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

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Abstract

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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References

  1. Friedman SR, Bolyard M, Khan M, et al. Group sex events and HIV/STI risk in an urban network. JAIDS. 2008;49(4):440-446.

    Article  PubMed  Google Scholar 

  2. Elshibly S, Kallings I, Hellberg D, Mardh PA. Sexual risk behaviour in women carriers of Mycoplasma hominis. Br J Obstet Gynaecol. 1996;103(11):1124-1128.

    Article  PubMed  CAS  Google Scholar 

  3. Nilsson U, Hellberg D, Shoubnikova M, Nilsson S, Mardh PA. Sexual behavior risk factors associated with bacterial vaginosis and Chlamydia trachomatis infection. Sex Transm Dis. 1997;24(5):241-246.

    Article  PubMed  CAS  Google Scholar 

  4. Toscano S. Sex parties: female teen sexual experimentation. J Sch Nurs. 2006;22(5):24-28.

    Article  Google Scholar 

  5. Haggstrom-Nordin E, Hanson U, Tyden T. Associations between pornography consumption and sexual practices among adolescents in Sweden. Int J STD AIDS. 2005;16(2):102-107.

    Article  PubMed  CAS  Google Scholar 

  6. Stankovic M, Miljkovic S, Grbesa G, Visnjic A. General characteristics of adolescent sexual behaviour: national survey. Srpski Arhiv Za Celokupno Lekarstvo. 2009;137(7–8):409-415.

    Article  PubMed  Google Scholar 

  7. McInnes D, Bradley J, Prestage G. The discourse of gay men’s group sex: the importance of masculinity. Cult Health Sex. 2009;11(6):641-654.

    Article  PubMed  Google Scholar 

  8. Prestage GP, Hudson J, Down I, et al. Gay men who engage in group sex are at increased risk of HIV infection and onward transmission. AIDS Behav. 2009;13(4):724-730.

    Article  PubMed  Google Scholar 

  9. Zule WA, Costenbader E, Coomes CM, et al. Stimulant use and sexual risk behaviors for HIV in rural North Carolina. J Rural Health. 2007;23:73-78.

    Article  PubMed  Google Scholar 

  10. Kippax S, Campbell D, Van de Ven P, et al. Cultures of sexual adventurism as markers of HIV seroconversion: a case control study in a cohort of Sydney gay men. AIDS Care Psychol Socio Med Asp AIDS/HIV. 1998;10(6):677-688.

    Article  CAS  Google Scholar 

  11. Ullman SE. A comparison of gang and individual rape incidents. Violence Vict. 1998;14:1-11.

    Google Scholar 

  12. Sommers MS. Defining patterns of genital injury from sexual assault: a review. Trauma Violence Abuse. 2007;8(3):270-280.

    Article  PubMed  Google Scholar 

  13. Golding JM. Sexual-assault history and long-term physical health problems: evidence from clinical and population epidemiology. Curr Dir Psychol Sci. 1999;8(6):191-194.

    Article  Google Scholar 

  14. Reynolds MW, Peipert JF, Collins B. Epidemiologic issues of sexually transmitted diseases in sexual assault victims. Obstet Gynecol Surv. 2000;55(1):51-57.

    Article  PubMed  CAS  Google Scholar 

  15. Kaufman M, Comm A. Care of the adolescent sexual assault victim. Pediatrics. 2008;122(2):462-470.

    Article  Google Scholar 

  16. Holmes MM, Resnick HS, Kilpatrick DG, Best CL. Rape-related pregnancy: estimates and descriptive characteristics from a national sample of women. Paper presented at: 58th Annual Meeting of the South Atlantic Association of Obstetricians and Gynecologists, Lake Buena Vista, FL; 1996.

  17. Lee M, Ousey G. Counterbalancing disadvantage? Residential integration and urban Black homicide. Soc Probl. 2007;54(2):240-262.

    Article  Google Scholar 

  18. Parker KF, Maggard SR. Making a difference: the impact of traditional male role models on drug sale activity and violence involving Black urban youth. J Drug Iss. 2009;39(3):715-739.

    Google Scholar 

  19. Popkin S, Leventhal T, Weismann G. Girls in the ‘hood: evidence on the impact of safety. Poverty Race. 2006;15(5):3-7.

    Google Scholar 

  20. Rothman EF, Decker MR, Reed E, Raj A, Silverman JG, Miller E. “Running a Train”: adolescent boys’ accounts of sexual intercourse involving multiple males and one female. J Adolesc Res. 2008;23(1):97-113.

    Article  Google Scholar 

  21. Straus MA, Hamby SL, BoneyMcCoy S, Sugarman DB. The revised conflict tactics scales (CTS2)—development and preliminary psychometric data. J Fam Iss. 1996;17(3):283-316.

    Article  Google Scholar 

  22. Kessler RC, Barker PR, Colpe LJ, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatry. 2003;60(2):184-189.

    Article  PubMed  Google Scholar 

  23. Mamdani M, Sykora K, Li P, et al. Reader’s guide to critical appraisal of cohort studies: 2. Assessing potential for confounding. Br Med J. 2005;330(7497):960-962.

    Article  Google Scholar 

  24. Hensel DJ, Fortenberry JD, Orr DP. Factors associated with event level anal sex and condom use during anal sex among adolescent women. J Adolesc Health. 2010;46(3):232-237.

    Article  PubMed  Google Scholar 

  25. Manlove J, Ikramullah E, Terry-Humen E. Condom use and consistency among male adolescents in the United States. J Adolesc Health. 2008;43(4):325-333.

    Article  PubMed  Google Scholar 

  26. Merritt DF. Genital trauma in the pediatric and adolescent female. Obstet Gynecol Clin North Am. 2009;36(1):85-98.

    Article  PubMed  Google Scholar 

  27. Koumans EH, Farley TA, Gibson JJ, et al. Characteristics of persons with syphilis in areas of persisting syphilis in the United States—sustained transmission associated with concurrent partnerships. Sex Transm Dis. 2001;28(9):497-503.

    Article  PubMed  CAS  Google Scholar 

  28. Aral SO, Leichliter JS. Non-monogamy: risk factor for STI transmission and acquisition and determinant of STI spread in populations. Sex Transm Infect. 2010;86:29-36.

    Article  Google Scholar 

  29. Poulin C, Graham L. The association between substance use, unplanned sexual intercourse and other sexual behaviours among adolescent students. Addiction. 2001;96(4):607-621.

    Article  PubMed  CAS  Google Scholar 

  30. Flanigan BJ, Hitch MA. Alcohol use, sexual intercourse, and contraception: an exploratory study. J Alcohol Drug Educ. 1986;31(3):6-40.

    PubMed  CAS  Google Scholar 

  31. Ompad DC, Strathdee SA, Celentano DD, et al. Predictors of early initiation of vaginal and oral sex among urban young adults in Baltimore, Maryland. Arch Sex Behav. 2006;35(1):53-65.

    Article  PubMed  Google Scholar 

  32. Rothman E, Wise L, Bernstein E, Bernstein J. The timing of alcohol use and sexual initiation among a sample of Black, Hispanic and White adolescents. J Ethn Subst Abuse. 2009;8(2):129-145.

    Article  PubMed  Google Scholar 

  33. Mitchell KJ, Wolak J, Finkelhor D. Trends in youth reports of sexual solicitations, harassment and unwanted exposure to pornography on the Internet. J Adolesc Health. 2007;40(2):116-126.

    Article  PubMed  Google Scholar 

  34. US Centers for Disease Control and Prevention. Youth online: Comprehensive results. National Center for Chronic Disease Prevention and Health Promotion. http://apps.nccd.cdc.gov/yrbss/. Accessed March 19, 2010.

  35. US Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance summary: United States, 2003. MMWR Morb Mortal Wkly Rep. 2004;53(2).

  36. Gates GJ, Sonenstein FL. Heterosexual genital sexual activity among adolescent males: 1988 and 1995. Fam Plann Perspect. 2000;32(6):295-304.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

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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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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Authors and Affiliations

  1. Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Ave, 3rd Floor, Boston, MA, 02118, USA

    Emily F. Rothman

  2. Johns Hopkins University School of Public Health, Baltimore, MD, USA

    Michele R. Decker

  3. Division of Adolescent Medicine, Department of Pediatrics, Children’s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

    Elizabeth Miller

  4. George Washington University, Washington, DC, USA

    Elizabeth Reed

  5. Division of Global Public Health, School of Medicine, University of California at San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0507, USA

    Anita Raj & Jay G. Silverman

Authors
  1. Emily F. Rothman
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  2. Michele R. Decker
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  3. Elizabeth Miller
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  4. Elizabeth Reed
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  5. Anita Raj
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  6. Jay G. Silverman
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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). https://doi.org/10.1007/s11524-011-9630-1

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  • DOI: https://doi.org/10.1007/s11524-011-9630-1

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