Sex On Premises Venues Research Articles

Sexual network characteristics and partnership types among men who have sex with men diagnosed with syphilis, gonorrhoea and/or chlamydia in Lima, Peru

ObjectivesSexual networks are known to structure sexually transmitted infection (STI) transmission among men who have sex with men (MSM). We sought to estimate the risks of STI diagnosis for various...

Brief Report: Group Sex Among Men Who Have Sex With Men in the Era of PrEP: A Cross-Sectional Study.

Group sex has been commonly reported among gay and bisexual men who have sex with men (GBMSM); however, there are limited studies on the factors associated with participating in group sex. A cross-sectional study among GBMSM attending a sexual health clinic in Melbourne, Australia. Univariable and multivariable logistic regression were performed to examine the association between GBMSM participating in group sex in the previous 3 months and their demographic characteristics, including age, pre-exposure prophylaxis (PrEP) use, HIV status, any STI (gonorrhea, chlamydia, syphilis) diagnosis on the day, and method of seeking partners. There were 357 GBMSM who participated in the survey and their mean age was 32.9 years (SD = 10.9). Almost a third (n = 115; 32.2%) had participated in group sex in the previous 3 months. GBMSM who sought sex partners at sex on premises venues (SOPVs) [aOR 5.83; 95% confidence interval (CI): 3.23 to 10.53] had the highest odds of group sex participation after adjusting for other potential confounders. Compared with GBMSM not living with HIV and not taking PrEP, GBMSM taking PrEP had higher odds of group sex participation (aOR 2.09; 95% CI: 1.05 to 4.15), but GBMSM living with HIV did not (aOR 0.93; 95% CI: 0.23 to 3.68).Recent group sex participation was not associated with being diagnosed with any STI (chlamydia, syphilis, or gonorrhea) on the day in the adjusted analyses. PrEP users and MSM attending SOPVs are more likely to participate in group sex. SOPV could be important venues for future public health campaigns.

Cross-sectional study of sexual behaviour and health of gay and bisexual men in suburban Sydney, New South Wales, Australia: contrasts between sex venue and clinic attendees.

Men attending a SOPV during onsite HIV/STI screening from November 2015 for 12 months were compared with MSM attending a local SHC for screening. Each group completed a self-administered questionnaire and STI/HIV testing. Data analysis was performed using SPSS. Compared with SHC participants (n = 108), SOPV participants (n = 84) had a higher median age (47 years [range, 22-88] vs 33 years [range, 19-71]; P < 0.001) and less likely to report previous HIV testing (73% vs 89%; P < 0.01), STI testing (60% vs 90%; P < 0.001) or be vaccinated for hepatitis A (32% vs 65%; P < 0.001) or hepatitis B (35% vs 73%; P < 0.001). SOPV participants were more likely to be married, widowed or have a long-term female partner (39% vs 7%; P < 0.001) and have a higher prevalence of urethral and rectal chlamydia (7% vs 1%; P = 0.02 and 8% vs 2%; P = 0.03, respectively). There was no significant difference between the groups for detection of syphilis (4% vs 9%), gonorrhoea (5% vs 9%) or HIV (1% vs 0%). MSM attending the SOPV had higher anogenital chlamydial prevalence compared with those attending the SHC. They reported higher rates of sex with female partners, which may facilitate STI/HIV transmission to heterosexual populations. Our findings have implications for HIV/STI service provision, contact tracing and local health promotion initiatives.

Prevalence of sexually transmissible infections and HIV in men attending sex-on-premises venues in Australia: a systematic review and meta-analysis of observational studies.

EMBASE, Medline, PubMed and international conference proceedings were searched for articles reporting on-site SOPV testing between 1 January 2000 and 31 January 2017. Meta-analysis calculated pooled prevalence estimates of STIs by anatomical site. Twelve cross-sectional studies were identified. Most (8/12) were local sexual health clinics (SHC) outreach services. Participants' mean age was 41.1 years (95% confidence interval (CI) 37.0-43.3; range 17 to 84 years). Testing included CT and NG (9/12), HIV (8/12) and syphilis (5/12). CT and NG prevalence overall summary estimates were 3.4% (95% CI 1.9-5.2%, I2 = 88.7%, P < 0.01) and 1.3% (95% CI 0.7-2.2%, I2 = 75.5%, P < 0.01) respectively. CT and NG prevalence was highest in the ano-rectum and oro-pharynx respectively. The HIV and syphilis pooled estimates were 2.3% (95% CI 1.6-2.9%, I2 = 93.1%, P < 0.01) and 3.2% (95% CI 1.8-4.6%, I2 = 72.8%, P < 0.01) respectively. Participation rate varied. This review examines HIV and STI testing in Australian SOPVs before HIV pre-exposure prophylaxis (PrEP). Findings indicate a high prevalence of STIs. PrEP use and resultant condomless sex may influence STI prevalence. Further research is required to determine the effect of PrEP on the STI prevalence among SOPV patrons.

HIV Point of Care Testing (PoCT) at Late-Night Sex on Premises Venues (SOPV) for Gay and Bisexual Men and Other Men Who Have Sex with Men (GBMSM): A Mixed Methods Analysis.

The aim of this study was to establish 'proof of concept' for a novel approach to HIV and STI testing at a sex on premises venue (SOPV) for gay and bisexual and other men who have sex with men (GBMSM) during late night group sex theme parties. A mixed-methods approach was used, and the study aimed to: (1) Build upon existing SOPV funded service delivery and establish 'proof of concept' for this unique setting within an SOPV; (2) evaluate the uptake and feasibility/acceptability of routine HIV/STI testing for GBMSM during theme parties in SOPV; and (3) identify beliefs/perceptions regarding this health promotion activity and venue suitability. The characteristics of patrons utilising PoCT (Point of Care Testing) were established to help further reach potentially stigmatised, highly sexually adventurous GBMSM. The findings support further PoCT endeavours within MSM communities to target harder to reach communities to reduce the rate of new transmissions of HIV. Findings can inform future health promotion, screening and interventions, as well as to identify a successful method to engage harder to reach GBMSM that need further focused targeting for HIV and STI testing to reduce transmission.

O22 Acceptability of HIV self-testing among men who have sex with men attending a sex on premises venue in brighton: a cross sectional survey

IntroductionInterventions to target and test men who have sex with men (MSM) for HIV are crucial to reduce incidence. Accessing traditional healthcare services can act as a barrier to HIV testing. Testing in outreach settings, such as sex on premises venues (SOPV), may be more successful. This study aimed to determine the acceptability of HIV self-testing in MSM sauna clients.MethodsAn anonymous cross sectional, electronic/paper survey was conducted in a male SOPV in Brighton. Results were collated using Survey Monkey.ResultsA total of 281 clients responded. 23% were aged 25–34 years, 16% 35–44 years and 37% 45–64 years. 32% reported never testing for HIV; 56% had not tested in the last 12 months; 44% felt they were not at risk of HIV. 93% would consider collecting a HIV self-test at the sauna with 40% wanting to test there and then, and 53% preferring to test at home.DiscussionA significant number of MSM attending this SOPV felt they were not at risk of HIV, and had never tested for HIV or not tested for over 1 year. Despite this, most individuals found testing at the SOPV acceptable, and would consider HIV self-testing if it were available. Innovative methods to enable HIV self-testing in venues frequented by high risk MSM are urgently needed.

Kissing Is Association With the Source for Meeting Casual Partners in Men Who Have Sex With Men

Kissing has been identified as one of the most common sexual practices among men who have sex with men (MSM), and it has also been identified as one of the risk factors for pharyngeal gonorrhoea. We conducted this study to understand the kissing pattern amongst MSM by different sources for meeting partners. MSM attending the Melbourne Sexual Health Centre (MSHC), Australia MSM attending MSHC between March and September 2015 were asked about the sources they used to meet their casual sexual partners and about their kissing practices in the previous three months. Multivariate logistic regression analyses were performed to determine whether kissing is associated with the source for meeting partners. A total of 753 men completed the questionnaire with a median age of 29 (IQR 25-36). Our results showed that men who met partners at gay bars were 7.3 (95% CI 2.1-25.0) times more likely to kiss their sexual partners and they were less likely (aOR 0.6; 95% CI 0.4-0.8) to have sex-without-kissing partners after adjusting for age and other sources for meeting partners. Men who met partners via smartphone applications were 7.0 (95% CI 3.0-15.9) times more likely to kiss their partners. Kissing was not associated with men who met partners at sex on premises venues (SOPV) and via friends. In contrast, men who met partners at SOPV were 2.3 (95% CI 1.6-3.3) times more likely to have sex-without-kissing partners.

Health promotion within a sex on premises venue: notes from the field.

Despite their historical controversy as perceived public health risks, sex on premises venues (SOPV) such as saunas and sex clubs can afford structured opportunities for on-site sexual health interventions within a supportive, regulated and confidential environment. Building upon previous interventions to deliver on-site clinical and health promotion programmes, an education and referral outreach service was established at one particular SOPV within the inner Brisbane city area. This report outlines the experiences of that on-site education/referral outreach over a five-year period. The service did afford opportunities for a minority of patrons to discuss concerns, resolve misunderstandings, obtain advice and referral, and would suggest that a health promotion presence within such a venue is a useful mechanism for engaging with highly sexually active men.

Use of incentives to encourage sexually transmissible infection testing amongst sex-on-premises venue patrons

Incentives have been explored as a strategy for increasing access to sexually transmissible infection (STI) testing. This project sought to trial the offer of free entry to sex-on-premises venues (SOPVs) for venue patrons as an incentive to access sexual health checks. SOPV patrons were offered free entry into venues if they took advantage of sexual health testing at a range of clinics. Patrons were given testing cards from the SOPV that could be exchanged at the time of the clinical consultation for a free entry pass to the SOPV of their choice. Cards collected at clinics and SOPVs were collated. In total, 244 cards were distributed to patrons from four venues over a 6-month period. Ten persons accessed one of the six clinical sites, one person attending twice. Of these persons, five attended two general practices and the remaining five accessed public sexual health clinics. Of these 10 persons, three used their free entry passes to attend an SOPV. Two persons accessed these clinical sites for the first time, one of whom tested reactive for an STI. Another regular attendee also tested reactive. Despite the low uptake, the free entry promotion was inexpensive and could, given sufficient time, be considered an effective incentive. Nonetheless, this study may have contributed to at least two new persons undertaking testing, one of whom was diagnosed with an STI.

Staff perspectives of drug use issues among sex-on-premises attendees

Aims: Sex on premises venues (SOPV) have been given considerable attention, in particular when exploring the relationship between SOPV attendance and risk behaviours such as drug use and unsafe sex. Little attention has been given to the perspectives of those who work in these venues.Methods: Semi-structured interviews were conducted with staff recruited from four SOPV in Sydney, Australia. Content analysis was performed to identify common themes.Findings: Several themes emerged from the staff interviews. These themes concentrated on particular drugs of concern; interventions in place to deal with substance use and those under the influence; and that drug use among SOP patrons occurred at venues prior to attending SOPV.Conclusions: Interviews with SOP workers showed that these venues face unique challenges that may not be encountered by other settings. SOPV staff has a detailed understanding of their clientele and their perspectives may be important not only when informing trends in substance use but also the development and distribution of harm reduction materials.

Australian men's sexual practices in saunas, sex clubs and other male sex on premises venues

Sex on premises venues (SOPVs) where men have sex with men have been implicated in the spread of sexually transmissible infections, but few studies have described men's sexual encounters in SOPVs, particularly the degree to which men from different backgrounds engage in risky sexual practices. Interviewer administered surveys were conducted with 186 Australian men who have sex with men (MSM) within 48 h of visiting an SOPV. They reported their sexual practices, the characteristics of their partners and other circumstances surrounding their sexual encounters. All analyses were based on the number of sexual encounters (n = 430). Oral sex was the most common practice, occurring in 74.9% of encounters, followed by massage, frottage or kissing (53.7%), solo or mutual masturbation (36.3%), and anal sex (32.1%). Multivariate analyses revealed age as a significant factor for having protected anal sex (P = 0.001), insertive anal sex (P = 0.004) and receptive anal sex (P < 0.001). These practices were more frequent in encounters among younger men, while masturbation (P = 0.03) was more frequent among older men. When men's sexual partners were affected by alcohol, encounters were less likely to involve unprotected anal intercourse (P = 0.006) and more likely to involve massage, frottage or kissing (P = 0.009). Men disclosed their HIV status in only 7.7% of encounters. With the likelihood of risky sexual practices varying according to background, results from this study should be used to guide interventions aiming to promote safer sex in SOPVs.

Pilot of non-invasive (oral fluid) testing for HIV within a community setting

The present study sought to determine the level of undiagnosed HIV infection within a community setting of men who have sex with men (MSM) and identify any associated sexual risk behaviours. A total of 427 MSM were recruited in sex-on-premises venues (SOPV) and gay bars within the inner city of Brisbane. An additional 37 MSM were recruited in a smaller, regional centre (Toowoomba). Oral fluid testing for HIV antibodies was undertaken using the Orasure collection system and assay. Each participant was invited to complete a brief behaviour questionnaire and submit an oral fluid specimen. Confirmed serology results were linked to reported sexual behaviours, testing patterns and HIV status. Of the 464 men surveyed, 33 identified as HIV-positive, and all of these were reactive by the Orasure assay. A further eight people who identified as negative or unknown serostatus, had confirmed Orasure reactive results, resulting in 1.9% of the 'non-HIV positive' MSM sample unaware of their positive HIV status. Therefore, 19.5% of the total confirmed HIV-positive individuals were not aware of their true serostatus. A significant minority of HIV-positive MSM are currently unaware of their positive serostatus. However, an analysis of their risk behaviour does not seem to indicate any significant difference to those who are HIV-negative. Interestingly, 86% of those who were unaware they were HIV-positive identified that they had been tested in the previous 6 months and all of them claimed to have been tested in the previous 2 years.

Sex on premises venue (SOPV) health promotion project in response to sustained increases in HIV notifications

Due to increases in HIV notifications in Queensland, a health promotion outreach project was developed with sex on premises venues (SOPV) in Brisbane. A health promotion officer (HPO) promoted safer sex behaviours among SOPV patrons over 14 months, including providing information, counselling and skills to enhance safer sexual behaviours and providing referrals. Surveys were introduced to facilitate discussions regarding HIV/sexually transmissible infections, testing and safer sex practices. The project demonstrated feasibility within this highly sexualised environment, and was enhanced by careful monitoring and revising the procedure to improve patron/staff responses to the project. The introduction of a survey instrument was a significant contributor to the project's effectiveness, providing opportunities for patrons to discuss a variety of key sexual health issues. This initiative reflected effective partnering between the Health Department, a community HIV/lesbian, gay, bisexual and transgender organisation and private industry. Despite initial difficulties, the presence of a health worker within an SOPV was acceptable to patrons and allowed for brief interventions to be conducted. This project was deemed effective for a limited time period and within certain constraints.

More than just anal sex: the potential for sexually transmitted infection transmission among men visiting sex-on-premises venues

Objectives:This study aimed to obtain detailed data on the frequency of sexual practices among men who had sex with men (MSM) at sex-on-premises venues (SOPV) and to compare this with...

26. MORE THAN JUST ANAL SEX: THE POTENTIAL FOR STI TRANSMISSION AMONG MEN VISITING SEX ON PREMISES VENUES IN MELBOURNE

Objective: Sex On Premises Venues (SOPVs), where men have sex with other men, provide an environment where the transmission of sexually transmitted infections (STIs) is potentially enhanced. However, the extent to which SOPVs contribute to STI transmission is unknown. This study aimed to obtain detailed data on the types of sexual practices and frequency of these practices among men who have sex with men (MSM) visiting SOPVs in Melbourne, Australia. Methods: In a cross-sectional study, MSM visiting 6 Melbourne SOPVs between December 2006 and February 2007 were asked to complete an exit survey on the types of sexual practices and frequency of such practices they had engaged in at that visit. Of 447 men approached, 150 (34%) participated in the study. Results: The median age of participants was 42.5 years (range 20-79). Among participants who engaged in receptive oral sex (66%) and insertive oral sex (75%), the median number of such acts reported by each man during the visit was 2 (range 1-10) and 2 (range 1-10) respectively. Eleven men (7%) reported receptive oral sex with ejaculation into their mouth with a median of 1 act (range 1-3) per man. Among participants who engaged in receptive anal sex (19%) and insertive anal sex (38%), the median number of such acts per man during the visit was 1 (range 1-4) and 1 (range 1-8) respectively. Eleven men (7%) reported unprotected insertive anal sex with a median of 1 act (range 1-4) per man; 4 (3%) reported unprotected receptive sex. A substantial number of men who did not report any anal sex engaged in practices potentially capable of transmitting infections. Notably, 44 men (29%) reported unprotected rubbing or touching of their penis ('nudging') onto another man's anus without actual anal penetration with a total of 71 other men (median 1 act per man, range 1-10). When specifically asked, 17 (39%) of these men reported that they had not engaged in 'anal sex'. In addition, 32 men (21%) reported being the recipients of 'nudging' with 40 other men. Fourteen (44%) of these men reported not having had any 'anal sex'. Oro-anal sex, whether 'active' or 'passive', was reported by 57 (38%) of men, while 84 (56%) men reported anal penetration using fingers, whether receptive or insertive. A significant minority (11%) of men reported that their ability to have safe sex was compromised by the use of drugs or alcohol. Of note, 58 (39%) men reported having a regular male partner, with whom 23 (40%) had unprotected anal sex. And 13 (9%) reported having a regular female partner, with whom 10 (77%) reportedly had unprotected vaginal or anal sex. Conclusions: The potential for STI transmission between men visiting Melbourne SOPVs and to their partners outside these venues is high. The contribution of what might be perceived as 'safer' sex practices to the transmission of STIs among MSM may have been underrecognised.