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Behavioral & Social Science

Category: Behaviour

(P3) Oropharynx-related sex acts dominate sexual behavioural patterns in men who have sex with men: a 12-week cohort study

Tuesday, July 25, 2023
16:00 – 18:00 CST

    Primary Presenter(s)

  • Lei Zhang, PhD (he/him/his)

    Professor
    Central Clinical School, Monash University
    Carlton, Victoria, Australia

    • Co-author(s)

  • LZ

    Leilei Zhang

    China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, United States

  • YW

    Yudong Wei

    China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, United States

  • CF

    Christopher K. Fairley

    Melbourne Sexual Health Centre, Alfred Health, Victoria, Australia

  • SS

    Shu Su

    China-Australia Joint Research Centre for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Centre, United States



Background:
The pattern and sequence of sex acts play important role in the transmission of sexually transmitted infections (STIs) in men who have sex with men (MSM). We aimed to identify the pattern of sequential sexual acts involving the oropharynx, urethra and anorectum in an MSM cohort over a 12-week follow-up.

Method:
We established a cohort of 312 MSM and follow-up the participants weekly. Behavioural questionnaires aiming to identify the order of sexual acts in the most recent sexual episode of the week were collected. The distribution, order and association of individual sex acts and consecutive sex act pairs were investigated with network analysis.

Results:
There were 2280 sex episodes involving 7013 sex acts reported by the 312 MSM during the 12-week follow-up. Of the 2280 sex episodes, 274 unique sequential sex patterns were reported. ‘Kissing only’ was the most frequently occurring sex pattern and accounted for 18.3% of the 2280 reported episodes. ‘Kissing only’ was followed by sequential sex acts K-Or-Ai (8.8%) and K-Or-Ar (6.9%), K-Or-Oi (3.9%) and Or-Ai (3.5%). Of the 7013 individual sex acts, kissing (K) was the most common (29.8%), followed by receptive oral sex(Or, 18.8%), insertive oral sex (Oi, 16.8%), insertive anal sex (Ai, 13.0%), receptive anal sex (Ar, 12.5%), receptive rimming (Rr, 5.2%), insertive rimming (Ri, 4.0%). Kissing was most commonly followed by oral sex (69.5%), most (54.7%) of which were then followed by anal sex. Rimming was only performed in 27% of the 2280 sex episodes and often occurred between oral sex and anal sex. Network analysis demonstrated the most frequently occurring sex act pairs were oropharynx-related and the top three included K-Or (17.9%, 847/4733), followed by K-Oi (11.1%, 527/4733) and Or-Oi, (10.2%, 484/4733).

Conclusion:
This study is the first comprehensive investigation into the pattern and sequence of individual sex acts in MSM. Kissing and oropharynx-related sex acts dominate the sexual behavioural pattern in MSM.