AIDS in bisexual men in the United States: epidemiology and transmission to women

Abstract

Background: Homosexual and bisexual men with acquired immunodeficiency syndrome (AIDS) differ, and bisexual men play an important role in the sexual transmission of human immunodeficiency virus (HIV) to women.

Methods: To describe AIDS in these groups, we examined AIDS cases reported nationally through June 1990.

Results: Among 65 389 men who reported having had sex with men since 1977, 26% were bisexual. More Black (41%) and Hispanic men (31%) than White men (21%) reported bisexual behavior. Bisexual men were twice as likely to report intravenous drug use (20%) as were homosexual men (9%), regardless of race or ethnicity. Among 3555 women with heterosexually acquired AIDS, 11% reported sexual contact with a bisexual man and no other risk factor, although in some states approximately half reported such contact. In 1989, the AIDS rate due to sex with a bisexual man was three and five times higher among Hispanic and Black women, respectively, than among White women.

Conclusions: Differences between bisexual and homosexual men with AIDS and the relative importance of AIDS in women due to sexual contact with bisexual men should be considered in the development of HIV prevention programs.