While there’s historical evidence of men engaging in homosexual group sex in public spaces in the late 19th century, academic scholars, cultural anthropologists, and public health experts only became interested in studying group, public sex between men in the 1960s.

Researchers took an ethnographic approach during this time. The general consensus among researchers was that sexual interactions in these spaces were “furtive and impersonal.” Public restrooms, locker rooms, truck stops, parks, beaches, and even commercial spaces like bathhouses, allowed men to “cruise” relatively inconspicuously. Nothing more.

When the AIDS epidemic hit in the 1980s, research that focused on cruising shifted from studying a certain subset of men/gay culture to a more active epidemiological approach. Researchers were now asking, “How does public sex and sex parties contribute to the spread of HIV?” and “What can we do to stop the spread of HIV in these settings?”

Gay Pride marchers in New York City, June 1983.

Up until recently, HIV has been the main purpose of studying men who frequent bathhouses, truck stops, parks, and sex parties. Then, in 2012, the FDA approved Truvada, a pre-exposure prophylaxis (PrEP). Over half a decade later, it’s estimated that roughly 136,000 people are on PrEP in the United States. Given the high efficacy of PrEP (nearly 100%), it is possible to engage in condomless sex with various partners without fear of contracting HIV.

Since PrEP’s inception, there has been yet another visible shift slowly occurring in the literature: The widespread knowledge that men living with HIV who have an undetectable viral load are unable to pass on HIV to other men through sex. This is commonly explained with the phrase undetectable = untransmittable, and using treatment of HIV as prevention is known as TasP (Treatment as Prevention).

TasP and PrEP have changed the landscape of gay sex. While there is still and will continue to be high concern about transmitting HIV, researchers are also now willing to look at the ways sex parties influence a gay man’s identity—for better and for worse—and foster a sense of community.

Dr. Etienne Meunier and Karolynn Siegel of Columbia University’s Mailman School of Public Health are at the forefront of studying group sex research. In 2017, they collected data from men who had attended sex parties in the past 12 months and published their findings in the Journal of Sex Research.

The goal of the study, Meunier tells NewNowNext, is twofold. Firstly, it was to explore why men who attend group sex parties engage in high-risk behaviors.

“Do gay sex parties attract men who are riskier, or does something in the environments where group sex occurs cause men to engage in riskier behavior than they typically engage in?” he asks.

Secondly, “We wanted to get some data about how these new prevention strategies [TasP and PrEP] might impact safer-sex behavior and attitudes among sex-party goers.”

Recruitment advertisements were posted on a major social networking website, two social networking mobile applications for gay/bi men, on small-ad websites, and a blog listing sex parties in NYC.

In order to participate in the study, you had to be at least 18 years old, have had sex with a man in the past year, identify as male or transgender, and live in the NYC metropolitan area. Participants were then asked for HIV-status (and viral load levels) and if on PrEP (and how well they adhered to regimen). Lastly, participants were asked if they had been to a sex party with at least 20 people in the past year. (The 20 person requirement was used to exclude folks who had small, private threesomes or sex parties.)

Participants were then asked to rank 13 items, developed by the study team, using a five-point scale from one (strongly disagree) to five (strongly agree). Six of the items evaluated the assumptions participants had about other men at sex parties regarding their HIV, STI, and PrEP statuses. Three items explored the participants’ understanding of norms around HIV disclosure and responsibility at sex parties. Four items assessed participants’ subjective understanding of how the context of sex parties influence their own sexual risk behavior.

There were 234 men who had attended sex parties in the past year: 18% reported being HIV-positive (84% of them undetectable), 27% reported being HIV-negative men on PrEP, and 55% reported being HIV-negative and not on PrEP.

The researchers included 211 men in the final analyses to compare HIV-positive-undetectable men, HIV-negative men on PrEP, and HIV-negative men who had never used PrEP. (Men with HIV who were detectable were dropped from the analyses.)

A few trends emerged in the analyses.

The majority of the men who attended sex parties reported being HIV-negative and not on PrEP, roughly 54%. Seventeen percent reported being HIV-positive-undetectable, and 29% reported being HIV-negative men on PrEP.

Men not on PrEP, however, were significantly more likely to have only attended one sex party in the past six months, 31%, compared to men on PrEP and HIV-positive men, 17% and 7% respectively. Additionally, over half of HIV-positive men and men on PrEP reported five or more anal sex partners at sex parties in the past six months compared to the 27% of men never on PrEP.

What did prove worrisome were the number of men not on PrEP who reported not using condoms, as well as not asking partners’ about their status prior to having sex.

Among the 141 participants who reported anal sex at sex parties, 42.9% of men never on PrEP, 14.8% of HIV-positive-undetectable men, and 15.9% of men on PrEP reported using condoms with all their partners. Only 23% of men not on PrEP agreed with the statement, “People generally ask each other’s HIV status before having sex at parties,” compared to 9% of HIV-positive men and 8% of men on PrEP.

The setting itself may be what contributes to the lack of communication. Melendez-Torres and Bonell described gay venues as “littoral spaces”— spaces that are different from the everyday world in that they create a “disruption from normal sensory perception” or a “tear in the fabric of everyday experience.”

In a qualitative study by Matthew J. Mimiaga et al. in 2010, the researchers found that 75% of the 40 gay/bi sex party goers they interviewed in Boston said there was no discussion of condoms or HIV at the parties they attended. They explained that communicating about safer sex would “ruin the mood” or be “a buzzkill.”

It’s not surprising, then, that 38% of men not on PrEP in Meunier’s study agreed with the statement, “At sex parties, I have felt influenced or encouraged by other men there to take more risks than I otherwise would.”

While not being able to speak to their mindset, Meunier notes, “I think we managed to show that it is not due to a complete disregard for safety.”

He continues, “There seem to be men who go to sex parties with the idea of being safe, but once in there, the features of the physical environment and social pressures may cause them to take more risks than they had intended to take.”

Intervention should thus take a more targeted approach. Instead of targeting men who go into a sex party with the intent of having bareback sex with multiple partners (and presumably know the risk of doing so), “We can encourage those who prefer to use condoms to stick to their individual norm and not take more risks than they are comfortable with.”

In addition to the focus on risk-taking at sex parties in the era of PrEP and TasP, Meunier explains to the social component of sex parties.

“What I found in my ethnographic research on NYC sex parties is that they are social environments.” He elaborates, “For some regular attendees, sex parties thus fulfill multiple needs: sex, friendship, and even intimacy and community. The community element is especially salient at events that cater to a specific fetish or sexual subculture (e.g., Leather, Bear).”

While sex spaces may help foster queer identity and community, further intervention methods should look at ways to target gay men who are more susceptible to taking risks with which they are not particularly comfortable.