title: Correlates of bisexual behaviors among men who have sex with men in El Salvador.
abstract: Bisexual behaviors may increase transmission pathways of HIV and sexually transmitted infections (STIs) from a higher prevalence group to lower prevalence groups in El Salvador. In 2008, men who have sex with men (MSM) were recruited in San Salvador and San Miguel using respondent driven sampling. Participants were interviewed and tested for HIV and STIs. Sixteen seeds and 797 MSM participated; 34.9% in San Salvador and 58.8% in San Miguel reported bisexual behavior. Bisexual behavior was associated with drug use (adjusted odds ratio (AOR) = 2.57, 95% CI: 1.30-5.06) and insertive anal sex (AOR = 5.45, 95% CI: 3.01-9.87), and inversely associated with having a stable male partner (AOR = 0.47, 95% CI: 0.26-0.84) and disclosing MSM behavior to family (AOR = 0.41, 95% CI: 0.22-0.75). Bisexual behavior was associated with risk behaviors with male and female partners that may be associated with HIV and STI transmission. Bisexual men displayed a distinct identity calling for tailored interventions.
authors.affiliation: Division of Global HIV/AIDS, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS E-30, Atlanta, GA 30333, USA. ejkim@cdc.gov
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Kim
authors.forename: Jacob
authors.initials: J
authors.lastname: Creswell
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Guardado
authors.forename: Neha
authors.initials: N
authors.lastname: Shah
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Kim
authors.forename: Ana Isabel
authors.initials: AI
authors.lastname: Nieto
authors.forename: Flor
authors.initials: F
authors.lastname: de Maria Hernandez-Ayala
authors.forename: Edgar
authors.initials: E
authors.lastname: Monterroso
authors.forename: Gabriela
authors.initials: G
authors.lastname: Paz-Bailey
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000523:psychology / Q000706:statistics & numerical data*; D017280:Condoms / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004544:El Salvador / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000635:transmission; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult