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


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.

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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.

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Correspondence to Emily F. Rothman.

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Rothman, E.F., Decker, M.R., Miller, E. et al. Multi-person Sex among a Sample of Adolescent Female Urban Health Clinic Patients. J Urban Health 89, 129–137 (2012).

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  • Adolescent
  • Group sex
  • Sexual behavior
  • Rape
  • Sexually transmitted diseases
  • Sexual assault