European Association of Nurses in AIDS Care
8th Annual Conference - AD 2000: Advances in AIDS Care, September 1997
Key points of session - HIV risk reduction programmes for behaviourally bisexual men - Gwen van Servellan, University of California
Notes taken and webplaced by Ian Hodgson on 22.10.97
- this session focused on bisexual males, who reside in a kind of limbo, between the gay and heterosexual communities
- Julius Caesar is perhaps the best known bisexual, and was reputed to be 'husband to all women; wife to all men'
- men who have sex with men (MSM) make up 49% of people with AIDS (PWA) in the USA, and 70-80% of those in California
- highest seroincidence rates are among African-American and Latino men in the 25-44 age group
- 58% of MSM with AIDS report also having sex with women
- in Mexico and Latin American countries, homosexual acts are legitimised among adolescent males; and bisexuality is condoned in Thai society, though not necessarily with gays - more fun is to be had in sex with a heterosexual !
- in India, sex with a female virgin is highly valued, and therefore bisexuality as a convenience is more common
- in Africa - an elder (male) may initiate a younger male into sex - anal sex from an elder is thought to bestow good fortune
- problems: bisexuals are less likely to disclose their practices, or get tested for HIV, or disclose status once infected
- also, they are less likely to disclose to their partners, and remain an isolated group (as well as being disenfranchised from social and familial relationships
- this results in bisexuals not being reached by conventional campaigns, and therefore….
- a strategy - based on AIDS risk reduction model:
- establish patterns of behaviour - there is a likelihood of more male partners, unprotected sex, less use of condoms (though usually used with male partners), anal sex with both partners, as well as fisting
- know the community and culture
- MSM/women is a global phenomenon, with individuals being socially marginalised - programmes should address socio-cultural realities of this group (the 'macho' and ethnic elements, plus the conflict between rural and urban manifestations of behaviours)