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RESEARCH ARTICLE
Contents Vol 6(4)

The role of drugs during group sex among gay men in Australia

Garrett Prestage A B D , Jeffrey Grierson B , Jack Bradley A , Michael Hurley B and Jeff Hudson C
+ Author Affiliations
- Author Affiliations

A National Centre in HIV Epidemiology and Clinical Research, 376 Victoria Street, Darlinghurst, NSW 2010, Australia.

B Australian Research Centre in Sex Health and Society, 315 Franklin Street, Melbourne, Vic. 3000, Australia.

C Faculty of Medicine, University of Sydney, Sydney, NSW 2006, Australia.

D Corresponding author. Email: gprestage@nchecr.unsw.edu.au

Sexual Health 6(4) 310-317 https://doi.org/10.1071/SH09014
Submitted: 12 February 2009  Accepted: 21 July 2009   Published: 13 November 2009

Abstract

Background: Drug use has been associated with risk behaviour among gay men. We examined the use of drugs and sexual risk behaviour among homosexually-active men who engaged in group sex in Australia. Methods: We used an anonymous, self-complete survey about participants’ most recent occasion of group sex with other men and in-depth interviews with a small number of these survey participants. The 746 men who reported having engaged in group sex within the previous 6 months were included in these analyses. Results: Among 746 men who engaged in group sex within the previous 6 months, 63.0% reported using illicit drugs at the group sex encounter. Men commonly reported using drugs specifically to enhance their sexual experience and to intensify the pleasure of that experience. After controlling for each drug type and other risk factors, only use of methamphetamine (odds ratio = 1.74, confidence interval = 1.06–2.88, P = 0.030) and having more than five drinks (odds ratio = 2.41, confidence interval = 1.34–4.33, P = 0.003) were independently associated with unprotected anal intercourse with non-HIV seroconcordant partners in multivariate analysis. Conclusion: Methamphetamine and heavy alcohol use are associated with increased sexual risk behaviour among men who engage in group sex. Within more ‘adventurous’ gay community subcultures, drug use is often for the explicit purpose of enhancing the sexual experience and this complex relationship may be key to understanding HIV risk among these men.

Additional keywords: drug use, sexual behaviour, MSM.


Acknowledgements

The authors thank the AIDS Council of New South Wales, the Victorian AIDS Council and the Queensland Association for Healthy Communities for collaboration with the project, and the men who have participated in the Three or More Study. We also thank Professor Anthony Smith for methodological advice.


Sponsorship: The National Centre in HIV Epidemiology and Clinical Research and the Australian Research Centre in Sex Health and Society receive funding from the Commonwealth Department of Health and Ageing. TOMS was partly supported by the New South Wales Health Department. This funding agency had no further role: in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.


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