Bisexual Behavior Research Articles

Correlates of Bisexual Behaviors Among Men who have Sex with Men in El Salvador

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.

‘Stay Still So We Can See Who You Are’: Anxiety and Bisexual Activity in the Contemporary Femme Fatale Film

Within the huge proliferation of femme fatale figures in Western cinema of the past two decades, one of the most striking patterns is the frequency of femme fatale characters who seduce women as well as men; indeed, a large proportion of recent films featuring bisexually active women cast such characters as sexy, deadly, femme fatale types. Drawing on recent theoretical work on the bisexual body, this article explores the implications of the femme fatale's bisexual behavior for a critical understanding of embodied bisexuality in relation to narrative film. The author extends her interrogation of the bisexual femme fatale beyond the current critical discourse that views the bisexual behavior of this figure simply as a means of demonstrating an assumed universal availability. Taking Femme Fatale (2002), Bound (1996), Basic Instinct (1992) and Mulholland Drive (2001) as her examples, the author argues that these films engage with wider narratives and anxieties about the correlation between bodily actions, desires and identities. In this article, the author argues that the behaviorally bisexual femme fatale's refusal of a conflation of current object choice with sexual orientation provides vital space for a bisexual feminist questioning of sexuality and desire as attributes that are written on the body.

Beyond “Risk”: Exploring Sexuality among Diverse Typologies of Bisexual Men in the United States

Little public health research has explored male bisexuality and the wide range of behaviors experienced by bisexual men beyond disease transmission and other negative consequences. There is a general lack of information on diverse expressions of sexuality among diverse groups of bisexual men in the United States. Researchers collected data on a wide range of variables related to sexual behavior from a sample of 26,042 participants, recruited via a large social and sexual networking Website. Four distinct typologies of male bisexuality were constructed: self-identified bisexual, bisexual dating, bisexual with current sexual partners and bisexual by behavior. These categories were examined individually as well as compared and contrasted with one another. Demographic characteristics varied among men depending on bisexual categorization. Although participants that identified as bisexual within each typology often met criteria for other categories for other typologies, there was no absolute overlap between categories. The recency and frequency of sexual behaviors significantly varied based upon the participant's bisexual typology. Findings suggest that previous research on bisexual men's sexual behaviors and sexual risk behaviors may be misleading if bisexuality is restricted to a single typology. Further research should examine the potential subjective meanings and health implications of diverse typologies of male bisexuality, beyond sexual risk. Comprehensive and insightful research on aspects of life other than disease infection and transmission among bisexual men will help to ensure a more accurate understanding of male bisexuality in a comprehensive sexual health framework.

Bisexual behavior among Chinese young migrant men who have sex with men: implications for HIV prevention and intervention

Data from 307 young migrant men who have sex with men (MSM) in Beijing were analyzed to examine bisexual behavior and the associated sociodemographic and behavioral factors among Chinese young migrant MSM. More than one-fourth (27%) of the MSM were also concurrently engaged in sexual behavior with women (MSMW). Among MSMW, 8.4% were infected with HIV, and 10.8% with Syphilis, compared to 4.9% and 23.7%, respectively, among men who have sex with men only (MSM-only). Various HIV-related risk behaviors among MSMW were similar to those of MSM-only, such as unprotected anal sex, multiple sexual partners, involvement in commercial sex, and substance use. Compared with MSM-only, MSMW were less likely to have tested for HIV, to participate in HIV prevention activities, and were less knowledgeable about condom use and HIV/AIDS. MSMW also had a higher rate of unprotected sex with female stable sexual partners than with male stable sexual partners (79.5% vs. 59.5%). Results indicated that MSMW were at a very high risk for both HIV infection and transmission. Intervention efforts are needed to target this subgroup of MSM and promote AIDS knowledge and HIV/STD testing among MSMW, and to reduce HIV transmission through MSM's bisexual behavior.

Revisiting the Invisibility of (Male) Bisexuality: Grounding (Queer) Theory, Centering Bisexual Absences and Examining Masculinities

The article draws upon research published in the Journal of Bisexuality since the author's 2001 article to make observations about bisexuality research and about continuing sex and gender differences in bisexual visibility. Great interest in queer theory reflects the preponderance of theorizing about bisexuality as a transformative, liberatory and disruptive social identity. Advocating for sociological approaches and the analytic inclusion of nonbisexual identified but behaviorally bisexual individuals, the author suggests that more empirical attention to material relations, social structures and everyday social interactions is needed to complement the symbolic emphasis of queer theory and cultural studies. Further incorporating analytical attention to non-bisexual-identified individuals would better ground bisexuality studies and would involve a redirection of critical attention to the multiple social processes that generate bisexual ‘absences.’ Critical gender studies, which identify masculinity as a perpetually threatened status requiring continual performance to ward off discrediting stigmas, is identified as a promising framework for examining the continuing invisibility of male bisexuals and of bisexual behavior among men.

Bisexual Behavior and Infection with HIV and Syphilis Among Men Who Have Sex with Men Along the East Coast of China

This study examined the correlates of bisexual behavior and infection with HIV/syphilis among men who have sex with men only (MSM-only) and those who have sex with both men and women (MSMW) in Shandong, China. Cross-sectional surveys probed sociodemographic information, sexual and drug use behaviors, knowledge, and use of prevention services; blood samples were tested for HIV/syphilis status. Of 2996 participants, 39.5% acknowledged being MSMW; 60.5% being MSM-only; 2.5% were HIV-infected with similar rates for MSMW (2.5%) and MSM-only (2.6%); 5.5% syphilis-infected with comparable rates for MSMW (5.6%) and MSM-only (5.5%). In multivariable models, MSMW were more likely than MSM-only to be older, local residents, recruited from outdoor cruising area, drug users, and less likely to have used a condom during last anal sex with a male partner. HIV-infected MSMW were more likely to have syphilis and other sexually transmitted diseases (STDs) and less likely to have received peer education. HIV-infected MSM-only were more likely to be older, nonlocal residents, and have syphilis and other STDs. MSMW with syphilis were more likely to be recruited from Jinan, Qingdao, and Zibo (versus Yantai), infected with HIV, and less likely to have received lubricant promotion. MSM-only with syphilis were more likely to be recruited from Jinan and Qingdao (versus Yantai), drug users, infected with HIV, and have had sex with male partners in the past 6 months. High prevalence of bisexual behavior and HIV/other STDs with common unprotected sex and multiple sexual partners among Shandong's gay community revealed in this study highlighted the importance of bisexuals as a potential epidemiologic bridge. Further research is needed to investigate the impact of bisexual behaviors on population transmission.

What is the potential for bisexual men in China to act as a bridge of HIV transmission to the female population? Behavioural evidence from a systematic review and meta-analysis

BackgroundHIV prevalence among men who have sex with men (MSM) in China has rapidly increased in recent years. It is suggested that MSM could be a potential bridge of HIV transmission to the general female population. We investigated the bisexual behaviour of MSM in China through systematic review and meta-analysis.MethodsWe conducted a systematic review and meta-analyses on published peer-reviewed Chinese and English literature during 2001-2010 according to the PRISMA guidelines. Marital status and sexual behavioural indicators of MSM were presented graphically using forest plots. The pooled effect rates with 95% confidence intervals were also calculated. Meta-regression analyses were performed to examine the factors associated with high heterogeneities across the studies.ResultsForty-three eligible articles (11 in English and 32 in Chinese) were identified. Our results showed that 17.0% (95% CI: 15.1-19.1%) of MSM in China are currently married to a woman and 26.3% (95% CI: 23.6-29.1%) of MSM had female sexual partners in the last six months. The pooled estimates for condom use rate between MSM and female sex partners was 41.4% (95% CI: 35.5-47.5%) at the last sex act; and 25.6% (95% CI: 23.0-28.4%) in the last six months. The consistent condom use rates with regular, non-commercial, casual and commercial female sex partners in the last six months were 23.3% (95% CI: 11.25-42.1%), 39.0% (95% CI: 28.8-50.3%) and 55.8% (95% CI: 41.4-69.4%), respectively.ConclusionsA substantial proportion of Chinese MSM is currently married or had sexual relations with a female in the past six months. In addition, low condom usage was common between married MSM and their wives, hence posing a higher risk of transmitting HIV. Harm-reduction programs targeting married MSM and their female partners are necessary to curb the further spread of HIV infection to the general female population.

Human Immunodeficiency Virus Prevalence Is Increasing Among Men Who Have Sex With Men in China: Findings From a Review and Meta-Analysis

Multiple studies reported a fast-spreading human immunodeficiency virus (HIV) epidemic among men who have sex with men (MSM) in China. This study aimed to estimate the magnitude and time trends of HIV prevalence among MSM in different geographical regions of China through a systemic review and meta-analysis. A total of 94 articles were identified (25 in English and 69 in Chinese) and analyzed. National HIV prevalence among Chinese MSM has increased over this period, from 1.4% (95% confidence interval [CI]: 0.8%-2.4%) in 2001 to 5.3% (95% CI: 4.8%-5.8%) in 2009. MSM in Southwest China have the highest HIV prevalence, of 11.4% (95% CI: 9.6%-13.5%) in comparison with other regions, which range 3.5% to 4.8%. Significant increases in HIV prevalence among MSM were consistently observed across all Chinese regions. There is an urgent need for implementation of effective public health interventions to curb the spread of HIV infection among MSM across China, especially in the Southwest.

P1-184 A meta-analysis of the prevalence of HIV/syphilis among Chinese bisexual men who have sex with men (MSM)

IntroductionIn China, sexual transmission has become the major route of HIV transmission, prevalence of HIV is rapidly increasing among China men who have sex with men (MSM). This study investigate...

Heterosexual Anal Intercourse: Increasing Prevalence, and Association with Sexual Dysfunction, Bisexual Behavior, and Venereal Disease History

Representative samples of the Czech population were surveyed with regard to sexual behavior in 1993, 1998, 2003, and 2008 (N = 7,720). Lifetime prevalence of heterosexual anal intercourse increased from 1993 to 2008 (16.6% to 19.7% among women, 15.7% to 25.3% among men). Anal intercourse was associated with lifetime number of sex partners, current masturbation, and histories (prevalence of which increased from 1993 to 2008) of homosexual sex, prostitution, venereal disease (adjusted for number of sex partners), and women's sexual dysfunction. The authors discuss the possible reasons for the increasing prevalence and the associations. Multivariate predictors of ever having a sexual dysfunction or a venereal disease are also presented.

Public health challenges of the emerging HIV epidemic among men who have sex with men in China

A large-scale national survey was conducted in 2008 across 61 cities throughout China, covering over 18,000 men who have sex with men (MSM). The prevalence of human immunodeficiency virus (HIV) was 4.9% and incidence ranged from 2.6 to 5.4 per 100 person-years. The prevalence of sexually transmitted diseases ranged from 2.0% to 29.9% among MSM in different parts of China. Syphilis status, recruitment of sexual partners mainly from gay saunas, duration of MSM experience, and unprotected sex with regular male sex partners and multiple male sex partners predicted HIV seroconversion. The prevalence of consistent condom use was low during anal sex, ranging from 29.4% to 37.3%. Within this context, this paper considers the factors surrounding HIV prevention activity, and identifies a number of public health challenges which need to be considered if optimum outcomes are to be achieved. HIV prevention targeting MSM is a delayed response. The high risk associated with gay saunas and the need for steady condom supply at these venues needs urgent consideration. In addition, approximately one-third of MSM in China reported bisexual behavior, which may be attributed to sociocultural reasons and stigma against MSM. Female sex partners of MSM are seldom aware of their exposure to high risk of HIV transmission. Finally, the primitive nature of non-government organizations for HIV prevention and issues around their sustainability pose another serious challenge for the future of HIV prevention campaigns targeting MSM in China.

Models of Sexual and Relational Orientation: A Critical Review and Synthesis

Many frameworks exist to explain and describe the phenomenon of same‐sex sexuality as it applies to human development. This conceptual article provides a critical overview and synthesis of previous models to serve as a theoretical bridge for the suggested multiple continua model of sexual and relational orientations. Recommendations for how counselors can adapt the multiple continua model to improve their work with same‐sex sexual clients are presented, and future directions for research are discussed.

Association of human immunodeficiency virus (HIV) preventive information, motivation, self-efficacy and depression with sexual risk behaviors among male freelance laborers

The waves of rural-urban migration are increasingly growing in many developing countries, including Vietnam. This migratory process, whether voluntary or not, may result in the spread of human immunodeficiency virus (HIV) infection to both those who migrate and those who receive migrants. Coupled with this process, is the experience of depression that may facilitate risk behaviors for HIV. However, there has been little research concerning this dimension. This study examined self-reported risk behaviors and factors associated among 450 male freelance laborers in Hanoi, Vietnam. Risk of acquiring and transmitting HIV was high among these men. One third reported having intercourse with commercial sex workers and one quarter had casual sex partners. One in every 12 men reported homosexual or bisexual behavior. These men on average had 3 partners within the preceding year, and condom use was inconsistent. These men have limited HIV knowledge and only moderate motivation and perceived behavioral skills for protective behavior. Although mobility was not associated with sexual risk behavior, three elements of IMB (information-motivation-behavioral skills) model and depression associated with this process were a robust predictor of sexual behavior. Men who are better informed, motivated, display higher self-efficacy and less depressed are more likely to alter their risk behavior. The study highlights an important need for HIV-related information, motivation, self-efficacy, depression and risk behavior change. Key words: Vietnam, freelance laborer, human immunodeficiency virus /acquired immune deficiency syndrome (HIV/AIDS), information-motivation-behavioral skills (IMB) model, depression, sexual behavior, sexual risk behavior.

Epidemiological profile of men suffering from sexually transmitted infections in Rural Central India

Thus it has now become necessary to evolve effective prevention, treatment strategy and comprehensive understanding of prevalent STI.The study was conducted from September 2009 to August 2010 in Department of Skin and V.D. at MGIMS, Sewagram to find out clinico-epidemiological profile of men suffering from STI in Rural Central India. A total of 380 patients were enrolled in the study. Detailed history, thorough clinical examination, and relevant investigations were done to ensure the diagnosis.Maximum patients were in the age group from 25−44 years (54.21%). Sixty-three percent were married, and 84% were living with their families. Seventy-one percent men acquired infection heterosexually, 10% homosexually, 10% through bisexual behavior, and in 9% mode of transmission could not be decisively pin-pointed. In 75% of those contracting infection heterosexually, the source was a sex worker. Patients were put into various groups based on the syndromic diagnosis of STI [Table 1]. About 2.36% of the patients were HIV positive.In rural areas the patients were in elder age group, mostly married, living with their families. This type of study might have an implication in planning prevention of STI in rural set up.Sonia Jain

Male injecting drug users in the Deep South: bisexual behaviour is a marker for elevated HIV risk

This study determined whether bisexual male injecting drug users (IDUs) as compared with heterosexual IDUs were more likely to engage in HIV-associated risk behaviours. Respondent-driven sampling was employed to recruit a sample of 382 male IDUs residing in the southeastern USA. Data were collected in face-to-face interviews. Weighted analyses showed that bisexual IDUs in the past 12 months were 4.6 times as likely to share needles and 3.5 times as likely to share a cooker; having multiple female sexual partners and trading money or drugs for sex with women were marginally significant. Bisexual IDUs were 10 times as likely to self-report HIV. Male IDUs, who engage in bisexual behaviour, are also engaging in HIV-associated drug and to some degree sexual-risk behaviours with women more so than heterosexual IDUs. Their higher prevalence of HIV infection coupled with their risk behaviours place themselves and other IDUs at heightened risk of both acquiring and transmitting HIV.

Comparison of Teenagers' Early Same-Sex and Heterosexual Behavior: UK Data From the SHARE and RIPPLE Studies

PurposeNorth American research finds increased sexual risk-taking among teenagers with same-sex partners, but understanding of underlying processes is limited. The research carried out in the United Kingdom compares teenagers' early sexual experiences according to same- or opposite-sex partner, focusing on unwanted sex in addition to risk-taking, and exploring underlying psychosocial differences.MethodsMultivariate analyses combined self-reported data from two randomized control trials of school sex education programs (N = 10,250). Outcomes from sexually experienced teenagers (N = 3,766) were partner pressure to have first sex and subsequent regret, and sexual risk measures including pregnancy. Covariates included self-esteem, future expectations, substance use, and communication with mother.ResultsBy the time of follow-up (mean age, 16), same-sex genital contact (touching or oral or anal) was reported by 2.3% of teenagers, with the majority also reporting heterosexual intercourse. A total of 39% reported heterosexual intercourse and no same-sex genital contact. Boys were more likely to report partner pressure (Odds ratio [OR] = 2.56, 95% confidence intervals [CI] = 1.29–5.08) and regret (OR = 2.32; 95% CI = 1.39–3.86) in relation to first same-sex genital contact than first heterosexual intercourse, but girls showed no differences according to partner type. Teenagers with bisexual behavior reported greater pregnancy or partner pregnancy risk than teenagers with exclusively opposite-sex partners (girls, OR = 4.51, 95% CI = 2.35–8.64; boys, OR = 4.43, 95% CI = 2.41–8.14), partially reduced by attitudinal and behavioral differences.ConclusionsThis UK study confirms greater reporting of sexual risk-taking among teenagers with same-sex partners, and suggests that boys in this group are vulnerable to unwanted sex. It suggests limitations to the interpretation of differences, in terms of psychosocial risk factors common to all adolescents.

HIV Testing Among Bisexual Men in the United States

Little is known about HIV testing among bisexual men in the United States. Existing studies lack adequate representation, multivariate analytical strategies, and measurement of bisexuality indicators. To address these limitations, this study used the National Survey of Family Growth (N = 3,875). Sexual behavior and identity measures compared bisexual and other men along HIV testing history, reasons for testing, and recency of testing. Multivariate analyses adjusted for sociodemographic and risk factors that covary with testing. Bisexually active men were significantly less likely than homosexually active men to ever test, and they tested less often to know their HIV serostatuses. Bisexual identification decreased the odds of testing among bisexually active men but not others. Findings suggest that bisexual behavior and identity interact to decrease men's likelihoods of HIV testing. Interventions must recognize the potentially mediating roles of bisexual identity and behavior as well as risk factors that increase bisexual men's susceptibility to HIV infection.

Syphilis and HIV Seroconversion Among a 12-Month Prospective Cohort of Men Who Have Sex With Men in Shenyang, China

Cross-sectional studies have found a high prevalence of syphilis and HIV infection among men who have sex with men (MSM) in China. A total of 218 HIV-negative MSM participated in this prospective cohort study. Interviewer-administered questionnaires were completed, and blood samples were obtained for HIV and syphilis testing, both upon enrollment and at 12-month follow-up. Of enrolled participants, 56% (122) were retained for the full 12-month follow-up period. The cohort had an HIV incidence density of 5.4 (95% CI: 2.0-11.3)/100 person-year (PY) and a syphilis incidence density of 38.5(95% CI: 27.7-50.2)/100 PY. Having syphilis (odds ratio [OR]: 11.4, 95% CI: 1.2-104.7) and more than 5 male sexual partners within the past 12 months (OR: 6.5, 95% CI: 1.1-39.8) were independent risk factors for HIV seroconversion (each P < 0.05). Being married (OR: 3.5, 95% CI: 1.4-8.2) and having more than 5 male sexual partners within the past 12 months (OR: 4.7, 95% CI: 2.0-6.2) were risk factors for syphilis seroconversion, while age > or =30 (OR 2.1, 95% CI 0.7-9.5) and having recently engaged in unprotected receptive anal sex (OR: 2.4, 95% CI: 0.7-13.1) were marginally associated with syphilis seroconversion. The high incidence rates of HIV and syphilis in the Shenyang MSM community are significant cause for concern. The seroconversion rate for syphilis, in particular, indicates the high prevalence of high-risk sexual behaviors and the potential for increased HIV transmission. Appropriate interventions that address MSM-specific issues, including stigma, pressures from traditional society, and bisexual behavior, need to be tailored to inform and empower MSM in order to prevent HIV and syphilis in this community.

Men who have sex with men and women in Bangalore, South India, and potential impact on the HIV epidemic

The aim of this study was to quantify differences in patterns of sexual behaviour among men who have sex with men and women (MSMW) compared with men who have sex with men only (MSMO), and to examine the extent to which bisexual behaviour may act as a bridge for introducing HIV infection into the general population. A cross-sectional survey in Bangalore city in 2006, which sampled men seeking sex with men in public places and hammams (bath houses where transgender individuals sell sex to men). Among a sample of 357 men reporting same-sex behaviour; 41% also reported sex with a woman in the past year and 14% were currently married to a woman, only two of whom had informed their wives about having sex with men. Condom use was very inconsistent with all male partners, while 98% reported unprotected vaginal sex with their wives. MSMW reported lower rates of risky behaviour with other men than MSMO: fewer reported selling sex (17% vs 58%), or receptive anal sex with known (28% vs 70%) or unknown (30% vs 59%) non-commercial partners. Bisexual behaviour was common among men seeking sex with men sampled in this survey. Although MSMW reported lower rates of risky sexual behaviour with male partners than MSMO, inconsistent condom use with both male and female partners indicates a potential means of HIV transmission into the general population. HIV prevention programmes and services should reach bisexual men who potentially expose their male and female partners to HIV.

The Relation Between Sexual Orientation and Suicide Attempts in Austria

Previous studies indicate that homosexual or bisexual individuals are at a higher risk of attempting suicide compared to heterosexuals. To overcome biases in these studies, more rigorous definitions of "suicide attempts" and the assessment of multiple dimensions of sexual orientation are needed. In addition, studies from the German speaking region are sparse, especially those not recruiting participants from the gay or lesbian communities. We solicited self-reported suicide attempts among 1,382 Austrian adults recruited through structured snowball sampling from students' social networks. Suicide attempts were more frequently reported by those participants with homosexual or bisexual fantasies, partner preference, behavior, and self-identification, compared to their heterosexually classified counterparts. This was true for any dimension of sexual orientation and for suicide attempts with intent to die or suicide attempts that required medical treatment. Our Austrian study confirmed existing evidence that homosexual and bisexual individuals are at an increased risk for attempting suicide. This should be considered in suicide preventive efforts.