Journal of Urban Health

, Volume 89, Issue 1, pp 129–137 | Cite as

Multi-person Sex among a Sample of Adolescent Female Urban Health Clinic Patients

  • Emily F. RothmanEmail author
  • Michele R. Decker
  • Elizabeth Miller
  • Elizabeth Reed
  • Anita Raj
  • Jay G. Silverman


Adolescent sexual activity involving three or more people is an emerging public health concern. The goal of this exploratory, cross-sectional study was to describe the prevalence, correlates, and context of multiple-person sex among a sample of adolescent females seeking health care from an urban clinic. Because sex involving multiple people may either be consensual (i.e., “three-ways” or “group sex”) or forced (i.e., “gang rape”), we use the term “multi-person sex” (MPS) to encompass these experiences. Subjects were 328 females, ages 14–20 years old, who utilized a Boston-area community- or school-based health clinic between April and December of 2006, and completed an anonymous survey using computer-assisted self-interview software. Overall, 7.3% reported ever having had a MPS experience. Of these, 52% reported ever being pressured to engage in MPS and 43% reported ever being threatened or forced. Condom nonuse by at least one male participant in the most recent MPS was reported by 45%. Controlling for potential demographic confounders, MPS was associated with cigarette smoking (adjusted prevalence ratio [APR], 3.83; 95% confidence interval [CI], 1.56–9.44), sexual initiation prior to age 15 (APR, 2.50; 95% CI, 1.04–5.98), ever being diagnosed with an STI (APR, 2.55; 95% CI, 1.08–6.03), dating violence victimization (APR, 4.43; 95% CI, 1.68–11.69), childhood sexual abuse victimization (APR, 4.30; 95% CI, 1.83–10.07) and past-month pornography exposure (APR, 4.79; 95% CI, 1.91–11.98). Additional study of the perpetration and prevention of adolescent MPS is urgently needed.


Adolescent Group sex Sexual behavior Rape Sexually transmitted diseases Sexual assault 



The research described was supported by grants from the National Center for Injury Prevention and Control/CDC (U36/CCU300430-23), the National Institute on Alcohol Abuse and Alcoholism (1K01AA017630-01A1), and from the W.T. Grant Foundation.

Open Access

This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.


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Copyright information

© The New York Academy of Medicine 2011

Authors and Affiliations

  • Emily F. Rothman
    • 1
    Email author
  • Michele R. Decker
    • 2
  • Elizabeth Miller
    • 3
  • Elizabeth Reed
    • 4
  • Anita Raj
    • 5
  • Jay G. Silverman
    • 5
  1. 1.Department of Community Health SciencesBoston University School of Public HealthBostonUSA
  2. 2.Johns Hopkins University School of Public HealthBaltimoreUSA
  3. 3.Division of Adolescent Medicine, Department of Pediatrics, Children’s Hospital of PittsburghUniversity of Pittsburgh Medical CenterPittsburghPennsylvania
  4. 4.George Washington UniversityWashingtonUSA
  5. 5.Division of Global Public Health, School of MedicineUniversity of California at San DiegoLa JollaUSA

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