|David J. Malebranche, MD, MPH, assistant professor of medicine at Emory University School of Medicine and internist at Grady Memorial Hospital, will explore bisexual behavior and activity among African-American men as part of a two-year grant from the National Institute of Child Health and Human Development (NICHD) of the National Institutes of Health. The grant will examine and survey sexual behaviors and same-sex disclosure as it pertains to African-American bisexual men.
As part of the study, Dr. Malebranche and co-investigator Kim Jacob-Arriola, PhD, MPH, assistant professor of behavioral sciences and health education at Emory's Rollins School of Public Health, will conduct 60 survey interviews with bisexually active black men in metropolitan Atlanta who have had sexual relationships with both men and women within the past six months. Study participants, whose ages range from 18-45 years, will include individuals who are both HIV positive and HIV negative.
Each participant will be asked questions about racial identity development; discrimination experiences and perceived masculine gender role norms/expectations; religion/spiritual influences and beliefs; sexual behavior/condom use with men and women; HIV beliefs, perceived risk and testing practices; and the impact of HIV on their sexual practices.
Dr. Malebranche, principal investigator of the study, says the overall purpose of the project is to explore how African-American bisexual men make decisions regarding who they tell about their sexual behavior and factors influencing their condom use with both their male and female sexual partners.
"Up until to this point, researchers have always addressed bisexuality from a pathological perspective," Dr. Malebranche says. "The problem is, we don't know enough about bisexual men. This study will allow us to become familiar with these men and explore issues of relationships, sexuality, same-sex disclosure and sexual practices. When it comes to same-sex disclosure, for example, many people believe it's an all-or-nothing proposition: either you tell everyone or you don't tell anyone. The truth is there is a gray area because of the decision-making process involved. People must weigh the pros and cons about whom they can tell. It depends on a number of factors, like work status, employment, class, and if the sexual partner is a woman or a man."
"What we want to do on one level is delve into the complexity of this decision-making process to figure out how a man decides who and who not to tell," he adds. "The second piece will be looking at sexual behavior risk. We want to see how these men are using condoms. There is a misperception that bisexually active men are irresponsible with condoms and engage in unprotected sex more frequently than exclusively heterosexual or homosexual people. While research shows that bisexually active men are less likely to wear condoms with their steady female partners because of the love/trust issue, they are also more likely to use condoms with their male casual partners."
Dr. Malebranche says the study is particularly important because it will help inform researchers about the social influences on the sexual practices and condom use of bisexual African-American men, instead of simply assuming that these men are driving the rapid rise of HIV infection among African-American women.
Participants will be recruited through community-based organizations and the Internet, as well as the Ponce Clinic, where Dr. Malebranche sees patients.