Sexual Behaviors of Non-gay Identified Non-disclosing Men Who Have Sex with Men and Women

The sexual behaviors of non-gay identified men who have sex with men and women (MSMW) who do not disclose their same-sex behavior to their female partners (referred to by some as men "on the down low") were examined, including the potential for these men to serve as a "bisexual bridge" for HIV and STD acquisition and transmission. Self-reported sexual behavior data were collected as part of an exploratory study of an ethnically diverse (41% African American, 35% Latino, 22% White, and 2% Asian) sample of 46 non-gay identified, non-disclosing MSMW in New York City. Men reported significantly more male than female sexual partners, but more frequent sex with females. The prevalence and frequency of unprotected sex did not differ significantly between male and female partners in the past 3 months. Men reported risk behavior more often with steady female and steady male partners (e.g., wives, girlfriends, boyfriends) than with more casual male and female partners (regular uncommitted partners, one-night stands). Men, especially African American/Black men, were significantly less likely to report receptive sexual behaviors with men than insertive behaviors. Unprotected sex was common with male and female partners in the past 3 months (e.g., 35% of anal sex with men; 50% of vaginal sex). Indeed, 22% of the sample (38% of those who had both recent males and female partners) reported both unprotected vaginal sex and unprotected anal sex with a male partner during the past 3 months. Although the study was limited by a small convenience sample, the findings suggest that non-gay identified non-disclosing MSMW are at risk for the acquisition and transmission of HIV and STDs, and may serve as a potential bridge, suggesting the need for further research and intervention targeting this unique population.     

The Sociodemographic Characteristics of Concurrent Sexual Partnerships and their Risky Sexual Behaviors: Results of a Nationally Representative Sample of South Korean Adults

This study assessed the risky sexual behavior of a group of adult men and women with sexual experience within the past 1 year who, while in a relationship with a stable partner, reported having sex with another person. The data were collected in 2003 using a nationally representative, multi-stage stratified probability sample (n = 1,271) of women and men in South Korea. Via hierarchical regression models, we assessed the gendered effects of socioeconomic characteristics, health behavior, sex behavior, and safe sex attitude factors. According to the results, for groups with concurrent sexual partnership experience, if the subject was a single person with smoking and drinking who had engaged in sex resulting in unwanted pregnancy, and anal sex initiated before the age of 17, the likelihood of engaging in concurrent sexual partnerships was statistically significant. Furthermore, our gender-elaborated analysis demonstrated that the majority of sexual risk was borne by women. When the partners of concurrent sexual partnerships are categorized by type, the key characteristic of a casual relationship or relationship with female sex workers is one-night-stand sex, accompanied by drinking. This study found that, for groups with concurrent sexual partnerships experience, there is a statistical association between health risky variables and risky sexual behavior. We should attempt to intervene in these concurrent sexual partnerships groups for the effective management of sexually transmitted infections.     

Comparing Gay and Bisexual Men on Sexual Behavior, Condom Use, and Psychosocial Variables Related to HIV/AIDS

Interviews were conducted with 750 men, recruited from a variety of sources in Chicago, who reported sex with men in the past 3 years. Behavioral criteria were used to establish groups of gay and bisexual men. We predicted that gay men, compared to bisexual men, would report more male sexual partners, more experience with receptive sex, and more tolerant attitudes toward homosexuality. The only reliable difference between the gay and bisexual men with respect to number of partners was that gay men were more likely to have had a steady male partner or lover. Gay men were more likely than bisexual men to have engaged in receptive sex, including unprotected receptive anal sex. Bisexual men were more self-homophobic and saw other people as less accepting of same-sex activity. There were no differences between gay and bisexual men in other psychosocial variables. Interventions designed to reduce the transmission of HIV/AIDS need to consider differences in gay and bisexual men's sexual behavior and attitudes toward homosexual behavior.     

男男性接触者中异性爱者与素质性同性爱者艾滋病高危性行为比较

目的探讨中国男男性接触者（MSM）中异性爱者与素质性同性爱者（gay）艾滋病高危性行为状况。方法采用定向抽样方法，对9城市2250例MSM进行匿名问卷调查，比较其中异性爱组与gay组的高危性行为。结果异性爱组累计同性性伴数（平均13．8个）、近6个月同性性伴数（平均3．8个）、累计同性口交性伴数（平均10．5个）和同性肛交性伴数（平均12．4个），均低于gay组；在婚异性爱组累计女性性伴数（平均4．9个）、近6个月女性性伴数（平均1．7个），均高于在婚gay组。异性爱组同性性交安全套使用率（68．8％）低于gay组；但最近1次同性肛交安全套使用率（91．3％）、与女性性交安全套使用率（63．7％）均高于gay组；两组最近1次同性肛交安全套使用率（分别为91．3％、71．0％）均高于最近1次同性口交安全套使用率。异性爱组最近1年曾参加群交百分率（9．9％）、性交时自己或对方出血过百分率（16．7％）、到外地并与当地男性性交百分率（11．4％），曾向同性买性百分率（4．6％）、16岁前遭遇过成年男性实施的强迫性交百分率（4．2％），均低于gay组。结论MSM中异性爱者与gay的高危性行为存在诸多差异，为有效阻断HIV传播，干预工作应选择重点亚人群进行。     

Same-Sex Sexual Orientation,Childhood Sexual Abuse,and Suicidal Behavior in University Students in Turkey

This questionnaire study investigated the prevalence of, and interrelationships among, self-reported same-sex sexual orientation, childhood sexual abuse, and suicidal behavior in 1262 university students in Turkey. Approximately 7% of the sample reported lifetime or current same-sex sexual attractions, 5% reported that they engaged in same-sex sexual behavior, and almost 2% self-identified as either homosexual or bisexual. Overall, almost 10% of the sample acknowledged some form of a same-sex sexual orientation. Twenty-eight percent of the participants reported at least one instance of sexual abuse during their childhood. Almost 42% of the students reported suicidal ideation during the past 12 months or lifetime, and 7% reported that they attempted to kill themselves during their lifetime or in the past 12 months. Five hypotheses about the interrelationships among same-sex sexual orientation, childhood sexual abuse, and suicidal behavior were developed and tested in the study. Self-reported childhood sexual abuse was associated with same-sex sexual behavior. Participants who engaged in same-sex sexual behavior and those who identified themselves as homosexual or bisexual perceived more distance between themselves and their fathers than those who did not. Being sexually abused by someone of ones own sex was related to same-sex sexual orientation in male participants but not in female participants. Childhood sexual abuse was found to be an independent predictor of both suicidal ideation and attempts during the past 12 months. Only identifying oneself as homosexual or bisexual was associated with an increased risk for suicidal ideation during the past 12 months.     

Differences in Sexual Risk Behaviors Between College Students with Same-Sex and Opposite-Sex Experience: Results from a National Survey

The goal of this study was to identify differences in the sexual health behaviors (condom use and number of sexual partners) between college students with same-sex sexual experiences and those with only opposite-sex partners. Data from a random sample of American university students were gathered as part of the 1997 College Alcohol Study. Odds ratios were estimated for consistent condom use and multiple sex partners for students with same-sex or both-sex sexual partners compared to those with exclusively heterosexual contacts. Five percent of respondents reported ever having a same-sex partner. Significant differences in safer-sex practices were found between groups. Females with both-sex experience and males with both-sex or only same-sex experiences were more likely to report multiple recent sexual partners than their peers with only opposite-sex partners. Odds ratios of consistent condom use were lower for men with only same-sex experience than among those with only opposite-sex partners. Findings have implications for sexual health education on the college campus. Consistent condom use remains low among college students. Education programs should emphasize the importance of limiting the number of lifetime sex partners, especially among students with same-sex experiences.     

Sexual Risk-Taking in Gay Men: The Relevance of Sexual Arousability, Mood, and Sensation Seeking

This paper examined the relationship of three aspects of personality to sexual risk-taking in gay men: (1) sexual arousability, as propensity for sexual excitation, and propensity for inhibition of sexual arousal in the face of threat (measured by the Sexual Excitation, SES, and Sexual Inhibition, SIS1, SIS2, scales); (2) the relation between negative mood and sexuality; and (3) sensation seeking. Risk-taking was assessed for the past 6 months in relation to unprotected anal intercourse (UAI), oral sex, number of casual partners, and patterns of cruising behavior. A combination of number of partners and use of condoms was used to derive a longer-term risk grouping. Two patterns of association were identified. UAI and high risk oral sex were more likely in those with low inhibition of sexual response due to threat of performance consequences" (i.e., low SIS2) and low trait anxiety (low STAI). High numbers of casual partners and frequent cruising were associated with increased sexual interest in states of depression and high propensity for sexual excitation (SES). Higher long-term risk was also associated with low SIS2. Unexpectedly, high SIS1, which is strongly related to vulnerability to erectile failure, was also predictive of higher long-term risk. Possible reasons for this are discussed. Disinhibition from the Sensation Seeking Scales was a positive predictor of all types of sexual risk assessed. All three aspects of personality are of potential relevance to designing better interventions to reduce high risk sexual behavior and in evaluating their effectiveness.     

Sexual Decision-Making in HIV-Positive Men Who Have Sex with Men: How Moral Concerns and Sexual Motives Guide Intended Condom Use with Steady and Casual Sex Partners

Determinants of intended condom use with steady and casual sex partners were examined among Dutch HIV-positive men who have sex with men (MSM) (N = 296). Given the proposition that safer sex behavior among HIV-positive people is a form of prosocial behavior, the present study extended the general framework of the Theory of Planned Behavior with Schwartz's norm-activation theory and tested the assumption that personal norms would mediate the effects of other psychosocial factors on intended condom use for anal sex. In addition, it was hypothesized that, depending on the context in which sex occurs, specific motives for unprotected anal sex may have a negative influence on intended condom use and, as such, undermine a prosocial tendency to practice safer sex. Therefore, we also investigated the influence of sexual motives for unprotected anal sex on intended condom use with steady and casual sex partners. Results indicated that the Theory of Planned Behavior adequately predicted condom use intentions (for casual sex partners and steady sex partners, the explained variance was 52% and 53%, respectively). However, our proposed model of sexual decision-making significantly improved the prediction of behavioral intentions. For steady and casual sex partners, the assumption of the mediating role of personal norms on condom use intention was confirmed empirically. Additionally, sexual motives for unprotected anal sex exerted, as expected, a direct, negative effect on condom use intention with casual sex partners. The implications of the findings for future research and the development of HIV-prevention programs for HIV-positive MSM are discussed.     

Predictors of Early Initiation of Vaginal and Oral Sex Among Urban Young Adults in Baltimore, Maryland

Over the past three decades, most research on adolescent sexual behavior has focused on vaginal intercourse and related behaviors, including contraception and unintended pregnancy. In this study, we describe the prevalence and correlates of vaginal, oral, and anal sex in an epidemiologically defined population in Baltimore, Maryland. Young adults (ages 18–24), who had been enrolled in a behavioral intervention trial during elementary school, were interviewed by telephone between 1998 and 2002 to assess their sexual behavior. Of 1679 respondents interviewed, 70.8% were Black and 55% were women. Overall, 93% of the young adults reported vaginal intercourse, 78% reported receiving oral sex, 57% reported performing oral sex, and 10% reported receptive anal intercourse. Among men, 27% reported insertive anal intercourse. Blacks initiated vaginal intercourse at an earlier age than Whites; White women performed oral sex earlier than Black women. Significant interactions were observed between age of first vaginal partner and both gender and race/ethnicity. Blacks with older partners initiated sex at an earlier age than both Blacks with a partner the same age or younger and Whites. We also observed a relationship between older female sex partners and earlier vaginal sex initiation among men. We conclude that older sex partners play an important role in sexual initiation among young adults. In light of the rates of oral and anal sex, sexual education and intervention programs should address the risk for unintended consequences of these behaviors.     

Timing of Puberty and Sexuality in Men and Women

We examined the relations among timing of puberty, timing of first experience of sexual arousal, strength of sex drive, and sexual attitudes and behaviors in 277 men (M age, 22.4 years) and women (M age, 21.8 years). Kinsey had suggested that earlier maturers have a stronger sex drive and, therefore, engage in a higher frequency of sexual behaviors (including same-sex contacts) than do later maturers. The purpose of this study was to test Kinseys claim. Participants completed questionnaires on pubertal timing, timing of first experience of sexual arousal, sex drive in adulthood, sexual attitudes (e.g., sociosexuality or degree of comfort with casual sex), and sexual behaviors (e.g., lifetime number of sexual partners). Timing of puberty (i.e., emergence of secondary sex characteristics) was related to these variables for men but not for women. Timing of first sexual arousal was related to several aspects of adult sexuality in both sexes, but particularly in women. Earlier first sexual arousal was associated with having a higher sex drive, a less restricted sociosexual orientation, and with having had more sexual partners than was later first sexual arousal. Earlier first sexual arousal, but not timing of puberty, was related to sexual orientation for women only. We discuss classes of explanations for these results.     

Comparison of Teenagers' Early Same-Sex and Heterosexual Behavior: UK Data From the SHARE and RIPPLE Studies

PurposeNorth American research finds increased sexual risk-taking among teenagers with same-sex partners, but understanding of underlying processes is limited. The research carried out in the United Kingdom compares teenagers' early sexual experiences according to same- or opposite-sex partner, focusing on unwanted sex in addition to risk-taking, and exploring underlying psychosocial differences.MethodsMultivariate analyses combined self-reported data from two randomized control trials of school sex education programs (N = 10,250). Outcomes from sexually experienced teenagers (N = 3,766) were partner pressure to have first sex and subsequent regret, and sexual risk measures including pregnancy. Covariates included self-esteem, future expectations, substance use, and communication with mother.ResultsBy the time of follow-up (mean age, 16), same-sex genital contact (touching or oral or anal) was reported by 2.3% of teenagers, with the majority also reporting heterosexual intercourse. A total of 39% reported heterosexual intercourse and no same-sex genital contact. Boys were more likely to report partner pressure (Odds ratio [OR] = 2.56, 95% confidence intervals [CI] = 1.29–5.08) and regret (OR = 2.32; 95% CI = 1.39–3.86) in relation to first same-sex genital contact than first heterosexual intercourse, but girls showed no differences according to partner type. Teenagers with bisexual behavior reported greater pregnancy or partner pregnancy risk than teenagers with exclusively opposite-sex partners (girls, OR = 4.51, 95% CI = 2.35–8.64; boys, OR = 4.43, 95% CI = 2.41–8.14), partially reduced by attitudinal and behavioral differences.ConclusionsThis UK study confirms greater reporting of sexual risk-taking among teenagers with same-sex partners, and suggests that boys in this group are vulnerable to unwanted sex. It suggests limitations to the interpretation of differences, in terms of psychosocial risk factors common to all adolescents.     

Coming-Out Across the Life Course: Implications of Age and Historical Context

Effects of age and the calendar year when individuals first self-identified as gay, lesbian, or bisexual on their sexual orientation identity development were examined in a large community sample (N=767, 47% female, 18-74-years-old). These 2 variables were used to examine the timing and sequencing of 7 coming-out experiences: first awareness of same-sex attraction; first sexual experiences with opposite-sex partners; first sexual experiences with same-sex partners; self-identification as gay, lesbian, or bisexual; disclosure to someone other than a parent; disclosure to mother; and disclosure to father. The significant effects of age revealed that self-identification in adolescence as opposed to adulthood was associated with an overall young coming-out trajectory for all milestone experiences, which occurred in both earlier and recent historical contexts. Adolescents as opposed to adult self-identifiers were also more likely to demonstrate identity-centered sequences in which self-identification preceded same-sex sexual experiences, and fewer of these individuals had any heterosexual experience. Significant historical context effects indicated recent trends toward younger disclosure of orientation to others and to parents, greater likelihood of an identity-centered sequence, and younger ages for first heterosexual but not same-sex, sexual experiences. Among women, there was a recent trend toward greater likelihood of having a bisexual identity milestone. In general, the maturational effects were independent of historical context, with the exception that only adolescent self-identifiers who came out recently disclosed to others and to parents at an average age younger than 18 years. These developmental and historical trends expand on the stage-sequential framework to show how the process of sexual orientation identity development is driven by maturational factors as well as social changes.     

Patterns of sexuality in a high-risk sample: Results from a survey of new intakes at a county jail

Described the sexual habits and behaviors in a sample of individuals thought to be at high risk for infection with the AIDS virus. The sample is drawn from new arrestees at a county jail in the San Francisco Bay Area. Results indicate that the individuals in this sample are very sexually active: The majority began their sexual activities at a young age; most are currently in a primary relationship; and a large proportion report having had two or more sexual partners in the last 12 months. Furthermore, for the most part, the patterns of sexual behavior reported by respondents did not differ on the basis of gender. Although it was true that men tended to initiate intercourse at an earlier age than women, men and women did not differ with respect to the numbers of sexual partners reported in the last year, frequency of vaginal intercourse, frequency of anal intercourse, or in the distribution of sexual risk-taking. Overall, women in this sample are very much like men in terms of their sexual behavior.Supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (R01 AA08564) to the Medical Research Institute of San Francisco.     

When do online sexual fantasies become reality? The contribution of erotic chatting via the Internet to sexual risk-taking in gay and other men who have sex with men

Seeking sexual partners online is associated with sexual risk-taking among men who have sex with men (MSM), but it is not well understood how this use of the Internet is implicated in potential sexual risks. The present study explores whether fantasizing about unprotected anal intercourse (UAI) during online chatting is associated with UAI with partners met online. An online survey of 2058 MSM in France included assessments of UAI with partners met online, responses to erotic chatting about UAI, intentions to use condoms, attitudes regarding UAI, practicing UAI with casual partners, alcohol and drug use with sex and biographical characteristics. While intentions to use condoms with casual partners were high, one-third (32.1%) of respondents reported UAI with partners met online. Responding positively to online chatting about UAI was significantly associated with UAI with partners met online, controlling for intentions, attitudes, behavior and biographic characteristics. These findings suggest that, while MSM may not go online to seek UAI, some engage in online fantasizing about UAI that is associated with possible sexual risk-taking. This speaks critically to the assumption that online fantasizing has no behavioral implications, and underscores the importance of human immunodeficiency virus prevention that addresses the dynamics of online chatting.     

Sexual Risk Behavior of HIV-Positive Methamphetamine-Using Men Who Have Sex with Men: The Role of Partner Serostatus and Partner Type

This study examined the role of partner serostatus and partner type in relation to the sexual risk behaviors and disclosure practices of HIV-positive methamphetamine (meth)-using men who have sex with men (MSM). The sample consisted of 132 HIV-positive meth-using MSM who reported having both serodiscordant (i.e., HIV-negative and unknown serostatus) and seroconcordant (i.e., HIV-positive) partners. HIV-positive meth-using MSM engaged in significantly fewer acts of anal sex with serodiscordant partners as compared to seroconcordant partners. However, mean levels of unprotected anal and oral sex were high, and mean levels of protected sex were low for both seroconcordant and serodiscordant partners. Oral sex was practiced twice as often as anal sex; however, both types of sex were primarily unprotected. This pattern of risky sexual behavior was reported for steady, casual, and anonymous partners, regardless of partner serostatus. Despite high rates of unprotected sex, rates of HIV serostatus disclosure were consistently high for HIV-positive and HIV-negative steady, casual, and anonymous partners. However, rates of disclosure to unknown serostatus partners were low, particularly in relation to anonymous partners. Future research should address the reasons why HIV-positive meth-using MSM engage in risky sexual activity with serodiscordant partners, and HIV prevention programs for this population should emphasize the risks associated with unprotected sex with seroconcordant partners.     

Sexual behavior and HIV risk among age-discrepant,same-sex male couples

Research has suggested that men who have sex with men and who have older sexual partners are at increased risk of HIV infection. However, while several studies have explored risk among men in age-discrepant non-primary partnerships, only two have explored age discrepancy and risk in primary same-sex male relationships. We used data from semi-structured in-depth interviews to explore sexual behaviour and HIV risk among 14 Black, white and interracial (Black/white) same-sex male couples with an age difference of 10 or more years. Most couples regularly used condoms, and sexual positioning tended to lead to lower risk for younger partners. Some serodiscordant couples abstained from anal sex, while others used seropositioning to avoid transmission within the relationship. Within some couples, older partners acted as mentors on HIV prevention and broader life lessons. Future studies should further explore the potential risks and benefits of large age differences in same-sex male primary relationships.     

Sexual Attitudes and Number of Partners in Young British Men

The relationship between sexual attitudes and number of heterosexual partners in a survey-based and nationally representative random sample of 551 British men aged 16–25 years was examined. The main predictor of the number of partners in the last 5 years was the time since the first sexual intercourse, whereas age, marital status, education, social class, smoking, and alcohol consumption contributed on a smaller but significant level. Sexual attitudes were summarized in terms of three underlying dimensions which could be described as permissiveness, attitudes toward sexual relations of same-sex partners, and importance of orgasm for sex. None of these was a significant predictor of the number of partners in the last 5 years. Both permissiveness and number of partners were associated with the age of first sexual intercourse and other background variables indicating opportunities for social contact. In conclusion, common factors of sexual attitudes and the number of sexual partners are not directly related but rather jointly predicted by a very similar set of background variables such as age, time since first sexual intercourse, social class, smoking, and alcohol consumption. Given the absence of a significant relationship between sexual attitudes and number of young men's partners, promoting safer sex may be a more sensible strategy than trying to change these attitudes.     

Sex Differences in Sexual Psychology Produce Sex-Similar Preferences for a Short-Term Mate

We explored aspects of men's and women's short-term sexual psychology as a function of a potential short-term partner's relationship status. A total of 209 men and 288 women reported how likely they would be to pursue a casual sexual relationship with an attractive member of the opposite sex who was (1) married, (2) not married but has casual sexual partners, or (3) not married and has no casual sexual partners. Guided by sperm competition theory, we predicted and found that men prefer short-term sex partners who are not already involved in relationships and hence present a relatively low risk of sperm competition. Because women sometimes use short-term sexual relationships to acquire long-term partners, we predicted and found that women prefer short-term sexual partners who are not already involved in relationships and hence present relatively greater promise as a potential long-term partner. Finally, across each of the three levels of the imagined partner's relationship status, men reported a greater likelihood than did women of pursuing a casual sexual relationship. Discussion addressed methodological limitations and directions for future work.     

The Characteristics and Risk Factors of Web-Based Sexual Behaviors Among Men Who Have Sex With Men in Eastern China: Cross-sectional Study

BackgroundFinding casual sex partners on the internet has been considered a huge challenge for HIV transmission among men who have sex with men (MSM) in China.ObjectiveThis study aimed to identify the characteristics and risk factors of finding causal sex partners on the internet among MSM in Zhejiang Province, China.MethodsThis was a cross-sectional study. Participants were enrolled by 4 community-based organizations (CBOs) and 10 Voluntary Counselling and Testing (VCT) clinics through advertisements in bathrooms, bars, and gay hook-up apps from June to December 2018. A CBO- or physician-assisted survey was conducted to collected information on finding casual sex partners, perceived HIV infection, and HIV risk behaviors.ResultsAmong 767 participants, 310 (40.4%) reported finding causal sex partners on the internet. Factors associated with finding casual sex partners on the internet included watching pornographic videos on the internet more than once a week (adjusted odds ratio [aOR]=1.881, 95% CI 1.201-2.948), discussing “hooking-up online” with friends (aOR=4.018, 95% CI 2.910-5.548), and perceiving that the likelihood of HIV infection among casual sex partners sought on the internet was “medium” (aOR=2.034, 95% CI 1.441-2.873) or “low” (aOR=2.548, 95% CI 1.524-4.259). Among the participants who reported finding casual sex partners on the internet, 30.2% (91/310) reported having unprotected sex with casual sex partners encountered on the internet in the past 6 months. On multivariate logistic regression analyses, knowing the HIV infection status of casual sex partners sought on the internet was significantly associated with performing inserted intercourse (aOR=1.907, 95% CI 1.100-3.306) and a decreased risk of inconsistent condom use (aOR=0.327, 95% CI 0.167-0.642).ConclusionsWeb-based casual sexual behavior is becoming more prevalent, and the rate of unprotected sex among MSM in Zhejiang Province is high. Future HIV prevention approaches should emphasize the importance for MSM to proactively determine the HIV infection status of potential casual sex partners sought on the internet.     

Predictors of Unprotected Sexual Contacts in HIV-Infected Persons in Switzerland

Predictors of sexual risk behavior with regular and casual partners among HIV-infected heterosexual and gay persons were addressed. Sociodemographic data as well as self- and interviewer-reported data on sexual behavior were obtained from 117 asymptomatic HIV-infected persons enrolled in the Zurich part of the Swiss HIV Cohort Study (SHCS). Participants who reported sexual intercourse at least once (vaginal and/or anal) without condom use in the 6 months prior to interview were considered to have risk behavior. Sexual risk behavior was analyzed separately in contacts with regular and casual partners. In the 6-month preinterview period, 92% (108 of 117) of the HIV-infected study population reported sexual contacts, and 30/117 (26%) had at least one unprotected vaginal and/or anal contact. Among 93 persons using condoms, 25% of the heterosexual and 10% of the homosexual participants reported breakage of the condom. The main predictor for unprotected sexual behavior with regular partners was an elevated number of contacts. Predictors for sexual risk behavior with casual partners were the combination of alcohol and sexual encounters and the change of sexual behavior since the epidemic of AIDS. These findings did not differ between persons with hetero- and homosexual behavior. Considering that these contacts may have passed the virus on to the seronegative population, that the probability of unsafe sex increased with the growing number of contacts, and that the number of condom breakages was remarkable, it is imperative that this group be educated and motivated to take the active role in insisting on safer sex practices in each encounter.