Bisexual Partners Research Articles

Counseling Heterosexual Spouses of Bisexual Men and Women and Bisexual-Heterosexual Couples

SUMMARY In approximately two million current or former marriages in the United States, one of the spouses is bisexual, gay, or lesbian. When lesbian, gay, or bisexual spouses disclose their sexual orientation, their heterosexual spouses face unique issues. Their coping proceeds through common stages from initial trauma to eventual transformation. Mixed-orientation couples, too, progress through typical stages as they deal with complex relationship challenges. Heterosexual spouses of bisexual partners and bisexual-heterosexual couples face the additional challenge of understanding bisexuality. Resolving the issues and coming to terms with the disclosure for spouses and couples may take more than three years. Peer support and counseling help spouses clarify their needs, goals, and values during this period. For therapists working with such clients, scant literature about heterosexual spouses in these marriages and bisexual-heterosexual couples and the general lack of knowledge about bisexuality and mixed-orientation relationships make it difficult to know how best to counsel spouses. Counseling is most effective when therapists know the core issues of heterosexual spouses, typical stages of their resolving them, and the common path through which bisexual-heterosexual couples progress. With effective counseling, heterosexual spouses and bisexual-heterosexual couples are more likely to resolve issues constructively and to grow in individual strength and mutual understanding.

Stress, coping, and depressive symptomatology in Latina and Anglo aids caregivers

In a survey of 432 AIDS caregivers, we examined differences in the stress and coping process and predictors of depressive symptomatology by ethnicity and gender. Our sample included 192 Anglo gay and bisexual male partners, 86 Anglo women, and 154 Latina family caregivers. We examined differences in primary and secondary stressors as predictors of depression; differences in sociodemographic and background factors, and differences in the predictive value and mediating influences of factors that may attenuate the relationship between stress and depression. Results indicate substantial differences in predictors and mediators of depression across groups. While all groups evidenced moderate levels of depression, background factors influenced depression mostly for Latinas. Depression in gay and bisexual partners was more influenced by primary objective stressors such as assisting with activities of daily living (ADLs). Service acquisition appears to be shaped by access, knowledge, and cultural acceptance. Based on our findings, we suggest that service provision for caregivers must also vary and be attuned to cultural and gender differences that may influence perception of stress and depression for caregivers.

The extent of bisexual behaviour in HIV-infected men and implications for transmission to their female sex partners

Heterosexual transmission of HIV is a growing problem for women, but many women do not know how their partners acquired HIV. We described a group of HIV-infected men and women, and focused on: (1) sexual identity and bisexual behaviour in men, and (2) the proportion of women who acknowledged having a bisexual male partner. This study examined HIV-infected persons who participated in a cross-sectional interview project from January 1995 through July 2000; 5,156 men who have sex with men (MSM), and 3,139 women. The proportion of MSM who reported having sex with women (MSM/MSW) varied by race: 34% of black MSM, 26% of Hispanic MSM, and 13% of white MSM. While 14% of white women acknowledged having a bisexual partner, only 6% of black and 6% of Hispanic women reported having a bisexual partner. Most behaviourally bisexual men identified as either bisexual (59%) or homosexual (26%). Among MSM/MSW, 30% had more female partners than male partners, while only 10% had more male partners than female partners. These data suggest that bisexual activity is relatively common among black and Hispanic HIV-infected MSM, few identify as heterosexual, and their female partners may not know of their bisexual activity.

Outside Belonging

This article draws from an ongoing Australian research project with over 60 culturally and sexually diverse women in monogamous, open, and polyamorous relationships with bisexual-identifying and/or bisexual-behaving men. Positioned within a queer feminist deconstructive theoretical framework, this research provides insights into the border existences of these women and their partners, and their negotiations of “new rules” and boundaries in order to construct healthy relationships. What are the various ways that HIV/AIDS impacts women in relationships with bisexual men? How do they deal with issues such as social, community, workplace and familial ostracism? Probyn's term, “outside belonging” (1996: 9) is applicable to the border existences of these women and their bisexual male partners. Their multi-sexual relationships are both “outside” gendernormative and heteronormative constructs of marital and defacto relationships and yet “belonging,” for the partners may “pass” as a “normal” couple. They are also “outside” the dominant constructs of Australian gay identity and community while simultaneously “belonging” due to their partners', and sometimes their own, same-sex attractions and relationships.

Human immunodeficiency virus seroprevalence and condom use among female sex workers in Italy.

In two different studies, we evaluated the human immunodeficiency virus (HIV) seroprevalence rate and the condom use in a group of female sex workers working in Italy. In the first study we collected data on HIV serologic testing of female sex workers; in the second study, we evaluated the use of condoms and high-risk sexual practices by sex workers with their clients and nonpaying partners. Overall, 131 of 802 (16%) were HIV positive: 36 of 558 (6%) professional sex workers and 95 of 244 (39%) sex workers who used intravenous drugs. There was a significant increase of seroprevalence among professional sex workers between 1988 to 1990 and 1991 to 1995 (2% versus 11%, P < or = 0.001), whereas among the sex workers who used intravenous drugs, the increase was not significant (37% versus 40%, P = 0.70). Similarly, the HIV seroprevalence in the Italian professional sex workers is constant in the two periods of time (2% versus 1%). In the second study, 97 of 102 (95%) sex workers reported regular condom use with clients, whereas 63% of sex workers reported they never used them with nonpaying partners. Fourteen sex workers reported having nonpaying partners who used intravenous drugs and 6 reported having nonpaying bisexual partners; 8 of these 20 partners were HIV positive. The results of the first study showed a significant increase of seroprevalence among professional sex workers, whereas the high seroprevalence among sex workers who used intravenous drugs was constant. The results of the second study showed that sex workers may be at higher risk for HIV infection through noncommercial sexual intercourses.

Social Workers and HIV-Affected Families: Is the Profession Prepared?

The recent death of a mother with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in a northeastern city has raised concern about how well social workers are prepared to deal with families affected by HIV. In this instance, a decision was made not to allow the mother to see her children in the final stages of her illness. When an advocate confronted child welfare authorities with this concern, she was brusquely challenged about her priorities: Was she concerned about the mother or the children? Regrettably, professionals who were taught to think in systems perspectives abandoned those principles and reverted to treating the actors in a divisive manner. Not only were the children and their mother prevented from seeing one another at the end of this tragedy, but the children were separated and placed in different homes. So much for providing support for existing family units. HIV infection is growing rampantly in the African American and Latino communities. Ninety-four percent of HIV-infected children are Latino or African American. Women are especially vulnerable to infection, either through sexual contact with bisexual or drug-addicted partners or through personal injecting of drugs. It is anticipated that by the end of 1995, maternal deaths caused by HIV/AIDS will have orphaned 24,600 children and 21,000 adolescents. By the year 2000, it is estimated that there will be more than 80,000 youths orphaned by HIV (Michaels & Levine, 1992). The social work profession has much work to do in these areas. We need to recognize our limitations in providing services to the populations affected. Social workers need to deal with their own fear of HIV/AIDS and help the general population do the same through sound education that destroys myths and presents accurate information about how HIV/AIDs is contracted. Social workers need to rethink their approach in working with families with HIV/AIDS and recognize the value of family mutual aid and the need for family support systems, especially in the African American and Latino communities. Mothers with HIV/AIDS must be allowed to love and care for their children as long as they are able to do so. They need to be provided appropriate moral and practical supports to perform their traditional tasks as homemakers and mothers for as long as they are physically able to do so. There is no reason why principles of normalization should be abandoned when it comes to people living with HIV/AIDS. Most social workers study death and dying as part of their professional education but abandon that learning when the client in question has HIV/AIDS. Somehow, they perceive, HIV/AIDS is different. As a consequence of these biases and ignorance, people with HIV/AIDS and their families are further victimized by these attitudes and are not provided with the appropriate social services. The death of a person with HIV/AIDS need not be treated any differently than other types of death. There is a need for support for dying people and their families. There is a need to allow for a process of appropriate farewells and resolution of unfinished business between the parties involved. There is a need for community intervention to provide support services to these families. They can make it, but not in isolation or without support. The number of children orphaned by the HIV/AIDS epidemic presents new challenges for the social work profession. …

Changing patterns of HIV-1 transmission in southern Brazil 1985-1991.

In order to describe the changing patterns of risk factors for HIV-1 transmission of patients using hospital services at an AIDS referral centre in Porto Alegre, southern Brazil, data on demographic characteristics, referral patterns and risk factors at time of first presentation were collected prospectively on 405 patients between October 1985 and September 1991. Overall HIV-related patient workload increased during the study period, as did the proportion of infected female patients seen (P < 0.05). Of all patients, 147 (36%) presented with symptomatic HIV disease and 77 (19%) presented with an AIDS defining condition; men were more likely to present with symptomatic disease than women. Approximately 156 (44%) of men were self-referred compared with 4 (8%) of the women (P < 0.0001). Of the 357 infected men, 82 (23%) were bisexuals; of the 26 heterosexually infected women, 7 (24%) had bisexual male partners. These data suggest the increasing importance of heterosexual HIV transmission in this hitherto 'low' prevalence area, with male bisexuals constituting an important route through which heterosexual females are being infected in this area. The data also suggest that heterosexual women in Southern Brazil do not perceive themselves to be at risk for HIV-1 infection.

Contraceptive and Sexual Practices Among Single Women with an Unplanned Pregnancy: Partner Influences

Data from an urban obstetrics clinic on 291 unmarried women with a current unplanned pregnancy show that women with only one partner in the past year are older and are more likely to use the most effective contraceptive methods than are women who have more than one partner. Women with only one partner are also more likely to be solely responsible for decision-making about the choice of contraceptive methods, and are not as likely to use drugs in conjunction with sex. However, women with one partner are also less likely than others to use condoms or to protect in some other way against sexually transmitted diseases or the human immunodeficiency virus.

Condom use and high-risk sexual practices of female prostitutes in Italy

A study of 53 prostitutes in Italy (Rome Udine Prodenone Bologna Reggio Emilia Ravenna and Lecco) between October 1989-September 1991 examined the role of female prostitution in the spread of HIV infection. Questionnaires were distributed to prostitutes at their place of work by the Italian Committee for the Civil Rights of Prostitutes. Prior studies have found <2% of HIV infection among non-IV drug using (IVDU) prostitutes compared with 35% among IVDU prostitutes. Of the 53 prostitutes 47 were non-IVDU and 6 were IVDU. The median age was 37 years. The median number of clients reported was 100/month. 52 reported using condoms with their clients. Only 2 (4%) used condoms regularly with nonpaying partners and 32 never used condoms. 10 prostitutes had IVDU nonpaying partners and 3 bisexual nonpaying partners. Of the 13 nonpaying partners 5 were seropositive and were partners of 3 non-IVDU prostitutes. 98% engaged in vaginal intercourse; 9% engaged in anal intercourse which was more frequent (30%) with nonpaying partners. Oral intercourse was more common with nonpaying partners (89%) than with clients (60%). 74% had received HIV testing of which both IVDU prostitutes were HIV seropositive. It is concluded that prostitutes are not at increased risk for HIV infection due to their commercial sexual activity. However risk behavior is engaged in with nonpaying partners through nonuse of condoms and participating in anal intercourse. It is this nonpaying partner sexual behavior that increases risks of HIV infection for prostitutes.

Risk Behaviors for HIV Infection in Clients of Pennsylvania Family Planning Clinics

Responses from a statewide survey of risk behaviors among clients of Planned Parenthood clinics in Pennsylvania indicate that a sizable proportion of these women are at intermediate or high risk for exposure to the human immunodeficiency virus (HIV). Overall, nearly five percent of the 15,499 women in the sample reported personal behavior, or a partner's behavior, that placed them at high risk, while an additional 20 percent were at intermediate risk. Among all women surveyed, 13 percent had had three or more partners in the past year, 12 percent had had a sexually transmitted disease, four percent had partners who were intravenous (IV) drug users, two percent were either current or past IV drug users, one percent had bisexual partners and less than one percent had partners who had hemophilia or who were infected with the AIDS virus.

Human immunodeficiency virus and female prostitutes, Sydney 1985.

One hundred and thirty two female prostitutes and 55 non-prostitutes who were tested for antibodies to human immunodeficiency virus (HIV) were surveyed by questionnaire at this centre. The two groups were well matched for age and were very similar in other except for numbers of their sexual partners. Questions were asked about drug taking, sexual practices, general health, and episodes of sexually transmitted diseases (STDs). None of the women in the survey was found to be seropositive, but both groups were found to be seriously at risk of HIV infection through using intravenous (IV) drugs, having unprotected sexual intercourse with men who used IV drugs, having unprotected sexual intercourse with bisexual men, or exposure to several STDs.

Male transsexuals in the homosexual subculture.

The author describes 20 male transsexuals who differ from most discussed in professional studies and from those in media portrayals in that they live in the male homosexual subculture. Furthermore, interviews with these individuals indicated that transsexuals are no more sexually or socially homogeneous than heterosexuals or homosexuals. In general, these men entered the homosexual subculture in their teens; they knew they were not heterosexual and therefore assumed they must be homosexual. As their gender identity crystallized, homosexual activity became repugnant and they rejected and were rejected by male homosexuals. Being unable to attract heterosexual men, they sought bisexual partners in a futile effort to confirm their identity as females. The author suggests that in addition to efforts to help transsexuals shift their gender identity, psychiatrists should emphasize prevention of this psychopathologic symptom.