Seasonal variations in kissing and sexual activities among men who have sex with men in Melbourne, Australia: implications for seasonal sexually transmissible infection preventions and interventions
Eric P. F. Chow
A B C , Lenka A. Vodstrcil A B and Christopher K. Fairley A B
+ Author Affiliations
- Author Affiliations
A Melbourne Sexual Health Centre, Alfred Health, 580 Swanston Street, Carlton, Vic. 3053, Australia.
B Central Clinical School, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia.
C Corresponding author. Email: eric.chow@monash.edu
Sexual Health 17(2) 149-154 https://doi.org/10.1071/SH19046
Submitted: 9 March 2019 Accepted: 15 November 2019 Published: 6 March 2020
Journal compilation © CSIRO 2020 Open Access CC BY-NC-ND
Abstract
Background: Previous studies have shown that there is a peak in sexually transmissible infection (STI) cases and sexual activities around summer, but there has been no study examining whether kissing also follows a similar seasonal pattern. The aim of this study was to examine the seasonal patterns of kissing and sex partners among gay, bisexual and other men who have sex with men (MSM). Methods: A short cross-sectional study was conducted among MSM attending the Melbourne Sexual Health Centre between March 2016 and February 2017. Participants were asked to report the number of kissing-only, sex-only and kissing-with-sex male partners in the last 3 months. The mean number of male partners was calculated and stratified by Australia’s seasons. The seasonal trend in the number of partners was assessed by negative binomial regression models. Results: In total, 4391 MSM were included in the analysis. The number of kissing-only and sex-only partners increased significantly from autumn to summer among MSM in Melbourne (Ptrend <0.001). MSM reported the highest number of male partners for kissing-only (mean: 4.91; 95% confidence intervals (CI): 4.78–5.04) and sex-only (mean: 1.91; 95% CI: 1.83–1.99) around summer compared with other seasons. However, the number of kissing-with-sex partners remained stable across seasons. Conclusions: The study data suggest that there is a peak in kissing-only and sex-only partners among MSM around summer and holiday seasons.
Additional keywords: bisexual, gay, gonorrhoea, holidays, homosexual, kiss, season, sexual behaviours, sexual practice, summer.
References
[1] Chow EPF, Grulich AE, Fairley CK. Epidemiology and prevention of sexually transmitted infections in men who have sex with men at risk of HIV. Lancet HIV 2019; 6 e396–405.| Epidemiology and prevention of sexually transmitted infections in men who have sex with men at risk of HIV.Crossref | GoogleScholarGoogle Scholar | 31006612PubMed |
[2] Kirkcaldy RD, Weston E, Segurado AC, Hughes G. Epidemiology of gonorrhoea: a global perspective. Sex Health 2019; 16 401–11.
| Epidemiology of gonorrhoea: a global perspective.Crossref | GoogleScholarGoogle Scholar |
[3] Callander D, Guy R, Fairley CK, McManus H, Prestage G, Chow EPF, et al Gonorrhoea gone wild: rising incidence of gonorrhoea and associated risk factors among gay and bisexual men attending Australian sexual health clinics. Sex Health 2019; 16 457–63.
| Gonorrhoea gone wild: rising incidence of gonorrhoea and associated risk factors among gay and bisexual men attending Australian sexual health clinics.Crossref | GoogleScholarGoogle Scholar |
[4] Phillips TR, Fairley CK, Chen MY, Bradshaw CS, Chow EPF. Risk factors for urethral gonorrhoea infection among heterosexual males in Melbourne, Australia: 2007–17. Sex Health 2019; 16 508–13.
| Risk factors for urethral gonorrhoea infection among heterosexual males in Melbourne, Australia: 2007–17.Crossref | GoogleScholarGoogle Scholar |
[5] Chow EP, Williamson DA, Fortune R, Bradshaw CS, Chen MY, Fehler G, et al Prevalence of genital and oropharyngeal chlamydia and gonorrhoea among female sex workers in Melbourne, Australia, 2015–2017: need for oropharyngeal testing. Sex Transm Infect 2019; 95 398–401.
| Prevalence of genital and oropharyngeal chlamydia and gonorrhoea among female sex workers in Melbourne, Australia, 2015–2017: need for oropharyngeal testing.Crossref | GoogleScholarGoogle Scholar | 31113904PubMed |
[6] Hansdotter F, Blaxhult A. ‘Chlamydia Monday’ in Sweden. Euro Surveill 2008; 13 18984
| ‘Chlamydia Monday’ in Sweden.Crossref | GoogleScholarGoogle Scholar | 18801322PubMed |
[7] Martinez ME. The calendar of epidemics: seasonal cycles of infectious diseases. PLoS Pathog 2018; 14 e1007327
| The calendar of epidemics: seasonal cycles of infectious diseases.Crossref | GoogleScholarGoogle Scholar | 30408114PubMed |
[8] Schroeder B, Tetlow P, Sanfilippo JS, Hertweck SP. Is there a seasonal variation in gonorrhea and chlamydia in adolescents? J Pediatr Adolesc Gynecol 2001; 14 25–7.
| Is there a seasonal variation in gonorrhea and chlamydia in adolescents?Crossref | GoogleScholarGoogle Scholar | 11358703PubMed |
[9] Cornelius CE. Seasonality of gonorrhea in the United States. HSMHA Health Rep 1971; 86 157–60.
| Seasonality of gonorrhea in the United States.Crossref | GoogleScholarGoogle Scholar | 5544389PubMed |
[10] Wright RA, Judson FN. Relative and seasonal incidences of the sexually transmitted diseases. A two-year statistical review. Br J Vener Dis 1978; 54 433–40.
| Relative and seasonal incidences of the sexually transmitted diseases. A two-year statistical review.Crossref | GoogleScholarGoogle Scholar | 581655PubMed |
[11] Cornelisse VJ, Chow EP, Chen MY, Bradshaw CS, Fairley CK. Summer heat: a cross-sectional analysis of seasonal differences in sexual behaviour and sexually transmissible diseases in Melbourne, Australia. Sex Transm Infect 2016; 92 286–91.
| Summer heat: a cross-sectional analysis of seasonal differences in sexual behaviour and sexually transmissible diseases in Melbourne, Australia.Crossref | GoogleScholarGoogle Scholar | 26546343PubMed |
[12] Li B, Bi P, Chow EPF, Donovan B, McNulty A, Ward A, et al Seasonal variation in gonorrhoea incidence among men who have sex with men. Sex Health 2016; 13 589–92.
| Seasonal variation in gonorrhoea incidence among men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 27712614PubMed |
[13] Fairley CK, Cornelisse VJ, Hocking JS, Chow EPF. Models of gonorrhoea transmission from the mouth and saliva. Lancet Infect Dis 2019; 19 e360–6.
| Models of gonorrhoea transmission from the mouth and saliva.Crossref | GoogleScholarGoogle Scholar | 31324517PubMed |
[14] Fairley CK, Hocking JS, Zhang L, Chow EP. Frequent transmission of gonorrhea in men who have sex with men. Emerg Infect Dis 2017; 23 102–4.
| Frequent transmission of gonorrhea in men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 27983487PubMed |
[15] Zhang L, Regan DG, Chow EPF, Gambhir M, Cornelisse V, Grulich A, et al Neisseria gonorrhoeae transmission among men who have sex with men: an anatomical site-specific mathematical model evaluating the potential preventive impact of mouthwash. Sex Transm Dis 2017; 44 586–92.
| Neisseria gonorrhoeae transmission among men who have sex with men: an anatomical site-specific mathematical model evaluating the potential preventive impact of mouthwash.Crossref | GoogleScholarGoogle Scholar | 28876289PubMed |
[16] Lewis DA. Will targeting oropharyngeal gonorrhoea delay the further emergence of drug-resistant Neisseria gonorrhoeae strains? Sex Transm Infect 2015; 91 234–7.
| Will targeting oropharyngeal gonorrhoea delay the further emergence of drug-resistant Neisseria gonorrhoeae strains?Crossref | GoogleScholarGoogle Scholar | 25911525PubMed |
[17] Unemo M, Lahra MM, Cole M, Galarza P, Ndowa F, Martin I, et al World Health Organization Global Gonococcal Antimicrobial Surveillance Program (WHO GASP): review of new data and evidence to inform international collaborative actions and research efforts. Sex Health 2019; 16 412–25.
| World Health Organization Global Gonococcal Antimicrobial Surveillance Program (WHO GASP): review of new data and evidence to inform international collaborative actions and research efforts.Crossref | GoogleScholarGoogle Scholar |
[18] Wi T, Lahra MM, Ndowa F, Bala M, Dillon JR, Ramon-Pardo P, et al Antimicrobial resistance in Neisseria gonorrhoeae: global surveillance and a call for international collaborative action. PLoS Med 2017; 14 e1002344
| Antimicrobial resistance in Neisseria gonorrhoeae: global surveillance and a call for international collaborative action.Crossref | GoogleScholarGoogle Scholar | 28746372PubMed |
[19] Whittles LK, White PJ, Paul J, Didelot X. Epidemiological trends of antibiotic resistant gonorrhoea in the United Kingdom. Antibiotics (Basel) 2018; 7 60
| Epidemiological trends of antibiotic resistant gonorrhoea in the United Kingdom.Crossref | GoogleScholarGoogle Scholar |
[20] Williamson DA, Fairley CK, Howden BP, Chen MY, Stevens K, De Petra V, et al Trends and risk factors for antimicrobial-resistant Neisseria gonorrhoeae, Melbourne, Australia, 2007 to 2018. Antimicrob Agents Chemother 2019; 63 e01221-19
| Trends and risk factors for antimicrobial-resistant Neisseria gonorrhoeae, Melbourne, Australia, 2007 to 2018.Crossref | GoogleScholarGoogle Scholar | 31383663PubMed |
[21] Unemo M, Golparian D, Potocnik M, Jeverica S. Treatment failure of pharyngeal gonorrhoea with internationally recommended first-line ceftriaxone verified in Slovenia, September 2011. Euro Surveill 2012; 17 20200
| Treatment failure of pharyngeal gonorrhoea with internationally recommended first-line ceftriaxone verified in Slovenia, September 2011.Crossref | GoogleScholarGoogle Scholar | 22748003PubMed |
[22] Golparian D, Ohlsson A, Janson H, Lidbrink P, Richtner T, Ekelund O, et al Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg) or cefotaxime (500 mg), Sweden, 2013 and 2014. Euro Surveill 2014; 19 20862
| Four treatment failures of pharyngeal gonorrhoea with ceftriaxone (500 mg) or cefotaxime (500 mg), Sweden, 2013 and 2014.Crossref | GoogleScholarGoogle Scholar | 25108533PubMed |
[23] Read PJ, Limnios EA, McNulty A, Whiley D, Lahra MM. One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500mg ceftriaxone in Sydney, Australia. Sex Health 2013; 10 460–2.
| One confirmed and one suspected case of pharyngeal gonorrhoea treatment failure following 500mg ceftriaxone in Sydney, Australia.Crossref | GoogleScholarGoogle Scholar | 24028864PubMed |
[24] Weinstock H, Workowski KA. Pharyngeal gonorrhea: an important reservoir of infection? Clin Infect Dis 2009; 49 1798–800.
| Pharyngeal gonorrhea: an important reservoir of infection?Crossref | GoogleScholarGoogle Scholar | 19911969PubMed |
[25] Olesen SW, Torrone EA, Papp JR, Kirkcaldy RD, Lipsitch M, Grad YH. Azithromycin susceptibility among Neisseria gonorrhoeae isolates and seasonal macrolide use. J Infect Dis 2019; 219 619–23.
| Azithromycin susceptibility among Neisseria gonorrhoeae isolates and seasonal macrolide use.Crossref | GoogleScholarGoogle Scholar | 30239814PubMed |
[26] Chow EPF, Cornelisse VJ, Williamson DA, Priest D, Hocking JS, Bradshaw CS, et al Kissing may be an important and neglected risk factor for oropharyngeal gonorrhoea: a cross-sectional study in men who have sex with men. Sex Transm Infect 2019; 95 516–21.
| Kissing may be an important and neglected risk factor for oropharyngeal gonorrhoea: a cross-sectional study in men who have sex with men.Crossref | GoogleScholarGoogle Scholar | 31073095PubMed |
[27] Rogstad KE. Sex, sun, sea, and STIs: sexually transmitted infections acquired on holiday. BMJ 2004; 329 214
| Sex, sun, sea, and STIs: sexually transmitted infections acquired on holiday.Crossref | GoogleScholarGoogle Scholar | 15271833PubMed |
[28] Finney H. Contraceptive use by medical students whilst on holiday. Fam Pract 2003; 20 93
| Contraceptive use by medical students whilst on holiday.Crossref | GoogleScholarGoogle Scholar | 12509379PubMed |
[29] Milhausen RR, Reece M, Perera B. A theory-based approach to understanding sexual behavior at Mardi Gras. J Sex Res 2006; 43 97–106.
| A theory-based approach to understanding sexual behavior at Mardi Gras.Crossref | GoogleScholarGoogle Scholar | 16817056PubMed |
[30] Kates SM. Producing and consuming gendered representations: an interpretation of the Sydney Gay and Lesbian Mardi Gras. Consumption Markets & Culture 2003; 6 5–22.
| Producing and consuming gendered representations: an interpretation of the Sydney Gay and Lesbian Mardi Gras.Crossref | GoogleScholarGoogle Scholar |
[31] Cornelisse VJ, Priest D, Fairley CK, Walker S, Bradshaw CS, Phillips T, et al The frequency of kissing as part of sexual activity differs depending on how men meet their male casual sexual partners. Int J STD AIDS 2018; 29 598–602.
| The frequency of kissing as part of sexual activity differs depending on how men meet their male casual sexual partners.Crossref | GoogleScholarGoogle Scholar | 29256822PubMed |
[32] Priest D, Chow EPF. Kissing while high on ecstasy: lessons from a gay dance party attendee. Sex Transm Infect 2018; 94 143
| Kissing while high on ecstasy: lessons from a gay dance party attendee.Crossref | GoogleScholarGoogle Scholar | 29463767PubMed |
[33] Cornelisse VJ, Bradshaw CS, Chow EPF, Williamson DA, Fairley CK. Oropharyngeal gonorrhea in absence of urogenital gonorrhea in sexual network of male and female participants, Australia, 2018. Emerg Infect Dis 2019; 25 1373–6.
| Oropharyngeal gonorrhea in absence of urogenital gonorrhea in sexual network of male and female participants, Australia, 2018.Crossref | GoogleScholarGoogle Scholar | 31211673PubMed |
[34] Grierson J, Smith A, Von Doussa H. An ordinary night out: a report on the research project Pivotal, Peripheral of Positional: understanding SOPVs for intervention. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University; 2007.
[35] Chow EP, Fairley CK. The role of saliva in gonorrhoea and chlamydia transmission to extragenital sites among men who have sex with men: new insights into transmission. J Int AIDS Soc 2019; 22 e25354
| The role of saliva in gonorrhoea and chlamydia transmission to extragenital sites among men who have sex with men: new insights into transmission.Crossref | GoogleScholarGoogle Scholar | 31468730PubMed |
[36] Chow EPF, Walker S, Hocking JS, Bradshaw CS, Chen MY, Tabrizi SN, et al A multicentre double-blind randomised controlled trial evaluating the efficacy of daily use of antibacterial mouthwash against oropharyngeal gonorrhoea among men who have sex with men: the OMEGA (Oral Mouthwash use to Eradicate GonorrhoeA) study protocol. BMC Infect Dis 2017; 17 456
| A multicentre double-blind randomised controlled trial evaluating the efficacy of daily use of antibacterial mouthwash against oropharyngeal gonorrhoea among men who have sex with men: the OMEGA (Oral Mouthwash use to Eradicate GonorrhoeA) study protocol.Crossref | GoogleScholarGoogle Scholar | 28659133PubMed |
[37] Chow EP, Howden BP, Walker S, Lee D, Bradshaw CS, Chen MY, et al Antiseptic mouthwash against pharyngeal Neisseria gonorrhoeae: a randomised controlled trial and an in vitro study. Sex Transm Infect 2017; 93 88–93.
| Antiseptic mouthwash against pharyngeal Neisseria gonorrhoeae: a randomised controlled trial and an in vitro study.Crossref | GoogleScholarGoogle Scholar | 27998950PubMed |
[38] Chow EPF, Maddaford K, Trumpour S, Fairley CK. Translating mouthwash use for gonorrhoea prevention into a public health campaign: identifying current knowledge and research gaps. Sex Health 2019; 16 433–41.
| Translating mouthwash use for gonorrhoea prevention into a public health campaign: identifying current knowledge and research gaps.Crossref | GoogleScholarGoogle Scholar |
[39] Cornelisse VJ, Fairley CK, Walker S, Young T, Lee D, Chen MY, et al Adherence to, and acceptability of, Listerine® mouthwash as a potential preventive intervention for pharyngeal gonorrhoea among men who have sex with men in Australia: a longitudinal study. Sex Health 2016; 13 494–6.
| Adherence to, and acceptability of, Listerine® mouthwash as a potential preventive intervention for pharyngeal gonorrhoea among men who have sex with men in Australia: a longitudinal study.Crossref | GoogleScholarGoogle Scholar | 28636870PubMed |
[40] Walker S, Bellhouse C, Fairley CK, Bilardi JE, Chow EP. Pharyngeal gonorrhoea: the willingness of Australian men who have sex with men to change current sexual practices to reduce their risk of transmission – a qualitative study. PLoS One 2016; 11 e0164033
| Pharyngeal gonorrhoea: the willingness of Australian men who have sex with men to change current sexual practices to reduce their risk of transmission – a qualitative study.Crossref | GoogleScholarGoogle Scholar | 27992427PubMed |
[41] Chow EP, Walker S, Phillips T, Fairley CK. Willingness to change behaviours to reduce the risk of pharyngeal gonorrhoea transmission and acquisition in men who have sex with men: a cross-sectional survey. Sex Transm Infect 2017; 93 499–502.
| Willingness to change behaviours to reduce the risk of pharyngeal gonorrhoea transmission and acquisition in men who have sex with men: a cross-sectional survey.Crossref | GoogleScholarGoogle Scholar | 28676558PubMed |
[42] Chow EPF, Carlin JB, Read TRH, Chen MY, Bradshaw CS, Sze JK, et al Factors associated with declining to report the number of sexual partners using computer-assisted self-interviewing: a cross-sectional study among individuals attending a sexual health centre in Melbourne, Australia. Sex Health 2018; 15 350–7.
| Factors associated with declining to report the number of sexual partners using computer-assisted self-interviewing: a cross-sectional study among individuals attending a sexual health centre in Melbourne, Australia.Crossref | GoogleScholarGoogle Scholar | 29966584PubMed |
