Rates of advertised for high-risk sexual behaviours were very high, particularly for oral sex involving ejaculation into the mouth (88.0% for receptive oral sex, 77.4% for insertive oral sex), anal sex involving ejaculation into the anus (79.7% for insertive anal sex, 69.4% for receptive anal sex), multiple partner sex (77.9%) and felching (16.5%). A multivariate analysis of the correlates of sexual risk preferences identified seven factors that were related to a propensity towards enhanced sexual risk: younger age (β = 0.12, P = 0.0001), not being African American (β = 0.05, P = 0.0341), self-identification as a sexual ‘bottom’ (β = 0.20, P = 0.0001), not caring about one’s potential sex partners’ HIV serostatus (β = 0.15, P = 0.0001), preferring to have sex while under the influence of drugs (β = 0.08, P = 0.0022), a greater involvement in and commitment to the use of the website to locate potential unprotected sex partners (β = 0.16, P = 0.0001) and not being HIV-negative (β = 0.08, P = 0.0081). The HIV intervention-related implications of these findings are discussed.

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Performance of a tool to identify different types of self-reported sexual risk among women attending a contraception and sexual health clinic: results of a cross-sectional survey

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2019-200482 ◽

2020 ◽

pp. bmjsrh-2019-200482

Author(s):

Natalie Edelman ◽

Jennifer Whetham ◽

Jackie Cassell ◽

Richard de Visser ◽

Catherine Mercer ◽

...

Keyword(s):

Sexual Health ◽

Sexual Risk ◽

Prediction Rule ◽

Clinical Prediction Rule ◽

Psychosocial Interventions ◽

Self Report ◽

Health Clinic ◽

Cross Sectional Survey ◽

Sexual Risks ◽

Cross Sectional

IntroductionA clinical prediction rule (CPR) using psychosocial questions was previously derived to target sexual healthcare in general practice by identifying women at risk of unintended pregnancy (UIP) and sexually transmitted infections (STIs). This psychosocial CPR may help target resources within contraception and sexual health (CASH) services. This study investigated how well it predicted recent self-reported risk of UIP and STI acquisition among women attending a CASH clinic.MethodsFemale patients aged 16–44 years attending a CASH clinic in South-East England were offered a questionnaire on arrival. This comprised psychosocial questions, and others addressing three sexual risks: (1) two or more male sexual partners in the last year (2+P), (2) risk of STI acquisition through most recent partner and (3) risk of UIP in the last 6 months. A CPR score was calculated for each participant and cross-tabulated against self-report of each sexual risk to estimate CPR sensitivity and specificity.ResultsThe psychosocial questions predicting 2+P had sensitivity 83.2% (95% CI 79.3% to 86.5%) and specificity 56.1% (95% CI 51.3%−60.6%). Those predicting combined 2+P and/or risk of STI acquisition through most recent partner had a sensitivity of 89.1% (95% CI 85.7%−91.8%) and specificity of 43.7% (95% CI 39.0%−48.5%). Questions predicting risk of UIP in the last 6 months had a sensitivity of 82.5% (95% CI 78.6%−86.0%) and specificity of 48.3% (95% CI 43.4%−53.1%).ConclusionsThe CPR demonstrated good sensitivity but low specificity, so may be suited to triaging or stratifying which interventions to offer CASH patients and by which mode (eg, online vs face-to-face). Further investigation of causal links between psychosocial factors and sexual risk is warranted to support development of psychosocial interventions for this patient group.

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