Sexual Behaviors, Sex Toy and Condom Use Reported by Women who have Sex with Women and Men (WSWM)

Introduction: Relative to women who engage in sex with exclusively men or women, women who have sex with women and men (WSWM) are more likely to report a history of sexually transmitted infections.  Knowledge of the diversity and specificity of the sexual behaviors in which they engage may provide insight into the behavioral mechanism of infection. The present study sought to document a range of diverse behaviors including concurrent multi-person sexual activity (i.e., group sex, orgy, threesome), sexual activity involving their own or their partner’s anus, and sex toy use. Barrier use methods during specific behaviors were assessed.

Methods: Eighty women who reported recent genital contact with at least one man and one woman were recruited via targeted internet, venue-based and snowball sampling methods. Consenting participants were directed to an online survey. Items were adapted from the National Survey on Sexual Health and Behavior (NSSHB) and other studies.

Results: The most frequently reported sexual behaviors were similar regardless of partner gender. Almost three-quarters of the sample reported at least one concurrent multi-person sexual activity, with 60% reporting a threesome with a man and a woman. A sizable number of the participants reported engaging in sexual behavior that involved their own or their partner’s anus. Barrier use for sexual behaviors other than penile-vaginal intercourse was uncommon.

Conclusions: The sexual repertoires reported by participants in this study were diverse. Understanding the range of diverse sexual behaviors of the participants may enable the construction of tailored recommendations for sexual health maintenance among WSWM.