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Introduction: Bisexual male youth are more likely to engage in certain behaviors that contribute to HIV/STI transmission (e.g., substance use) than are heterosexual and gay male youth. However, sexuality education rarely addresses the unique needs of sexual minority youth, especially bisexual, pansexual, and queer (bi+) youth, and little is known about their sexuality education experiences and preferences. As such, the goal of this study was to examine bi+ male youth's experiences learning about sex and their preferences for sexuality education. Methods: In 2019, 56 bi+ male youth ages 14–17 were surveyed and interviewed about their sexuality education experiences and preferences. Participants identified as bisexual (64%), pansexual (27%), and queer (9%), were racially/ethnically diverse (39% white, 32% Latinx, 20% Black, 9% other races), and included cisgender (79%) and transgender (21%) male youth. Results: Participants described varied experiences with school-based sexuality education (e.g., none, abstinence only, covered sexual health in some way), but it rarely addressed their unique needs. They typically learned about sex by searching for information online and from sexually explicit media. Participants identified several topics they wanted to learn more about (e.g., sex with same-gender partners, anal sex, consent), but they typically believed they were prepared to have sex. Finally, some participants described benefits of tailoring sexuality education to their unique needs, while others described benefits of more inclusive programs. Conclusions and Policy Implications: Findings suggest that bi+ male youth do not receive adequate sexuality education to make informed decisions about safer sex, highlighting the critical need for reform. [ABSTRACT FROM AUTHOR]

Bisexual individuals have disproportionately higher rates of physical and mental health concerns compared to both heterosexual and gay/lesbian individuals. Few studies have examined diverse bisexual-identified men's perceived health concerns for themselves and other bisexual men or their experiences in healthcare settings. This qualitative study explored health and healthcare experiences among cisgender and transgender bisexual men, most of whom were also men of color. Data were collected through semi-structured interviews. Participants included 31 self-identified bisexual men from the Chicago area. Participants were asked questions surrounding bisexual men's health and healthcare experiences in general and their personal experiences, drawing connections between intersecting bisexual and racial/ethnic identities. Interview transcripts were analyzed using thematic analysis. Participants reported sexual health and mental health as the top health concerns for bisexual men. Participants viewed their bisexual identity as a motivator for seeking healthcare services and adopting safer sex practices. Mental health challenges faced by respondents were connected to bisexual stereotypes and fear of disclosing bisexual and transgender identities. Furthermore, perceptions of masculinity amongst bisexual men of color were particularly salient in connecting to their mental health experiences. The intersection of participants' transgender and bisexual identities impacted their healthcare experiences in general healthcare settings, with many participants reporting a lack of cultural competence and provider knowledge concerning their identities. LGBTQ Federally Qualified Health Centers, however, were described as providing compassionate care. Our findings suggest the need for more interventions that account for bisexual men's intersecting identities. Furthermore, increased provider training is necessary for providing affirmative care to bisexual men. [ABSTRACT FROM AUTHOR]

Background: Although gay and bisexual men (GBM) represent the largest group of HIV-infected individuals in the United States, nearly all evidence on their HIV risk and prevention outcomes derive from nonprobability samples. Setting: A probability-based cohort of GBM (N = 502) from 45 states and Washington, DC. Methods: Cross-sectional survey. Results: Among HIV-negative/unknown/untested GBM, only 6.7% reported using pre-exposure prophylaxis (PrEP) in the past 6 months. Two-thirds (63.3%) of PrEP users reported daily adherence in the past week. Over half (54.2%) of GBM reported not using a condom during anal sex with their most recent male partner; of these men, 93.8% were not on PrEP. Most GBM had been tested for HIV (80.7%) and other sexually transmitted infections (67.1%) in their lifetime, with 45.2% having tested for HIV during the past year. Among those ever tested, 14.1% reported being HIV infected, whereas an additional 8.9% reported testing positive for at least one other sexually transmitted infection after their most recent test. All HIV-positive GBM reported being currently on antiretroviral treatment, and 94.7% reported an undetectable viral load, but nearly one-third (30.4%) reported not taking their medication every day during the past month. A majority of HIV-negative/unknown/ untested GBM (64.3%) reported that they had never discussed HIV prevention with their primary health care provider. Conclusions: Our findings present a decidedly mixed picture regarding the success of the US National HIV/AIDS Strategy in meeting its stated goals of addressing HIV risk among the general population of GBM. [ABSTRACT FROM AUTHOR]

Self-identified bisexual men are at increased risk for negative health outcomes, but there are no interventions tailored to their unique needs. In order to develop interventions for this population, it is first necessary to understand their preferences. As part of a larger study, 128 cisgender men who identified as bisexual reported on their preferences for different intervention components. Large proportions of participants prioritized addressing both health (e.g., mental health, HIV/STI) and psychosocial experiences (e.g., dating/relationships, discrimination/victimization). A slightly larger proportion of participants preferred an intervention for gay and bisexual men together compared to an intervention for bisexual men only. However, those who reported more discrimination and recent female sexual partners were more likely to prefer an intervention for bisexual men only. Larger proportions of participants preferred a group intervention compared to an individual intervention and an in-person intervention compared to an online intervention. These findings highlight the importance of addressing both health and psychosocial experiences in tailored interventions for self-identified bisexual men. Further, while in-person and group interventions may appeal to larger proportions of self-identified bisexual men, the appeal of an intervention for gay and bisexual men together compared to an intervention for bisexual men only may depend on individual and social/contextual factors. [ABSTRACT FROM AUTHOR]

Despite comprising the largest proportion of the "lesbian, gay, and bisexual" population, research focusing on the unique health concerns and needs of bisexual individuals is relatively scarce. While health disparities are increasingly well documented among lesbian, gay, bisexual, and transgender individuals relative to their heterosexual and cisgender counterparts, gaps remain in our basic understanding of how health status, behaviors, and outcomes vary within these groups, especially bisexual individuals. The lack of specified research on bisexual health is even more curious given that, when separated from both heterosexual and gay/lesbian individuals, bisexual individuals consistently report higher rates of a wide range of negative health outcomes, including mood and anxiety disorders, substance use, suicidality, as well as disparities related to healthcare access and utilization. Indeed, in scientific research, mass media, and in public health interventions, bisexual individuals remain relatively invisible. This Special Section represents an effort to shed light on a new generation of quantitative, qualitative, and mixed methods research studies that examine health-related concerns, outcomes, and intervention opportunities specifically among diverse samples of bisexual individuals from a variety of social and cultural contexts. The research herein focuses on intersections of multiple identities, the development of new measures, the use of large national data sets, and diverse groups of self-identified bisexual men (who tend to be least visible in health research). Findings from these studies will significantly advance our knowledge of factors associated with health disparities, as well as health and well-being more generally, among bisexual individuals and will help to inform directions for future health promotion research and intervention efforts. [ABSTRACT FROM AUTHOR]

Introduction Although a large body of previous research has examined sexual behavior and its relation to risk in men of diverse sexual identities, most studies have relied on convenience sampling. As such, the vast majority of research on the sexual behaviors of gay and bisexual men, in particular, might not be generalizable to the general population of these men in the United States. This is of particular concern because many studies are based on samples of men recruited from relatively “high-risk” venues and environments. Aims To provide nationally representative baseline rates for sexual behavior in heterosexual, gay, and bisexual men in the United States and compare findings on sexual behaviors, relationships, and other variables across subgroups. Methods Data were obtained from the 2012 National Survey of Sexual Health and Behavior, which involved the administration of an online questionnaire to a nationally representative probability sample of women and men at least 18 years old in the United States, with oversampling of self-identified gay and bisexual men and women. Results from the male participants are included in this article. Main Outcome Measures Measurements include demographic characteristics, particularly sexual identity, and their relations to diverse sexual behaviors, including masturbation, mutual masturbation, oral sex, vaginal sex, and anal sex. Behaviors with male and female partners were examined. Results Men of all self-identified sexual identities reported engaging in a range of sexual behaviors (solo and partnered). As in previous studies, sexual identity was not always congruent for gender of lifetime and recent sexual partners. Conclusion Patterns of sexual behaviors and relationships vary among heterosexual, gay, and bisexual men. Several demographic characteristics, including age, were related to men's sexual behaviors. The results from this probability study highlight the diversity in men's sexual behaviors across sexual identities, and these data allow generalizability to the broader population of gay and bisexual men, in particular, in the United States, which is a major advancement in research focused on individuals in a sexual minority. [ABSTRACT FROM AUTHOR]

Unlabelled: Background There is a lack of research that examines event-level lubricant use and outcomes among gay and bisexual men, with the majority of current research addressing lubricant use within the context of sexual risk. Most studies examining sexual health among gay and bisexual men have relied on convenience sampling strategies for participant recruitment.Methods: Data were collected from the 2012 wave of the National Survey of Sexual Health and Behaviour (NSSHB), which involved the administration of an online questionnaire to a nationally representative probability sample of women and men in the United States aged 18 years and older, including an oversampling of self-identified gay and bisexual men and women. The findings from gay (n=307) and bisexual (n=25) participants who reported sexual behaviours with other male partners during their last sexual encounter are included in this paper. Post-stratification data weights were applied to the data to maximise the generalisability of the findings.Results: Men who reported lubricant use during their last sexual event with a male partner (n=163) were significantly more likely to be non-White, Hispanic and between 30 and 39 years old. Bisexual men had lower odds of using lubricant than gay-identified men. The majority of men reported using lubricant during anal intercourse, along with lower numbers with a range of other sexual behaviours.Conclusion: Public health promotion specialists should consider recommending continued lubricant use as a part of comprehensive sexual health promotion efforts for gay and bisexual men, including that it reduces pain and maximises pleasure. [ABSTRACT FROM AUTHOR]

Although frequently cited as being at high risk for HIV/STI transmission, little is known about behaviorally bisexual men's patterns and experiences of condom use and nonuse with male and female sexual partners. Using a variety of recruitment techniques informed by a Community Advisory Committee, a total of 77 behaviorally bisexual men were recruited from Indianapolis, Indiana to participate in semi-structured interviews focused on sexual health. Qualitative data were collected containing detailed information on their patterns and experiences of condom use and nonuse with both male and female partners. Participants described numerous commonly reported barriers for consistent condom use, as well as distinct bisexual-specific barriers. The majority reported consistent condom use with male and female casual partners, but many who did not use condoms described doing so in the context of ongoing relationships. In addition, participants provided reasons for condom use and nonuse that varied based on the gender of the partner and the type of relationship with the partner. Future interventions focused on increasing condom use among behaviorally bisexual men should take into account the unique complexities of gender and relationship configurations in this distinct population. [ABSTRACT FROM AUTHOR]

Research examining the sexual behaviors and experiences of behaviorally bisexual men is limited. Most studies focus primarily on highlighting sexual risk behaviors among groups of 'men who have sex with men (MSM)' or 'gay and bisexual men,' which may not be appropriate in terms of behaviorally bisexual men's sexual repertoires with both men and women. This study aimed to assess a broad range of sexual behaviors and associated experiences among bisexual men living in the midwestern United States. An interviewer-administered questionnaire containing items from the National Survey of Sexual Health and Behavior assessed lifetime and recent (i.e., past 6 months and last event) sexual behaviors and experiences with both male and female partners among a diverse sample of 75 behaviorally bisexual men. Responses were quantified and analyzed using descriptive and multivariate statistics. A wide range of sexual behaviors with partners of both genders was found. Vaginal intercourse and oral sex with both men and women were the most commonly reported behaviors. Subjective reports of pleasure, arousal, and sexual function during sexual activity were similar with both male and female sexual partners. Many participants reported using condoms during insertive sexual behaviors with male and female partners, but less during oral sex. Unprotected receptive anal sex was less commonly reported. Overall, participants reported a variety of sexual behaviors and experiences; however, unlike other populations, they shared these with partners of both genders. Results have implications for interventions targeting the sexual behaviors and associated issues among behaviorally bisexual men. [ABSTRACT FROM AUTHOR]

Limited research exists regarding community involvement and social support among behaviourally bisexual men. Previous studies suggest that bisexual men experience high levels of social stigma in both heterosexual and homosexual community settings. Research focusing on social support has demonstrated that individuals with limited access to similar individuals experience greater risk for negative health outcomes. Using a community-based research design, participants were recruited using multiple methods. Researchers conducted in-depth, semi-structured interviews with 75 men who reported having engaged in bisexual behaviour within the past six months. Interviews elucidated the experiences of behaviourally bisexual men in heterosexual and homosexual settings, as well as their perceptions of the existence of a bisexual community or bisexual spaces. All participants perceived a lack of a visible bisexual community and expressed difficulty with being comfortable, or a feeling of belonging, within a variety of heterosexual and homosexual community spaces. Findings suggest the need for interventions focused on community building among, as well as creating spaces specifically designed for, bisexual men in order to increase perceived social support and decrease isolation and possible negative health outcomes. [ABSTRACT FROM PUBLISHER]

The midwestern United States has a high number of recent Latino migrants, but little information is available regarding their sexual behaviors. A total of 75 behaviorally bisexual men (25 Latino, 25 Black and 25 White) participated in an exploratory study on sexual health. The data presented in this article are restricted to the 25 self-identified Latino men. Qualitative in-depth interviews were conducted and optional self-administered sexual transmitted infection (STI) screening was provided. The measures used were taken from the National Survey of Sexual Health and Behavior (NSSHB), a probability study of the sexual behaviors of nearly 6,000 individuals, age 14 to 94, in the United States. In this sample of bisexual men, the most commonly reported sexual behaviors were masturbation, vaginal intercourse and receiving oral sex from male and female partners. The majority of the participants were the insertive partner during anal sex with male partners. Many of the participants reported alcohol use during their most recent sexual activity. A fair number reported not using condoms during their last sexual event. Pleasure, arousal, orgasm and erectile functioning were markedly similar despite partner gender. A small number of participants also engaged in sexual activities with transgender individuals. All of the Latino participants took part in optional self-collection for STI specimens. The results of the study provide rich insights into the sexual behavior and related factors, as well as potential risk behaviors, of bisexual Latino men that may be targeted for future sexual health promotion efforts. [ABSTRACT FROM AUTHOR]

Studies concerning behaviorally bisexual men continue to focus on understanding sexual risk according to a narrow range of sexual behaviors. Few studies have explored the subjective meanings and experiences related to bisexual men's sexual behaviors with male and female partners. In-depth, semistructured interviews were conducted with 75 men who engaged in bisexual behavior within the past 6 months. Participants were asked about their subjective sexual experiences with male and female partners. Findings suggest adherence to normative gender roles, with attraction to men and women conforming to these stereotypes, as well as a segregation of sexual behaviors along gendered lines. Overall, condom use was influenced by perceptions of potential negative consequences. Based on these findings, it remains critical that public health and other social and behavioral sciences continue to study bisexual men's sexual health issues as separate and distinct from their exclusively homosexual and heterosexual counterparts. [ABSTRACT FROM AUTHOR]

An introduction is presented to a special issue on bisexual health, including topics such as health terminology, identity issues for bisexual women, and the sexual health of bisexual men.

Little public health research has explored male bisexuality and the wide range of behaviors experienced by bisexual men beyond disease transmission and other negative consequences. There is a general lack of information on diverse expressions of sexuality among diverse groups of bisexual men in the United States. Researchers collected data on a wide range of variables related to sexual behavior from a sample of 26,042 participants, recruited via a large social and sexual networking Website. Four distinct typologies of male bisexuality were constructed: self-identified bisexual, bisexual dating, bisexual with current sexual partners and bisexual by behavior. These categories were examined individually as well as compared and contrasted with one another. Demographic characteristics varied among men depending on bisexual categorization. Although participants that identified as bisexual within each typology often met criteria for other categories for other typologies, there was no absolute overlap between categories. The recency and frequency of sexual behaviors significantly varied based upon the participant's bisexual typology. Findings suggest that previous research on bisexual men's sexual behaviors and sexual risk behaviors may be misleading if bisexuality is restricted to a single typology. Further research should examine the potential subjective meanings and health implications of diverse typologies of male bisexuality, beyond sexual risk. Comprehensive and insightful research on aspects of life other than disease infection and transmission among bisexual men will help to ensure a more accurate understanding of male bisexuality in a comprehensive sexual health framework. [ABSTRACT FROM PUBLISHER]

Little information is available about sexual risk, protective, and disclosure practices among Black bisexually active men and how these may be amenable to intervention when necessary. In-depth interviews were conducted with 30 at-risk urban Black men who have sex with both men and women (MSMW). Participants reported protecting themselves and their partners through routine HIV testing, using condoms consistently, engaging in strategic positioning during sexual activity, and limiting the number of sexual partners. In addition, they described several reasons for not using protection, including not having condoms available, enjoying sexual activity more without condoms, and perceiving female partners to be “safer” than male partners. Disclosure of bisexuality was complex and reportedly difficult, in particular to female and gay-identified male partners. Future interventions must not only build protection and disclosure skills among MSMW, but also increase broader social awareness and acceptance of male bisexuality. [ABSTRACT FROM AUTHOR]

Traditionally, religion has been a major source of institutional support and well-being for Black people in the USA. However, when juxtaposed against sexuality, religion's positive effect upon the lives of non-heterosexual individuals is questionable. Research suggests that non-heterosexuals often abandon structured religion for spirituality due to the homonegativity perpetuated through religious institutions. Although studies have examined religion and spirituality among gays and lesbians, few have examined their roles in the lives of bisexuals. In this study, we analyzed qualitative interviews from 28 bisexual Black men who resided in New York City. In addition to church attendance, participants expressed belonging to religious communities through activities such as music ministry. Despite rejection because of their bisexuality, some participants saw other religious individuals as being accepting of them. Others discussed the church as a place where non-heterosexuals interacted, often for meeting sexual partners. Participants evoked beliefs in God in coping with adverse life experiences; some linked faith to family and sexual responsibilities. Drawing upon relevant literature, we discuss the implications of religion and spirituality for the quality of life of bisexual Black men in the USA. [ABSTRACT FROM AUTHOR]

Relatively little is known about condom use among bisexual men as separate and distinct from exclusively homosexual and heterosexual men. Most previous research on bisexual men has relied on nonprobabilistic, high-risk samples with limited generalizability. We examined the relationship between behavioral bisexuality and condom use in the 2002 cycle of the National Survey of Family Growth (NSFG). Bisexually active men positively differed from heterosexually and homosexually active men on every indicator of confounding risk. Bisexually active men, however, did not report using condoms less often than other men during their last sexual encounters with males and females. Indeed, with female partners, bisexually active men reported higher rates of condom use than did other men. These relationships remained when all sociodemographic and confounding risk factors were held constant. Our results suggest that caution must be used when making assumptions about condom use in the general population of bisexual men from nonprobabilistic samples. [ABSTRACT FROM AUTHOR]

Objectives. We sought to determine whether there were differences in sexual risk among behaviorally and self-identified bisexual men, men who reported having sex with both men and women without reporting a bisexual identity and men who self-identified as bisexual but reported only recent homosexual behavior over the past 6 months. Methods. Through a secondary data analysis, we conducted stepwise linear regression equation modeling to determine which factors were significant predictors of sexual risk among various subgroups of bisexual Latino men. Results. Having sex with women, regardless of sexual identity, increased the likelihood of insertive unprotected anal intercourse with men. Bisexual identity was not statistically associated with unprotected anal intercourse with men. Conclusions. Future studies should begin to examine differences within groups rather than focusing on group comparisons that yield limited insights into sexual risk predictors for homosexually and bisexually active men. Further research that explores risk and protective factors in the sexual lives of Latino bisexual men is also needed. (Am J Public Health. 2007;97:1102-1106. doi:10.2105/AJPH. 2005.078345) [ABSTRACT FROM AUTHOR]

The article discusses research on the feasibility of self-obtained rectal specimens for screening sexually transmissible infections (STI) among behaviourally bisexual men. Aside from examining the specimens collected, the study included qualitative and quantitative interviews about sexual behaviours which involve solo masturbation, oral sex provision and receptive anal sex. It is noted that a high prevalence of chlamydia infection has been diagnosed among subjects in the study. It is concluded that routine rectal screenings for chlamydia and gonorrhea are necessary to control STI.