AIDS and Behavior

, Volume 17, Issue 3, pp 848–855

HIV Risk Behaviors Among Black/African American and Hispanic/Latina Female Partners of Men Who Have Sex With Men and Women

  • Nina T. Harawa
  • William J. McCuller
  • Constance Chavers
  • Mike Janson
Original Paper


We examined the frequencies of HIV-related risk factors among women reporting and not reporting sex with a man who has sex with men and women (MSMW). We used data from 15,625 visits of Black and Hispanic/Latina females, ages 15–64 years, to Los Angeles County HIV testing sites (2007–2008). The following risk factors were associated with reporting an MSMW partner: number of sex partners, use of party drugs, anal sex, and sexual partners with other risk factors. Overall, females who reported an MSMW partner differed little in their likelihood of testing HIV positive (0.93%) compared to those who did not (0.58%, p value = 0.19). Among females reporting one male sex partner, having an MSMW partner was strongly associated with HIV (2.8 vs. 0.63%, p = 0.03). Interventions targeting women who report other risky behaviors may reach many who have been with MSMW. Women with one partner are an important focus of such efforts.


Black/African American Hispanic/Latino HIV infection/epidemiology Bisexuality HIV testing 


Se examinó la frecuencia de factores de riesgo relacionados con el VIH entre las mujeres que reportaron y no reportaron relaciones sexuales con un hombre que tiene sexo con hombres y mujeres (HSHM). Se utilizaron los datos de 15.625 visitas de mujeres afro-americanas e hispanas/latinas, de 15-64 años de edad, a sitios de prueba del VIH del Condado de Los Angeles (2007-08). Los siguientes factores de riesgo se asociaron con reportar una pareja HSHM: número de parejas sexuales, uso de drogas de fiesta, el sexo anal, y parejas sexuales con otros factores de riesgo. En general, las mujeres que reportaron una pareja HSHM se diferenció poco en sus probabilidades de tener una prueba positiva de VIH (0,93%) en comparación con las que no reportaron una pareja HSHM. (0,58%, valor p = 0,19). Entre las mujeres que reportaron sólo una pareja sexual masculina, tener una pareja HSHM estuvo fuertemente asociado con el VIH (2,8% versus 0,63%, p = 0,03). Las intervenciones dirigidas a las mujeres que reportan otras conductas de riesgo pueden llegar a muchas que han estado con HSHM. Mujeres con una pareja son un foco importante de estos esfuerzos.

Palabras clave

Negros/afro americanos hispanos/latinos infección del VIH/epidemiología la bisexualidad la prueba del VIH 


  1. 1.
    Centers for Disease Control and Prevention. HIV Surveillance Report, 2009, vol. 21. Accessed 10 July 2011.
  2. 2.
    Montgomery JP, Mokotoff ED, Gentry AC, Blair JM. The extent of bisexual behaviour in HIV-infected men and implications for transmission to their female sex partners. AIDS Care. 2003;15(6):829–37.PubMedCrossRefGoogle Scholar
  3. 3.
    Sanchez T, Finlayson T, Drake A, Behel S, Cribbin M, Dinenno E, et al. Human immunodeficiency virus (HIV) risk, prevention, and testing behaviors—United States, National HIV Behavioral Surveillance System: men who have sex with men, November 2003–April 2005. MMWR Surveill Summ. 2006;55(6):1–16.PubMedGoogle Scholar
  4. 4.
    Schmidt MA, Mokotoff ED. HIV/AIDS surveillance and prevention: improving the characterization of HIV transmission. Public Health Rep. 2003;118(3):197–204.PubMedGoogle Scholar
  5. 5.
    Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2007, vol. 19. 2009. Accessed 2 June 2011.
  6. 6.
    Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2008, vol. 20. 2010. Accessed 2 June 2011.
  7. 7.
    Harrison KM, Kajese T, Hall HI, Song R. Risk factor redistribution of the national HIV/AIDS surveillance data: an alternative approach. Public Health Rep. 2008;123(5):618–27.PubMedGoogle Scholar
  8. 8.
    Stokes JP, McKirnan DJ, Doll LS, Burzette RG. Female partners of bisexual men: what they don’t know might hurt them. Psychol Women Q. 1996;20:257–84.CrossRefGoogle Scholar
  9. 9.
    O’Leary A, Jones KT. Bisexual men and heterosexual women: how big is the bridge? How can we know? Sex Transm Dis. 2006;33(10):594–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Prabhu R, Owen CL, Folger K, McFarland W. The bisexual bridge revisited: sexual risk behavior among men who have sex with men and women, San Francisco, 1998–2003. AIDS. 2004;18(11):1604–6.PubMedCrossRefGoogle Scholar
  11. 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.PubMedCrossRefGoogle Scholar
  12. 12.
    Kahn JG, Gurvey J, Pollack LM, Binson D, Catania JA. How many HIV infections cross the bisexual bridge? An estimate from the United States. AIDS. 1997;11(8):1031–7.PubMedCrossRefGoogle Scholar
  13. 13.
    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.PubMedCrossRefGoogle Scholar
  14. 14.
    California Department of Health Services Office of AIDS. Prevalence of HIV infection and related risk behaviors among young Latino men who have sex with men: San Diego-Tijuana border region. December 2006. Accessed 8 January 2011.
  15. 15.
    Martinez J, Hosek SG. An exploration of the down-low identity: nongay-identified young African–American men who have sex with men. J Natl Med Assoc. 2005;97(8):1103–12.PubMedGoogle Scholar
  16. 16.
    O’Leary A, Fisher HH, Purcell DW, Spikes PS, Gomez CA. Correlates of risk patterns and race/ethnicity among HIV-positive men who have sex with men. AIDS Behav. 2007;11(5):706–15.PubMedCrossRefGoogle Scholar
  17. 17.
    Voetsch AC, Thomas PE, Johnson AS, Millett GA, Mundey L, Goode C, et al. Sex with bisexual men among Black female students at historically Black colleges and universities. J Natl Med Assoc. 2010;102(12):1198–205.PubMedGoogle Scholar
  18. 18.
    SAS Institute Inc. 2008. SAS/STAT® 9.2. User’s Guide. The GLIMMIX Procedure. Chapter 38. Cary, NC: SAS Institute Inc.Google Scholar
  19. 19.
    Mattison AM, Ross MW, Wolfson T, Franklin D. Circuit party attendance, club drug use, and unsafe sex in gay men. J Subst Abuse. 2001;13(1–2):119–26.PubMedCrossRefGoogle Scholar
  20. 20.
    Mansergh G, Colfax GN, Marks G, Rader M, Guzman R, Buchbinder S. The circuit party men’s health survey: findings and implications for gay and bisexual men. Am J Public Health. 2001;91(6):953–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Kurtz SP. Post-circuit blues: motivations and consequences of crystal meth use among gay men in Miami. AIDS Behav. 2005;9(1):63–72.PubMedCrossRefGoogle Scholar
  22. 22.
    Binson D, Woods WJ, Pollack L, Paul J, Stall R, Catania JA. Differential HIV risk in bathhouses and public cruising areas. Am J Public Health. 2001;91(9):1482–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Parsons JT, Kelly BC, Wells BE. Differences in club drug use between heterosexual and lesbian/bisexual females. Addict Behav. 2006;31(12):2344–9.PubMedCrossRefGoogle Scholar
  24. 24.
    Fendrich M, Wislar JS, Johnson TP, Hubbell A. A contextual profile of club drug use among adults in Chicago. Addiction. 2003;98(12):1693–703.PubMedCrossRefGoogle Scholar
  25. 25.
    Finlinson HA, Colon HM, Robles RR, Soto M. Sexual identity formation and AIDS prevention: an exploratory study of non-gay-identified Puerto Rican MSM from working class neighborhoods. AIDS Behav. 2006;10(5):531–9.PubMedCrossRefGoogle Scholar
  26. 26.
    Goldbaum G, Perdue T, Wolitski R, Rietmeijer C, Hedrich A, Wood R, et al. Differences in risk behavior and sources of AIDS information among gay, bisexual, and straight-identified men who have sex with men. AIDS Behav. 1998;2(1):13–21.CrossRefGoogle Scholar
  27. 27.
    Rietmeijer CA, Wolitski RJ, Fishbein M, Corby NH, Cohn DL. Sex hustling, injection drug use, and non-gay identification by men who have sex with men. Associations with high-risk sexual behaviors and condom use. Sex Transm Dis. 1998;25(7):353–60.PubMedCrossRefGoogle Scholar
  28. 28.
    Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, Fortenberry JD. Sexual behavior in the United States: results from a national probability sample of men and women ages 14–94. J Sex Med. 2010;7(5):255–65.PubMedCrossRefGoogle Scholar
  29. 29.
    Reynolds GL, Fisher DG, Napper LE, Fremming BW, Jansen MA. Heterosexual anal sex reported by women receiving HIV prevention services in Los Angeles county. Women’s Health Issues. 2010;20(6):414–9.PubMedCrossRefGoogle Scholar
  30. 30.
    Tross S, Hanner J, Hu MC, Pavlicova M, Campbell A, Nunes EV. Substance use and high risk sexual behaviors among women in psychosocial outpatient and methadone maintenance treatment programs. Am J Drug Alcohol Abuse. 2009;35(5):368–74.PubMedCrossRefGoogle Scholar
  31. 31.
    Mackesy-Amiti ME, McKirnan DJ, Ouellet LJ. Relationship characteristics associated with anal sex among female drug users. Sex Transm Dis. 2010;37(6):346–51.PubMedGoogle Scholar
  32. 32.
    Spikes PS, Purcell DW, Williams KM, Chen Y, Ding H, Sullivan PS. Sexual risk behaviors among HIV-positive black men who have sex with women, with men, or with men and women: implications for intervention development. Am J Public Health. 2009;99(6):1072–8.PubMedCrossRefGoogle Scholar
  33. 33.
    Centers for Disease Control and Prevention (CDC). HlV/STD risks in young men who have sex with men who do not disclose their sexual orientation—six U.S. cities, 1994–2000. MMWR Morb Mortal Wkly Rep. 2003;52(5):81–6.Google Scholar
  34. 34.
    Mutchler MG, Bogart LM, Elliott MN, McKay T, Suttorp MJ, Schuster MA. Psychosocial correlates of unprotected sex without disclosure of HIV-positivity among African–American, Latino, and White men who have sex with men and women. Arch Sex Behav. 2008;37(5):736–47.PubMedCrossRefGoogle Scholar
  35. 35.
    HIV Epidemiology Program, Los Angeles County Department of Public Health. An Epidemiologic Profile of HIV and AIDS in Los Angeles County, 2009:1–151. Accessed 22 August 2011.
  36. 36.
    Office of AIDS Programs and Policy, Los Angeles County Department of Public Health. 2007 HIV Counseling and Testing at OAPP-funded Sites, Annual Report. December 2008. Accessed 8 January 2011.
  37. 37.
    Carmona JV, Romero GJ, Loeb TB. The impact of HIV status and acculturation on Latinas’ sexual risk taking. Cultur Divers Ethnic Minor Psycho. 1999;5(3):209–21.CrossRefGoogle Scholar
  38. 38.
    Carter M, Henry-Moss D, Hock-Long L, Bergdall A, Andes K. Heterosexual anal sex experiences among Puerto Rican and black young adults. Perspect Sex Reprod Health. 2010;42(4):267–74.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Nina T. Harawa
    • 1
  • William J. McCuller
    • 1
  • Constance Chavers
    • 2
  • Mike Janson
    • 2
  1. 1.Department of ResearchCharles R. Drew University of Medicine and Science, 1731Los AngelesUSA
  2. 2.Research and Evaluation Division, Office of the Medical DirectorOffice of AIDS Programs and PolicyLos AngelesUSA

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