Sexual Risk and Substance Use Behaviors Among African American Men Who Have Sex with Men and Women |
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Authors: | Email author" target="_blank">Don?OperarioEmail author Carla?Dillard?Smith Emily?Arnold Susan?Kegeles |
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Affiliation: | (1) Department of Community Health, Brown University, 121 South Main St., 5th Floor, Providence, RI 02903, USA;(2) CAL-PEP, Oakland, CA, USA;(3) Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA |
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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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