(P230) Group sex and behavior changes among men who have sex with men in Southern California

Background: The Monkeypox (Mpox) epidemic (May 2022 - September 2022) disproportionately affected sexually active gay, bisexual, and other men who have sex with men. To understand community-level changes in sexual behavior, we surveyed individuals in a semi-urban area in Southern California.

Methods: We recruited adults between October 2022 to January 2023, using geolocation-focused online advertisements on social media and dating apps along with palm cards with a QR code distributed by local clinics and organizations. Eligible participants were: 1) male, 2) over the age of 18 years; 3) reported sex with men; 4) residents of San Bernardino or Riverside counties, California; 5) HIV-uninfected; and 6) currently not taking PrEP. Descriptive analyses (mean, standard deviations, frequencies, and proportions) were performed.

Results: Our sample included 64 males with median age of 36.2 years (range 18-70 years). The majority were Hispanic/Latinx (50%) and White (36%). Most participants reported sex with men only (78.1%), with 50% having participated in group sex in the past year. On average, participants used condoms 37.2% of their sexual encounters during the past 6 months.

Forty-two percent reported that they changed their sexual behavior during the Mpox epidemic.

Among those who participated in group sex before the outbreak (n=32), 53.1% participated in group sex at least once a year and 21.9% 2-4 times/year. The average number of partners during group sex was 3.4. During the outbreak, 44% (14/32) reported they participated in group sex and the average number of partners was 3.6. Among them, 57% (8/14) reported 2-4 instances of group sex. To reduce the risk of Mpox infection, group sex participants reported that they limited the number of sex partners (34.4%), used condoms during anal sex (12.5%), avoided crowded places (9.4%) and asked their partners about Mpox symptoms before sex (9.4%).

Conclusion: Survey participants reported modest sexual behavior changes in response to the Mpox outbreak. Since group sex is a sex behavior that increases the risk for Mpox, HIV and other sexually transmitted infections, public health messages should include specific discussion of safer group sex practices in sexual health promotion.