Bisexuality among Men who have Sex with Men in Sub-Saharan Africa: Findings from the HPTN 075 Study

Studies among men who have sex with men (MSM) in sub-Saharan Africa (SSA) focus mainly on HIV epidemiology, revealing little about the diversity within this population. We utilized data from the HIV Prevention Trials Network (HPTN) 075 study, to explore demographic and psychosexual characteristics of MSM in SSA who also have sex with women. Persons included in the analyses were aged 18-44 years and assigned male sex at birth and identified as male, reported anal sex with a man in the past 3 months, and had enrolled at one of four study sites (Kisumu, Kenya; Blantyre, Malawi; Cape Town and Soweto, South Africa). Nearly a quarter of the participants had recently engaged in sex with both men and women (MSMW). These men differed in terms of demographic and psychosexual characteristics, and sexual behavior from men who only had had sex with men (MSME). Compared to the latter, MSMW were more likely to prefer the insertive sexual role, reported more sexual partners in the past three months, and had more instances of condomless insertive anal intercourse with a man. These findings suggest that men who have sex with both men and women have specific characteristics and need tailored interventions that take their specific needs into account. Los estudios entre hombres que tienen sexo con hombres (HSH) en & Aacute;frica subsahariana (ASS) se centran principalmente en la epidemiolog & iacute;a del VIH y revelan poco sobre la diversidad dentro de esta poblaci & oacute;n. Utilizamos datos del estudio 075 de la Red de Ensayos de Prevenci & oacute;n del VIH (HPTN) para explorar las caracter & iacute;sticas demogr & aacute;ficas y psicosexuales de los HSH en el & Aacute;frica subsahariana que tambi & eacute;n tienen relaciones sexuales con mujeres. Las personas incluidas en los an & aacute;lisis ten & iacute;an entre 18 y 44 a & ntilde;os y se les asign & oacute; sexo masculino al nacer y se identificaron como hombres, informaron haber tenido sexo anal con un hombre en los & uacute;ltimos 3 meses y se hab & iacute;an inscrito en uno de cuatro sitios (Kisumu, Kenia; Blantyre, Malawi; Ciudad del Cabo y Soweto, Sud & aacute;frica). Casi una cuarta parte de los participantes hab & iacute;a tenido relaciones sexuales recientemente con hombres y mujeres (HSH). Estos hombres difer & iacute;an en t & eacute;rminos de caracter & iacute;sticas demogr & aacute;ficas, psicosexuales y comportamiento sexual de los hombres que s & oacute;lo hab & iacute;an tenido sexo con hombres (MIPYME). En comparaci & oacute;n con estos & uacute;ltimos, los HSH ten & iacute;an m & aacute;s probabilidades de preferir el rol sexual insertivo, reportaron m & aacute;s parejas sexuales en los & uacute;ltimos tres meses y tuvieron m & aacute;s casos de relaciones sexuales anales insertivas sin cond & oacute;n con un hombre. Estos hallazgos sugieren que los hombres que tienen relaciones sexuales tanto con hombres como con mujeres tienen caracter & iacute;sticas espec & iacute;ficas y necesitan intervenciones personalizadas que tengan en cuenta sus necesidades espec & iacute;ficas.