SEXUAL-BEHAVIOR AND SEXUAL IDENTITY IN MALE INJECTION-DRUG USERS

Sexual behavioral data from a survey of 396 male drug injectors showed that 301 (76%) were behavioral heterosexuals, 49 (12.45%) were bisexu als, and 46 (11.6%) were homosexuals over the previous 5 years. Among those sexually active during the 6 months before the interview, bisexu als were similar to heterosexuals and homosexuals in reporting two or more female or male partners, respectively. Overall, almost three four ths of the bisexuals had two or more sexual partners. Bisexuals were a lso similar to heterosexuals in reported heterosexual anal intercourse (16 and 15%, respectively), and to homosexuals in reported homosexual insertive anal intercourse (33 and 54%, respectively). They were less likely than heterosexuals to engage in vaginal and insertive oral sex with women and than homosexuals to practice receptive anal and oral s ex with men. The three groups all practiced high levels of unprotected sex. Almost half the behavioral bisexuals identified themselves as he terosexuals. Self-identified heterosexuals in the sample were less lik ely than self-identified gays or bisexuals to state they reduced sexua l risk; however, reported condom use was low for all three groups. Wit h human immunodeficiency virus infection rates of 54% (21 of 39) for b ehavioral homosexuals, 24% (11 of 45) for bisexuals, and 9% (24 of 260 ) for heterosexuals, these findings indicate an urgent need for more e ffective sexual risk reduction among injection drug users and their pa rtners.