Background: Men who have sex with men (MSM) remain the group most affected by the HIV epidemic in the United States. At least one-quarter of MSM report engagement in group sex events (GSEs), which can pose a risk for HIV transmission and acquisition. In this study, we sought to identify event-level correlates of sexual and drug use behaviors at GSEs to better inform prevention activities.
Methods: For this study, we recruited participants via banner and pop-up advertisements placed on a geosocial networking mobile phone application for MSM to meet.
Results: Of the 1,997 individuals who completed the study screener, 36.0% reported participating in at least one GSE in the prior year. In multivariable logistic regression, attendance at a GSE in the past year was significantly associated with older age, full/part time employment, and being HIV-positive. Of the men who attended a GSE, more than half reported condomless anal sex (CAS) with at least one of their partners (insertive: 57.7%; receptive: 56.3%). MSM who indicated drug use had significantly higher odds of having insertive CAS (odds ratio (OR) = 2.45; 95% confidence interval (CI): 1.37, 4.39) and receptive CAS (OR = 3.60; 95% CI: 1.96, 6.63) at their last GSE.
Conclusions: The high prevalence of HIV-positive MSM engaging in group sex, coupled with their greater odds of CAS, poses a significant risk for HIV/STI transmission within the group sex setting. More research is needed to determine patterns of condom use at these events, and whether seroadaptive behaviors are driving CAS.