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

  • D. O
  • C.D. S
  • E. A
 et al. 
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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.

Author-supplied keywords

  • *African American
  • *African Americans/sn [Statistics & Numerical Data
  • *Bisexuality/eh [Ethnology]
  • *Risk-Taking
  • *Substance-Related Disorders/eh [Ethnology]
  • *Unsafe Sex
  • *addiction
  • *bisexuality
  • *high risk behavior
  • *unsafe sex
  • Adult
  • African Americans/px [Psychology]
  • Aged
  • Cross-Sectional Studies
  • Female
  • HIV Infections/di [Diagnosis]
  • HIV Infections/ep [Epidemiology]
  • HIV Infections/pc [Prevention & Control]
  • Human immunodeficiency virus infection/di [Diagnos
  • Human immunodeficiency virus infection/ep [Epidemi
  • Human immunodeficiency virus infection/pc [Prevent
  • Humans
  • Male
  • Middle Aged
  • San Francisco/ep [Epidemiology]
  • Sexual Partners
  • Sexually Transmitted Diseases/di [Diagnosis]
  • Sexually Transmitted Diseases/ep [Epidemiology]
  • Sexually Transmitted Diseases/pc [Prevention & Con
  • Street Drugs
  • United States/ep [Epidemiology]
  • Urban Population
  • Young Adult
  • adult
  • aged
  • article
  • cross-sectional study
  • ethnology
  • female
  • human
  • male
  • middle aged
  • psychological aspect
  • sexuality
  • sexually transmitted disease/di [Diagnosis]
  • sexually transmitted disease/ep [Epidemiology]
  • sexually transmitted disease/pc [Prevention]
  • statistics
  • street drug
  • urban population

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Authors

  • Operario D.

  • Smith C.D.

  • Arnold E.

  • Don Operario

  • Carla Dillard Smith

  • Emily Arnold

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