A new study published Sunday by the Centers for Disease Control and Prevention reveals that bisexual men experience higher rates of HIV than straight men and may be at greater risk for other sexually transmitted infections than either straight or gay men, in large part due to societal biphobia.
The study, carried in the American Journal of Preventive Medicine, confirms that men who have sex with men and women (MSMW) -- regardless of whether they identify as bisexual -- have distinct health care needs that distinguish this population from men who have sex with men, and from men who have sex with women. The study concluded that these men are disproportionally affected by HIV, though that does not mean that bisexual men constitute a "bridge" in HIV transmission to heterosexual women, the report cautions. Instead, the biphobia that men who have sex with men and women experience can hinder them in coming out, getting tested, and seeking care.
"Societal biphobia -- negative attitudes and behaviors toward bisexual individuals -- is more prevalent than antigay sentiment," said study author William Jeffries of the Division of HIV/AIDS at the CDC's National Center for HIV/AIDS, Viral Hepatitis, and TB Prevention, in a press release. "It is sometimes perpetrated by lesbians and gay men, and public health professionals who interact with MSMW. Biphobia can manifest in erroneous beliefs that MSMW are closeted gay men and, particularly for black men, responsible for HIV transmission to women."
"Experiencing these sentiments can contribute to MSMW's social isolation and psychological distress, which in turn may promote HIV/STI risk through substance use, sexual risk behaviors, and avoidance of prevention services," Jeffries continued. "Researchers have argued that biphobia may explain some MSMW's HIV testing avoidance, substance use, and high number of sexual partners. For example, because biphobia manifests in beliefs that bisexuality is not a legitimate sexual orientation, MSMW may feel inclined to publicly validate their bisexuality through multiple sexual partnerships with men and women."
The CDC study acknowledged that bisexual men represent a small part of the entire population but also noted that this population is understudied. Although previous studies have shown that bisexual men are less at risk to contract STI's and HIV than are gay men, Sunday's report found that bisexual men are also receiving less treatment due to the biphobia in and out of the LGBT community. Many bisexual men fear coming out as such to healthcare providers due to the lack of education and understanding.
The study highlighted bisexual men of color in particular, as they face particular barriers to treatment and prevention, including racism, poverty, homophobia, and disproportionate rates of incarceration. These are unique sociocultural aspects that contribute to the increase of the suspetability of contracting STIs and HIV, the study found.
The study also outlined suggestions to reduce the risk for this population, beginning with bi-specific social marketing campaigns to increase testing and condom use, especially for bi men of color. Jeffries also suggested creating sexual education programs for youth who identify as bisexual, and suggested health care providers undergo bisexual sensitivity training to better serve their bisexual patients. The study also stressed the importance of bisexual support groups in improving health outcomes for bi people.