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At least 19 recordsLinked to original sources
PubMed1990

Homosexual and bisexual men's coping with the AIDS epidemic: qualitative interviews with 10 non-HIV-tested homosexual and bisexual men.

This paper describes how the threat of HIV infection is appraised and coped with by homosexual and bisexual men. Very little is known about men who do not want to be HIV tested, thus non-HIV-tested homosexual and bisexual men have been interviewed in depth about themes concerning their lives during the AIDS epidemic. Men with sexual risk behaviour appeared to be very reluctant to participate, and therefore six men with safe sexual behaviour and four men with unsafe sexual behaviour were interviewed. The results showed that all the men were well informed about AIDS and preventive measures. Reasons for not wanting a test were fear of psychological distress caused by a possible positive test and the fact that no treatment is available. The men who had adopted safe sex appraised their sex lives to have suffered a minor loss but found that sexuality played a subordinate role compared to trust and friendship. The men with risk behaviour considered sexuality to play an important role in their lives. They found condoms a barrier to intimacy and used defensive strategies to manage stress. Most of them were able to exchange social support with their network but had difficulties in setting their own limits. All four men had experienced undertreated traumatic events in their past. The results indicate that knowledge of AIDS and satisfactory social support do not necessarily result in safe sexual behaviour. The role of undertreated traumatic events forming barriers against adopting safe sexual practices should be further studied. Proposals are put forward for future health education programmes.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Sociodemographics and HIV risk behaviors of bisexual men with AIDS: results from a multistate interview project.

OBJECTIVE: To describe the sociodemographic characteristics and sexual and drug use behaviors of men with AIDS who engage in bisexual activity. METHODS: We interviewed 2120 men aged > or = 18 years who were reported with AIDS in 11 states and cities. Men were considered bisexual if they reported having had sex with a man and a woman in the previous 5 years. RESULTS: Of the 2020 men with AIDS who reported being sexually active in the previous 5 years, 1150 (57%) had had male partners only, 522 (26%) had had female partners only and 348 (17%) had had both. White men were least likely to report bisexual behavior (15%; 161 out of 1071). Men of Latin American descent were most likely to report bisexual behavior (24%; 37 out of 155), especially those born outside the United States who had lived there for < or = 10 years (38%; 11 out of 29). Bisexual Latin American men, regardless of birthplace, were more likely to be currently married than all other bisexual men (22 versus 7%; P < 0.05). HIV risk behaviors differed between men reporting bisexual and those reporting exclusively homosexual or heterosexual activity. Injecting drug use in the previous 5 years was more common among bisexual than homosexual men (12 versus 6%; P < 0.05). Bisexual men were more likely (P < 0.05) to have received money for sex (11%) than homosexual (4%) or heterosexual men (4%). This difference was even greater among injecting drug users receiving money for sex: bisexual (29%), homosexual (13%), heterosexual (3%). CONCLUSIONS: Demographics and HIV risk behaviors of bisexual men with AIDS differ from those of homosexual and heterosexual men with AIDS. These findings indicate that special efforts are needed to prevent sexual transmission of HIV among bisexual men.

Acquired Immunodeficiency Syndrome↗
PubMed1992

AIDS in bisexual men in the United States: epidemiology and transmission to women.

BACKGROUND: Homosexual and bisexual men with acquired immunodeficiency syndrome (AIDS) differ, and bisexual men play an important role in the sexual transmission of human immunodeficiency virus (HIV) to women. METHODS: To describe AIDS in these groups, we examined AIDS cases reported nationally through June 1990. RESULTS: Among 65 389 men who reported having had sex with men since 1977, 26% were bisexual. More Black (41%) and Hispanic men (31%) than White men (21%) reported bisexual behavior. Bisexual men were twice as likely to report intravenous drug use (20%) as were homosexual men (9%), regardless of race or ethnicity. Among 3555 women with heterosexually acquired AIDS, 11% reported sexual contact with a bisexual man and no other risk factor, although in some states approximately half reported such contact. In 1989, the AIDS rate due to sex with a bisexual man was three and five times higher among Hispanic and Black women, respectively, than among White women. CONCLUSIONS: Differences between bisexual and homosexual men with AIDS and the relative importance of AIDS in women due to sexual contact with bisexual men should be considered in the development of HIV prevention programs.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Sexual behavior and status for human immunodeficiency virus type 1 among homosexual and bisexual males in Mexico City.

The authors examined sexual behaviors, the seroprevalence of human immunodeficiency virus type 1 (HIV-1), and condom use among 2,314 homosexual and bisexual men tested during 1988-1989 at the AIDS (acquired immunodeficiency syndrome) National Center in Mexico City. Bisexuals constituted 24% of the sample; the seroprevalence rate was lower for bisexuals than homosexuals (21 vs. 34%). In logistic regressions, HIV-1 seropositivity was independently related to age, education, pattern of insertive/receptive behavior in anal sex, lifetime number of male sex partners, having sex with someone with AIDS, homosexual versus bisexual behavior, and a history of condyloma. The same logistic regressions were found to fit bisexuals and homosexuals. The rate of HIV-1 was reduced in individuals who indicated always requiring their partners to use a condom when practicing receptive anal sex (1% of the total). The most common practice for both homosexuals and bisexuals was "mixed" behavior (i.e., both insertive and receptive anal sex); this was also the practice with the highest risk. Bisexuals practiced both vaginal and anal sex with women and reported little condom use. The substantial seroprevalence among bisexuals, their frequent sexual contact with women, and their low rate of condom use imply a continuing role as a bridge of infection to females. Whether this risk will lead to a sustained heterosexual epidemic remains to be determined.

Adolescent↗
PubMed1995

Biology of bisexuality: critique and observations.

Differentiation of human sexual orientation, particularly bisexuality, has been little studied. Most studies have lumped bisexuals with homosexuals. Those examining bisexuals separately have uniformly observed that bisexuals are often unlike either heterosexuals or homosexuals. Some authors have overgeneralized the results of animal studies as applying to humans. While animal models can provide useful hypotheses, human sexual orientation is unique. Therefore, conclusions about human sexuality based on animal research are suspect. Human sexual orientation is influenced by biological, cognitive, cultural, and subcultural variable in interaction, leading to multiple types of heterosexuals, bisexuals, and homosexuals. Understanding of human sexual orientation will improve only if these factors are accounted for in research and theory. Several studies seem to indicate that some bisexuals have a predominantly heterosexual or homosexual orientation, but high erotic responsiveness or more "masculine" characteristics, leading to versatility in sexual behavior. Early exposure to masculinizing hormones seems to predispose human females toward bisexuality rather than exclusive homosexuality.

Adult↗
PubMed1992

Beyond gender: the basis of sexual attraction in bisexual men and women.

The construct of sexual orientation has typically considered the gender of the sexual partner as defining whether the individual is homosexual, bisexual, or heterosexual, and the Kinsey scale conceptualises bisexuality as a point midway between homosexuality and heterosexuality. We propose an alternative model which places homosexuality and heterosexuality at one end of a continuum as gender-linked choices of sexual partner, and bisexuality at the other as nongender-specific. As a test of this model, we administered repertory grids to nine bisexual men and women to investigate the characteristics of sexual attraction in individuals for whom gender of partner was not a critical variable. Results supported the hypothesis that gender is not a critical variable in sexual attraction in bisexual individuals. Personality or physical dimensions not related to gender and interaction style were the salient characteristics on which preferred sexual partners were chosen, and there was minimal grid distance between preferred male and preferred female partners. These data support the argument that, for some bisexual individuals, sexual attraction is not gender-linked.

Adult↗
PubMed1981

Bisexuality: some comments on research and theory.

Though evidence suggests that bisexuals may outnumber homosexuals and that bisexuality is increasing, there is a paucity of research on this group. Further, because researchers have included large numbers of bisexuals as "homosexuals" in their studies of homosexuality, we cannot even be sure of what we know about homosexuals. The author examines a variety of issues: sex differences, life-styles, discrimination, changes in sexual orientation over the life span, etc. Four beliefs about bisexuals are presented and examined: Bisexuality as: (1) real and natural, (2) transitory (the bisexual will become exclusive at the orientation opposite to his or her original orientation), and (4) homosexual denial.

Attitude↗
PubMed1985

Identity conflict or adaptive flexibility? Bisexuality reconsidered.

A definition of bisexuality is offered, followed by a discussion of two opposing models of bisexual functioning: the "conflict model," which views bisexuality as problematic, stemming from identity conflict and confusion that marks a transitional stage to a homosexual orientation; and the "flexibility model," which views bisexuality as the coexistence of heteroeroticism and homoeroticism, as the successful integration of homosexual and heterosexual identities into a dual sexual orientation. The Kinsey data are reviewed in an effort to determine the incidence of bisexuality in the U.S. population. Finally, specific clinical and empirical studies investigating bisexual subjects are reviewed in light of the two models.

Adaptation, Psychological↗
PubMed1985

Psycho-social issues related to counseling bisexuals.

An increasing number of persons who experience bisexual feelings or behaviors are seeking professional counseling. This article explores the psycho-social issues related to counseling individuals and couples concerned about their own or their partner's feelings, fantasies, or behaviors with both men and women, and the appropriateness or inappropriateness of adopting a bisexual identity or developing a bisexual life-style. The steps for helping individuals to differentiate problems, handle confusion, and conceptualize bisexuality are outlined. The counseling process with bisexuals includes developing support systems, examining internalized homophobia and sex-role stereotyping, helping them deal with heterosexual concerns, and with issues which affect partners when one or both is bisexual.

Child Rearing↗
PubMed1995

A community-wide outbreak of hepatitis A: risk factors for infection among homosexual and bisexual men.

PURPOSE: To assess risk factors for hepatitis A infection among homosexual and bisexual men during a community-wide outbreak of hepatitis A in New York City. PATIENTS AND METHODS: Twenty-five homosexual and bisexual men, 20 to 49 years of age with hepatitis A identified from health department surveillance data (cases) were compared with 42 homosexual and bisexual men of similar age distribution who were seronegative for hepatitis A virus and identified from private physician offices (controls). Odds ratio (OR) were determined for acute hepatitis A infection according to demographics, numbers of sexual partners, frequency of specific sexual behaviors, and self-reported human immunodeficiency virus status. RESULTS: Cases had more anonymous sex partners (0 to 1 partner versus > 1 partner) than controls during the 6 weeks before illness onset (OR = 4.4, 95% confidence interval [CI] 1.4 to 14.4). Cases were more likely than controls to have engaged in group sex (OR = 3.8, 95% CI 1.1 to 12.6). Among specific sexual behaviors examined, oral-anal intercourse (oral role) and digital-rectal intercourse (digital role) with anonymous sex partners were more commonly reported by cases than controls (OR = 9.7, 95% CI 1.2 to 78.7 and OR = 2.6, 95% CI 1.0 to 7.4, respectively). Multivariate analysis showed that > 1 anonymous sex partner, group sex, oral-anal intercourse, and digital-rectal intercourse were associated with illness in models controlling for duration of sexual activity. Because these variables were highly correlated, independent risk could not be evaluated in a single model. CONCLUSIONS: Hepatitis A infection among homosexual and bisexual men is associated with oral-anal and digital-rectal intercourse, as well as with increasing numbers of anonymous sex partners and group sex. These findings reinforce the importance of developing educational activities for homosexual and bisexual men that focus on risk reduction for hepatitis A as well as other sexually transmitted disease spread via the fecal-oral route.

Adult↗
PubMed1990

Factors associated with AIDS and AIDS-like syndrome among homosexual and bisexual men in Minas Gerais, Brazil.

A case-control study to determine factors associated with AIDS and AIDS-like syndrome among homosexual/bisexual men was conducted in the State of Minas Gerais (Brazil). Eighty-three per cent (45 patients) of all AIDS/AIDS-like syndrome cases in homosexual/bisexual men reported in Minas Gerais between February, 1986 and June, 1987 were compared to 133 seronegative controls seen at the same clinic. Blood samples were tested by ELISA and confirmed by Western blot. Sex with men from the USA, sex with someone who developed AIDS, number of male partners (greater than or equal to 100 lifetime), age (greater than or equal to 30 years old) and ethnicity (white) were independently associated with AIDS/AIDS-like syndrome (Odds Ratios = 5.5, 4.3, 3.9, 3.5 and 2.7, respectively). Thirty-nine per cent of cases and 44% of controls reported bisexual activity during the previous two years. From these, a high proportion reported anal intercourse with women in the same period (53% of bisexual cases and 33% of bisexual controls). Bisexual men had more male partners than female partners in the previous two years (median male partners = 20 for cases and five for controls; median female partners = three for both cases and controls). This explains in part why the epidemic has increased more rapidly among men then among women in Minas Gerais, despite the large proportion of bisexuals with the disease.

AIDS-Related Complex↗
PubMed1992

HIV education for gay, lesbian, and bisexual youth: personal risk, personal power, and the community of conscience.

Adolescent gay and bisexual males face a higher risk of infection with HIV than most other young people because of their behaviors and because HIV prevention programs have failed to address their unique concerns. Ironically, current efforts to heighten public awareness about the AIDS pandemic may be nullifying the potential for gay, lesbian, and bisexual young persons at high risk to form the support networks needed to modify their behavior. The personal and group empowerment of gay, lesbian, and bisexual young people is a necessary prerequisite to their ability to make healthy behavioral choices around HIV and other health issues. This paper proposes a comprehensive health education model for HIV prevention for gay, lesbian, and bisexual adolescents. Current health education efforts would be augmented by broader self and group empowerment training that would develop self-esteem, social skills, support networks, and access to risk reduction materials. An integrated system of care involving school-based programs, multi-service youth agencies, and self-help groups would be in a position to deliver appropriate educational, mental health, medical, and social support services. Such a system of care presents gay, lesbian, and bisexual youth with their best chance to reduce their risk of infection with HIV and develop into emotionally healthy individuals.

Adolescent↗
PubMed1994

Seroprevalence of HIV and risk behaviors among young homosexual and bisexual men. The San Francisco/Berkeley Young Men's Survey.

OBJECTIVE: To estimate the prevalence of human immunodeficiency virus (HIV) infection and risk behaviors among young homosexual and bisexual men sampled from public venues in San Francisco and Berkeley, Calif. DESIGN: A survey of 425 young homosexual and bisexual men sampled from 26 locations during 1992 and 1993. Participants were interviewed and blood specimens were drawn and tested for HIV, level of CD4+ T lymphocytes, and markers of hepatitis B and syphilis. SETTING: Public venues in San Francisco and Berkeley, including street corners and sidewalks, dance clubs, bars, and parks. POPULATION STUDIED: Homosexual and bisexual men aged 17 to 22 years. MAIN OUTCOME MEASURES: Prevalence of HIV infection and risk behaviors. RESULTS: The HIV seroprevalence was 9.4% (95% confidence interval, 6.8% to 12.6%). The prevalence of markers for hepatitis B was 19.8% (95% confidence interval, 16.1% to 23.9%), and that for syphilis was 1.0% (95% confidence interval, 0.3% to 2.4%). The HIV seroprevalence was significantly higher among African Americans (21.2%) than among other racial/ethnic groups (P = .002). Approximately one third (32.7%) of the participants reported unprotected anal intercourse, and 11.8% reported injecting drug use in the previous 6 months. At the time of interview, 70.0% of the HIV-infected men did not know that they were HIV seropositive, and only 22.5% were receiving medical care for HIV infection. CONCLUSIONS: The prevalence of HIV infection is high among this young population of homosexual and bisexual men, particularly among young African-American men. The high rates of HIV-related risk behaviors suggest a considerable risk for HIV transmission in this population. Prevention programs and health services need to be tailored to address the needs of a new generation of homosexual and bisexual men.

Adolescent↗
PubMed1993

Sexual behavior of homosexual and bisexual men attending an HIV testing clinic in Jerusalem 1986/7-1990.

We investigated whether the sexual practices of homosexual and bisexual men attending the Jerusalem AIDS Clinic had changed between 1986/7 and 1990. The responses of a group of 79 homosexual and bisexual men to a questionnaire in 1986/7 were compared to the responses of a group of 37 homosexuals/bisexuals in 1990. Consistent yet statistically insignificant differences in sexual behavior between the 1990 and 1986/7 groups were observed: More individuals were using condoms (53% vs 36% respectively), and at an earlier age. The practice of anal sex was less common (48% vs 67% respectively) and that of oral sex more common (46% vs 27% respectively). These differences were not confounded by the level of education between the two groups. Analyzed separately for homosexuals and bisexuals, the increase in condom use was more noticeable among homosexuals compared with bisexuals, while the decrease in anal sex was greater in bisexuals compared with homosexuals. These results may indicate a trend towards safer sexual behavior in this at risk population, but further studies are needed to support or refute these observations.

AIDS Serodiagnosis↗
PubMed1996

Trends and predictors of human immunodeficiency virus antibody testing by homosexual and bisexual adolescent males, 1989-1994.

OBJECTIVE: To identify temporal trends and predictors of human immunodeficiency virus (HIV) antibody testing in homosexual and bisexual youth, using the Health Belief Model as a conceptual framework. DESIGN: Cross-sectional survey. SUBJECTS: Five hundred one male volunteers, 13 to 21 years old, self-identified as homosexual, bisexual, or as having sex with men, were enrolled from June 1, 1989, to May 30, 1994. METHODS: Structured reviews and written instruments, including measures of perceived susceptibility to and severity of HIV disease, benefits and barriers to testing, and cues to action. Based on significant (P < .001) bivariate association, variables were selected for forward stepwise logistic regression analysis. OUTCOME MEASURES: Self-reported HIV antibody testing. RESULTS: Forty-five percent of the subjects had undergone HIV antibody testing, with no significant differences between annual cohorts. Predictors of testing were having discussed same-sex feelings or experiences with a physician or counselor, a history of unprotected receptive anal intercourse, substance abuse, younger age at self-identification as bisexual or homosexual, ever having had a steady male partner, having many friends who understand sexual orientation, living away from family, and older age. CONCLUSIONS: Testing practices did not change significantly across time. Human immunodeficiency virus testing was related to age, risky behaviors, living situation, bisexual or homosexual acculturation, and contacts with health professionals, corresponding to Health Belief/Model dimensions of perceived susceptibility, barriers, and cues to action.

AIDS Serodiagnosis↗
PubMed1988

Hepatitis B and Delta virus infection among heterosexuals, homosexuals and bisexual men.

The hepatitis B virus (HBV) and hepatitis Delta virus (HDV) infection rates were estimated in patients attending a venereal disease outpatient clinic: 759 heterosexuals and 154 homosexual-bisexual men. The anti-HBc prevalence was higher in homo-bisexual men (68.8 per 100) than in heterosexuals (41.8 per 100), whereas HBsAg was roughly the same in the two groups (about 6 per 100). The anti-HBc prevalence rate among heterosexuals was higher than that estimated in hospital personnel from the same geographical area. A positive association between anti-HBc prevalence and present or past sexually transmitted diseases (STD) was found among homo-bisexual men. Anti-HBc was also positively associated with herpes simplex type 2 antibodies in both heterosexuals and homo-bisexual men. These data are consistent with the hypothesis that sexual behavior also plays a role in the spread of infection among heterosexuals. Ten of the 46 HBsAg-positive subjects were anti-HDV positive: 6 of the 36 heterosexuals and 4 of the 10 homosexuals. All HDV-positive subjects had present or past STDs. These findings suggest sexual transmission of HDV infection.

Age Factors↗
PubMed1993

Testing for HIV infection among heterosexual, bisexual and gay men.

This paper answers the questions: who is and is not tested for human immunodeficiency virus (HIV) antibodies, why, where are they tested, and what do they find difficult about the testing process? The data came from two samples of sexually active heterosexual, bisexual and gay men in Perth (N = 545). Bisexual and gay men were much more likely to be tested than heterosexual men, although the commonest reason for testing for all three groups was risky sex. The three groups differed on reasons for not having the HIV antibody test: heterosexual men most commonly claimed that they were not at risk; bisexual men explained that they had been meaning to go but kept putting it off; and gay men primarily feared a positive test result and lacked trust in the confidential treatment of results. Gay men were more likely to trust their regular doctors than were heterosexual and bisexual men who had more trust in state health clinics. Waiting for test results was the most difficult part of the testing process for all respondents. Few respondents agreed that employers and the police should be notified by a doctor of an antibody-positive test result; nearly all agreed that those who had contracted HIV should be notified; notification of surgeons received moderate support. Knowing one's HIV infection status appears to be strongly associated with safer sex practices, and therefore the HIV antibody test could be promoted as part of a preventive health care program.

AIDS Serodiagnosis↗
PubMed1994

Are bisexually identified men in San Francisco a common vector for spreading HIV infection to women?

OBJECTIVES: This article examines sexual risk taking among self-identified bisexual men in San Francisco and whether risk reduction has occurred, with respect to both homosexual and heterosexual behaviors, among human immunodeficiency virus (HIV) antibody-positive and HIV antibody-negative men. It also examines psychosocial correlates of unprotected anal and vaginal intercourse. METHODS: The participants were members of a population-based longitudinal cohort of 1034 single men aged 25 through 54 years recruited from the 19 census tracts in San Francisco that had the greatest prevalence of the acquired immunodeficiency syndrome in 1984. Of the total sample, 140 subjects initially identified themselves as bisexual; 85% of these men remained in the study. RESULTS: The participants reported dramatic reductions in sexual risk taking. Prevalences of unprotected anal sex with men were similar among HIV-positive bisexual men (89% in 1984-1985 and 18% in 1988-1989) and those who were HIV negative (65% and 20%). The prevalence of unprotected vaginal sex was much lower for HIV-positive men (16% in 1984-1985 and 2% in 1988-1989) than for HIV-negative men (35% and 20%). Unprotected intercourse was associated primarily with situational and interpersonal factors. CONCLUSIONS: Striking reductions in risk behaviors were reported. This subgroup of single, bisexually identified men appears unlikely to be a common vector for spreading HIV infection to women.

Adult↗