title: Sexual risk and substance use behaviors among African American men who have sex with men and women.
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.
authors: Department of Community Health, Brown University, Providence, RI 02903, USA. Don_Operario@brown.edu
authors: Don
authors: D
authors: Operario
authors: Carla Dillard
authors: CD
authors: Smith
authors: Emily
authors: E
authors: Arnold
authors: Susan
authors: S
authors: Kegeles
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D000368:Aged; D001727:Bisexuality / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012495:San Francisco / Q000453:epidemiology; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D019966:Substance-Related Disorders / Q000208:ethnology*; D047568:Unsafe Sex; D014505:Urban Population; D055815:Young Adult
chemical_list: D013287:Illicit Drugs