The Relationship Between Self-Reported Sexual Orientation and Behavior in a Sample of Middle-Aged Male Injection Drug Users

Abstract

Data are sparse on injection drug using (IDU) men who have sex with men (MSM). Previous literature suggests perceived taboos can result in an underreporting of atypical sexual orientation (i.e., bisexuality, homosexuality). As a result, HIV prevention programs have been difficult to mount, particularly programs for IDU-MSM. The association between self-reported sexual orientation and sexual behavior at semi-annual study visits was longitudinally assessed in a population of 1300 male IDUs in Baltimore during the period 1993 to 1998. Overall, a small minority (5%) of the male IDUs inconsistently reported their sexual orientation over time. Logistic regression analyses were performed, which yielded five significant predictors. These men tended to be older, to have been incarcerated, to have attended shooting galleries during follow-up, and were more than twice as likely to be HIV-seropositive (OR, 2.66; 95% CI, 1.62-4.36) compared with those who consistently reported their sexual orientation. Furthermore, men reporting inconsistent sexual orientation tended to engage in higher risk behaviors, suggesting that these men should be especially targeted for interventions.

Exploring the Use of Web-Based HIV Prevention for Injection-Drug-Using Black Men Who Have Sex with Both Men and Women: A Feasibility Study

“…Consistent with previous research, participants inconsistently reported their sexual orientation/identity and sexual behavior (Washington et al, 2006). Hence, Web-based prevention programs are needed that include language specific to IDU-MSM/W, whose desire for money to purchase drugs may override their sexual preference.…”

“…Many studies of HIV infection that included injection drug users (IDUs), since 1991, have focused on whether injection or sexual risk factors, or both, were associated with HIV seroconversion, and have not included STDs Kral, Bluthenthal, Lorvick, & Gee, 2001;Longshore, Bluthenthal, & Stein, 2001). Others have examined risk factors among IDUs (Kral, Bluthenthal, Erringer, Lorvick, & Edlin, 1999;McFarland, Kellog, Dilley, & Katz, 1997;Dushay, Singer, Weeks, Rohena, & Gruber, 2001), and explored the relationship between self-reported sexual orientation and behavior among IDUs (Pathela et al, 2006;Washington et al, 2006).…”

HIV Among People Who Use Drugs: A Global Perspective of Populations at Risk

“…Interventions for non-identifying MSM may benefit from addressing community norms, sexual identity, and stigma as underlying factors that contribute to drug use and sexual risk behaviors 21. Interventions for bisexual and non-identifying MSM-IDUs should consider race/ethnicity as well as social and contextual factors, such as internalized homophobia and fear of disclosure 22.…”

The Problem With ‘Behavioral Bisexuality': Assessing Sexual Orientation in Survey Research

“…Moreover, the timeframe used for data collection will affect the classifications and potentially the results. Although some studies used relatively short times frames (3-6 months) to assess sexual behavior (Gorbach et al, 2009;Knight et al, 2007;Washington, Galai, & Cohn, 2006;Wheeler et al, 2008;Zule et al, 2009), larger population-based data sets tended to assess sexual behavior over the past year (Jeffries & Dodge, 2007;Koh & Ross, 2006;Spikes et al, 2009;Tao, 2008), 5 years (Midanik et al, 2007), or lifetime (Bostwick et al, 2010;Cochran & Mays, 2007;Koh & Ross, 2006;Levin et al, 2009;Pathela & Schillinger, 2010;Zellner, Marinez-Donate, & Sanudo, 2009).…”