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APHA Scientific Session and Event Listing

Recorded presentation

Seth Welles, ScD, PhD¹, Anita Raj, PhD², M. Christina Santana, MPH², and C. Robert Horsburgh, MD¹. (1) Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, T3E, Boston, MA 02118, 617) 638-5471, slwelles@bu.edu, (2) Department of Social & Behavioral Sciences, Boston University School of Public Health, 715 Albany St., T2W, Boston, MA 02118

Background: While recent studies have reported high rates of unrecognized HIV infection among young B/AA men recruited at gay venues, little is known about the proportion of men who have sex with men (MSM) among B/AA men recruited at non-gay venues.

Methods: 539 B/AA men with two or more sexual partners in the past year were recruited at five healthcare clinics. Men were asked if they had female and/or male sex partners in the past 90 days, six months, and year, and subsequently were asked the frequencies of vaginal/anal intercourse, or oral sex with men and women in the past 90 days.

Results: Participants had little education and low income (28% with less than a high school education, 55% with household income <$5,000, 63% unemployed). Among all men, 104 (19.3%) were MSM. Initially, only 61 of MSM reported male sex partners. Additionally, 43 MSM who reported no male sex partners subsequently reported oral sex to ejaculation with men (n=42), or anal intercourse (n=1). 70.5% of MSM who initially reported male sex partners identified as gay/bisexual, while 90.1% of MSM who initially did not report male sex partners identified as heterosexual.

Conclusions: There was much disagreement as to what constituted sex and sexual orientation among our sample of sexually active B/AA MSM. 40% of MSM had oral sex to ejaculation with other men but did not report male sex partners, and overwhelmingly identified as heterosexual. These incongruences present special challenges for healthcare providers when targeting men at heightened risk for HIV/STDs.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify the disconnect between what is considered as 'sex' and sexual behaviors among adult black or African-American men who have sex with men (MSM)
• Recognize the high level of non-gay identification among MSM, especially those who do not consider their sexual behaviors with men as being 'sex'
• Appreciate a need to reformulate how we assign STD/HIV risk to MSM in this community, since what is considered as 'sex' and sexual orientation are often incongruent

Keywords: Sexual Behavior, Sexuality

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation