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

Tiffany R Phillips,Christopher K Fairley,Heidi Constantinou,Marcus Y Chen,Kate Maddaford,Eric P F Chow,Catriona S Bradshaw,Jane S Hocking

doi:10.3390/ijerph182312668

Abstract

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.

Highlights

IntroductionTransmitted infections (STIs), such as gonorrhoea and syphilis, have been on the rise in heterosexuals in the last decade in Australia [1,2,3] and other developed countries [4,5]
We found that one-fifth of participants had engaged in anal sex and receptive rimming in the previous three months, and a majority of those who engaged in anal sex had condomless anal sex
While our study does not have sufficient power to compare anal sex practice between those aged 16 and those aged 24, our findings showed a similar age pattern with a higher proportion of older individuals engaging in anal sex and insertive rimming compared to younger heterosexuals

Summary

Introduction

Transmitted infections (STIs), such as gonorrhoea and syphilis, have been on the rise in heterosexuals in the last decade in Australia [1,2,3] and other developed countries [4,5]. There was a 10% increase in HIV notifications for heterosexuals in Australia between 2013 and 2017 [6]. Despite these rises, much of the behavioural surveillance data on sexual practices focuses on men who have sex with men (MSM). The most recent comprehensive report of heterosexual sex practices in Australia, to our knowledge, was the Second Australian Study of Health and Relationships (ASHR2), a representative survey of the general population in 2011–2012 [7], which was almost 10 years ago

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