The extent of bisexual behaviour in HIV-infected men and implications for transmission to their female sex partners

Abstract

Heterosexual transmission of HIV is a growing problem for women, but many women do not know how their partners acquired HIV. We described a group of HIV-infected men and women, and focused on: (1) sexual identity and bisexual behaviour in men, and (2) the proportion of women who acknowledged having a bisexual male partner. This study examined HIV-infected persons who participated in a cross-sectional interview project from January 1995 through July 2000; 5,156 men who have sex with men (MSM), and 3,139 women. The proportion of MSM who reported having sex with women (MSM/MSW) varied by race: 34% of black MSM, 26% of Hispanic MSM, and 13% of white MSM. While 14% of white women acknowledged having a bisexual partner, only 6% of black and 6% of Hispanic women reported having a bisexual partner. Most behaviourally bisexual men identified as either bisexual (59%) or homosexual (26%). Among MSM/MSW, 30% had more female partners than male partners, while only 10% had more male partners than female partners. These data suggest that bisexual activity is relatively common among black and Hispanic HIV-infected MSM, few identify as heterosexual, and their female partners may not know of their bisexual activity.

Acknowledgments

This project was funded through a cooperative agreement between the Centers for Disease Control and Prevention and the Michigan Department of Community Health. Institutional review board approval was obtained from human subjects committees at all participating medical facilities and the CDC. Informed consent was obtained from all subjects prior to starting an interview. The authors would like to thank the following project officers and their staff who conduct the SHAS Project: Denise K. Boyd, Arizona Department of Health Services, Phoenix; Arthur J. Davidson, Colorado Department of Health, Denver; Aaron J. Roome, Connecticut State Department of Health Services, Hartford; Judith Gendler, Delaware Department of Health and Social Services; Rebecca Grigg, Florida Department of Health; John F. Beltrami, Georgia Department of Human Resources, Atlanta; Lilia Espinoza, Los Angeles County Health Department, Los Angeles; Samuel J. Costa, New Jersey Department of Health, Trenton; Jill Gatwood, New Mexico Department of Health; John E. Barnhart, South Carolina Department of Health and Environmental Control, Columbia; Maria Courogen, Washington State Department of Health, Olympia; as well as Delores A. Burgess, Allyn K. Nakashima, Michael L. Campsmith and Glenn Nakamura from CDC.