title: Sexual transmission risk behavior reported among behaviorally bisexual HIV-positive injection drug-using men.
abstract: BACKGROUND
  Few research studies have examined the HIV transmission risk behaviors of HIV-positive injection drug users (IDUs) who are men who have sex with men and women (MSMW).
  
  
  METHODS
  We compared unprotected vaginal or anal sex with an HIV-negative or unknown (UNK) status sexual partner of MSMW (n=118) with men who have sex exclusively with women (MSW; n=469) and men who have sex exclusively with men (MSM; n=90) using baseline information from the Intervention for Seropositive Injectors-Research and Evaluation (INSPIRE) study, a 4-city randomized controlled trial.
  
  
  RESULTS
  MSMW were twice as likely to report unprotected vaginal sex (P<0.001) and 3 times as likely to report unprotected anal sex with an HIV-negative/UNK status female partner (P<0.001) as MSW. MSMW did not differ in their report of unprotected insertive anal sex and were half as likely to report unprotected receptive anal sex with HIV-negative/UNK status men (P=0.02) as MSM. MSMW were 2 times as likely to report engaging in transactional sex (buying or selling sex in exchange for money, drugs, or housing) than MSM or MSW (81%, 43%, and 36%, respectively; P<0.001).
  
  
  CONCLUSIONS
  Further research is needed to understand the contexts of unprotected sex among HIV-positive injection drug-using MSMW. Prevention programs should target the unique prevention needs of this population, particularly their risk with female partners.
authors: Center for AIDS Prevention Studies, Department of Medicine, University of California at San Francisco, San Francisco, CA 94110-1372, USA. kelly.knight@ucsf.edu
authors: Kelly R
authors: KR
authors: Knight
authors: Starley B
authors: SB
authors: Shade
authors: David W
authors: DW
authors: Purcell
authors: Carol Dawson
authors: CD
authors: Rose
authors: Lisa R
authors: LR
authors: Metsch
authors: Mary H
authors: MH
authors: Latka
authors: Carl A
authors: CA
authors: Latkin
authors: Cynthia A
authors: CA
authors: Gómez
mesh_terms: D000328:Adult; D001727:Bisexuality; D003625:Data Collection / Q000379:methods; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012309:Risk-Taking; D012650:Self Disclosure; D015819:Substance Abuse, Intravenous / Q000150:complications*; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex