Group Sex and Sex Outside the Home: Consent and Safety

I believe adults have the right to choose the shape of their own sex lives, as long as everyone consents and no one is harmed. So having sex with several people at once (group sex), or going to parties with sexual activity, is not something I will judge. Medically, though, as the number of people increases, several risks increase too. This article focuses on what helps you get home safe in body and mind.

Consent is the heart of it

Consent is not a one-off agreement at the start. It has to be there the whole time, and anyone can change their mind partway through.

• Talk first about what is okay and what is not, whether condoms will be used, and whether photos are allowed (the default answer should be "no").
• Set a stop signal: a word or gesture everyone knows, and stop immediately when someone uses it.
• Watch body language. If someone looks uncomfortable, goes unusually quiet or pulls away, stop and ask.
• Being very drunk or high means consent is not possible. Someone who is unconscious or cannot speak clearly cannot consent, medically or legally.
• Consent with one person is not consent with everyone.

If your activity includes elements of BDSM, read more about safety in the article on sexual masochism and BDSM.

Consent

• Talk first about what is and isn't OK
• Ongoing; can change your mind midway
• A stop signal, and stopping at once
• Photos only if everyone agrees

Not consent

• Someone very drunk, unconscious or incoherent
• Consent to one person ≠ consent to everyone
• Silence, discomfort or pulling away
• Going along under pressure or fear of being left

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Preventing HIV and sexually transmitted infections

1. Bring enough condoms and change them every time you change partners, including when switching from anal to vaginal or oral sex, and put condoms on shared sex toys.
2. Lubricant: choose water- or silicone-based. Don't use oil, lotion or saliva, because they weaken condoms and make tears more likely.
3. PrEP: if you take it daily, take it consistently long enough for protective drug levels to be reached before the event. Men who have sex with men may be able to use on-demand 2-1-1 dosing if a doctor assesses it as suitable.
4. PEP: if you were not on PrEP and had a risk, start as soon as possible, within 72 hours, and take it for 28 days.
5. Doxy-PEP: the 2024 CDC guideline recommends considering it for men who have sex with men and transgender women who have had syphilis, gonorrhoea or chlamydia in the past year, to reduce the chance of these bacterial infections. A doctor must assess you first.
6. Vaccines: check whether you have had hepatitis A and B vaccines and the HPV vaccine. Where mpox is circulating, mpox vaccination may also be considered.

Preparing before you go

• Get enough sleep, eat and drink water.
• Tell a trusted friend where you are going and who with, and agree a time to message them that you are safe.
• Pack condoms, lubricant and any regular medicines.
• If you are going to douche, use a small amount of warm water, no soap or antiseptic, don't do it too often, and leave some time before sex, because heavy douching makes the lining fragile.
• Ask yourself, "Am I really ready?" If you are going because you are afraid of being left or feel pressured, you don't have to go.

During the event

• Don't rush, don't force anyone, and respect it when someone says no.
• Be careful with alcohol and drugs, especially GHB with alcohol, and poppers with erection medicines (read about chemsex).
• No body-shaming, and no discrimination based on anyone's gender or HIV status.
• If anyone loses consciousness or is breathing abnormally, call 1669 (Thailand's medical emergency number) immediately.

The law and privacy

• Public places: indecent acts in public are an offence under the Thai Criminal Code, and may force people who did not consent to see them. Keep it to private spaces that everyone knows about and agrees to.
• Photos and videos: everyone's consent is required. Sharing obscene or private images of others without their consent is against the law.
• Age: everyone must be an adult. Sexual activity with someone under the legal age is a serious crime, whether or not they "consented".

Afterwards: looking after yourself

1. Shower, drink water and rest.
2. If you had unprotected risk, think about PEP within 72 hours.
3. If you regularly have multiple partners, test for HIV, syphilis, gonorrhoea and chlamydia every 3 months, testing every site that had contact, such as the throat and rectum (read: PCR STI testing).
4. Watch for symptoms such as sores, bumps, discharge, burning when you pee, a rash or fever, and come in to be tested.
5. Check in with yourself about how you feel. If you feel guilty, anxious or that a line was crossed, you can talk to a doctor about it. If you were assaulted, go to hospital as soon as possible.

1. Before going
   Prepare protection

   Condoms, water/silicone lube, PrEP as planned, tell a trusted friend

2. During
   Change condoms every time

   With every partner or position change; watch substances and alcohol

3. Within 72 h
   PEP if at risk

   If not on PrEP, start as soon as possible and continue 28 days

4. Every 3 months
   STI tests at every site

   HIV, syphilis, gonorrhea, chlamydia, including throat and rectum

How Dr. Kris can help

At Dr. Kris Clinic we help you plan prevention before you go, including PrEP, PEP and doxy-PEP where appropriate, vaccines, and STI testing when you get back. We can also talk about consent and how you feel afterwards, without judgment. Consultations are available at the clinic in Surat Thani and online anywhere in Thailand, including in English.