Beyond the Down Low: Sexual Risk, Protection, and Disclosure Among At-Risk Black Men Who Have Sex with Both Men and Women (MSMW)

Abstract

Little information is available about sexual risk, protective, and disclosure practices among Black bisexually active men and how these may be amenable to intervention when necessary. In-depth interviews were conducted with 30 at-risk urban Black men who have sex with both men and women (MSMW). Participants reported protecting themselves and their partners through routine HIV testing, using condoms consistently, engaging in strategic positioning during sexual activity, and limiting the number of sexual partners. In addition, they described several reasons for not using protection, including not having condoms available, enjoying sexual activity more without condoms, and perceiving female partners to be “safer” than male partners. Disclosure of bisexuality was complex and reportedly difficult, in particular to female and gay-identified male partners. Future interventions must not only build protection and disclosure skills among MSMW, but also increase broader social awareness and acceptance of male bisexuality.

HIV Acquisition and Transmission Potential Among African American Men Who Have Sex with Men and Women in Three U.S. Cities

“…Sexual minorities experience disparities in social support and connectedness, mediating the development of harmful psychosocial outcomes (Coulter, Herrick, Friedman, & Stall, 2016;Frost, Meyer, & Schwartz, 2016). However, cultivating sources of social support may be particularly difficult for some black MSMW, who often face ongoing marginalization from familial and religious institutions into adulthood (Dodge et al, 2008).…”

“…Black MSMW may also be more likely than MSM of other race/ethnicities to have undiagnosed infection (Maulsby, Sifakis, German, Flynn, & Holtgrave, 2012;Young, Shoptaw, 5 It is likely that sexual behaviors differ between male, female, and transgender partners of MSMW . Some research suggests that MSMW practice more unprotected sex with their female partners than with their male partners (Dodge, Jeffries, & Sandfort, 2008;Mimiaga et al, 2009) and with primary partners compared to non-primary partners (Sanchez et al, 2006;Sullivan, Salazar, Buchbinder, & Sanchez, 2009). Harawa et al noted that Black MSMW who had only primary female partners had fewer male partners and were also more likely to have only primary partners .…”

Differences in Sexual Identity, Risk Practices, and Sex Partners between Bisexual Men and Other Men among a Low-Income Drug-Using Sample

“…[3][4][5][6] The considerable research on male same-sex behavior typically focuses on men who have sex with men only (MSM) and does not treat MSMW as a distinct subpopulation. 7 A survey of about 10,000 men who have sex with men conducted in 2003-2005 by the Centers for Disease Control and Prevention in 17 US metropolitan areas found that 14% also reported having sex with women in the previous 12 months. 8 While this study did not report on racial/ethnic differences in male bisexuality, a review of 26 studies by Millet and colleagues 5 concluded that among MSM in the USA, bisexual behavior is more prevalent among blacks than whites and Latinos.…”

“…Behaviorally, MSMW are not a monolithic group, as some have sex more often with women, others with men, and others equally with women and men. 7,31 Some studies suggest that bisexual men who experience greater dissonance between their behavior and orientation or who are more secretive about their male sexual relationships engage in greater risk, including having more sex partners and unprotected sex and using condoms less consistently 32 while other studies report less risk. 33 Sexual self-identification is also important for accessing MSMW for interventions.…”

Harga Diri, Sexting dan Jumlah Pasangan Seks yang Dimiliki oleh Pria Lajang Pelaku Perilaku Seks Berisiko

“…Sementara itu, studi lain menyebutkan rerata jumlah pasangan seks seumur hidup yang dapat dimiliki individu sejumlah 10 orang (Dodge, Jeffries IV, & Sandfort, 2008).…”