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The Role of Syndemic in Explaining Health Disparities Among Bisexual Men: A Blueprint for a Theoretically Informed Perspective

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Understanding the HIV/AIDS Epidemic in the United States

Part of the book series: Social Disparities in Health and Health Care ((SDHHC))

Abstract

Although studies have documented dramatic health disparities among bisexual men and women, relative to their exclusively homosexual and heterosexual counterparts, research on potential explanatory factors underlying these differences in health outcomes has lagged. In an attempt to frame future research on health among bisexual individuals, this review will interpret previous research on health and risk disparities among bisexual men, using the lens of Syndemic Theory. We review findings from studies on a wide range of health concerns (including adverse childhood events, psychosocial conditions, sexual risk behavior, incidence and prevalence of HIV and other sexually transmitted infections (STIs), and health behavior following an HIV diagnosis) in an attempt to provide theoretically-informed perspectives from which to further study health disparities among bisexual men and women in more nuanced ways. Though there is emerging research on syndemic disparities among bisexual women, this review centers on bisexual men due to the deeper vein of HIV-related research in this population.

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References

  • Agronick, G., O’Donnell, L., Stueve, A., Doval, A. S., Duran, R., & Vargo, S. (2004). Sexual behaviors and risks among bisexually- and gay-identified young Latino men. AIDS Behavior, 8(2), 185–197. doi:10.1023/B:AIBE.0000030249.11679.d0.

    Article  Google Scholar 

  • Bacon, O., Lum, P., Hahn, J., Evans, J., Davidson, P., Moss, A., & Page-Shafer, K. (2006). Commercial sex work and risk of HIV infection among young drug-injecting men who have sex with men in San Francisco. Sexually Transmitted Diseases, 33(4), 228–234. doi:10.1097/01.olq.0000204914.91923.ad.

    Article  Google Scholar 

  • Baral, S. D., Friedman, M. R., Geibel, S., Rebe, K., Bozhinov, B., Diouf, D., et al. (2015). Male sex workers: Practices, contexts, and vulnerabilities for HIV acquisition and transmission. The Lancet, 385(9964), 260–273.

    Article  Google Scholar 

  • Bernstein, K. T., Liu, K. L., Begier, E. M., Koblin, B., Karpati, A., & Murrill, C. (2008). Same-sex attraction disclosure to health care providers among New York City men who have sex with men: Implications for HIV testing approaches. Archives of Internal Medicine, 168(13), 1458–1464. doi:10.1001/archinte.168.13.1458.

    Article  Google Scholar 

  • Biello, K. B., Colby, D., Closson, E., & Mimiaga, M. J. (2014). The syndemic condition of psychosocial problems and HIV risk among male sex workers in Ho Chi Minh City. Vietnam. AIDS and Behavior, 18(7), 1264–1271.

    Article  Google Scholar 

  • Billy, J., Tanfer, K., Grady, W. R., & Klepinger, D. H. (1993). The sexual behavior of men in the United States. Family Planning Perspectives, 52–60.

    Google Scholar 

  • Binson, D., Michaels, S., Stall, R., Coates, T. J., Gagnon, J. H., & Catania, J. A. (1995). Prevalence and social distribution of men who have sex with men: United States and its urban centers. Journal of Sex Research, 32(3), 245–254.

    Article  Google Scholar 

  • Blake, S. M., Ledsky, R., Lehman, T., Goodenow, C., Sawyer, R., & Hack, T. (2001). Preventing sexual risk behaviors among gay, lesbian, and bisexual adolescents: The benefits of gay-sensitive HIV instruction in schools. American Journal of Public Health, 91(6), 940–946.

    Article  Google Scholar 

  • Bockting, W., Miner, M., & Rosser, B. (2007). Latino men’s sexual behavior with transgender persons. Archives of Sexual Behavior, 36(6), 778–786. doi:10.1007/s10508-006-9133-4.

    Article  Google Scholar 

  • Bontempo, D. E., & d’Augelli, A. R. (2002). Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths’ health risk behavior. Journal of Adolescent Health, 30(5), 364–374.

    Article  Google Scholar 

  • Boyer, D. (1989). Male prostitution and homosexual identity. Journal of Homosexuality, 17(1–2), 151–184.

    Article  Google Scholar 

  • Branson, B. M. (1998). Home sample collection tests for HIV infection. Journal of the American Medical Association, 280(19), 1699–1701.

    Article  Google Scholar 

  • Chu, S. Y., Peterman, T. A., Doll, L. S., Buehler, J. W., & Curran, J. W. (1992). AIDS in bisexual men in the United States: Epidemiology and transmission to women. American Journal of Public Health, 82(2), 220–224.

    Article  Google Scholar 

  • Cochran, S. D., & Mays, V. M. (2009). Burden of psychiatric morbidity among lesbian, gay, and bisexual individuals in the California Quality of Life Survey. Journal of Abnormal Psychology, 118(3), 647–658. doi:10.1037/a0016501.

    Article  Google Scholar 

  • Coker, T. R., Austin, S. B., & Schuster, M. A. (2010). The health and health care of lesbian, gay, and bisexual adolescents. Annual Review of Public Health, 31, 457–477.

    Article  Google Scholar 

  • Corliss, H. L., Rosario, M., Wypij, D., Fisher, L. B., & Austin, S. B. (2008). Sexual orientation disparities in longitudinal alcohol use patterns among adolescents: Findings from the Growing Up Today Study. Archives of Pediatrics and Adolescent Medicine, 162(11), 1071–1078.

    Article  Google Scholar 

  • Davila, Y. R. (2000). Hispanic women and AIDS: Gendered risk factors and clinical implications. Issues in Mental Health Nursing, 21(6), 635–646.

    Article  Google Scholar 

  • Diaz, R. M. (2013). Latino gay men and HIV: Culture, sexuality, and risk behavior. New York: Routledge.

    Google Scholar 

  • Diaz, T., Chu, S. Y., Frederick, M., Hermann, P., Levy, A., Mokotoff, E., et al. (1993). Sociodemographics and HIV risk behaviors of bisexual men with AIDS: Results from a multistate interview project. AIDS, 7(9), 1227–1232.

    Article  Google Scholar 

  • Dodge, B., Sandfort, T., & Firestein, B. A. (2007). A review of mental health research on bisexual individuals when compared to homosexual and heterosexual individuals. Becoming Visible: Counseling Bisexuals Across the Lifespan (pp. 28–51).

    Google Scholar 

  • Dodge, B., Jeffries, W. L., & Sandfort, T. G. (2008a). Beyond the down low: Sexual risk, protection, and disclosure among at-risk black men who have sex with both men and women (MSMW). Archives of Sexual Behavior, 37(5), 683–696. doi:10.1007/s10508-008-9356-7.

    Article  Google Scholar 

  • Dodge, B., Reece, M., & Gebhard, P. H. (2008b). Kinsey and beyond: past, present, and future considerations for research on male bisexuality. Journal of Bisexuality, 8(3–4), 175–189.

    Article  Google Scholar 

  • Dodge, B., Schnarrs, P. W., Goncalves, G., Malebranche, D., Martinez, O., Reece, M., et al. (2012a). The significance of privacy and trust in providing health-related services to behaviorally bisexual men in the United States. AIDS Education and Prevention, 24(3), 242.

    Article  Google Scholar 

  • Dodge, B., Schnarrs, P. W., Reece, M., Goncalves, G., Martinez, O., Nix, R., et al. (2012b). Community involvement among behaviourally bisexual men in the Midwestern USA: Experiences and perceptions across communities. Culture, Health & Sexuality, 14(9), 1095–1110.

    Article  Google Scholar 

  • Dodge, B., Van Der Pol, B., Reece, M., Malebranche, D., Martinez, O., Goncalves, G., et al. (2012c). Rectal self-sampling in non-clinical venues for detection of sexually transmissible infections among behaviourally bisexual men. Sexual Health, 9(2), 190–191.

    Google Scholar 

  • Eisenberg, M., & Wechsler, H. (2003). Substance use behaviors among college students with same-sex and opposite-sex experience: Results from a national study. Addictive Behaviors, 28(5), 899–913.

    Article  Google Scholar 

  • Finlinson, H., Colon, H. M., Robles, R. R., & Soto, M. (2006). Sexual identity formation and AIDS prevention: An exploratory study of non-gay-identified Puerto Rican MSM from working class neighborhoods. AIDS and Behavior, 10(5), 531–539. doi:10.1007/s10461-006-9107-5.

    Article  Google Scholar 

  • Flores, S. A., Bakeman, R., Millett, G. A., & Peterson, J. L. (2009). HIV risk among bisexually and homosexually active racially diverse young men. Sexually Transmitted Diseases, 36(5), 325–329. doi:10.1097/OLQ.0b013e3181924201.

    Article  Google Scholar 

  • Friedman, M. R., Coulter, R. W. S., Silvestre, A. J., Plankey, M. W., Shoptaw, S., Surkan, P. J., Teplin, L., & Stall, R. (2015). Someone to count on: the moderating influence of social support on the relationship between syndemics and HIV viral load. AIDS Impact (Amsterdam, Netherlands). Oral presentation.

    Google Scholar 

  • Friedman, M. R., Dodge, B., Schick, V., Herbenick, D., Hubach, R. D., Bowling, J., et al. (2014a). From bias to bisexual health disparities: Attitudes toward bisexual men and women in the United States. LGBT Health, 1(4), 309–318.

    Article  Google Scholar 

  • Friedman, M. R., Kurtz, S. P., Buttram, M. E., Wei, C., Silvestre, A. J., & Stall, R. (2014b). HIV risk among substance-using men who have sex with men and women (MSMW): Findings from South Florida. AIDS and Behavior, 18(1), 111–119.

    Article  Google Scholar 

  • Friedman, M. R., Stall, R., Silvestre, A. J., Mustanski, B., Shoptaw, S., Surkan, P. J., et al. (2014c). Stuck in the middle: Longitudinal HIV-related health disparities among men who have sex with men and women. JAIDS Journal of Acquired Immune Deficiency Syndromes, 66(2), 213–220.

    Google Scholar 

  • Friedman, M. R., Wei, C., Klem, M. L., Silvestre, A. J., Markovic, N., & Stall, R. (2014d). HIV infection and sexual risk among men who have sex with men and women (MSMW): A systematic review and meta-analysis. PLoS ONE, 9(1), e87139.

    Article  Google Scholar 

  • Friedman, M. R., Stall, R., Silvestre, A. J., Wei, C., Shoptaw, S., Herrick, A., et al. (2015). Effects of syndemics on HIV viral load and medication adherence in the multicentre AIDS cohort study. AIDS, 29(9), 1087–1096.

    Article  Google Scholar 

  • Friedman, M. R., Plankey, M. W., Herrick, A. L., Silvestre, A. J., Shoptaw, S., Surkan, P. J., Teplin, L., & Stall, R. (2016). Bi now, bi later: Stability of bisexual behavior and viral bridging among men who have sex with men and women (MSMW). Archives of Sexual Behavior (under review).

    Google Scholar 

  • Friedman, M. S., Koeske, G. F., Silvestre, A. J., Korr, W. S., & Sites, E. W. (2006). The impact of gender-role nonconforming behavior, bullying, and social support on suicidality among gay male youth. Journal of Adolescent Health, 38(5), 621–623.

    Article  Google Scholar 

  • Friedman, M. S., Marshal, M. P., Guadamuz, T. E., Wei, C., Wong, C. F., Saewyc, E., et al. (2011a). A meta-analysis of disparities in childhood sexual abuse, parental physical abuse, and peer victimization among sexual minority and sexual nonminority individuals. American Journal of Public Health, 101(8), 1481–1494. doi:10.2105/ajph.2009.190009.

    Article  Google Scholar 

  • Friedman, M. R., Guadamuz, T., & Marshal, M. (2011b). Male youth engaged in sex work: health disparities and outcomes in early adulthood. National HIV Prevention Conference, Atlanta, Georgia. Oral presentation.

    Google Scholar 

  • Garofalo, R., Wolf, R. C., Kessel, S., Palfrey, J., & DuRant, R. H. (1998). The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics, 101(5), 895–902.

    Article  Google Scholar 

  • Goodenow, C., Netherland, J., & Szalacha, L. (2002). AIDS-related risk among adolescent males who have sex with males, females, or both: Evidence from a statewide survey. American Journal of Public Health, 92(2), 203–210.

    Article  Google Scholar 

  • Gorbach, P. M., Murphy, R., Weiss, R. E., Hucks-Ortiz, C., & Shoptaw, S. (2009). Bridging sexual boundaries: men who have sex with men and women in a street-based sample in Los Angeles. Journal of Urban Health, 86(Suppl 1), 63–76. doi:10.1007/s11524-009-9370-7.

    Article  Google Scholar 

  • Harawa, N. T., Williams, J. K., Ramamurthi, H. C., Manago, C., Avina, S., & Jones, M. (2008). Sexual behavior, sexual identity, and substance abuse among low-income bisexual and non-gay-identifying African American men who have sex with men. Archives of Sexual Behavior, 37(5), 748–762. doi:10.1007/s10508-008-9361-x.

    Article  Google Scholar 

  • Hays, R. B., Paul, J., Ekstrand, M., Kegeles, S. M., Stall, R., & Coates, T. J. (1997). Actual versus perceived HIV status, sexual behaviors and predictors of unprotected sex among young gay and bisexual men who identify as HIV-negative, HIV-positive and untested. AIDS, 11(12), 1495–1502.

    Article  Google Scholar 

  • Heckman, T. G., Kelly, J. A., Bogart, L. M., Kalichman, S. C., & Rompa, D. J. (1999). HIV risk differences between African-American and white men who have sex with men. Journal of the National Medical Association, 91(2), 92–100.

    Google Scholar 

  • Herek, G. M. (2002). Heterosexuals’ attitudes toward bisexual men and women in the United States. Journal of Sex Research, 39(4), 264–274.

    Article  Google Scholar 

  • Herrick, A. L., Lim, S. H., Plankey, M. W., Chmiel, J. S., Guadamuz, T. T., Kao, U., et al. (2013). Adversity and syndemic production among men participating in the multicenter AIDS cohort study: A life-course approach. American Journal of Public Health, 103(1), 79–85.

    Article  Google Scholar 

  • Herrick, A. L., Egan, J. E., Coulter, R., Friedman, M. R., & Stall, R. (2014). Raising sexual minority youths’ health levels by incorporating resiliencies into health promotion efforts. American Journal of Public Health, 104(2), 206–210.

    Article  Google Scholar 

  • Hightow, L. B., Leone, P. A., Macdonald, P. D., McCoy, S. I., Sampson, L. A., & Kaplan, A. H. (2006). Men who have sex with men and women: A unique risk group for HIV transmission on North Carolina college campuses. Sexually Transmitted Diseases, 33(10), 585–593. doi:10.1097/01.olq.0000216031.93089.68.

    Article  Google Scholar 

  • Huhn, G. D., McIntyre, A. F., Broad, J. M., Holmes, S. W., Studzinski, A., Rabins, C., et al. (2008). Factors associated with newly diagnosed HIV among persons with concomitant sexually transmitted diseases. Sexually Transmitted Diseases, 35(8), 731–737. doi:10.1097/OLQ.0b013e31817f97a0.

    Article  Google Scholar 

  • Ibañez, G. E., Purcell, D. W., Stall, R., Parsons, J. T., & Gomez, C. A. (2005). Sexual risk, substance use, and psychological distress in HIV-positive gay and bisexual men who also inject drugs. AIDS, 19(Suppl 1), S49–S55.

    Article  Google Scholar 

  • Jeffries, W. L., & Dodge, B. (2007). Male bisexuality and condom use at last sexual encounter: results from a national survey. Journal of Sex Research, 44(3), 278–289. doi:10.1080/00224490701443973.

    Article  Google Scholar 

  • Jeffries, W. L., Dodge, B., & Sandfort, T. (2008). Religion and spirituality among bisexual black men in the USA. Culture, Health & Sexuality, 10(5), 463–477.

    Article  Google Scholar 

  • Jeffries, W. (2010). HIV testing among bisexual men in the United States. AIDS Education and Prevention, 22(4), 356–370. doi:10.1521/aeap.2010.22.4.356.

    Article  Google Scholar 

  • Jones, K. T., Gray, P., Whiteside, Y. O., Wang, T., Bost, D., Dunbar, E., et al. (2008). Evaluation of an HIV prevention intervention adapted for black men who have sex with men. American Journal of Public Health, 98(6), 1043–1050.

    Article  Google Scholar 

  • Kalichman, S. C., Roffman, R. A., Picciano, J. F., & Bolan, M. (1998). Risk for HIV infection among bisexual men seeking HIV-prevention services and risks posed to their female partners. Health Psychology, 17(4), 320–327.

    Article  Google Scholar 

  • Knight, K. R., Shade, S. B., Purcell, D. W., Rose, C. D., Metsch, L. R., Latka, M. H., et al. (2007). Sexual transmission risk behavior reported among behaviorally bisexual HIV-positive injection drug-using men. Journal of Acquired Immune Deficiency Syndrome, 46(Suppl 2), S80–87. doi:10.1097/QAI.0b013e3181576828.

    Article  Google Scholar 

  • Latkin, C., Yang, C., Tobin, K., Penniman, T., Patterson, J., & Spikes, P. (2011). Differences in the social networks of African American men who have sex with men only and those who have sex with men and women. American Journal of Public Health, 101(10), e18–e23. doi:10.2105/ajph.2011.300281.

    Article  Google Scholar 

  • Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago: University of Chicago Press.

    Google Scholar 

  • Leaver, C. A., Allman, D., Meyers, T., & Veugelers, P. J. (2004). Effectiveness of HIV prevention in Ontario, Canada: A multilevel comparison of bisexual men. American Journal of Public Health, 94(7), 1181–1185.

    Article  Google Scholar 

  • Levin, E. M., Koopman, J. S., Aral, S. O., Holmes, K. K., & Foxman, B. (2009). Characteristics of men who have sex with men and women and women who have sex with women and men: Results from the 2003 Seattle Sex Survey. Sexually Transmitted Diseases, 36(9), 541–546. doi:10.1097/OLQ.0b013e3181a819db.

    Article  Google Scholar 

  • Li, A., Varangrat, A., Wimonsate, W., Chemnasiri, T., Sinthuwattanawibool, C., Phanuphak, P., et al. (2009). Sexual behavior and risk factors for HIV infection among homosexual and bisexual men in Thailand. AIDS Behavior, 13(2), 318–327. doi:10.1007/s10461-008-9448-3.

    Article  Google Scholar 

  • Lichtenstein, B. (2000). Secret encounters: black men, bisexuality, and AIDS in Alabama. Medical Anthropology Quarterly, 14(3), 374–393.

    Article  Google Scholar 

  • Lu, B., Viscidi, R. P., Lee, J., Wu, Y., Villa, L. L., Lazcano-Ponce, E., et al. (2011). Human papillomavirus (HPV) 6, 11, 16, and 18 seroprevalence is associated with sexual practice and age: Results from the multinational HPV Infection in Men Study (HIM Study). Cancer Epidemiology, Biomarkers and Prevention, 20(5), 990–1002.

    Article  Google Scholar 

  • Mark, H. D., Sifakis, F., Hylton, J. B., Celentano, D. D., Mackellar, D. A., Valleroy, L. A., et al. (2005). Sex with women as a risk factor for herpes simplex virus type 2 among young men who have sex with men in Baltimore. Sexually Transmitted Diseases, 32(11), 691–695.

    Article  Google Scholar 

  • Marshal, M. P., Friedman, M. S., Stall, R., King, K. M., Miles, J., Gold, M. A., et al. (2008). Sexual orientation and adolescent substance use: A meta-analysis and methodological review*. Addiction, 103(4), 546–556.

    Article  Google Scholar 

  • Marshal, M. P., Dietz, L. J., Friedman, M. S., Stall, R., Smith, H. A., McGinley, J., et al. (2011). Suicidality and depression disparities between sexual minority and heterosexual youth: A meta-analytic review. Journal of Adolescent Health, 49(2), 115–123.

    Article  Google Scholar 

  • Martínez-Donate, A. P., Zellner, J. A., Fernández-Cerdeño, A., Sañudo, F., Hovell, M. F., Sipan, C.L., et al. (2009). Hombres Sanos: Exposure and response to a social marketing HIV prevention campaign targeting heterosexually identified Latino men who have sex with men and women. AIDS Education & Prevention, 21(Supplement B), 124–136.

    Google Scholar 

  • Martinez-Donate, A. P., Zellner, J. A., Sanudo, F., Fernandez-Cerdeno, A., Hovell, M. F., Sipan, C. L., et al. (2010). Hombres Sanos: Evaluation of a social marketing campaign for heterosexually identified Latino men who have sex with men and women. American Journal of Public Health, 100(12), 2532–2540. doi:10.2105/ajph.2009.179648.

    Article  Google Scholar 

  • Maulsby, C., Sifakis, F., German, D., Flynn, C. P., & Holtgrave, D. (2012). Partner characteristics and undiagnosed HIV seropositivity among men who have sex with men only (MSMO) and men who have sex with men and women (MSMW) in Baltimore. AIDS Behavior, 16(3), 543–553. doi:10.1007/s10461-011-0046-4.

    Article  Google Scholar 

  • McKirnan, D. J., Stokes, J. P., Doll, L., & Burzette, R. G. (1995). Bisexually active men: Social characteristics and sexual behavior. Journal of Sex Research, 32(1), 65–76. doi:10.1080/00224499509551775.

    Article  Google Scholar 

  • McQuitty, M., McFarland, W., Kellogg, T. A., White, E., & Katz, M. H. (1999). Home collection versus publicly funded HIV testing in San Francisco: Who tests where? Journal of Acquired Immune Deficiency Syndrome, 21(5), 417–422.

    Article  Google Scholar 

  • Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36(1), 38–56.

    Article  Google Scholar 

  • Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697.

    Article  Google Scholar 

  • Miller, M., Serner, M., & Wagner, M. (2005). Sexual diversity among black men who have sex with men in an inner-city community. Journal of Urban Health, 82(1 Suppl 1), i26–i34. doi:10.1093/jurban/jti021.

    Article  Google Scholar 

  • Millett, G., Malebranche, D., Mason, B., & Spikes, P. (2005). Focusing “down low”: Bisexual black men, HIV risk and heterosexual transmission. Journal of the National Medical Association, 97(7 Suppl), 52S–59S.

    Google Scholar 

  • Mills, T. C., Paul, J., Stall, R., Pollack, L., Canchola, J., Chang, Y., et al. (2004). Distress and depression in men who have sex with men: The Urban Men’s Health Study. The American Journal of Psychiatry, 161(2), 278–285. doi:10.1176/appi.ajp.161.2.278.

    Article  Google Scholar 

  • Mimiaga, M. J., Reisner, S. L., Cranston, K., Isenberg, D., Bright, D., Daffin, G., et al. (2009). Sexual mixing patterns and partner characteristics of black MSM in Massachusetts at increased risk for HIV infection and transmission. Journal of Urban Health, 86(4), 602–623. doi:10.1007/s11524-009-9363-6.

    Article  Google Scholar 

  • Montgomery, J., Mokotoff, E., Gentry, A., & Blair, J. (2003). The extent of bisexual behaviour in HIV-infected men and implications for transmission to their female sex partners. AIDS Care, 15(6), 829–837. doi:10.1080/09540120310001618676.

    Article  Google Scholar 

  • Myers, H. F., Javanbakht, M., Martinez, M., & Obediah, S. (2003). Psychosocial predictors of risky sexual behaviors in African American men: Implications for prevention. AIDS Education and Prevention, 15(Suppl1), 66–79. doi:10.1521/aeap.15.1.5.66.23615.

    Article  Google Scholar 

  • Nakamura, N., Semple, S. J., Strathdee, S. A., & Patterson, T. L. (2011). HIV risk profiles among HIV-positive, methamphetamine-using men who have sex with both men and women. Archives of Sexual Behavior, 40(4), 793–801. doi:10.1007/s10508-010-9713-1.

    Article  Google Scholar 

  • O’Leary, A., Purcell, D., Remien, R., Fisher, H., & Spikes, P. (2007a). Characteristics of bisexually active men in the Seropositive Urban Mens’ Study (SUMS). AIDS Care, 19(7), 940–946. doi:10.1080/09540120701211454.

    Article  Google Scholar 

  • O’Leary, A., Purcell, D. W., Remien, R. H., Fisher, H. E., & Spikes, P. S. (2007b). Characteristics of bisexually active men in the Seropositive Urban Mens’ Study (SUMS). AIDS Care, 19(7), 940–946. doi:10.1080/09540120701211454.

    Article  Google Scholar 

  • Ochs, R. (1996). Biphobia: It goes more than two ways. In B. A. Firestein (Ed.), Bisexuality: The psychology and politics of an invisible minority (pp. 217–239). Thousand Oaks: Sage Publications.

    Google Scholar 

  • Operario, D., Smith, C. D., Arnold, E., & Kegeles, S. (2010). The Bruthas Project: evaluation of community-based HIV prevention intervention for African American men who have sex with men and women. AIDS Education and Prevention, 22(1), 37–48. doi:10.1521/aeap.2010.22.1.37.

    Article  Google Scholar 

  • Operario, D., Smith, C. D., Arnold, E., & Kegeles, S. (2011). Sexual risk and substance use behaviors among African American men who have sex with men and women. AIDS Behavior, 15(3), 576–583. doi:10.1007/s10461-009-9588-0.

    Article  Google Scholar 

  • Orellana, E. R., Picciano, J. F., Roffman, R. A., Swanson, F., & Kalichman, S. C. (2006). Correlates of nonparticipation in an HIV prevention program for MSM. AIDS Education and Prevention, 18(4), 348–361.

    Article  Google Scholar 

  • Ostrow, D. G., Plankey, M. W., Cox, C., Li, X., Shoptaw, S., Jacobson, L. P., et al. (2009). Specific sex-drug combinations contribute to the majority of recent HIV seroconversions among MSM in the MACS. Journal of Acquired Immune Deficiency Syndromes, 51(3), 349–355.

    Article  Google Scholar 

  • Pathela, P., & Schillinger, J. A. (2010). Sexual behaviors and sexual violence: adolescents with opposite-, same-, or both-sex partners. Pediatrics, 126(5), 879–886. doi:10.1542/peds.2010-0396.

    Article  Google Scholar 

  • Paul, J. P., Catania, J., Pollack, L., Moskowitz, J., Canchola, J., Mills, T., et al. (2002). Suicide attempts among gay and bisexual men: Lifetime prevalence and antecedents. American Journal of Public Health, 92(8), 1338–1345.

    Article  Google Scholar 

  • Pedersen, W., & Hegna, K. (2003). Children and adolescents who sell sex: A community study. Social Science Medicine, 56(1), 135–147.

    Article  Google Scholar 

  • Purcell, D. W., Patterson, J. D., Spikes, P. S., Wolitski, R. J., Stall, R., & Valdiserri, R. O. (2007). Childhood sexual abuse experienced by gay and bisexual men: Understanding the disparities and interventions to help eliminate them. In R. J. Wolitski, R. Stall, & R. O. Valdiserri (Eds.), Unequal opportunity: Health disparities affecting gay and bisexual men in the United States (pp. 72–96). New York: Oxford University Press.

    Chapter  Google Scholar 

  • Purcell, D. W., Johnson, C. H., Lansky, A., Prejean, J., Stein, R., Denning, P., et al. (2012). Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. Open AIDS Journal, 6(1), 98–107.

    Article  Google Scholar 

  • Reece, M., Herbenick, D., Schick, V., Sanders, S. A., Dodge, B., & Fortenberry, D. (2010). Sexual behaviors, relationships, and perceived health among adult men in the United States: results from a national probability sample. The Journal of Sexual Medicine, 7(s5), 291–304.

    Article  Google Scholar 

  • Rhodes, F., Deren, S., Wood, M. M., Shedlin, M. G., Carlson, R. G., Lambert, E. Y., et al. (1999). Understanding HIV risks of chronic drug-using men who have sex with men. AIDS Care, 11(6), 629–648. doi:10.1080/09540129947550.

    Article  Google Scholar 

  • Rietmeijer, C. A., Wolitski, R. J., Fishbein, M., Corby, N. H., & Cohn, D. L. (1998). Sex hustling, injection drug use, and non-gay identification by men who have sex with men: associations with high-risk sexual behaviors and condom use. Sexually Transmitted Diseases, 25(7), 353–360.

    Article  Google Scholar 

  • Robin, L., Brener, N. D., Donahue, S. F., Hack, T., Hale, K., & Goodenow, C. (2002). Associations between health risk behaviors and opposite-, same-, and both-sex sexual partners in representative samples of Vermont and Massachusetts high school students. Archives of Pediatrics and Adolescent Medicine, 156(4), 349–355.

    Article  Google Scholar 

  • Rogers, S. M., & Turner, C. F. (1991). Male-male sexual contact in the USA: Findings from five sample surveys, 1970–1990. Journal of Sex Research, 28(4), 491–519.

    Article  Google Scholar 

  • Ross, L. E., Dobinson, C., & Eady, A. (2010). Perceived determinants of mental health for bisexual people: A qualitative examination. American Journal of Public Health, 100(3), 496–502.

    Article  Google Scholar 

  • Russell, S. T., Driscoll, A. K., & Truong, N. (2002). Adolescent same-sex romantic attractions and relationships: Implications for substance use and abuse. American Journal of Public Health, 92(2), 198–202.

    Article  Google Scholar 

  • Rust, P. C. (2000). Bisexuality in the United States: A social science reader. New York: Columbia University Press.

    Google Scholar 

  • Saewyc, E. M., Skay, C. L., Hynds, P., Pettingell, S., Bearinger, L. H., Resnick, M. D., et al. (2008). Suicidal ideation and attempts in North American school-based surveys: Are bisexual youth at increasing risk? Journal of LGBT Health Research, 3(2), 25–36.

    Article  Google Scholar 

  • Saewyc, E. M., Homma, Y., Skay, C. L., Bearinger, L. H., Resnick, M. D., & Reis, E. (2009). Protective factors in the lives of bisexual adolescents in North America. American Journal of Public Health, 99(1), 110–117.

    Article  Google Scholar 

  • Sandfort, T. (1998). Homosexual and bisexual behaviour in European countries. Sexual Behaviour and HIV/AIDS in Europe, 68–105.

    Google Scholar 

  • Sandfort, T., & Dodge, B. (2008). “And then there was the down low”: Introduction to black and Latino male bisexualities. Archives of Sexual Behavior, 37(5), 675–682. doi:10.1007/s10508-008-9359-4.

    Article  Google Scholar 

  • Shoptaw, S., Weiss, R. E., Munjas, B., Hucks-Ortiz, C., Young, S. D., Larkins, S., et al. (2009). Homonegativity, substance use, sexual risk behaviors, and HIV status in poor and ethnic men who have sex with men in Los Angeles. Journal of Urban Health, 86(Suppl 1), 77–92. doi:10.1007/s11524-009-9372-5.

    Article  Google Scholar 

  • Singh, S., Hu, X., Wheeler, W., & Hall, I. (2014). HIV diagnoses among men who have sex with men and women—United States and 6 dependent areas, 2008-2011. American Journal of Public Health, 104(9), 1700–1706.

    Article  Google Scholar 

  • Smith, T. W. (2006). Sexual behavior in the United States. Sex and Sexuality, 1, 104–132.

    Google Scholar 

  • Solorio, R., Swendeman, D., & Rotheram-Borus, M. J. (2003). Risk among young gay and bisexual men living with HIV. AIDS Education and Prevention, 15(1 Suppl A), 80–89.

    Google Scholar 

  • Spikes, P. S., Purcell, D. W., Williams, K. M., Chen, Y., Ding, H., & Sullivan, P. S. (2009). Sexual risk behaviors among HIV-positive black men who have sex with women, with men, or with men and women: Implications for intervention development. American Journal of Public Health, 99(6), 1072–1078. doi:10.2105/ajph.2008.144030.

    Article  Google Scholar 

  • Stall, R., & Purcell, D. W. (2000). Intertwining epidemics: A review of research on substance use among men who have sex with men and its connection to the AIDS epidemic. AIDS and Behavior, 4(2), 181–192.

    Article  Google Scholar 

  • Torian, L. V., Makki, H. A., Menzies, I. B., Murrill, C. S., & Weisfuse, I. B. (2002). HIV infection in men who have sex with men, New York City Department of Health sexually transmitted disease clinics, 1990-1999: A decade of serosurveillance finds that racial disparities and associations between HIV and gonorrhea persist. Sexually Transmitted Diseases, 29(2), 73–78.

    Article  Google Scholar 

  • Udry, J. R., & Chantala, K. (2002). Risk assessment of adolescents with same-sex relationships. Journal of Adolescent Health, 31(1), 84–92.

    Article  Google Scholar 

  • Ueno, K. (2005). Sexual orientation and psychological distress in adolescence: Examining interpersonal stressors and social support processes. Social Psychology Quarterly, 68(3), 258–277.

    Article  Google Scholar 

  • Weinberg, M. S., Williams, C. J., & Pryor, D. W. (2001). Bisexuals at midlife commitment, salience, and identity. Journal of Contemporary Ethnography, 30(2), 180–208.

    Article  Google Scholar 

  • Wheeler, D. P. (2006). Exploring HIV prevention needs for nongay-identified black and African American men who have sex with men: A qualitative exploration. Sexually Transmitted Diseases, 33(7 Suppl), S11–S16. doi:10.1097/01.olq.0000216021.76170.e1.

    Article  Google Scholar 

  • Wheeler, D. P., Lauby, J. L., Liu, K. L., Van Sluytman, L. G., & Murrill, C. (2008). A comparative analysis of sexual risk characteristics of black men who have sex with men or with men and women. Archives of Sexual Behavior, 37(5), 697–707. doi:10.1007/s10508-008-9372-7.

    Article  Google Scholar 

  • Wolitski, R. J., & Fenton, K. A. (2011). Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States. AIDS Behavior, 15(Suppl 1), S9–S17. doi:10.1007/s10461-011-9901-6.

    Article  Google Scholar 

  • Wolitski, R. J., Stall, R., & Valdiserri, R. O. (2008). Unequal opportunity: Health disparities affecting gay and bisexual men in the United States. New York: Oxford University Press.

    Google Scholar 

  • Wyatt, G. E., Myers, H. F., Ashing-Giwa, K. T., Durvasula, R. S., & Staples, R. (1998). Dating patterns: sociocultural factors affecting sexual risk taking in African American men and women—results from two empirical studies. The Black Family: Essays and Studies. Belmont, CA: Wadsworth, 45–57.

    Google Scholar 

  • Zea, M. C., Reisen, C. A., & Diaz, R. M. (2003). Methodological issues in research on sexual behavior with Latino gay and bisexual men. American Journal of Community Psychology, 31(3–4), 281–291.

    Article  Google Scholar 

  • Zellner, J. A., Martinez-Donate, A. P., Sanudo, F., Fernandez-Cerdeno, A., Sipan, C. L., Hovel, M. F., et al. (2009). The interaction of sexual identity with sexual behavior and its influence on HIV risk among Latino men: Results of a community survey in northern San Diego County, California. American Journal of Public Health, 99(1), 125–132. doi:10.2105/AJPH.2007.129809.

    Article  Google Scholar 

  • Ziyadeh, N. J., Prokop, L. A., Fisher, L. B., Rosario, M., Field, A. E., Camargo, C. A., et al. (2007). Sexual orientation, gender, and alcohol use in a cohort study of U.S. adolescent girls and boys. Drug and Alcohol Dependence, 87(2), 119–130.

    Article  Google Scholar 

  • Zule, W. A., Bobashev, G. V., Wechsberg, W. M., Costenbader, E. C., & Coomes, C. M. (2009). Behaviorally bisexual men and their risk behaviors with men and women. Journal of Urban Health, 86(Suppl 1), 48–62. doi:10.1007/s11524-009-9366-3.

    Article  Google Scholar 

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Acknowledgments

The lead author would like to thank his doctoral committee: Nina Markovic, Ron Stall, Tony Silvestre, and Chongyi Wei.  Portions of the material herein were previously presented in different form in the lead author’s doctoral dissertation: Friedman, M.R. (2013). HIV among men who have sex with men and women (MSMW): Prevalence estimates, acquisition and transmission risks, and implications for interventions (Doctoral dissertation, University of Pittsburgh).  The authors have no conflicts of interest to disclose.

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Friedman, M.R., Dodge, B.M. (2016). The Role of Syndemic in Explaining Health Disparities Among Bisexual Men: A Blueprint for a Theoretically Informed Perspective. In: Wright, E., Carnes, N. (eds) Understanding the HIV/AIDS Epidemic in the United States. Social Disparities in Health and Health Care. Springer, Cham. https://doi.org/10.1007/978-3-319-34004-3_4

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