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Sexual Risk and Substance Use Behaviors Among African American Men Who Have Sex with Men and Women

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Abstract

African American men who have sex with men and women (MSMW), but who do not form a sexual identity around same-sex behavior, may experience risk for HIV infection and transmission. This paper reports cross-sectional survey findings on sexual behaviors and substance use of urban non-gay- or non-bisexual-identified African American MSMW (n = 68), who completed behavior assessment surveys using audio-computer assisted self-interviewing technology. Overall, 17.6% reported being HIV-positive. In the past 3 months, 70.6% had unprotected insertive sex with a female, 51.5% had unprotected insertive anal sex (UIAS) with a male, 33.8% had unprotected receptive anal sex (URAS) with a male, 25% had UIAS with a transgender female, and 10.3% had URAS with a transgender female. Findings indicated a bridging potential for HIV and sexually transmitted infections across groups, such that 38.2% reported concurrent unprotected sex with female and male partners and 17.6% reported concurrent unprotected sex with female and transgender female partners. In the past 3 months, 70.6% used alcohol before sex and 85% used drugs before sex. Men who used drugs before sex had a tenfold increased likelihood for unprotected sex with male partners, and men who injected drugs had a nearly fivefold increased likelihood for unprotected sex with a transgender female. Interventions to address sexual risk behaviors, especially partner concurrency, and substance use behavior for these men are warranted.

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References

  1. Laurencin CT, Christensen DM, Taylor ED. HIV/AIDS and the African American community: a state of emergency. J Natl Med Assoc. 2008;100(1):35–43.

    PubMed  Google Scholar 

  2. Centers for Disease Control and Prevention. Twenty-five years of HIV/AIDS-United States, 1981–2006. MMWR. 2006;55(21):585–9.

    Google Scholar 

  3. Centers for Disease Control and Prevention. Trends in HIV/AIDS diagnoses—33 states, 2001–2004. MMWR. 2005;54(45):1149–53.

    Google Scholar 

  4. Ford CL, Whetten KD, Hall SA, Thrasher AD, Kaufman JS. Black sexuality, social construction, and research targeting “The Down Low” (“The DL”). Ann Epidemiol. 2007;17(3):209–16.

    Article  PubMed  Google Scholar 

  5. Malebranche DJ. Black men who have sex with men and the HIV epidemic: next steps for public health. Am J Public Health. 2003;93(6):862–5.

    Article  PubMed  Google Scholar 

  6. Mays VM, Cochran SD, Zamudio A. HIV prevention research: are we meeting the needs of African-American men who have sex with men? J Black Psychol. 2004;30(1):78–105.

    Article  PubMed  Google Scholar 

  7. Saleh LD, Operario D. Moving beyond “the down low”: a critical analysis of terminology guiding HIV prevention for African American men who have secretive sex with men. Soc Sci Med. 2009;68(2):390–5.

    Article  PubMed  Google Scholar 

  8. Operario D, Smith CD, Kegeles S. Social and psychological context of HIV risk in non-gay-identified African American men who have sex with men. AIDS Educ Prev. 2008;20(4):347–59.

    Article  PubMed  Google Scholar 

  9. Wheeler DP, Lauby JL, Liu K, Van Sluytman L, Murrill C. A comparative analysis of sexual risk characteristics of black men who have sex with men or with men and women. Arch Sex Behav. 2008;37(5):697–707.

    Article  PubMed  Google Scholar 

  10. Operario D, Burton J, Underhill K, Sevelius J. Men who have sex with transgender women: challenges to category-based HIV prevention. AIDS Behav. 2008;12(1):18–26.

    Article  PubMed  Google Scholar 

  11. Siegel K, Schrimshaw EW, Lekas HM, Parsons JT. Sexual behaviors of non-gay identified non-disclosing men who have sex with men and women. Arch Sex Behav. 2008;37(5):720–35.

    Article  PubMed  Google Scholar 

  12. Mercer CH, Hart GH, Johnson AM, Cassell JA. Behaviourally bisexual men as a bridge population for HIV and sexually transmitted infections? Evidence from a national probability survey. Int J STD AIDS. 2009;20(2):87–94.

    Article  PubMed  CAS  Google Scholar 

  13. Hosmer DW, Lemeshow S. Applied logistic regression. New York: Wiley; 1989.

    Google Scholar 

  14. Myers HF, Javanbakht M, Martinez M, Obediah S. Psychosocial predictors of risky sexual behaviors in African American men: implications for prevention. AIDS Educ Prev. 2003;15(1 Suppl A):66–79.

    Article  PubMed  Google Scholar 

  15. Malebranche DJ. Bisexually active black men in the United States and HIV: acknowledging more than the “Down Low”. Arch Sex Behav. 2008;37(5):810–6.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This research was supported by the California HIV/AIDS Research Program Grant (AL04-CALPEP-817-SF-818) to Carla Dillard Smith, Susan Kegeles and Don Operario; and California HIV/AIDS Research Program Grant 00025475 to Carla Dillard Smith and Emily Arnold.

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Authors and Affiliations

  1. Department of Community Health, Brown University, 121 South Main St., 5th Floor, Providence, RI, 02903, USA

    Don Operario

  2. CAL-PEP, Oakland, CA, USA

    Carla Dillard Smith

  3. Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA

    Emily Arnold & Susan Kegeles

Authors
  1. Don Operario
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  2. Carla Dillard Smith
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  3. Emily Arnold
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  4. Susan Kegeles
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Correspondence to Don Operario.

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Operario, D., Smith, C.D., Arnold, E. et al. Sexual Risk and Substance Use Behaviors Among African American Men Who Have Sex with Men and Women. AIDS Behav 15, 576–583 (2011). https://doi.org/10.1007/s10461-009-9588-0

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  • DOI: https://doi.org/10.1007/s10461-009-9588-0

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