Definitions Matter

Even into the early 2000s, knowledge about bisexual men’s recent sex partners remained little understood—an important research gap, because of bisexual men’s increased risk for HIV and other STDs. Bisexual men were often lumped together in studies with homosexual men, and it was unclear whether bisexuality (or sexual orientation more generally) should be defined in terms of behavior, identity or attraction. 

In a 2011 Perspectives article, William L. Jeffries IV found that these distinctions mattered. He studied the issue using data on 3,875 sexually active men who participated in the 2002 National Survey of Family Growth—and found that behaviorally bisexual men had had 2.5 more partners in the past year than behaviorally heterosexual men and 2.6 more partners than behaviorally homosexual men. When bisexuality was based on sexual identity or sexual attraction, “a different narrative emerged,” Jeffries wrote: Neither identity nor attraction was independently associated with the recent number of sexual partners.

The results, according to Jeffries, implied that STD risk reduction interventions for bisexual men should focus on sexual behavior, rather than on sexual identity or attraction alone. In his conclusion, the author argued for culturally appropriate interventions, because men of racial or ethnic minorities are disproportionately represented among the U.S. population of behaviorally bisexual males. He also called for holistic intervention approaches that acknowledge behaviorally bisexual men’s higher participation in risk behaviors such as injection-drug use.

Further research on bisexual men, Jeffries wrote, “will lead to a more thorough understanding of their nuanced risk and behavioral characteristics.”

Perspectives on Sexual and Reproductive Health and Family Planning Perspectives may be accessed through Wiley Online Library (2003–) and JSTOR (1969–2011).

Cover illustrations of Margaret Sanger © Matthew and Eve Levine