To estimate the number of men who have sex with men and women who are HIV-positive in the United States, and to compare HIV prevalence rates between men who have sex with men and women, men who have sex with men only, and men who have sex with women exclusively.
We conducted event rate, effect size, moderation and sensitivity analyses. We estimate that 1. Men who have sex with men and women are less than half as likely to be HIV-positive as men who have sex with men only They are less likely to engage in unprotected receptive anal intercourse than men who have sex with men only This represents the first meta-analysis of HIV prevalence in the U.
This is an open-access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Since the beginning of the epidemic, HIV transmission researchers have suggested that men who have sex with men and women MSMW are integral viral bridges, responsible for the spread of HIV and other sexually transmitted infections STI from a discrete population — men who have sex with men MSM — to the general population of heterosexuals [1] — [4].
Nationally representative population-based surveys have consistently estimated that past-year MSMW comprise 0. The composition of MSMW in these surveys is somewhat less than the proportion of men who have sex with men only MSMO , albeit variable according to length of recall window of bisexual behavior: looking through five-year windows, estimated proportions of these two distinct groups of MSM roughly equalize [14] , [15]. Researchers have recently estimated that past-year MSM comprise 2.
Few studies have attempted to model the number and proportion of HIV acquisitions and transmissions attributable to MSMW via sex with male and female partners. To calculate these estimates, we elected to conduct a systematic review and comprehensive meta-analysis. Fourth, what is the proportion of MSM engaged in bisexual behavior in studies that have assessed HIV prevalence among males, and what factors moderate this? This review estimates comparative rates of HIV infection among males in the United States by gender status of sexual partners and, coincidentally, rates of bisexual behavior and HIV risk behavior among males in the United States recruited into research assessing HIV prevalence.
