Group sex among adolescents a public health concern, new study says

December 16, 2011

One in 13 teenage girls, aged 14 to 20, reported having a group-sex experience, with those young women more likely to have been exposed to pornography and childhood sexual abuse than their peers, according to a new study led by a Boston University School of Public Health (BUSPH) researcher.

In a study published in the Journal of Urban Health: Bulletin of the New York Academy of Medicine, Emily Rothman, associate professor of community health sciences at BUSPH, and colleagues surveyed 328 females who had utilized a Boston-area community or school-based health clinic, to explore whether they had ever had sex with multiple partners -- either consensual or forced. The authors call this sexual experience "multi-person sex," or MPS, in order to underscore that it refers to any group sex experience on a continuum from gang rape to sex parties.

Of the 7.3 percent who said they had group sex, more than half reported being pressured to engage in the group-sex situation. Forty-five percent reported a lack of condom use by a male participant during the most recent group-sex encounter. Participants with MPS experience also were more likely to report cigarette smoking, dating violence victimization, or ever being diagnosed with a sexually transmitted disease, the study found.

In addition, those who had seen pornography in the past month were approximately five times as likely as those who had not seen pornography to report ever having had a group-sex experience.

The average age of the first group-sex experience was 15.6 years old. The majority of those who reported such activity said it was a one-time experience; 21 percent had multiple group-sex experiences. One-third reported using alcohol or drugs prior to their most recent experience, but half of those girls reported that their alcohol or drug use was not voluntary, indicating that they were "liquored up" or drugged by their sexual partner.

Multi-person sex "appeared to pose a potential risk to sexual and reproductive health, as only 55 percent of participants reported that condoms were used consistently during their most recent MPS," Rothman and colleagues said. "The majority of MPS-experienced girls in this sample reported being pressured, threatened, coerced, or forced to participate in MPS at least once."

More than half (54%) of those teens were younger than 16 when they had a group-sex experience, which in Massachusetts would mean that their sexual partners were violating state law regarding the age of consent, the study found.

"Given the substantial proportion of girls who reported that their MPS was nonconsensual, additional research to understand more about the perpetrators, and how to prevent this particular form of sexual violence, is warranted," the authors said. "Researchers and clinicians should pay particular attention to younger adolescents engaging in MPS. Given heightened concerns about potential consequences, information about how to address MPS with this subgroup is urgently needed."

The authors noted a "strong association between exposure to pornography, having been forced to do things that their sex partner saw in pornography, and MPS." Even if participation was voluntary, they said, "it is crucial to know how this early experience shapes their sexual behavior trajectory and affects their lifetime risk for negative sexual, reproductive, and other health risk behaviors."

The authors said that while there has been considerable research on adult MPS and its association with HIV transmission and sexually transmitted diseases, relatively little attention has been given to adolescent group-sex encounters. They cited a recent study of high-school girls in the Northeast that found that "sex parties" are currently an "accepted activity" of a certain subset of teens. Another study, in Sweden, found that 7 percent of female high school seniors who were sexually active reported having group sex.

"Group sex among youth is an important public health topic that has received very little attention to date," Rothman said. "It's time for parents, pediatricians, federal agencies, and community-based organizations to sit up, pay attention, and take notice: group sex is happening, and we need to be prepared to address it."

She said the study was designed to estimate the prevalence and health correlates of adolescent multi-partner sex, in hopes of stirring further research.
-end-
Besides Rothman, researchers on the study were: Michele R. Decker, of Johns Hopkins University School of Public Health; Elizabeth Miller, of the Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center; Elizabeth Reed, of George Washington University ; and Anita Raj and Jay G. Silverman, of the Division of Global Public Health, School of Medicine, University of California at San Diego.

The research was supported by grants from the National Center for Injury Prevention and Control/CDC, the National Institute on Alcohol Abuse and Alcoholism, and the W.T. Grant Foundation. The full study is available here: http://www.springerlink.com/content/1787w3361233210t/fulltext.pdf

Founded in 1976, Boston University School of Public Health offers master's and doctoral-level education in public health concentrations including biostatistics; environmental health; epidemiology; health law, bioethics & human rights; health policy & management; international health; and community health sciences. The faculty conducts policy-changing research around the world with the mission of improving the health of populations, especially the disadvantaged, underserved and vulnerable.

Boston University Medical Center

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