SEXUAL RISK IN THE CONTEXT OF SAME-SEX BEHAVIOR

Grant Title: HIV Risk and Prevention Among At-Risk Men Who Have Sex with Both Men and Women (MSMW)

Funding Source and Project Period: HIV Center Pilot Studies Program; 2005 - 2006

Collaborating Institutions and Key Personnel:
HIV Center:
Principal Investigator: Brian Dodge, Ph.D.
Mentor: Theo Sandfort, Ph.D.
Co-Investigators: Miguel Muñoz-Laboy, Dr.P.H.; Linwood Lewis, Ph.D.

National Development and Research Institutes, Inc.
Consultant: Lloyd Goldsamt, Ph.D. (Institute for Research on Youth at Risk)

Columbia University, Joseph L. Mailman School of Public Health
Research Assistant: Toby Anekwe (Sociomedical Sciences)

Minority Task Force on AIDS, Inc.
Research Assistant: Leslie Campbell

University of Florida, College of Public Health and Health Professions
Research Assistant: William L. Jeffries (Social and Behavioral Sciences)

Project Overview: In much previous HIV/AIDS research, men who have sex with both men and women (MSMW) and men who have sex exclusively with men (MSM) have been combined under the rubric of "MSM" without being examined separately in terms of their risk and prevention needs. However, a body of literature has also emerged that compares MSMW with MSM and explicitly identifies bisexual behavior and identity as significant psychosocial risk factors for HIV infection, particularly for African-American men and other men of African descent. As yet, little information is available on factors associated sexual risk behavior and how such behavior may be amenable to change through interventions. The primary goal of this pilot study is to elicit qualitative data on individual, sexual, and social factors associated with HIV risk among at-risk MSMW. Our primary study aims are

1. To describe the patterns and meanings of sexual behavior in the lives of at-risk MSMW;
2. To explore the experiences of identities and communities among at-risk MSMW;
3. To identify potential determinants of risk involved in sexual interactions of at-risk MSMW.

This exploratory study is composed of a sample of 30 young MSMW, ages 18-30, who are at-risk for HIV transmission. In our study, at-risk MSMW are defined as men who (1) have had sex with at least one male and at least one female partner in the past twelve months, (2) have used condoms inconsistently with these sexual partners, and (3) identify as African-American, Black, or of African descent. Furthermore, we focus on MSMW who have not engaged in bisexual behavior only in exchange for money or drugs in the past twelve months, who have not injected drugs in the past twelve months, and who have not tested positive for HIV. Participants have been recruited using targeted sampling techniques in spaces where MSMW have been found to interact socially and/or sexually with other men and women, based on previous ethnographic mapping by members of our study team. The information gained from the pilot study will serve as a framework for more detailed investigations of individual, sexual, and social factors associated with HIV risk among at-risk MSMW. Specifically, we anticipate that this pilot study will be the foundation from which to design a larger-scale research project on at-risk men who have sex with both men and women, with the ultimate goal of developing and testing risk-reduction/prevention interventions for this population.

Publications:

Dodge, B., Jeffries, W. L., & Sandfort, T. G. M. (In press). Beyond the down low: Sexual risk, protection, and disclosure among at-risk Black men who have sex with men and women (MSMW). Archives of Sexual Behavior.

Sandfort, T. G. M. & Dodge, B. (In press). And then there was the down low: Introduction to Black and Latino Male Bisexualities. Archives of Sexual Behavior.

Sandfort, T. G. M. & Dodge, B. (Eds.). (In press). Archives of Sexual Behavior. [Special issue] (Black and Latino Male Bisexualities).

Jeffries, W. L., Dodge, B., & Sandfort, T. G. M. (In press). Religion and spirituality among bisexual Black men in the USA. Culture, Health, & Sexuality.

Sandfort, T. G. M., & Dodge, B. (in press). Homosexual and bisexual labels and behaviors among men: The need for clear conceptualizations, accurate operationalizations, and appropriate methodological designs. In V. Reddy, T. G. M. Sandfort, and R. Rispel (Eds.) Perspectives on same-sex sexuality, gender and HIV/AIDS in South Africa: From social silence to social science. Pretoria: Human Sciences Research Council.

Dodge, B., Reece, M., & Gebhard, P. H. (In press). Kinsey and beyond: Past, present, and future considerations for research on male bisexuality. Journal of Bisexuality.

Jeffries, W. L., & Dodge, B. (2007). Male bisexuality and condom use at last sexual encounter: Results from a national survey. The Journal of Sex Research, 44(3), 278-289.

Muñoz-Laboy, M. A., & Dodge, B. (2007). Bisexual Latino men and HIV and sexually transmitted infections risk: An exploratory analysis. American Journal of Public Health, 97(6), 1102-1106.

Dodge, B., & Sandfort, T. G. M. (2007). A review of mental health research on bisexual individuals when compared to homosexual and heterosexual individuals. In B. A. Firestein (Ed.) Becoming Visible: Counseling Bisexuals Across the Lifespan (pp. 28-51). New York: Columbia University Press.

Presentations:

Dodge, B., Sandfort, T. G. M., Munoz-Laboy, M., Lewis, L. J., Goldsamt, L., & Jeffries, W. L. (2005). HIV risk and prevention among at-risk African-American and Latino men who have sex with both men and women (MSMW). Annual Meeting of the American Public Health Association, Philadelphia.

Dodge, B. (2006). Going both ways down a one-way street: Researching male bisexuality in contemporary America. Seminar Series of the Sexual Health Research Working Group (SHRWG), Indiana University, Bloomington.

Dodge, B. (2006). HIV/AIDS among Black and Latino bisexual men. Keeping with the Pace: An HIV Update Annual Conference, Florida Department of Health, Gainesville.

Dodge, B. (2006). Beyond the Down Low: Negotiating sexual risk and disclosure among Black men who have sex with both men and women (MSMW). Grand Rounds of the HIV Center for Clinical and Behavioral Studies, Columbia University Department of Psychiatry and the New York State Psychiatric Institute, New York.

Dodge, B. (2006). New findings on sexual risk and disclosure among Black bisexually-active men in New York City. Center for HIV Educational Studies and Training (CHEST), Hunter College at the City University of New York (CUNY), New York.

Dodge, B. (2006). Black and Latino male bisexuality and HIV/AIDS: Gender, context, and culture. Scientific session chaired and conducted at the Annual Meeting of the American Public Health Association, Boston.

Dodge, B., Sandfort, T. G. M., Jeffries, W. L., & Fontaine, Y. M. (2006). Roles of gender in the sexual and risk behaviors of Black men who have sex with both men and women (MSMW) in New York City. Annual Meeting of the American Public Health Association, Boston.

Jeffries, W. L., Dodge, B., Sandfort, T. G. M., & Fontaine, Y. M. (2006). Family, religion, communities and implications for HIV prevention in the lives of bisexually-active Black men. Annual Meeting of the American Public Health Association, Boston.

Sandfort, T. G. M., Dodge, B. Fontaine, Y. F., Udoh, I., & Jeffries, W. L. (2007). Sexual self-identifications and perceptions of the "Down Low" in Black bisexual men. University Consortium on Sexuality Research and Training Conference, The Kinsey Institute, Indiana University, Bloomington.

Sandfort, T. G. M. (2007). Black bisexual men, their sexual identity, and perceptions of the Down Low. Grand Rounds of the HIV Center for Clinical and Behavioral Studies, Columbia University Department of Psychiatry and the New York State Psychiatric Institute, New York.

Dodge, M. & Reece, M. (2007). A new understanding of bisexuality and its influence on sexual health among Latino men. Presented at the Annual Meeting of the Puerto Rico Public Health Association, San Juan, PR.

Jeffries, W. L., & Dodge, B. (2007). Male bisexuality and condom use at last sexual encounter: Results from a national survey. Annual Meeting of the Society for the Scientific Study of Sexuality, Indianapolis, IN.

Update: 1/2/2008