New studies out of Australia and Kenya focus on the special health challenges of bi-sexual men, who are often neglected due to their relative invisibility. Bi men often conceal their identity from partners, fearing rejection, and are stigmatized as the vectors of HIV and other sexually transmitted infections to women, who are especially vulnerable.
Using the resources of an HIV prevention program in Kenya, 730 young men under the age of 30 were recruited to fill out questionnaires; the majority reported having received payment for sex. Those who were exclusively gay were more likely to have engaged in receptive anal sex and reported greater perceptions of stigma. However, the bi-sexual men had more sexual partners and were more likely to practice risky behaviors associated with alcohol and drug use. Nearly a quarter of the men who regarded themselves as bi-sexual had never had sex with a cisgender woman, but only with men and trans women, and over 40% of those regarding themselves as exclusively gay did have relations with trans women as well as men. Attraction to trans partners calls for a rethinking of traditional categories of straight, gay, and bi-sexual.
The Australian study did go beyond the traditional categories by surveying over 2100 bi, pan, queer, and fluid persons of all genders (Bi+), and found that they were far more likely than the general population to have suffered sexual violence, STIs, and face psychological distress due to isolation from both gay and straight communities. Bi men in particular, although reporting more sexual partners and condomless sex, are often closeted and feel uncomfortable disclosing their sexual history or health problems to medical personnel.
