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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.158725v1 100/1/159    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Malebranche, D. J. Articles by Patel, S. N. Search for Related Content PubMed PubMed Citation Articles by Malebranche, D. J. Articles by Patel, S. N. Related Collections HIV/AIDS African Americans/Blacks Sexual Health Lesbian/Gay/Bisexual/Transgender Persons Men's Health Qualitative Research

David J. Malebranche, MD, MPH, Kimberly Jacob Arriola, PhD, MPH, Tyrrell R. Jenkins, MPH, Emily Dauria, MPH and Shilpa N. Patel, MPH

At the time of the study, David J. Malebranche was with the Division of General Medicine, Emory University School of Medicine, Atlanta, GA, and the Behavioral Science and Health Education Department, Rollins School of Public Health, Emory University. Kimberly Jacob Arriola was with the Behavioral Science and Health Education Department, Rollins School of Public Health, Emory University. Tyrrell R. Jenkins was a student in the Health Policy and Management Department, Rollins School of Public Health, Emory University. Emily Dauria and Shilpa N. Patel were students in the Behavioral Science and Health Education Department, Rollins School of Public Health, Emory University.

Correspondence: Correspondence should be sent to David J. Malebranche, MD, MPH, Emory University School of Medicine, Division of General Medicine, 49 Jesse Hill Jr. Drive, Suite 413, Atlanta, GA 30303 (e-mail: dmalebr{at}emory.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We explored factors influencing sexual behavior, disclosure of same-sex behavior, and condom-use practices among Black bisexual men.

Methods. We conducted semistructured interviews with 38 Black men in Atlanta, Georgia, who reported having had oral, vaginal, or anal sex with both men and women in the prior 6 months.

Results. Participants described approaches to disclosure of same-sex behavior as part of a complex decisional balance influenced by both situational and individual factors and ranging from full disclosure to total secrecy. Influences on sexual behavior and condom-use practices included: (1) type of relationship, (2) gender-specific considerations, (3) perceptions of comfort or trust, and (4) fear of disease or pregnancy.

Conclusions. Disclosure of same-sex behavior was not a major influence on the sexual behavior and condom-use practices of the Black bisexual men in our study, who demonstrated heterogeneity in approaches to sexual behavior, disclosure of same-sex behavior, and condom-use practices. Additional research is needed to assess the social determinants of sexual risk for this population. Future HIV-prevention efforts should include initiatives to encourage accuracy in risk assessment and in taking sexual histories in clinical settings.