Sigma Research

Survey shows unprotected sex is a common behaviour in bisexual men

BMJ, 1995, 311: 1163-1164 (28 October)

Authors: Peter Weatherburn, David S. Reid

Letter - full text

Editor, - The proportion of men who have sex with both men and women and the pattern of their sexual behaviour have long been recognized as of potential importance to the future pattern of spread of HIV infection and other sexually transmitted diseases 1. Until now most information has been based on studies of gay men 2 or small studies of (mainly) self-identified bisexuals 3. The British national study of sexual attitudes and lifestyles estimated that 0.8% of the male population had sex with both males and females in the five years before interview, it acknowledged that several factors made this a lower bound estimate 4. The members of this group who do not identify themselves as gay or bisexual have never been included in any numbers by a major European study of sexual behaviour.

In a recent national study commissioned by the Health Education Authority in Britain, we interviewed 745 men who reported having had sexual contact with both men and women in the previous five years. Participants had responded to an invitation to take part in anonymous telephone interviews which had been placed in the 'lonely hearts' or 'contact' sections of local and national newspapers and magazines. The sample came from 107 of 120 postal districts in Britain. The age range was 16-73 (mean = 33.3; (standard deviation = 8.7) years, with only 148 coming from social and occupational classes 1 and 2.

Preliminary analysis shows that 644 reported having had sexual contact with men and women in the year before the interview, (mean 3 male and 3 female partners). 699 reported vaginal intercourse with a female partner of whom 502 had not used a condom. 461 reported anal intercourse with male partners of whom 135 had not used a condom. 531 reported that they currently had a regular female partner but only 233 currently had a regular male partner. 174 had both female and male regular partners. Almost all the respondents' regular male partners (203) knew of their sexual activity with women but only a third (144) of their regular female partners knew of their homosexual activities. Considerable potential exists for the spread of sexually transmitted diseases within and by this population. With it’s high numbers of partners and appreciable rate of unprotected anal and vaginal intercourse. The extent to which HIV will spread within this population depends crucially on the patterns of sexual contact with existing core groups (especially gay men).


1. Winklestein W, Wiley JA, Padian N, Levy J. Potential for transmission of AIDS-associated retrovirus from bisexual men in San Francisco to their female sexual contacts. JAMA, 1986, 256:901.

2. Davies PM, Hickson FCI, Weatherburn P, Hunt AJ. Gay Men, Sex and AIDS. London, Falmer Press, 1993.

3. Boulton M, Hart G, Fitzpatrick R. The sexual behavior of bisexual men in relation to HIV transmission. AIDS Care, 1992; 4(2): 165-175.

4. Johnson AM, Wadsworth J, Wellings K, Field J. Sexual Attitudes and Lifestyles. London, Blackwell Scientific Press, 1994.

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