Sexual risk and substance use behaviors among African American men who have sex with men and women

AIDS Behav. 2011 Apr;15(3):576-83. doi: 10.1007/s10461-009-9588-0. Epub 2009 Jul 2.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bisexuality / ethnology*
  • Black or African American / psychology
  • Black or African American / statistics & numerical data*
  • Cross-Sectional Studies
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control
  • Humans
  • Illicit Drugs
  • Male
  • Middle Aged
  • Risk-Taking*
  • San Francisco / epidemiology
  • Sexual Partners
  • Sexually Transmitted Diseases / diagnosis
  • Sexually Transmitted Diseases / epidemiology
  • Sexually Transmitted Diseases / prevention & control
  • Substance-Related Disorders / ethnology*
  • Unsafe Sex*
  • Urban Population
  • Young Adult

Substances

  • Illicit Drugs