Wold C, Seage G R, Lenderking W R, Mayer K H, Cai B, Heeren T, Goldstein R
Institute for Urban Health Policy and Research, Boston Department of Health and Hospitals, Massachusetts, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Apr 1;17(4):361-7. doi: 10.1097/00042560-199804010-00011.
The sexual behaviors of bisexually active men, defined as men having sex with a man and a woman in previous 6 months, were compared with men who had sex with men only. Differential sexual practices associated with HIV risk between the two groups of men, as well as in the bisexual men with their male and female partners, were evaluated. Cross-sectional analyses were performed on baseline data from a prospective cohort of 508 young gay men recruited from bars, college campuses, and a health center in Boston from 1993 to 1994. Odds ratios (OR) and 95% confidence intervals (CI) were calculated on categorical variables, and McNemar's chi2 was used to compare the behaviors of bisexual men with their male versus female sex partners. Six months before the interview, 47 (10%) men had male and female sex partners, and 383 men had only male sex partners during the past year or ever. Fifty-eight percent of the men in the study had a female sexual partner in their lifetime, and 18% during the past year. Bisexual men were more likely to have drinking problems as identified by the Michigan Alcoholism Screening Test (MAST; OR = 3.96, 95% CI = 1.54-10.20), and fewer male partners over their lifetime (mean +/- standard deviation [SD], 24+/-42; median, 7; versus mean +/- SD, 69+/-516; median, 12), although this difference was not statistically significant. The two groups had similar levels of unprotected anal intercourse (25.5% versus 29.5%); however, bisexual men were half as likely to have anal sex as homosexual men (OR = 0.50; 95% CI = 0.27-0.93). Bisexual men were three times as likely to have unprotected sex with their female partner as their male partner (OR = 3.0; 95% CI = 1.02-8.8). Stratified analysis revealed similar discordant behavior while sober (OR = 4.0), drinking (OR = 7.0), and while drinking with concurrent drug use (OR = 8.0). Among this cohort of men who have sex with men (MSM), a sizable proportion also had vaginal sex with female partners in the previous 6 months. Bisexually active men were more likely to have unprotected sex with their female partners compared with their male partners, potentially increasing the risk for HIV and other sexually transmitted diseases. Behavioral interventions directed toward MSM need to address bisexual behaviors.
将双性恋活跃男性（定义为在过去6个月内与男性和女性都有过性行为的男性）的性行为与仅与男性发生性行为的男性进行了比较。评估了两组男性之间以及双性恋男性与其男性和女性伴侣之间与艾滋病毒风险相关的不同性行为方式。对1993年至1994年从波士顿的酒吧、大学校园和一个健康中心招募的508名年轻男同性恋者的前瞻性队列的基线数据进行了横断面分析。对分类变量计算了比值比（OR）和95%置信区间（CI），并使用麦克尼马尔卡方检验来比较双性恋男性与其男性和女性性伴侣的行为。在访谈前6个月，47名（10%）男性有男性和女性性伴侣，383名男性在过去一年或曾经只有男性性伴侣。研究中的男性有58%一生中曾有过女性性伴侣，18%在过去一年中有过。根据密歇根酒精中毒筛查测试（MAST）确定，双性恋男性更有可能有饮酒问题（OR = 3.96，95% CI = 1.54 - 10.20），并且一生中的男性伴侣较少（平均值±标准差[SD]，24±42；中位数，7；相比之下，平均值±SD，69±516；中位数，12），尽管这种差异没有统计学意义。两组无保护肛交水平相似（25.5%对29.5%）；然而，双性恋男性进行肛交的可能性只有同性恋男性的一半（OR = 0.50；95% CI = 0.27 - 0.93）。双性恋男性与女性伴侣进行无保护性行为的可能性是与男性伴侣的三倍（OR = 3.0；95% CI = 1.02 - 8.8）。分层分析显示，在清醒时（OR = 4.0）、饮酒时（OR = 7.0）以及饮酒同时使用毒品时（OR = 8.0），存在类似的不一致行为。在这个男男性行为（MSM）队列中，相当大比例的人在过去6个月内也与女性伴侣有过阴道性行为。与男性伴侣相比，双性恋活跃男性与女性伴侣进行无保护性行为的可能性更大，这可能会增加感染艾滋病毒和其他性传播疾病的风险。针对男男性行为者的行为干预需要解决双性恋行为问题。
