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Recent research shows that co-use of stimulants and opioids appears to be increasing and injection of opioids and stimulants carries a risk for HIV transmission. This study examined stimulant injection and sexual HIV risk behaviors among individuals who reported nonmedical use of gabapentin and opioids (n = 62). Comparisons of people who injected stimulants to those who did not were conducted using chi-square and t-tests. Compared to those who did not, people who injected stimulants, were less likely to be African American/Black (p < 0.05) and more likely to report sex with another person who injects drugs (p < 0.01), recent injections of prescription and/or illicit opioids (p <.000), and hepatitis C infection (p < 0.01). Condomless intercourse during group sex was more prevalent among stimulant injectors, significant at the trend level (p < 0.1). Given the documented association between the use of opioids and nonmedical use of gabapentin and the growing trend of opioid-stimulant co-use, future research must examine whether nonmedical use of gabapentin is an indicator of substance use disorder severity and/or a risk factor for injection drug use. Education and intervention opportunities that address group sex and other sexual risk behaviors are warranted. [ABSTRACT FROM AUTHOR]

Group sex (i.e., sex involving four or more simultaneous partners) is a prevalent but stigmatized sexual behaviour. People assume that group sex centers around self-focused pleasure/physical gratification and that accordingly, this must be the primary motivation people have for engaging in group sex. Yet emerging research on group sex, as well as broader sexuality research and theory, suggests that group sex motivations are multifaceted and, for many, tied to community and belonging. In the present study, we focus on people's reasons for engaging in group sex. We recruited twenty participants of diverse genders, sexual identities/orientations, ages (≥18 years), abilities, and group sex communities for individual interviews in southwestern British Columbia. We found that participants had engaged in group sex for a plurality of reasons, including their desire for novelty, sexual exploration, spirituality, and their upbringing. Importantly, many were motivated to have group sex by their belonging and acceptance in communities of like-minded individuals that embraced sex-positive principles and values. Pleasure was also an important motivator and was described in multifaceted ways and was intertwined with sexual empowerment, emotional vulnerability, and feelings of connection and intimacy. These findings shed light on an understudied aspect of group sex – that is, why people have it – and challenge the assumption that group sex is entirely motivated by self-focused desire for physical pleasure/gratification. Instead, they highlight how group sex motivation can be multifaceted and community focused. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Background: Few studies have examined the types of sexual activities and condom use during group sex among men who have sex with men (MSM). This study aimed to examine sexual activities and condom use during group sex. Setting: A cross-sectional survey among MSM attending a sexual health clinic in Melbourne, Australia, between May 2019 and March 2020. Method: Participants were asked whether they had engaged in group sex (sex involving more than 2 participants) within the past 3 months, the number of people involved, the sexual activities they engaged in, and their condom use during the most recent group sex. Results: More than a quarter (26.8%, 287 of 1071) had engaged in group sex in the past 3 months, and the median number of people involved was 3 (interquartile range 3–4), including the participant. Fellatio was the most common activity in group sex (94.4%, 271 of 287), followed by kissing (85.7%, 246 of 287) and anal sex (79.8%, 229 of 287). The proportion of men who always used condoms and changed condoms between partners was 27.0% (48 of 178) for insertive and 32.3% (52 of 161) for receptive anal sex. Compared with men not taking pre-exposure prophylaxis (PrEP), men living with HIV (adjusted odds ratio [aOR]: 2.35; 95% confidence interval [CI]: 1.20 to 4.59) and men taking PrEP (aOR: 3.07; 95% CI: 2.21 to 4.26) had higher odds of engaging in group sex after adjusting for confounders. Conclusion: Two-thirds of MSM either did not use condoms or did not change condoms between partners during group sex, which may increase sexually transmitted infection transmission between partners. [ABSTRACT FROM AUTHOR]

This paper explores the ways in which swingers negotiate their world in swinger settings in Spain and France. This includes previously ignored subgroups in swinger subculture, such as single swingers, intergenerational and intercultural couples as well as cuckold couples. Demographics differ slightly from previous studies, including 7 nationalities, suggesting a higher level of multiculturalism among swingers in cosmopolitan and touristic areas, such as the south of Spain and south of France. Drawing on ethnographic data collected in Andalusia, Spain, and Cap d´Agde, France, as well as qualitative interviews with 40 participants, we demonstrate the ways in which swingers negotiate their world. Strategies by swingers were used to avoid misunderstandings, create boundaries, claim agency, transgress, and deal with stigma. [ABSTRACT FROM AUTHOR]

Background: Few studies investigate group sex among heterosexuals. The aim of this study was to provide an exploration of characteristics and practices among heterosexual men and women who engage in group sex.Method: We conducted a cross-sectional survey between May 2019 and March 2020 among heterosexual men and women attending a sexual health clinic in Melbourne, Australia. Participants were asked whether they had participated in group sex (sex involving more than two participants) in the past 3months, the size of the most recent event, sexual activities in which they engaged, and condom use.Results: Of 3277 heterosexuals surveyed (1509 women and 1768 men), the mean age was 29.9years (s.d. 8.8) and more than half (56.0%, n=1834) were born outside Australia. One in 20 participants (5.4%) had engaged in group sex in the past 3months with the number of events ranging 1-10times. Kissing was the most common activity in group sex, and women were significantly more likely to kiss a same-sex partner than men. Overall, of 165 participants who engaged in vaginal sex, 57 (34.5%) reported always using condoms and changing condoms between consecutive partners. Of the 100 men and women who had condomless vaginal sex, 79 (79.0%) received or performed fellatio after condomless vaginal sex.Conclusion: About two-thirds of heterosexuals who engaged in group sex neither used condoms nor changed condoms between partners in the most recent group sex event. Safe sex messages on changing condoms between partners and between sexual activities should be reinforced for sexually transmitted infections prevention. [ABSTRACT FROM AUTHOR]

Federal and state rape shield laws generally prohibit criminal defendants in a sexual assault case from introducing any victim's prior sexual history into evidence. Legislatures designed these laws to protect victims from shame, public scrutiny, and the forbidden propensity inference that a sexually active complainant is likely to engage in the kind of behavior at issue in the case. Rape shield laws often include exceptions for introducing evidence, specifically evidence of the complainant's prior consent to sex with the defendant, and where the Constitution so requires. In a time where relationships are more amorphous and unconventional, courts are ill-equipped to consider admission of evidence not contemplated by the rape shield drafters. Group sexual interactions seem to fit the exception for prior consensual relations with the defendant. Courts, however, treat such interactions inconsistently. In 2012, in Gagne v. Booker, the U.S. Court of Appeals for the Sixth Circuit found a state trial court's exclusion of group sex evidence reasonable. The Circuit, however, split into eight divisive opinions. In 1981, in People v. Keith, the California Court of Appeals for the Second Appellate District determined that exclusion of prior group sex evidence was reversible error. This Note considers, through a feminist legal theory lens, the implications of admitting prior instances of group sexual intercourse under the consent exception to rape shield laws. This Note argues that courts should admit this evidence when it is not unfairly prejudicial because admission may help destigmatize unconventional relationships and uphold the constitutional rights of defendants. This Note further argues that legislatures, followed by the courts, should lead the legal recognition of such relationships, to avoid instrumentalizing victims of sexual assault. [ABSTRACT FROM AUTHOR]

Gay and bisexual men's (GBM) group sex parties are considered HIV risk environments due to their association with concurrent sexual partners, condomless anal sex, and polysubstance use. The possibility of group sex party hosts acting as gatekeepers to minimize risks has been suggested, but remains understudied. We analyzed qualitative data from 20 in-depth interviews with North American GBM who recently attended private group sex parties to determine if hosts' actions constitute harm reduction strategies. Results showed hosts acting as gatekeepers before parties by establishing and disseminating themes and rules, screening applicants, and selecting guests. During parties hosts enforced rules and rejected uninvited guests. By their actions, hosts established a more controlled environment compared to public sex-on-premises bathhouses, and facilitated boundary play, the paradoxical behavior of simultaneously desiring risk and safety, previously noted for GBM circuit parties. Results suggest initiating education programs focusing on private group sex party hosts as gatekeepers. [ABSTRACT FROM AUTHOR]

"Sex Toys on the Altar" describes Ibrahim Farajaje's influence on one of his colleagues and coconspirators, centering his influence directly in the pulsating power point where spiritual and erotic energy converge in people' everyday lives. This piece spans some of Farajaje's bicoastal and international experiences, explaining his influence/guidance, from two different theological schools, on the authors own research into queer feminist sacred sexuality contemporary traditions and trends. His supervision/support of the practices and evaluation of her two internship projects as well as his way of creating international multireligious community and family are explored, with particular attention to the political issues the author was involved with him, in Washington, DC, and on a national level. This is one attempt to bring critical thinking to the topic of group lovemaking and to understand somantic sex education and devotional practices in the context of multireligiousities, using the tripartite Christian, Hebrew and Muslim belief systems to build beyond, integrating sex and spirit, making space for the contradictions and compassion inherent in the ecstatic and mystical experiences of humanity. The title of the piece comes from a remark Farajaje made, about treating everything about lovemaking between humans as sacred, special, and of precious value to be treated with reverence. [ABSTRACT FROM AUTHOR]

BackgroundThere are few studies investigating group sex among female sex workers (FSWs). This study aimed to examine the typical number of group sex participants, sexual activities and condom use in group sex among FSWs attending a sexual health clinic in Melbourne, Australia.MethodsWe conducted a cross-sectional survey between May 1, 2019 and March 13, 2020 among FSWs in Melbourne. Participants were asked whether they had participated in group sex (sex involving more than two participants) within the past 3 months, the size of the most recent group sex event, sexual activities they engaged in and condom use. It is unknown whether this was a paid or unpaid event in our study.ResultsOf the 247 FSWs surveyed, the mean age was 28.9 years and 51.8% were born in Australia. More than a quarter (27.5%, n = 68) had had group sex in the past 3 months with the number of events ranging from 1 to 10 times. The median size of the group was 3 participants with one man and two women (including the FSW) being the most common combination. Kissing was the most common activity in group sex. Of 58 FSWs who had vaginal sex during group sex, 77.3% (51/58) reported their male partners always used condoms but 13.7% (7/51) of these did not change condoms between women.ConclusionThis study finds that group sex is common among FSWs. Although condoms are always used during group sex, one in six men did not change their condoms between partners, which may increase STI transmission between partners.

Group sex among men who have sex with men may be understood as a 'radical' practice insofar as it transgresses dominant social discourses around appropriate sexual relations—prioritizing heteronormative, monogamous and risk‐averse sex. These practices are generally defined as steeped in risk, most commonly due to the potential for transmitting human immunodeficiency virus and sexually transmitted infections and accompanied by the possibility of legal and social repercussions. Our ethnographic research study explored the desires, practices and contexts of group sex participants (n = 10) within a popular group sex party destination located in the United States. We employ a poststructuralist perspective (utilizing the work of Deleuze and Guattari) to understand group sex events with the pretext that bodies have no inherent ethics, meaning or essence: they are 'bodies without organs'. We identify group sex as a form of boundary play, in which participants pursue new limits to what their bodies can do but within a carefully constructed environment that establishes norms of interaction meant to secure trust and safety between participants. A variety of risk reduction practices are shown to be promoted and honoured within these eventful sexual(ized) spaces. The application of poststructuralist concepts of 'boundary play' and 'bodies without organs' helped to depict the construction and navigation of pleasure, safety and risk among group sex participants. [ABSTRACT FROM AUTHOR]

Background: There have been limited studies of group sex among heterosexual individuals. This study aimed to explore the factors associated with group sex among heterosexual males and females to improve risk assessment guidelines and inform sexually transmitted infection (STI) screening requirements.Methods: A cross-sectional survey was conducted among heterosexual males and females aged ≥16 years attending the Melbourne Sexual Health Centre between March and April 2019. The survey asked about group sex participation, methods used to meet sexual partners, number of casual and/or regular partners, and injection drug use (IDU) in the previous 3 months. HIV and STI (chlamydia, gonorrhoea, syphilis) diagnoses were extracted. A multivariable logistic regression was conducted to identify the factors associated with group sex participation.Results: A total of 698 participants (325 males, 373 females) were included and 4.7% (33/698) had participated in group sex in the previous 3 months. The proportion who participated in group sex increased with age (2.1% in 16-24 years, 5.5% in 25-34 years, 7.8% in ≥35 years, p trend =0.010). Meeting partners at sex venues (e.g. brothels) was associated with the highest odds of participating in group sex (aOR=5.74, 95% CI: 1.20-27.44), followed by dating apps (aOR=2.99, 95% CI: 1.36-6.58), friends/family (aOR=2.99, 95% CI: 1.34-6.69) and social venues (e.g. bar) (aOR=2.73, 95% CI: 1.18-6.30). Group sex was strongly associated with STI positivity (aOR=6.24, 95% CI: 2.41-16.13). There was no association between group sex and sex, casual and/or regular partners, HIV positivity or IDU.Conclusion: Heterosexual individuals participating in group sex had a six-fold risk of testing positive for STIs. Including group sex in a sexual history is useful to determine STI risk and inform testing practices. Safe sex messages on group sex that are delivered through multiple methods (e.g. at sex venues, social venues and dating apps simultaneously) would be beneficial. [ABSTRACT FROM AUTHOR]

COVID-19 has had a profound effect on every aspect of contemporary life, including sexuality. Physical distancing measures and limitations on large gatherings explicitly restrict in-person group sex events. We sought to understand how the pandemic and associated public health control measures have affected group sex practitioners and activities. We used a community-based participatory research approach. In fall 2019, we recruited a Community Advisory Board (CAB) of group sex key informants via community agencies, social media, and relevant websites (e.g., FetLife, Squirt). To be eligible, participants had to be at least 18 years old and have recently participated in a local group sex event (i.e. sex, broadly defined, with more than 3 people). Ethics approval was secured for the CAB as a longitudinal focus group study. Focus group meetings were audio recorded, transcribed, and thematically analyzed. In December 2019, participants were asked about definitions of group sex. In May 2020, participants were asked about COVID-19 impacts. Key informants shared that due to COVID-19 restrictions, group sex events were cancelled and participants only had sex with others they were isolating with. Participants emphasized the challenges of isolation, the need to be patient, but also the opportunities associated with isolation. Participants reported attending online group sex events (e.g. Zoom orgies) as well as skill-building classes (e.g. rope bondage). Participants anticipated in-person events in the future, but felt that moving online opened up new opportunities for community-building. In conclusion, participants adhered to physical distancing protocols and quickly adapted to social isolation through innovative use of technology. [ABSTRACT FROM AUTHOR]

Author(s): Emily F. Rothman [sup.1] Author Affiliations: (Aff1) 0000 0004 1936 7558, grid.189504.1, Department of Community Health Sciences, Floor 4, Boston University School of Public Health, , 801 Massachusetts Ave, [...], This article proposes new approaches to sexual violence prevention on college and university campuses in the United States. The author conducted four thought experiments about possible college sexual assault prevention strategies based on personal experience with campus administrators and sexual assault prevention specialists, review of existing research, and conversation with undergraduates and graduate students engaged in sexual assault prevention. Both advantages and drawbacks of each potential new strategy were contemplated. The four thought experiments were: (1) What if campuses stopped investing in sexual assault prevention and invested in fighting structural oppression instead?; (2) What if the mission to change social norms was not limited to campus, but aimed at the macro level?; (3) What if sexual assault prevention experts were trained in consent and pleasure related to kink, anal sex, and group sex?; and (4) What if colleges and universities provided on-campus education and counseling options for people who perpetrate sexual assault? First, encouraging a "root cause" perspective on sexual assault prevention would be strategic and socially responsible, but might be difficult to enact. Second, social norms change strategies that are global, not local, might be effective but might require an unrealistic level of cooperation between schools. Third, more information about consent as it pertains to kink, anal sex, and group sex may be useful components of sexual assault prevention education. Finally, there are too few evidence-based programs for people who have perpetrated sexual assault on campuses. Thought experiments are inexpensive to conduct and may invigorate the field.

Author(s): Amy Bonomi [sup.1] Author Affiliations: (Aff1) 0000 0001 2150 1785, grid.17088.36, Department of Human Development and Family Studies, Michigan State University, , 552 W. Circle Drive, 48824-1312, East Lansing, [...], During an era when campuses nationwide are increasingly in the spotlight for a range of sexual assault infractions, Rothman proposes four groundbreaking thought experiments that challenge the status quo in campus-based prevention programming and call for us to do better. Namely, Rothman&apos;s thought experiments-which suggest that campuses 1) invest in fighting structural oppression at the societal level, 2) direct their social norming work at the macro level, 3) educate preventionists in consent and pleasure related to kink, anal sex and group sex, and 4) enact education and counseling for sexual violence perpetrators-provide us with fresh opportunities to examine our willingness and capacity to change and to become even more impactful leaders in practices to reduce sexual violence. In the present editorial, I argue that for Rothman&apos;s experiments (which are focused fundamentally on changing underlying power structures at the intersection of gender, race, sexuality, ability status and socioeconomic status) to be optimally effective, campuses must first engage intensively and systematically in anti-bias curricula to prepare us to be effective fighters for civil rights and human rights. Accordingly, we must be willing to acknowledge that biases exist in all of us, that biases operate in across environments to both privilege and disadvantage at the intersection of gender, race, sexuality, ability status and socioeconomic status, and that we must replace our biases with equity-focused actions for greater equity for all. I applaud Rothman in her outside-the-box thought experiments, join her in challenging us to do things differently on our nation&apos;s campuses, and hope we have the courage to be leaders in anti-bias, civil rights and human rights practices to more impactfully reduce sexual violence against women and non-majority groups.

Research on consensual non-monogamy (CNM) has largely been restricted to comparisons between monogamous and CNM people, with researchers paying little attention to various CNM styles. The current research elucidated differences among three styles of CNM: open relationships, polyamory, and swinging. Across three studies, we demonstrated that people in polyamorous or swinger-style relationships have higher levels of relationship satisfaction and other relational outcomes (e.g., passionate love, trust) than those in open relationships. That is, people in open relationships consistently fared more poorly in their relational outcomes than those in other types of CNM relationships. In Studies 4 and 5, we isolated some of the reasons for these differences. We found that differences in relational outcomes between open-style and other styles of CNM dissipated when controlling for (a) couples' approach to communication, (b) extrinsic versus intrinsic motivations for participating in CNM, (c) adherence to pro-monogamy beliefs and (d) degree of contact with one's partner's partners ("metamours"). Thus, CNM-specific relational dynamics are associated with dyadic adjustment in these relationships. [ABSTRACT FROM AUTHOR]

Background: Findings from specific countries indicated group sex was common among men who have sex with men (MSM), and men who reported group sex participation were at increased risk of human immunodeficiency virus (HIV)/sexually transmitted infections (STIs). The purpose of the current analysis was to describe the prevalence and correlates of group sex participation among a community-based sample of MSM in Chongqing, southwestern China.Methods: Convenience sampling method was used to recruit participants and data were collected through an anonymous questionnaire. Logistic regression analysis was employed to identify correlates of group sex participation.Results: Overall, 1151 eligible participants were enrolled in the study. 14.7% of MSM reported participating in group sex in their lifetime, and 5.8% reported group sex participation in the prior 6 months. Factors positively associated with group sex participation in both the prior 6 months and the lifetime included: monthly income ≥3000 Yuan (adjusted odds ratios [aOR] = 3.67, 95% confidence interval [CI] 1.25-10.75; aOR = 2.30, 95% CI 1.21-4.35), initiating anal sex before 18 years old (aOR = 1.86, 95% CI 1.03-3.34; aOR = 2.00, 95% CI 1.31-3.05), using gay apps to seek sex partners (aOR = 7.41, 95% CI 2.57-21.33; aOR = 9.75, 95% CI 4.92-19.33), recreational drug use (aOR = 10.10, 95% CI 5.52-18.49; aOR = 4.75, 95% CI 3.20-7.05) and having condomless internal ejaculation (CIE) (aOR = 3.66, 95% CI 2.01-6.68; aOR = 1.61, 95% CI 1.11-2.35). Factors only associated with group sex participation in the lifetime were older age (age between 26 and 35 years old: aOR = 2.06, 95% CI 1.30-3.26; age > 35 years old: aOR = 1.95, 95% CI 1.10-3.46) and history of STIs (aOR = 2.51, 95% CI 1.37-4.62).Conclusions: The results of this study suggested that group sex participation was a potentially risky context for acquisition and transmission of HIV/STIs. Close attention should be given to MSM who participated in group sex, and appropriate risk reduction interventions should be developed specific to this subgroup of MSM. [ABSTRACT FROM AUTHOR]

Background Group sex is associated with increased risk of HIV and sexually transmissible infections (STIs), but there is limited data on group sex among female sex workers (FSW). Understanding current group sex practices among FSW may assist with understanding and addressing the rise in STIs observed among Australian FSW in the 2010s. The aim of this study was to examine the proportion of FSWs who had engaged in group sex.Methods: A cross-sectional survey was conducted among FSWs attending the Melbourne Sexual Health Centre, Australia, between March and April 2019. Females aged ≥18 years who self-reported as a sex worker were invited to participate in the survey asking whether they had had group sex in the past 3 months. Group sex was defined as sex that involved two or more sexual partners.Results: Of the 51 FSWs who completed the survey, the median age was 29 years (IQR 24-34). Almost half (49%; n = 25) reported having group sex in the past 3 months, with a median number of group sex events of two (IQR 1-4). Australian-born FSW were more likely to report group sex than overseas-born FSW (76% vs 42%; P = 0.02). Age, number of paid clients and injecting drug use were not associated with group sex.Conclusion: The present study findings show that group sex is common among FSW and should be included in peer sexual health education and interventions among FSW. [ABSTRACT FROM AUTHOR]

The current study sought to identify types of group sex acts among HIV-negative men who have sex with men (MSM) and assess their association with different sexual risk behaviors using cross-sectional data of group sex acts reported during 6 waves (2015-2018) of the Amsterdam MSM Cohort Study. Latent class analysis was performed to identify group sex types based on size, familiarity with partners, location, planning, and drug use. Associations between group sex types and sexual behaviors were evaluated using logistic regression with generalized estimating equations, employing the sample mean as a reference. Data at the level of group sex acts were analyzed, while correcting variance estimations for repeated measurements within MSM. A total of 392 MSM engaged in group sex ≥ 1 times, totaling 1033 group sex acts. Four types of group sex emerged: familiar (29%), intimate (27%), impromptu (36%), and party (8%). Familiar group sex (characterized by high proportions of mostly known partners, occurring in private places and involving drug use) had an increased adjusted odds of risky fingering (aOR 1.6, 95%CI 1.3-2.0) and of risky fisting and/or use of sex toys (aOR 2.3, 95%CI 1.6-3.1). Intimate group sex (characterized by high proportions of threesomes, occurring in private places, and not involving drug use) had a decreased adjusted odds of risky fisting and/or use of sex toys (aOR 0.6, 95%CI 0.4-0.9). Impromptu group sex (characterized by high proportions of spontaneity, mostly unknown partners, and taking place in public places) had a decreased adjusted odds of risky fisting and/or use of sex toys (aOR 0.5, 95%CI 0.3-0.7) and of condomless anal intercourse (CAI) (OR 0.6, 95%CI 0.5-0.8). Party group sex (characterized by high proportions of larger groups, mostly unknown partners, and being planned) had an increased adjusted odds of risky fisting and/or use of sex toys (aOR 1.6, 95%CI 1.0-2.7) and of CAI (aOR 1.5, 95%CI 1.1-2.1). The identified types of group sex reflect different dynamics and characteristics, with some types riskier for STIs and others riskier for HIV. HIV and STI prevention efforts could be tailored accordingly. For example, in certain type of public sex environments (e.g., cruising parks), traditional HIV and STI prevention efforts, such as promoting of condom use and PrEP, might be sufficient. However, in other settings (e.g., private parties), where group sex is more likely to be planned and where behaviors such as fisting, sharing of sex toys, and CAI are more likely to take place, which carry different levels of risk for HIV and STI transmission, including that of Hepatitis C, different approaches might be needed, such as broader HIV and STI prevention education efforts or targeting the organizers of group sex events. [ABSTRACT FROM AUTHOR]