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RESEARCH ARTICLE (Open Access)
Contents Vol 21(3)

Early sexual experiences of adolescent men who have sex with men

Chen Wang https://orcid.org/0009-0004-2699-0660 A B * , Christopher K. Fairley https://orcid.org/0000-0001-9081-1664 A B C , Rebecca Wigan A B , Suzanne M. Garland D E F , Catriona S. Bradshaw A B C , Marcus Y. Chen A B § and Eric P. F. Chow https://orcid.org/0000-0003-1766-0657 A B C §
+ 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.

D Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Vic., Australia.

E Murdoch Children’s Research Institute, Melbourne, Vic., Australia.

F Centre for Women’s Infectious Diseases, The Royal Women’s Hospital, Melbourne, Vic., Australia.

* Correspondence to: wangchen01189@gmail.com, cwan0129@student.monash.edu

Handling Editor: Megan Lim

Sexual Health 21, SH23211 https://doi.org/10.1071/SH23211
Submitted: 11 January 2024  Accepted: 2 May 2024  Published: 20 May 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

There are limited studies examining the early experiences of adolescent men who have sex with men (MSM), and the magnitude of changes in sexual practice among adolescent MSM is unclear. Therefore, we compared the sexual practice and trajectory among adolescent men who are MSM aged 16–20 years in two cohorts, 5 years apart in Melbourne, Australia.

Methods

A total of 200 self-identified same-sex attracted men aged 16–20 years were recruited in each of HYPER1 (2010–2012) and HYPER2 (2017–2018) using similar methodology. Men completed a questionnaire about their sexual practices. Men were also asked to report the age of first sex with different sexual activities with men and women.

Results

Compared to HYPER1, the median age at first sex with men was slightly increased in HYPER2: receiving oral sex (17.2 years in HYPER2 vs 16.5 years in HYPER1), performing oral sex (17.3 years vs 16.4 years), receptive anal sex (18 years vs 17.0 years) and insertive anal sex (18 years vs 17.3 years). Similar patterns were also observed in sexual practice with women: performing oral sex (17.0 years in HYPER2 vs 16.8 years in HYPER1), receiving oral sex (17.0 years vs 16.3 years) and vaginal sex (17.0 years vs 16.7 years).

Conclusions

In general, there was a small delay in first-sex activity among adolescent MSM between two cohorts 5 years apart. Most adolescent MSM started their sexual practices before the age of 18 years and have engaged in activities that are at risk of HIV and STI. Health education and promotion, including regular sexual health check-ups, are important for HIV and STI prevention and intervention in this population.

Keywords: adolescent, men who have sex with men, sexual behaviours, sexual debut, sexual practices, STI, youth.

References

1  Coleman A, Tran A, Hort A, Burke M, Nguyen L, Boateng C, et al. Young Australians’ experiences of sexual healthcare provision by general practitioners. Aust J Gen Pract 2019; 48(6): 411-4.
| Crossref | Google Scholar |

2  Delany-Moretlwe S, Cowan FM, Busza J, Bolton-Moore C, Kelley K, Fairlie L. Providing comprehensive health services for young key populations: needs, barriers and gaps. J Int AIDS Soc 2015; 18(2 Suppl 1): 19833.
| Crossref | Google Scholar | PubMed |

3  Australian Bureau of Statistics. 4102.0 - Australian Social Trends, Jun 2012 2012 [updated 25/092012]. Available at https://www.abs.gov.au/ausstats/abs@.nsf/lookup/4102.0main+features10jun+2012

4  King J, McManus H, Kwon JA, Gray R, McGregor S. HIV, viral hepatitis and sexually transmissible infections in Australia - Annual surveillance report 2023. Kirby Institute, UNSW Sydney; 2023. Available at https://www.kirby.unsw.edu.au/sites/default/files/documents/Annual-Surveillance-Report-2023_STI.pdf

5  Institute UK. HIV, viral hepatitis and sexually transmissible infections in Australia Annual surveillance report 2022. 2022. Available at https://www.kirby.unsw.edu.au/sites/default/files/documents/Annual-Surveillance-Report-2022_STI.pdf.

6  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 | PubMed |

7  Li J, Li S, Yan H, Xu D, Xiao H, Cao Y, et al. Early sex initiation and subsequent unsafe sexual behaviors and sex-related risks among female undergraduates in Wuhan, China. Asia Pac J Public Health 2015; 27(2): 21S-9S.
| Crossref | Google Scholar |

8  Magnusson BM, Masho SW, Lapane KL. Early age at first intercourse and subsequent gaps in contraceptive use. J Womens Health 2012; 21(1): 73-9.
| Crossref | Google Scholar | PubMed |

9  Baumgartner JN, Waszak Geary C, Tucker H, Wedderburn M. The influence of early sexual debut and sexual violence on adolescent pregnancy: a matched case-control study in Jamaica. Int Perspect Sex Reprod Health 2009; 35(1): 21-8.
| Crossref | Google Scholar | PubMed |

10  Ma Q, Ono-Kihara M, Cong L, Xu G, Pan X, Zamani S, et al. Early initiation of sexual activity: a risk factor for sexually transmitted diseases, HIV infection, and unwanted pregnancy among university students in China. BMC Public Health 2009; 9: 111.
| Crossref | Google Scholar | PubMed |

11  Stryhn JG, Graugaard C. [The age at first intercourse has been stable since the 1960s, and early coital debut is linked to sexual risk situations]. Ugeskr Laeger 2014; 176(37): V01140063.
| Google Scholar |

12  Olesen TB, Jensen KE, Nygård M, Tryggvadottir L, Sparén P, Hansen BT, et al. Young age at first intercourse and risk-taking behaviours--a study of nearly 65 000 women in four Nordic countries. Eur J Public Health 2012; 22(2): 220-4.
| Crossref | Google Scholar | PubMed |

13  Yode M, LeGrand T. Association between age at first sexual relation and some indicators of sexual behaviour among adolescents. Afr J Reprod Health 2012; 16(2): 173-88.
| Google Scholar | PubMed |

14  Sandfort TGM, Orr M, Hirsch JS, Santelli J. Long-term health correlates of timing of sexual debut: results from a national US study. Am J Public Health 2008; 98(1): 155-61.
| Crossref | Google Scholar | PubMed |

15  Epstein M, Bailey JA, Manhart LE, Hill KG, Hawkins JD, Haggerty KP, et al. Understanding the link between early sexual initiation and later sexually transmitted infection: test and replication in two longitudinal studies. J Adolesc Health 2014; 54(4): 435-41.e2.
| Crossref | Google Scholar | PubMed |

16  Upchurch DM, Mason WM, Kusunoki Y, Kriechbaum MJ. Social and behavioral determinants of self-reported STD among adolescents. Perspect Sex Reprod Health 2004; 36(6): 276-87.
| Crossref | Google Scholar | PubMed |

17  Santelli JS, Brener ND, Lowry R, Bhatt A, Zabin LS. Multiple sexual partners among U.S. adolescents and young adults. Fam Plann Perspect 1998; 30(6): 271-5.
| Crossref | Google Scholar | PubMed |

18  Greenberg J, Magder L, Aral S. Age at first coitus. A marker for risky sexual behavior in women. Sex Transm Dis 1992; 19(6): 331-4.
| Crossref | Google Scholar | PubMed |

19  Power J, Kauer S, Fisher C, Bellamy R, Bourne A. 7th National survey of secondary students and sexual health 2022. La Trobe University; 2022. Available at https://www.latrobe.edu.au/arcshs/work/national-survey-of-secondary-students-and-sexual-health-2022.

20  Grulich AE, de Visser RO, Badcock PB, Smith AM, Heywood W, Richters J, et al. Homosexual experience and recent homosexual encounters: the Second Australian Study of Health and Relationships. Sex Health 2014; 11(5): 439-50.
| Crossref | Google Scholar | PubMed |

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

22  Katz-Wise SL, Ranker LR, Gordon AR, Xuan Z, Nelson K. Sociodemographic patterns in retrospective sexual orientation identity and attraction change in the sexual orientation fluidity in youth study. J Adolesc Health 2023; 72(3): 437-43.
| Crossref | Google Scholar | PubMed |

23  Srivastava A, Hall WJ, Krueger EA, Goldbach JT. Sexual identity fluidity, identity management stress, and depression among sexual minority adolescents. Front Psychol 2022; 13: 1075815.
| Crossref | Google Scholar | PubMed |

24  Zou H, Prestage G, Fairley CK, Grulich AE, Garland SM, Hocking JS, et al. Sexual behaviors and risk for sexually transmitted infections among teenage men who have sex with men. J Adolesc Health 2014; 55(2): 247-53.
| Crossref | Google Scholar | PubMed |

25  Chow EPF, Tabrizi SN, Fairley CK, Wigan R, Machalek DA, Garland SM, et al. Prevalence of human papillomavirus in young men who have sex with men after the implementation of gender-neutral HPV vaccination: a repeated cross-sectional study. Lancet Infect Dis 2021; 21(10): 1448-57.
| Crossref | Google Scholar | PubMed |

26  Cornell JL, Halpern-Felsher BL. Adolescents tell us why teens have oral sex. J Adolesc Health 2006; 38(3): 299-301.
| Crossref | Google Scholar | PubMed |

27  Pakpahan C, Darmadi D, Agustinus A, Rezano A. Framing and understanding the whole aspect of oral sex from social and health perspectives: a narrative review. F1000Res 2022; 11: 177.
| Crossref | Google Scholar | PubMed |

28  Chow EPF, Wigan R, McNulty A, Bell C, Johnson M, Marshall L, et al. Early sexual experiences of teenage heterosexual males in Australia: a cross-sectional survey. BMJ Open 2017; 7(10): e016779.
| Crossref | Google Scholar | PubMed |

29  de Visser RO, Richters J, Rissel C, Badcock PB, Simpson JM, Smith AM, et al. Change and stasis in sexual health and relationships: comparisons between the first and second Australian studies of health and relationships. Sex Health 2014; 11(5): 505-9.
| Crossref | Google Scholar | PubMed |

30  Tanne JH. US teenagers think oral sex isn’t real sex. BMJ Open 2005; 330(7496): 865.
| Google Scholar |

31  Young Pregnant and Parenting Network. National curriculum on sex and respectful relationships. Available at https://youngpregnantandparenting.org.au/sex-and-relationships-ed/national-curriculum-on-sex-and-respectful-relationships/

32  Ramírez-Villalobos D, Monterubio-Flores EA, Gonzalez-Vazquez TT, Molina-Rodriguez JF, Ruelas-Gonzalez MG, Alcalde-Rabanal JE. Delaying sexual onset: outcome of a comprehensive sexuality education initiative for adolescents in public schools. BMC Public Health 2021; 21(1): 1439.
| Google Scholar | PubMed |

33  Malagón T, Burchell A, El-Zein M, Tellier PP, Coutlée F, Franco EL, et al. Assortativity and mixing by sexual behaviors and sociodemographic characteristics in young adult heterosexual dating partnerships. Sex Transm Dis 2017; 44(6): 329-37.
| Crossref | Google Scholar | PubMed |

34  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 | PubMed |

35  Greaves KE, Fairley CK, Engel JL, Ong JJ, Aung ET, Phillips TR, et al. Assortative sexual mixing by age, region of birth, and time of arrival in male-female partnerships in Melbourne, Australia. Sex Transm Dis 2023; 50(5): 288-91.
| Crossref | Google Scholar | PubMed |

36  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 | PubMed |

37  Australia PTU. People born (overseas) in predominantly English-speaking countries, 2021. 2021. Available at https://phidu.torrens.edu.au/notes-on-the-data/demographic-social/es-countries#:~:text=The%202021%20Census%20of%20Population,2016%20%5B1%5D%5B2%5D