A comparison of risk behaviors of non-gay-identified with gay-identified black men who have sex with men at Historically Black College and University Settings

Background: Black men who have sex with men (MSM), including bisexuals, represented 41% of the nearly 25,000 new HIV infections among blacks in 2006. We compared behaviors of non-gay/bisexual-identified MSM (NGI-MSM) with behaviors of gay/bisexual-identified MSM (GI-MSM) at historically black college and university (HBCU) settings.

Methods: Using convenience sampling, we recruited HIV testing participants to complete behavioral surveys at HBCUs in Arkansas, Georgia, Mississippi, and Washington, DC, from 2005 to 2007. Black males who reported ³ 1 male partner in the previous 12 months were included in this analysis.

Results: Of 1930 black males surveyed, 270 (14%) reported ³ 1 male partner, of whom 79 (29%) self-identified as gay, 67 (25%) as bisexual, 96 (36%) as heterosexual, and 28 (10%) as other/don't know/not applicable/refused. NGI-MSM were not different from GI-MSM in total number of partners in the previous 12 months or proportion reporting unprotected receptive anal intercourse. Compared with GI-MSM, NGI-MSM were less likely to report asking their last partner's HIV status (odds ratio [OR]=0.5, 95% confidence interval [CI]=0.3-0.9) and having been tested for HIV in the previous 12 months (OR=0.6, CI=0.3-0.9) and more likely to report not using a condom during last sex (OR=1.8, CI=1.2-3.4), having had sex with a female in the previous 12 months, (OR=4.1, CI=2.5-6.9), and perceiving they were at no risk for HIV infection (OR=3.1, CI=1.5-6.3).

Conclusion: More NGI-MSM reported high-risk behaviors and fewer reported HIV preventive behaviors than GI-MSM. Findings suggest that interventions should be developed to reach non-gay-identified black MSM.