1. Swingers were found to have a high rate of Chlamydia and Gonorrhea infections, at rates similar to young people, men who have sex with men, and female prostitutes.
2. Almost half of swingers reported use of multiple recreational drugs, which was associated with an increased risk of sexually transmitted infections among females.
Evidence Rating Level: 3 (Average)
Study Rundown: Swinging is the practice of engaging in group sex, mate swapping, and/or visiting sex clubs as a couple. Swingers are typically older and heterosexual. It is known that swingers are a high-risk group for sexually transmitted infections (STIs), but this was the first study to assess recreational drug use among this population. The study, conducted among swingers at an STI clinic in the Netherlands, found the group had a high rate of Chlamydia and Gonorrhea infections and substance use (e.g. recreational drugs, alcohol, erectile dysfunction drugs). Overall, there was an increased risk of STIs among females who reported multiple recreational drug use. This study was conducted within a very specific population, which limits the generalizability of the findings, but contributes to the limited literature available on swingers. Additional limitations include a low response rate and use of a self-reported questionnaire, which may have led to underreporting of high-risk behaviors. Overall, the study highlights swingers, a traditionally under-recognized and underserved group, as key targets for possible interventions to prevent or screen for STIs and drugs use.
In-Depth [cross-sectional study]: This study aimed to define the relationship between STIs, high-risk sexual behaviors, and drug use in a population of swingers. The authors used self-reported questionnaires to assess behaviors (e.g. group sex, number of partners, use of sex toys or condoms, substance use) among swingers at an STI clinic in the Netherlands between 2009-2012. The response rate was 28%, with a final study population of 289, and median age of participants was 45 years. The prevalence of Chlamydia or Gonorrhea was found to be 13%, as compared to 17% for those younger than 25, 20% in men who have sex with men, and 11% in female prostitutes. Approximately half of participants reported using multiple recreational drugs (e.g. MDMA, GHB). Substance use (recreational drugs, alcohol, erectile dysfunction drugs) was associated with high-risk sexual behaviors including swinging at home and using sex toys. In a logistic regression looking at key variables, drug use was associated with an increased risk of STIs among females who participated in group sex (OR 5.89, CI95% 1.56-22.5).
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