AIDS and Behavior

, Volume 15, Issue 3, pp 576–583

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

  • Don Operario
  • Carla Dillard Smith
  • Emily Arnold
  • Susan Kegeles
Original Paper


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.


African American Men MSMW HIV Substance use Risk behavior 


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Don Operario
    • 1
  • Carla Dillard Smith
    • 2
  • Emily Arnold
    • 3
  • Susan Kegeles
    • 3
  1. 1.Department of Community HealthBrown UniversityProvidenceUSA
  2. 2.CAL-PEPOaklandUSA
  3. 3.Center for AIDS Prevention StudiesUniversity of California San FranciscoSan FranciscoUSA

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