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RESEARCH ARTICLE (Open Access)

Sexual mixing in bisexual activity in male–male partnerships in Melbourne, Australia

Hayden A. Griffiths https://orcid.org/0009-0003-0434-5129 A B , Christopher K. Fairley https://orcid.org/0000-0001-9081-1664 A B , Jason J. Ong https://orcid.org/0000-0001-5784-7403 A B , Eric P. F. Chow https://orcid.org/0000-0003-1766-0657 A B C # * and Tiffany R. Phillips https://orcid.org/0000-0001-6920-7710 A B #
+ Author Affiliations
- Author Affiliations

A Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic, Australia.

B School of Translational Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia.

C Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic, Australia.

* Correspondence to: eric.chow@monash.edu
# These authors contributed equally to this paper

Handling Editor: Kevan Wylie

Sexual Health 21, SH23190 https://doi.org/10.1071/SH23190
Submitted: 8 January 2024  Accepted: 10 August 2024  Published: 29 August 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

The patterns of sexually transmitted infections (STIs) in populations may be influenced by the sexual mixing within the population. We aimed to investigate the assortative sexual mixing pattern by bisexuality in male–male partnerships.

Methods

This was a retrospective repeated cross-sectional study of men with mostly regular male partners attending the Melbourne Sexual Health Centre between 2011 and 2019. Data on sexual practices, including their sexual practices, presence of other male/female sex partners and the gender of sexual partners in the previous 3 and 12 months, were collected using computer-assisted self-interview. We calculated the proportion of male partnerships where at least one man in the partnership reported a female sex partner.

Results

A total of 2056 male–male partnerships (i.e. 4112 individuals) with a median age of 29 years (IQR 25 to 35) were included. Overall, in 94.4% (1941/2056) of male–male partnerships both men had male partners only; however, in 5.5% (113/2056) of partnerships, one man had both male and female partners, and in 0.1% (2/2056) partnerships, both men had both male and female partners. No assortative relationship was found on the sexual mixing by bisexuality in male–male partnerships due to the low assortativity coefficient (r = 0.006, 95% CI: −0.004 to 0.016).

Conclusion

One in 20 male–male partnerships had at least one man who had both male and female partners within the preceding year. Individuals were not selective by bisexuality, suggesting that partnerships of bisexual individuals are mixed proportionately to the distribution of their characteristics. Still, these sexual mixing practices may affect STI transmission dynamics.

Keywords: assortativity, bisexual, heterosexual, mixing, opposite-sex, same-sex, sexual mixing, sexual networks, sexual partners, sexual practice.

References

Thng CCM. A review of sexually transmitted infections in Australia – considerations in 2018. Acad Forensic Pathol 2018; 8(4): 938-46.
| Crossref | Google Scholar | PubMed |

Chow EPF, Grulich AE, Fairley CK. Epidemiology and prevention of sexually transmitted infections in men who have sex with men at risk of HIV. Lancet HIV 2019; 6(6): e396-405.
| Crossref | Google Scholar |

Aung ET, Chen MY, Fairley CK, Higgins N, Williamson DA, Tomnay JE, et al. Spatial and temporal epidemiology of infectious syphilis in Victoria, Australia, 2015–2018. Sex Transm Dis 2021; 48(12): e178-82.
| Crossref | Google Scholar |

Chow EPF, Fairley CK, Williamson DA, Chen MY. Spatial mapping of gonorrhoea notifications by sexual practice in Victoria, Australia, 2017–2019. Aust NZ J Publ Health 2021; 45: 672-4.
| Crossref | Google Scholar |

King J, McManus H, Kwon JA, Gray R, McGregor S. HIV, viral hepatitis and sexually transmissible infections in Australia: Annual surveillance report 2023. Sydney: Kirby Institute, UNSW Sydney; 2023. doi:10.26190/f5ph-f972

Borg SA, Tenneti N, Lee A, Drewett GP, Ivan M, Giles ML. The reemergence of syphilis among females of reproductive age and congenital syphilis in Victoria, Australia, 2010 to 2020: a public health priority. Sex Transm Dis 2023; 50(8): 479-84.
| Crossref | Google Scholar |

Mimiaga MJ, Reisner SL, Cranston K, Isenberg D, Bright D, Daffin G, et al. Sexual mixing patterns and partner characteristics of black MSM in Massachusetts at increased risk for HIV infection and transmission. Journal of Urban Health 2009; 86: 602-23.
| Crossref | Google Scholar |

Williamson DA, Chow EPF, Gorrie CL, Seemann T, Ingle DJ, Higgins N, et al. Bridging of Neisseria gonorrhoeae lineages across sexual networks in the HIV pre-exposure prophylaxis era. Nat Commun 2019; 10(1): 3988.
| Crossref | Google Scholar |

Doherty IA, Schoenbach VJ, Adimora AA. Sexual mixing patterns and heterosexual HIV transmission among African Americans in the southeastern United States. J Acquir Immune Defic Syndr 2009; 52(1): 114-20.
| Crossref | Google Scholar |

10  Chow EPF, Phillips TR, Bradshaw CS, Chen MY, Fairley CK. Brief report: sexual mixing patterns by HIV status and PrEP use among men who have sex with men partnerships in Melbourne, 2011–2018. J Acquir Immune Defic Syndr 2020; 83(2): 99-102.
| Crossref | Google Scholar |

11  Doherty IA, Adimora AA, Muth SQ, Serre ML, Leone PA, Miller WC. Comparison of sexual mixing patterns for syphilis in endemic and outbreak settings. Sex Transm Dis 2011; 38(5): 378-84.
| Crossref | Google Scholar |

12  Chow EPF, Read TRH, Law MG, Chen MY, Bradshaw CS, Fairley CK. Assortative sexual mixing patterns in male–female and male–male partnerships in Melbourne, Australia: implications for HIV and sexually transmissible infection transmission. Sex Health 2016; 13(5): 451-6.
| Crossref | Google Scholar |

13  Geary RS, Copas AJ, Sonnenberg P, Tanton C, King E, Jones KG, et al. Sexual mixing in opposite-sex partnerships in Britain and its implications for STI risk: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Int J Epidemiol 2019; 48(1): 228-42.
| Crossref | Google Scholar |

14  Martín-Sánchez M, Case R, Fairley C, Hocking JS, Bradshaw C, Ong J, et al. Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia. BMJ Open 2020; 10(11): e037608.
| Crossref | Google Scholar |

15  Greaves KE, Fairley CK, Engel JL, Ong JJ, Rodriguez E, Phillips TR, et al. Sexual mixing patterns among male–female partnerships in Melbourne, Australia. Sex Health 2022; 19(1): 33-8.
| Crossref | Google Scholar |

16  Chow EPF, Carlin JB, Read TRH, Chen MY, Bradshaw CS, Sze JK, et al. Factors associated with declining to report the number of sexual partners using computer-assisted self-interviewing: a cross-sectional study among individuals attending a sexual health centre in Melbourne, Australia. Sex Health 2018; 15(4): 350-7.
| Crossref | Google Scholar |

17  Prah P, Copas AJ, Mercer CH, Nardone A, Johnson AM. Patterns of sexual mixing with respect to social, health and sexual characteristics among heterosexual couples in England: analyses of probability sample survey data. Epidemiol Infect 2015; 143(7): 1500-10.
| Crossref | Google Scholar |

18  Diamond LM. Sexual fluidity in male and females. Curr Sex Health Rep 2016; 8: 249-56.
| Crossref | Google Scholar |

19  Scoats R, Joseph LJ, Anderson E. ‘I don’t mind watching him cum’: heterosexual men, threesomes, and the erosion of the one-time rule of homosexuality. Sexualities 2018; 21(1–2): 30-48.
| Crossref | Google Scholar |

20  Cleere EF, Fairley CK, McGrath L, Bradshaw CS, Chen MY, Chow EPF. Sex with a transgender or gender diverse person among patients attending a sexual health centre in Melbourne, Australia. Sex Transm Infect 2019; 95(1): 46-52.
| Crossref | Google Scholar |

21  Chow EPF, Wilson DP, Zhang L. What is the potential for bisexual men in China to act as a bridge of HIV transmission to the female population? Behavioural evidence from a systematic review and meta-analysis. BMC Infect Dis 2011; 11: 242.
| Crossref | Google Scholar |

22  Charleson FJ, Fairley CK, Hocking JS, Vodstrcil LA, Bradshaw CS, Chow EPF. Age, ethnic and travel-related disparities in kissing and sexual practices among heterosexual men in Melbourne, Australia. Sex Health 2020; 17(3): 279-87.
| Crossref | Google Scholar |