An Evaluation of the STD Profiles and Safe Sex Practices of a Sample of Swingers

An evaluation of the STD profiles and safe sex practices of a sample of swingers

Presented by: Edward M. Fernandes, Ph.D. Assistant Professor of Psychology Barton College, North Carolina

George Gaither, Ph.D. Associate Professor of Psychological Science Ball State University, Indiana

The purpose of this study was to gather information about the sexual activities of swingers, to determine the incidence and prevalence of STDs in this population, and to evaluate the safe sex practices of swingers.

STI - sexually transmitted infection- is a new term replacing STD.

According to the CDC and the American Sexual Health Association abstinence (not having oral, vaginal, or anal sex) is the best way to prevent STD. Mutual monogamy – having sex with only one, uninfected partner who only has sex with you

Limiting the number of sex partners to reduce possible exposure to STDs/STIs Using latex condoms consistently and correctly for all types of sexual contact (oral, vaginal, anal)

© Edward Fernandes, Ph.D. All rights reserved The estimated total number of people living in the US with a viral STD/STI is over 65 million. Cases of sexually transmitted diseases reported rates per 100,000 civilian population United States, 2007

Chlamydia 1,108,374 370.2 rate

Gonorrhea 355,991 118.9 rate

Syphilis (all stages) 40,920 13.7 rate

In a national survey of US physicians, fewer than one-third routinely screened patients for STDs/STIs

Source: CDC/NCHSTP 2003 STD Surveillance Report © Edward Fernandes, Ph.D. All rights reserved5 Gonorrhea Gonorrhea — Rates by gender: United States, 1981–2003 and the Healthy People year 2010 objective

Source: CDC/NCHSTP 2003 STD Surveillance Report © Edward Fernandes, Ph.D. All rights reserved6 Syphilis Syphilis — Reported cases by stage of illness: United States, 1941–2003

Source: CDC/NCHSTP 2003 STD Surveillance Report © Edward Fernandes, Ph.D. All rights reserved7 HIV/AIDS Estimated Incidence of AIDS and Death of Adults with AIDS*, United States, January 1985 – June 2003

Note: Adjusted for reporting delays Source: CDC/NCHSTP 2003 HIV/AIDS Surveillance Report © Edward Fernandes,8 Ph.D. All rights reserved Herpes Genital herpes — Initial visits to physicians’ offices: United States, 1966–2003

SOURCE: National Disease and Therapeutic Index (IMS America, Ltd.) © Edward Fernandes, Ph.D. All rights reserved9 Other STDs Pelvic Inflammatory Disease Initial visits to physicians’ offices by women 15-44 years of age United States, 1980–2003

SOURCE: National Disease and Therapeutic Index (IMS Health) © Edward Fernandes, Ph.D. All rights reserved10 Trichomoniasis and other vaginal infections in women — Initial visits to physicians’ offices: United States, 1966–2007

Over 6 million people acquire HPV each year

Each year, there are almost 3 million new cases of chlamydia

Consistent condom use provides substantial protection against the acquisition of many STDs, including statistically significant reduction of risk against HIV, chlamydia, gonorrhea, herpes, and syphilis

© Edward Fernandes, Ph.D. All rights reserved Our Study: Sample and Method Sample: The respondents were a self-selected sample of swingers (sample of convenience) recruited through an online advertisement in three of major swingers’ web dating sites. Instrument: A survey was constructed by the researchers. A link to the survey was made available through the participating sites. Survey questions included a demographics section, a sexual behaviour and attitudes section, a safe sex practices section, and a STD proﬁle section

Demographic Gender Differences within the Sample 2,103 (74%) men & 741 (26%) women

Sexual Orientation  Men: more heterosexuals (84%) than bisexuals (15%)  Women: more bisexuals (72%) than heterosexuals (28%)  Very few identiﬁed as homosexual  8 (0.4%) men; 1 (0.1%) woman Age  40% of men and women were 35-45  Men: more 45 or older (45%) than under 35 years old (16%)  Women: more under 35 years old (33%) than of over 45 (27%)

Race/Ethnicity  84% Caucasian; 10% Latino; 3% Black Present Marital Status  72% married; 13% cohabiting; 7% single Swinging Frequency  75% reported 2-12 times per year  More men than women reported swinging less than once a year (6% vs 3%)  More women than men reported swinging weekly (14% vs 7%)

© Edward Fernandes, Ph.D. All rights reserved Table 1. Proportions of participants (by sex) that reported engaging in each sexual activity during swinging. Men Women Swinging Activity (n = 2103) (n = 741) Oral Sex .87 .89 Vaginal Sex .83 .83 Exchange partners .78 .78 Group Sexual Activities .73 .69 MFM activities* .68 .58 FMF activities .58 .62 Anal Sex* .34 .24 Mutual Masturbation .31 .29 Watch Only* .21 .14 Woman on woman sex only* .13 .29 B&D .08 .11 Other .08 .07 Fisting .06 .06 S&M .05 .07 Do not Participate in any sexual activity .04 .03 Watersports .04 .03 Man on man sex only* .03 .01 Never exchange partners .02 .03 Note: * Diﬀerence is stascally signiﬁcant using independent samples t-tests and α set at .003 © Edward Fernandes, Ph.D. All rights reserved Table 3. Proportions of participants (by sex) that reported contracting any STD and specific STDs during swinging sexual activities.

Proportions that said "yes" Men Women (n = 2062) (n = 727) Ever contracted an STD during swinging sexual activities .06 .11

Vaginitis .01 .05 Chlamydia .02 .03 Gonorrhea .01 .00 Syphilis .00 .00 Herpes .01 .02 HPV .01 .03 HIV .00 .00 Yeast Infection .01 .06 Bladder Infection .00 .04 Kidney Infection .00 .00 Other STD .01 .01

© Edward Fernandes, Ph.D. All rights reserved Table 4. Proportions of participants (by sex) that reported currently having any STD and specific STDs. Proportions that said "yes" Men Women (n = 2012) (n = 709) Do you currently have an STD .04 .05 Vaginitis .00 .00 Chlamydia .00 .00 Gonorrhea .00 .00 Syphilis .00 .00 Herpes .03 .03 HPV .01 .03 HIV .00 .00 Yeast Infection .00 .00 Bladder Infection .00 .00 Kidney Infection .00 .00 Other STD .00 .00

© Edward Fernandes, Ph.D. All rights reserved Table 5. Percentages of participants who reported ever contracting an STD during swinging by marital status. Men Women n % Yes n % Yes Married 1478 6.0 492 7.7 Single 153 7.2 48 12.5 Cohabing 242 7.0 105 22.9 Widowed 11 0.0 6 16.7 Divorced 98 2.0 32 15.6 Other 37 2.7 25 20.0 Total 2019 5.9 708 11.2

The percentage of male participants who reported having ever contracted an STD through swinging activities did not differ by current marital status X2(5, N = 2019) = 5.01, p > .05. Among female participants, however, a significantly smaller proportion of married participants reported ever having contracted an STD, than other women X2(5, N =708) = 23.24, p < .001.

Men Women n % Yes n % Yes Less than once a year 122 5.7 24 4.2 At least once a year 174 5.2 49 4.1 At least 2 to 5 mes a year 595 4.0 168 10.7 At least 6 to 8 mes a year 473 5.3 186 11.3 Monthly 511 7.6 189 14.8 Weekly 155 12.3 105 11.4 Total 2030 6.1 721 11.4

A Chi Square test revealed that a significantly larger proportion of men who reported swinging weekly reported ever having contracted an STD through swinging activities than all other men, X2(5, N = 2,030) = 17.73, p = .003. Proportions did not differ significantly among women, X2(5, N = 721) = 6.12, p > .05.

© Edward Fernandes, Ph.D. All rights reserved Safer Sex Behavior Items Safer Oral Sex Behaviors When engaging in oral sex during swinging… I use condoms I ask my partner(s) to use condoms I use a latex barrier (i.e. dental dams) I ask my partner(s) to use a latex barrier (i.e. dental dams)

Safer Intercourse Behaviors When engaging in vaginal sex during swinging I use condoms When engaging in anal sex during swinging I use condoms When engaging in vaginal or anal sex during swinging I ask my partner(s) to use condoms

Safer Sex Assessment Behaviors I ask my sexual partners for their STD status I tell my partners about my STD I get tested for STDs at least once a year

Risky Sexual Behaviors I have engaged in swinging activities while infected by an STD I share sex toys with other sexual partners

Men No Yes F(3, 1940) = 4.49, p = .004 n = 1,826 n = 118 a M SD M SD Oral Sex .82 1.55 0.90 1.25 0.55 F(1, 1942) = 12.05, p = .001 Intercourse .90 4.12 1.16 4.02 1.14 F(1, 1942) = 0.76, p = .381 Assessment .79 3.26 1.35 3.04 1.2 F(1, 1942) = 3.20, p = .074 Risky Behaviors .13

Women No Yes F(3, 676) = 2.44, p = .063 n = 601 n = 79 a M SD M SD Oral Sex .84 1.59 1.00 1.43 0.82 F(1, 679) = 1.86, p = .173 Intercourse .90 4.34 1.08 4.28 1.01 F(1, 679) = 0.18, p = .669 Assessment .80 3.47 1.35 3.06 1.20 F(1, 679) = 6.69, p = .010 Risky Behaviors .11 © Edward Fernandes, Ph.D. All rights reserved Ever contracted an STD through Swinging by Risky Behaviors

Men No Yes F(3, 1545) = 4.90, p = .002 n = 1,445 n = 104 M SD M SD I share sex toys with other sex partners. 3.96 1.17 3.76 1.20 F(1, 1548) = 2.88, p = .090

I have engaged in swinging acvies while infected with an STD. 4.91 .056 4.70 0.87 F(1, 1548) = 11.87, p = .001 I swing with "single" individuals 3.35 1.03 3.27 0.95 F(1, 1548) = 0.66, p = .419

Women No Yes F(3, 574) = 3.83, p = .010 n = 506 n = 72 M SD M SD I share sex toys with other sex partners. 3.99 1.11 3.89 1.08 F(1, 577) = 0.57, p = .449

I have engaged in swinging acvies while infected with an STD. 4.92 0.51 4.72 0.76 F(1, 577) = 7.96, p = .005 I swing with "single" individuals 3.34 1.11 3.08 1.05 F(1, 577) = 3.36, p = .067

© Edward Fernandes, Ph.D. All rights reserved Conclusions based on this research . 1. Swingers, by self-report, have very low rates of STDs, even though not all engage in safer sex practices. . 2. Women are twice as likely to report getting infected with a STD during swinging. . 3. Diﬀerent variables diﬀer among those who have versus those that have not been infected with a STD through swinging. . 4. We may question the simple statement that multiple partners = high STD risk – we must consider the context as with this population. . 5. Swinging itself is not a high risk behavior. . 6. Swingers consider swinging a safe behavior; swingers also feel that other swingers are trustworthy.

© Edward Fernandes, Ph.D. All rights reserved . However: . Sample : self-selected sample of convenience . May not be representative of the population . Individuals infected with STIs may have dropped out of swinging . Respondents may have had a bias motivation in participating in the survey. . Further research is necessary using urogenital sampling.