title: HIV risk behaviors among African American men in Los Angeles County who self-identify as heterosexual.
abstract: There are limited data on high-risk behaviors among heterosexual African American men with HIV infection. Risk behaviors were examined in a case-control study of HIV-infected (n = 90) and uninfected (n = 272) African American men who self-identified as heterosexual. Of men who self-identified as heterosexual, 31% (n = 28) of the infected men and 16% (n = 43) of the uninfected men reported having had anal sex with men. Among the heterosexual men reporting anal sex with men, 100% of the infected and 67% of the uninfected men reported inconsistent condom use during anal sex with men. Few of the infected (12%) and uninfected (2%) men reported oral sex with other men. Of the men who self-identified as heterosexual, 46% of those who were HIV-positive and 37% of those who were HIV-negative reported anal sex with women with infrequent condom use. An increasing risk for HIV was associated with decreasing age at first sexual experience (chi2, 9.3; p = .002). A history of injecting drugs (odds ratio [OR], 3.1; 95% confidence intervals [CIs], 1.8, 5.4) and amphetamine (OR, 4.3; 95% CIs, 1.1, 16.7) and methamphetamine (OR, 2.9; 95% CIs, 1.4, 6.3) use were associated with HIV. Innovative HIV prevention strategies are needed that move beyond the traditional gay versus straight model to effectively access hard-to-reach African American men who self-identify as heterosexual.
authors.affiliation: HIV Epidemiology Program, Los Angeles County Department of Health Services, Los Angeles, California 90005, USA. awohl@dhs.co.la.ca.us
authors.forename: Amy Rock
authors.initials: AR
authors.lastname: Wohl
authors.forename: Denise F
authors.initials: DF
authors.lastname: Johnson
authors.forename: Sharon
authors.initials: S
authors.lastname: Lu
authors.forename: Wilbert
authors.initials: W
authors.lastname: Jordan
authors.forename: Gildon
authors.initials: G
authors.lastname: Beall
authors.forename: Judith
authors.initials: J
authors.lastname: Currier
authors.forename: Paul A
authors.initials: PA
authors.lastname: Simon
mesh_terms: D000328:Adult; D001741:Black or African American; D016022:Case-Control Studies; D017280:Condoms / Q000706:statistics & numerical data; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control; D020010:Heterosexuality; D018451:Homosexuality, Male; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000453:epidemiology