HIV Risk Among Bisexually and Homosexually Active Racially Diverse Young Men

In Brief Objectives: We addressed gaps in current HIV prevention research by examining the differences between 2 groups of young men: men who have sex with men only (MSM/O) and men who have sex with men and women (MSM/W). We examined patterns and correlates of sexual risk, and considered how race/ethnicity may affect these relationships. Methods: Cross-sectional self-report data were collected from a racially diverse sample of 10,295 young MSM from 1999 to 2002. The sample comprised data from 13 urban locations across the US. Results: MSM/W reported less unprotected anal intercourse (UAI) than MSM/O, despite reporting less exposure to HIV prevention interventions, lower social support, and less awareness of antiretroviral therapies. African American men were more likely to be MSM/W and less likely to report UAI. Ever getting an HIV test was associated with less UAI only among African American participants (MSM/W or MSM/O) in racial/ethnic group-specific analyses. Conclusions: HIV prevention interventions for MSM should address differences between MSM/W and MSM/O. An important component of HIV prevention efforts designed for African American MSM/W and MSM/O should be HIV testing. This large study reports that bisexually active men reported less unprotected anal sex than exclusively homosexually active men and that ever being tested for HIV was associated with less unprotected anal sex among African American men.