Emory University School of Medicine, Division of General Medicine, 49 Jesse Hill Jr. Drive, Suite 413, Atlanta, GA 30303, USA.
Am J Public Health. 2010 Jan;100(1):159-64. doi: 10.2105/AJPH.2008.158725.
We explored factors influencing sexual behavior, disclosure of same-sex behavior, and condom-use practices among Black bisexual men.
We conducted semistructured interviews with 38 Black men in Atlanta, Georgia, who reported having had oral, vaginal, or anal sex with both men and women in the prior 6 months.
Participants described approaches to disclosure of same-sex behavior as part of a complex decisional balance influenced by both situational and individual factors and ranging from full disclosure to total secrecy. Influences on sexual behavior and condom-use practices included: (1) type of relationship, (2) gender-specific considerations, (3) perceptions of comfort or trust, and (4) fear of disease or pregnancy.
Disclosure of same-sex behavior was not a major influence on the sexual behavior and condom-use practices of the Black bisexual men in our study, who demonstrated heterogeneity in approaches to sexual behavior, disclosure of same-sex behavior, and condom-use practices. Additional research is needed to assess the social determinants of sexual risk for this population. Future HIV-prevention efforts should include initiatives to encourage accuracy in risk assessment and in taking sexual histories in clinical settings.
我们探究了影响黑人双性恋男性性行为、同性性行为披露和 condom-use 实践的因素。
我们在佐治亚州亚特兰大对 38 名黑人男性进行了半结构化访谈，这些男性报告在过去 6 个月内与男性和女性发生过口交、阴道交或肛交。
参与者描述了同性性行为披露的方法，这是一个复杂的决策平衡的一部分，受到情境和个人因素的影响，从完全披露到完全保密不等。对性行为和 condom-use 实践的影响包括：（1）关系类型，（2）性别特定的考虑，（3）舒适或信任的感知，以及（4）对疾病或怀孕的恐惧。
同性性行为的披露并不是我们研究中黑人双性恋男性性行为和 condom-use 实践的主要影响因素，他们在性行为、同性性行为披露和 condom-use 实践方面表现出多样性。需要进一步研究来评估这一人群的性风险的社会决定因素。未来的 HIV 预防工作应包括鼓励在临床环境中准确评估风险和进行性史评估的举措。
