Rural Center for AIDS/STD Prevention

RAP Time

(Volume 2, No. 4, April 3, 1998)

Issue Contents

Female Partners of Bisexual Males Have Higher Risk for HIV Infection

A study of 415 men who reported having sex with men revealed that 87 percent also reported sex with women. Among bisexuals, 35 percent were HIV positive.

Description of the Sample
Of the men attending a sexually transmitted disease clinic in New York city between 1988 and 1993, 14 percent reported having sex with men. This 14 percent comprised the sample for this study.

Fifty-four percent of the sample were Hispanic, 41 percent were black and four percent were white. Based on individual interviews, 13 percent were classified as homosexual (having sexual encounters only with men since 1978), 35 percent were bisexual (having sexual encounters with at least two men and at least one women since 1978), and 52 percent were heterosexual (having sexual encounters only with women or only with one man since 1978).

Collection of Data
Participants were interviewed by trained personnel who administered a questionnaire in English or Spanish. Interviewers asked about current and past sexual practices, including numbers of male and female sex partners. Study particpants were asked about their sexual behavior, not sexual orientation.

Outcomes of the Study
Major findings of the study include:

  • Bisexual men were more likely and less likely to be HIV positive than heterosexual and homosexual men, respectively.
  • Since 1978, the average number of sex partners for bisexuals, homosexuals, and heterosexuals was 78, 65 and 45, respectively.
  • Twenty-nine percent of the bisexuals had anal sex during 50 percent or more of their sexual encounters, with either men or women.
  • Seventy-one percent of the bisexuals had anal sex with their most recent male sexual partner, and 74 percent were not using condoms during anal sex.
  • Eighteen percent of the bisexuals used condoms during 50 percent of more of their sexual encounters, with either men or women.
  • Twenty-nine percent of the bisexual men were married or had been married.
  • Those who were bisexual were more than twice as likely as heterosexuals to be HIV infected.

Implications for Prevention
Findings indicate that transfer of HIV to female sex partners of bisexual men may be a significant factor in the heterosexual transmission of HIV to women.

Infrequent condom use combined with a high rate of HIV infection among bisexual black and Hispanic men places their female partners at high risk. Because bisexual men living in rural areas are also likely to engage in similar behaviors, women in rural areas may be at high risk for HIV infection from their bisexual partners.

SOURCE: Lehner, T., & Chiasson, M. A. (1998). Seroprevalence of human immunodeficiency virus type I and sexual behaviors in bisexual African-American and Hispanic men visiting a sexually transmitted disease clinic in New York city. American Journal of Epidemiology, 147, 269-272.

Survey Shows an Increase in Condom Use among Women

Results from the 1995 National Survey of Family Growth show an increase in condom use by women since the same survey in 1982 and 1988. Over 10,000 women were interviewed regarding current use of contraceptive methods and condoms.

Among women surveyed in 1982 and 1988, 12 percent and 15 percent, respectively, reported condom use.

Increases were primarily attributed to greater use of condoms by black women, Hispanic women, unmarried women, and women under the age of 25. The study also found an increase since 1982 and 1988 in the use of condoms during first premarital intercourse.

Results suggest that concern about HIV/STD infection was probably a principal reason for the observed increases in condom use. The authors noted that abating public concern about HIV raises a question about continued use of condoms among women.

SOURCE: Piccinino, L. J. & Mosher, W. D. (1998). Trends in contraceptive use in the United States: 1982-1985. Family Planning Perspectives, 30, 4-10, 46.

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Young Blacks at Higher Risk for STDs than Whites and Hispanics

A survey of 5,189 adolescents indicated that blacks have at least three times more risk of STD infection than other adolescents. Data from the Youth Risk Behavior Survey included responses from white (60%), black (19%), and Hispanic (17%) adolescents. Nearly equal numbers of respondents were female and male.

Overall, seven percent of the sample reported a history of STDs. About 13 percent of the blacks reported STDs compared to about six percent of whites and four and one-half percent of Hispanics. The authors noted that the increased risk for blacks may be a result of higher rates of STDs among sex parnters (e.g. older men, women who trade sex for drugs) rather than behavioral differences.

This study also found that black adolescents with parent(s)/responsible adult(s) of high educational level were less likely to report a history of STDs.

SOURCE: Ellen, J. M., Aral, S. O. & Madger, L. S. (1998). Do differences in sexual behaviors account for the racial/ethnic differences in adolescents' self reported history of sexually transmitted disease? Sexually Transmitted Diseases, 25, 125-129.

Study Reports Higher HIV Risk for Rape Victims

In a study of 165 black women, 14 percent reported being raped. Rape victims were more likely to report behavioral risk factors for HIV infection, including not using condoms and more vaginal sex in the past three months.

SOURCE: Wingood, G. M., & DiClemente, R. J. (1998). Rape among African-American women: Sexual, psychological, and social correlates predisposing survivors to risk of STD/HIV. Journal of Women's Health, 7, 77-83.

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AIDS Impacting American Indians

American Indians and Alaskan Natives (AI/AN) with AIDS are clustered in the West, in small cities, and in rural areas. CDC also reports that AI/AN are affected disproportionally by social and behavioral factors related to increased HIV risk.

SOURCE: CDC (1998). HIV/AIDS among American Indians and Alaskan Natives—United States, 1981- 1997, MMWR, 47, 154.