More than just anal sex: the potential for sexually transmitted infection transmission among men visiting sex-on-premises venues

Objectives: This study aimed to obtain detailed data on the frequency of sexual practices among men who had sex with men (MSM) at sex-on-premises venues (SOPV) and to compare this with their sexual practices outside SOPV. Methods: A cross-sectional survey was undertaken of MSM at six SOPV between December 2006 and March 2007. Results: Of 604 men approached, 200 (33%) participated. Men reported sexual contact with a median of two other men (range 0–28). Receptive and insertive anal intercourse was reported by 19.5% and 34.0%, respectively, and was unprotected in 2.5% and 6.0%. The frequency of other practices included: unprotected insertive and receptive penile–anal touching or rubbing without penetration, or “nudging” (26.5% and 20.0%); unprotected, transient insertive and receptive anal intercourse, or “dipping” (6.0% and 5.0%) and insertive and receptive anal fingering (38.5% and 32.5%). Approximately 40% of men who reported “nudging” reported that they had not engaged in any “anal sex”. Compared with their practices with casual male partners outside SOPV, men having sex at SOPV were less likely to have receptive oral intercourse with ejaculation (odds ratio (OR) 0.4; 95% CI 0.2 to 1.0, p = 0.04) and unprotected receptive anal intercourse (OR 0.3; 95% CI 0.1 to 0.8, p = 0.01), but were more likely to have group sex (OR 2.0; 95% CI 1.1 to 3.6, p = 0.03). Conclusions: Substantial penile–anal contact not involving anal intercourse occurred at SOPV and may explain anal infections in the absence of reported anal sex. Some higher risk practices were reported more frequently with male partners outside of these venues than with partners within SOPV.