Exploring the "bisexual bridge": a qualitative study of risk behavior and disclosure of same-sex behavior among black bisexual men.

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.