leizy
Jun 9, 2006, 12:20 PM
Last section of my chapter, reviewing research on bisexuals. As always, comments and recommendations are greatly appreciated. You guys and gals are great.
thanks.
david
One of the most frightening, dangerous and concerning beliefs regarding bisexuals is that they spread disease, specifically, sexually transmitted diseases. In the early 1980's, bisexual men were "outed" as the group that was allegedly responsible for widespread AIDS transmission to their unsuspecting wives. Revelations about men having anonymous, unprotected gay sex led to an outcry among many sexual minority groups, including the bisexual community. One of the preeminent researchers in the bisexual community, Fritz Klein, MD, has talked about the changes in sexual practices that many bisexuals underwent in response to the AIDS crisis. Many bisexual men and women restricted their sexual activities with men, to limit their exposure, with some long-term studies showing that many individuals entered into monogamous relationships to protect themselves and their partners. As the heterosexual community reacted with against bisexuality, the gay community sought to distance itself from bisexuals. In response, the bisexual community drew together, organizing themselves for support, understanding, and counseling and information about their risk from infection. Researchers and epidemiologists began to study the phenomena of bisexuality, leading to renewed examination of bisexual identity and bisexual behavior. Thus, in a sense, the AIDS crisis supported the growth of both more cohesion within the developing community of bisexuals, and the growth of a research industry into the nature and incidence of bisexuality. The research and the bisexual community grew over the past two decades, with both moving away from the specter of AIDS, and towards deeper, more sophisticated and thoughtful conceptions of bisexuality.
Despite the advances in the treatment of AIDS and HIV, Men who have Sex with Men (MSM) still account for 40% of new HIV cases each year, according to Federal statistics compiled by the CDC. Increased incidence of gonorrhea, syphilis and other sexually transmitted diseases among men having sex with men have been reported in recent years. Does this mean that bisexuals are spreading disease through malicious ignorance at best, and careless hedonism at worst? Perhaps not, as numerous research studies indicate that the gay and bisexual communities have aggressively implemented safer sex practices, and use condoms and other protections from disease transmission at far higher rates than the straight community (91% of men who have sex with men, versus 36% of men who have never had sex with men), according to studies by the CDC. Research in 1994 by Ekstrand showed that bisexual males with and without HIV made dramatic changes in their behaviors, such that they were not likely to expose female partners to sexually transmitted disease.
Among MSM's, those who identify as straight are much less likely to use condoms when having anal sex with men, versus those who identify as gay or bisexual (64% of straight identifying men never use condoms when having anal sex with other men, versus only 16% of gay/bisexual men). Rates of HIV infection among MSM are slowing, while rates related injecting drug abusers and heterosexuals continue to climb. A national study by the CDC examining rates of disclosure of HIV status to partners compared gay/bisexual men to heterosexual men and to women. No apparent distinction was made regarding the sexual orientation of women. Gay and bisexual men did have higher rates of not disclosing their HIV status, to casual partners and when they knew their own status was the same as their partners. However, when a gay/bisexual male knew their HIV status was different from their partner, or when they were in a long-term relationship, gay/bisexual disclosure of HIV status was on level with disclosure by heterosexual men and women. When sex happened without disclosure, it was most often sexual activity with a relatively lower risk of infection, such as oral contact.
Rates of HIV infection in married women are so far below that of unmarried women that some CDC tables don't even report data on married women. Among women infected through heterosexual contact, the overwhelming majority of those infections were acquired through an etiology involving substance abuse and IV drugs, and heterosexual sex. Data regarding AIDS in Africa indicates that heterosexual transmission, with an etiology in drugs, prostitution or unsafe healthcare accounts for 80% to 90% of the known infections, with most of the remainder accounted for by perinatal transmission from mother to child. Bisexual women are reportedly at higher risk of HIV, and AIDS in the lesbian community is of growing concern, though these risks are reportedly due to promiscuity in the bisexual women, particularly with men, and low rates of condom use during heterosexual sex, not due to their bisexuality.
The problem faced by our nation and world is the problem of AIDS and HIV, not bisexuality, nor even sexuality. The problem of HIV and AIDS has brought attention to the needs of the bisexual, and increased research has revealed the complexity of bisexuality. Focusing upon bisexuality draws attention away from the rising risks in heterosexual and drug-related transmissions, though there are real risks of AIDS transmission among men who have sex with men, but do not identify as homosexual or bisexual. The gay/bisexual communities have responded to AIDS in ways where the heterosexual community lags behind. Women and men exposed to infection by nondisclosing partners face a serious, frightening and undeserved situation. But, despite the popular, fear-based literature and media attention this issue has received, the rates of HIV transmission through the vehicle of bisexual sexual activity remains low, when compared to drug-related and heterosexual pathways to infection. The stigma of a bisexual identity or label seems to keep many men who have sex with both men and women from acknowledging or identifying their sexuality. Instead, many express their sexuality in a covert way that inhibits public health initiatives around safe sex.
Currently, a vaccine for prevention of transmission of another STD, Human Papilloma Virus faces significant political opposition. HPV is a serious risk factor for cervical cancer in women, and often goes undetected and untreated. However, conservative groups oppose FDA approval of the vaccine, reportedly out of concern that vaccinating children against an STD might act as tacit approval of premarital sexual activity, and counteract efforts to support abstinence. It is difficult to imagine that such an argument might not arise if, or hopefully when, a vaccine against HIV is developed. Would such a vaccine be opposed, because to support it might send a message of tacit approval to children regarding homosexual or bisexual sex, not to mention injection drug use or heterosexual sex? Fear of bisexuality is really fear of that which is different, fear of that which one cannot control, fear of that which is within oneself that is frightening in its seductive appeal.
thanks.
david
One of the most frightening, dangerous and concerning beliefs regarding bisexuals is that they spread disease, specifically, sexually transmitted diseases. In the early 1980's, bisexual men were "outed" as the group that was allegedly responsible for widespread AIDS transmission to their unsuspecting wives. Revelations about men having anonymous, unprotected gay sex led to an outcry among many sexual minority groups, including the bisexual community. One of the preeminent researchers in the bisexual community, Fritz Klein, MD, has talked about the changes in sexual practices that many bisexuals underwent in response to the AIDS crisis. Many bisexual men and women restricted their sexual activities with men, to limit their exposure, with some long-term studies showing that many individuals entered into monogamous relationships to protect themselves and their partners. As the heterosexual community reacted with against bisexuality, the gay community sought to distance itself from bisexuals. In response, the bisexual community drew together, organizing themselves for support, understanding, and counseling and information about their risk from infection. Researchers and epidemiologists began to study the phenomena of bisexuality, leading to renewed examination of bisexual identity and bisexual behavior. Thus, in a sense, the AIDS crisis supported the growth of both more cohesion within the developing community of bisexuals, and the growth of a research industry into the nature and incidence of bisexuality. The research and the bisexual community grew over the past two decades, with both moving away from the specter of AIDS, and towards deeper, more sophisticated and thoughtful conceptions of bisexuality.
Despite the advances in the treatment of AIDS and HIV, Men who have Sex with Men (MSM) still account for 40% of new HIV cases each year, according to Federal statistics compiled by the CDC. Increased incidence of gonorrhea, syphilis and other sexually transmitted diseases among men having sex with men have been reported in recent years. Does this mean that bisexuals are spreading disease through malicious ignorance at best, and careless hedonism at worst? Perhaps not, as numerous research studies indicate that the gay and bisexual communities have aggressively implemented safer sex practices, and use condoms and other protections from disease transmission at far higher rates than the straight community (91% of men who have sex with men, versus 36% of men who have never had sex with men), according to studies by the CDC. Research in 1994 by Ekstrand showed that bisexual males with and without HIV made dramatic changes in their behaviors, such that they were not likely to expose female partners to sexually transmitted disease.
Among MSM's, those who identify as straight are much less likely to use condoms when having anal sex with men, versus those who identify as gay or bisexual (64% of straight identifying men never use condoms when having anal sex with other men, versus only 16% of gay/bisexual men). Rates of HIV infection among MSM are slowing, while rates related injecting drug abusers and heterosexuals continue to climb. A national study by the CDC examining rates of disclosure of HIV status to partners compared gay/bisexual men to heterosexual men and to women. No apparent distinction was made regarding the sexual orientation of women. Gay and bisexual men did have higher rates of not disclosing their HIV status, to casual partners and when they knew their own status was the same as their partners. However, when a gay/bisexual male knew their HIV status was different from their partner, or when they were in a long-term relationship, gay/bisexual disclosure of HIV status was on level with disclosure by heterosexual men and women. When sex happened without disclosure, it was most often sexual activity with a relatively lower risk of infection, such as oral contact.
Rates of HIV infection in married women are so far below that of unmarried women that some CDC tables don't even report data on married women. Among women infected through heterosexual contact, the overwhelming majority of those infections were acquired through an etiology involving substance abuse and IV drugs, and heterosexual sex. Data regarding AIDS in Africa indicates that heterosexual transmission, with an etiology in drugs, prostitution or unsafe healthcare accounts for 80% to 90% of the known infections, with most of the remainder accounted for by perinatal transmission from mother to child. Bisexual women are reportedly at higher risk of HIV, and AIDS in the lesbian community is of growing concern, though these risks are reportedly due to promiscuity in the bisexual women, particularly with men, and low rates of condom use during heterosexual sex, not due to their bisexuality.
The problem faced by our nation and world is the problem of AIDS and HIV, not bisexuality, nor even sexuality. The problem of HIV and AIDS has brought attention to the needs of the bisexual, and increased research has revealed the complexity of bisexuality. Focusing upon bisexuality draws attention away from the rising risks in heterosexual and drug-related transmissions, though there are real risks of AIDS transmission among men who have sex with men, but do not identify as homosexual or bisexual. The gay/bisexual communities have responded to AIDS in ways where the heterosexual community lags behind. Women and men exposed to infection by nondisclosing partners face a serious, frightening and undeserved situation. But, despite the popular, fear-based literature and media attention this issue has received, the rates of HIV transmission through the vehicle of bisexual sexual activity remains low, when compared to drug-related and heterosexual pathways to infection. The stigma of a bisexual identity or label seems to keep many men who have sex with both men and women from acknowledging or identifying their sexuality. Instead, many express their sexuality in a covert way that inhibits public health initiatives around safe sex.
Currently, a vaccine for prevention of transmission of another STD, Human Papilloma Virus faces significant political opposition. HPV is a serious risk factor for cervical cancer in women, and often goes undetected and untreated. However, conservative groups oppose FDA approval of the vaccine, reportedly out of concern that vaccinating children against an STD might act as tacit approval of premarital sexual activity, and counteract efforts to support abstinence. It is difficult to imagine that such an argument might not arise if, or hopefully when, a vaccine against HIV is developed. Would such a vaccine be opposed, because to support it might send a message of tacit approval to children regarding homosexual or bisexual sex, not to mention injection drug use or heterosexual sex? Fear of bisexuality is really fear of that which is different, fear of that which one cannot control, fear of that which is within oneself that is frightening in its seductive appeal.