Oral Sex Practice among Men Who Have Sex with Men: A Cross-Sectional Study in Indonesian Urban Settings

Authors: I Putu Yuda Hananta, Inke Kusumastuti

Abstract:

The latest Indonesian Biology and Behavior Surveillance (IBBS) conducted by Indonesian Ministry of Health reported a large proportion of men who have sex with men (MSM) engaging in oral sex in their recent sexual history. While it is considered as a pleasuring and safe, oral sex might facilitate the transmission of various sexually transmitted infection (STI) pathogens. This study was aimed to investigate the oral sex practice among MSM in Indonesian urban settings to help delineate demographic and behavior determinants of such practice. In 2014, 501 MSM in 8 clinic-based and outreach STI services were recruited in Jakarta, Yogyakarta and Denpasar, Indonesia. Respondents completed a self-administered questionnaire inquiring about their demographics and sexual history. Median age (interquartile range) of the respondents was 27 (24-30) years; most completed senior high school (54.3%), worked in informal jobs (57.9%), and single (60.9%); and 32.3% reported receiving money in exchange for sex. Oral sex was practiced by most respondents: insertive only (10.0%), receptive only (6.0%), and both (82.4%). A separate multivariable analysis was performed using logistic regression to identify the determinants for receptive and insertive oral sex. Factors associated with receptive oral sex were having more than 10 sex partner(s) in the preceding 6 months vs 1 partner, adjusted odds ratio (aOR) [95% CI]=3.40 [1.22-9.42], p=0.03; and history of receptive-insertive anal sex vs no history, aOR=4.37 [1.76-10.82], p=0.01. Factors associated with insertive oral sex were receiving money for sex vs. not receiving, aOR=2.98 [1.10-8.04], p=0.02; and history of receptive-insertive anal sex vs. no history, aOR=2.10 [0.51-8.74], p<0.001. Only a few respondents reported consistent condom use (11.6% and 12.0% for receptive and insertive oral sex, respectively). Our findings demonstrated that while oral sex is a common practice among MSM, the consistency of condom use in oral sex is very low. In addition, certain sex behavior (number of sex partners, sex work and history of anal sex) were associated with oral sex, and this might need to be addressed during health promotion efforts on STI prevention through oral-genital contact.

Keywords: behavior, Indonesia, men who have sex with men, oral sex