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ABSTRACT
Introduction: Some HIV-infected men who have sex with men also have sex with women. Additionally, some women do not know that they are or have been in a sexual relationship with a bisexual man. Knowledge of their male partner's risks for HIV infection is crucial if reductions in HIV/AIDS are to occur among women.
Methods: We examined AIDS diagnosed cases reported to CDC from the 50 states and the District of Columbia, 2000 through 2004, in women aged 13 years and older. Cases were analyzed by transmission category, race/ethnicity, age at diagnosis, and geographic region, and data were adjusted for missing risk factor information and reporting delays.
Results: From 2000 through 2004, an estimated 1,576 women (from a total of 35,376 women reported with HIV from heterosexual contact and diagnosed with AIDS) reported sexual contact with a bisexual man (BSXM) as their primary risk factor for HIV infection. Non-Hispanic blacks accounted for the majority (62.8%) of cases, followed by non-Hispanic whites (20.5%) and Hispanics (14.8%). The average AIDS rate attributed to sex with a BSXM differed significantly by race/ethnicity (p < 0.01), with the rate for non-Hispanic black women 13 times the rate for non-Hispanic whites and 4 times the rate for Hispanics. Sexual contact with a BSXM accounted for 6.3% of AIDS cases among non-Hispanic white women with heterosexually acquired HIV compared to 4.4% among Hispanics and 4.0% among non-Hispanic blacks.
Conclusions: The proportion of AIDS cases among women attributed to sex with a BSXM was similar across races/ethnicities; however, rates were highest among non-Hispanic black women. Because some women were unaware of their male partner's risk for HIV infection, the number of women with AIDS who had a bisexual partner was probably under-reported. HIV prevention programs should provide information on risks of sex with BSXM, as many women may not be fully aware of their risks for acquiring HIV infection.