A rejoinder to the comments of Hartman & fithian and pomeroy & brown on the female sexological examination

The spread of the international AIDS pandemic has drawn attention to the urgent need for data on human sexual behavior; yet the absence of an established tradition of theory and method in sex research has limited the development of initiatives in this area. This has been particularly evident in the lack of attention given to the ways in which cross‐cultural differences structure the meaning of sexual experience. While survey research can play an important role in documenting sexual behavior, qualitative research on sexual culture is equally important in order to develop a framework for the comparative analysis of behavioral data. This article seeks to contribute to the development of theory and method in sex research by outlining key research issues and possible methodologies for the qualitative investigation of sexual culture in relation to HIV/AIDS.     

Sexual behavior and AIDS knowledge of young male prostitutes in Manhattan

Despite their presumed high risk for AIDS, there are almost no sexual behavior data available which are sufficient for the development and assessment of intervention programs for male prostitutes. This study was designed to obtain such data. Fifty 14–27‐year‐old male prostitutes in Manhattan were interviewed using structured instruments to assess sexual orientation, sexual behavior, knowledge of AIDS, and substance abuse. The sample was 50% homosexual, 26% bisexual, and 24% heterosexual. High rates of condom use were found for anal intercourse (average 85%). Subjects were safest in sex with male customers, less safe with male partners for pleasure, and least safe with female partners. Differential use of condoms plus other unsafe sexual activities continue to place the male prostitute at risk for HIV infection. AIDS knowledge was high and positively correlated with safety of sex. Drug and alcohol abuse and dependence were frequent, although there was little intravenous drug use. These and other variables were not significantly associated with degree of safety in sex. The methods employed in this study can be used to assess other populations of male prostitutes as well as intervention programs.     

Mexican and Mexican American male sexual behavior & spread of AIDS in California∗

Data generated by the authors' field research on the bisexual and homosexual behaviors of men of Mexican origin living in southern California are presented and compared with the same behaviors of Anglo men in California and Mexican men in Mexico. Preferences for playing either the anal receptive or insertive sexual role and a focus on anal intercourse by unacculturated and less acculturated men of Mexican origin who have sex with men are the sexual behaviors judged to be most significantly different from Anglo men who have sex with men in California. Sexual socialization and acculturation were found to be the most important determinants of whether an individual's adult patterns of homosexual behavior will be more or less influenced by Mexican or Anglo homosexuality in spite of the length of time they may have lived in California. Evidence is presented about the effects that acculturation, preference for a sexual role in anal intercourse, and endogamy have on the spread of the AIDS virus in the Mexican origin population in California.     

Puerto rican drug users’ experiences of physical and sexual abuse: Comparisons based on sexual identities

This study integrates the results of quantitative and qualitative methods to elucidate the association between sexual identity and physical and sexual abuse among Puerto Rican drug users. A structured questionnaire was administered to 800 subjects in New York and 399 in Puerto Rico. A total of 93 subjects (7.9%) self‐identified as homosexual or bisexual. Gay males were significantly more likely than heterosexual males to report first occurrence of physical abuse by a family member in childhood. Both gay and bisexual males were more likely than their heterosexual counterparts to report first experiencing unwanted sex in childhood and intimate partner physical abuse later in life. Lesbians were more likely than female heterosexuals to report unwanted sex in childhood. Qualitative data were collected through in‐depth life histories with 21 subjects and suggest that gay and lesbian subjects perceive antihomosexual prejudice on the part of family members as one cause of childhood physical and sexual abuse.     

Prevalence of same‐gender sexual behavior and HIV in a probability household survey in Mexican men

The prevalence of male same‐gender sexual behavior in Mexico City in relation to HIV transmission was studied. A household probability survey of 8,068 adult men was conducted in 1992–93 using the Mexican National Health Survey sampling frame. The response rate was 59%. Differences between respondents and nonrespondents indicated no evidence for significant bias. A random subsample of 1,116 individuals provided serum or saliva for HIV testing. An estimated 2.5% of men practiced same‐gender sex in their lifetime: 2.1% (95% CI: 1.7 ‐ 2.4%) reported bisexual behavior and 0.4% (95% CI: 0.3 ‐ 0.6%) reported exclusively homosexual behavior. Among bisexuals, 70% reported sex only with women in the previous year, 7% reported sex only with men, 13% reported sex with both, and 10% were sexually inactive. A condom was used by 46% in their last homosexual encounter. An estimated 0.1% of married men were homosexually active in the previous year. The HTV prevalence estimate was 0.2% in the sample. The rate was 4% among homosexual/bisexual men and 0.09% in heterosexual men (p < 0.0001). Estimates of homosexual behavior and HTV infection from this population‐based sample are lower than results from nonprobability studies. The low prevalence of condom use anticipates future growth of the epidemic in the homosexual population. Bisexual behavior appeared to be infrequent and transitory, particularly among married men.     

Differences between sexual orientation behavior groups and social background,quality of life,and health behaviors

Within the literature, there is some question as to whether bisexual or homosexual persons practice more unhealthy lifestyles and experience a lower quality of life than heterosexual individuals. This study examined possible differences between sexual orientation behavior groups (homosexual, bisexual, heterosexual, and no sex partners) on demographic and social background variables, quality of life variables, lifestyle and health variables, and mental health or health background variables in a series of seven national probability samples between the years 1988 and 1996. Respondents were asked to report the sex of their sexual partners since they were age 18 and in the last 12 months. Data from a total of 11,543 interviews were collected by the National Opinion Research Center. Although there were some demographic and social background differences among the sexual orientation behavior (SORB) groups, there was little evidence that the behavioral dimension of sexual orientation is either strongly or directly related to quality of life, lifestyle, or health indicators. The report closes with a consideration of future research questions for this issue.     

Puerto Rican drug users experiences of physical and sexual abuse: comparisons based on sexual identities

This study integrates the results of quantitative and qualitative methods to elucidate the association between sexual identity and physical and sexual abuse among Puerto Rican drug users. A structured questionnaire was administered to 800 subjects in New York and 399 in Puerto Rico. A total of 93 subjects (7.9%) self-identified as homosexual or bisexual. Gay males were significantly more likely than heterosexual males to report first occurrence of physical abuse by a family member in childhood. Both gay and bisexual males were more likely than their heterosexual counterparts to report first experiencing unwanted sex in childhood and intimate partner physical abuse later in life. Lesbians were more likely than female heterosexuals to report unwanted sex in childhood. Qualitative data were collected through in-depth life histories with 21 subjects and suggest that gay and lesbian subjects perceive antihomosexual prejudice on the part of family members as one cause of childhood physical and sexual abuse.     

Fraternal Birth Order,Handedness, and Sexual Orientation in a Chinese Population

We examined the relationship between handedness, fraternal birth order, and sexual orientation in a Chinese population, and analyzed the influence of the components assessing sexual orientation and criteria classifying individuals as homosexual on this relationship. A large sample of heterosexual, bisexual, and homosexual men and women participated in a web-based survey. Our results showed that homosexual women are more likely to be non-right-handed than heterosexual women, regardless of how sexual orientation was defined, whereas bisexual women are more likely to be non-right-handed than heterosexual women when sexual orientation was assessed via sexual attraction and sexual identity. Bisexual men are more likely to be non-right-handed than heterosexual men when sexual orientation was assessed via sexual attraction. We found neither a fraternal birth-order effect nor an interaction between sibling sex ratio, handedness, and sexual orientation. The small number of siblings may be the reason why we could not replicate the fraternal birth-order effect in this Chinese population, which highlights the importance of cultural differences in the understanding of handedness, fraternal birth order, and sexual orientation.     

Vietnamese American sexual behaviors & HIV infection

This brief report presents some preliminary findings of an on‐going ethnosexual field study of Vietnamese American sexual behaviors in Orange County, California, and indicates how they may be related to HIV infection. The primary objective of the study is to gather data on those sexual behaviors having the highest likelihood of transmitting the AIDS virus. The field research data indicate that in the ‘Vietnamese American population, highly acculturated Vietnamese homosexual men, whose partner preference is primarily for Anglo men with whom they play both sexual roles in anal intercourse, appear at present to be at highest risk for HIV infection. Transmission of the AIDS virus within the Vietnamese American population may be facilitated by Vietnamese American men who practice unsafe sex with both Anglo and Vietnamese men. The field research data also indicate that a potential exists for the spread of HIV into the heterosexual population through the sexual activity of Vietnamese men with non‐Vietnamese female prostitutes in California and Mexico, and through the sexual activity of ‘Vietnamese men with Thai and Vietnamese prostitutes in Thailand and Vietnam while on return visits to Southeast Asia.     

Bisexual and homosexual behavior and HIV risk among Chinese‐, Filipino‐, and Korean‐American men

Seventy bisexually or homosexually active men primarily of Chinese‐, Filipino‐, and Korean‐American backgrounds participated in extensive interviews focusing on acculturation and sexuality. Impressionistic data showed higher involvement in gay culture than Asian culture, a shift away from the complexity of bisexual lifestyles, and two patterns of exogenous selection of male partners. The findings suggest that Asian‐American men who had sex with men were more likely than comparison groups to comply with safer sex; acculturation to Asian society enhanced this compliance, but identification with Western Protestantism, or traditional Latin homosexual roles, was related to higher risk behavior. The reported behavior of the men who had sex with both men and women did not substantiate fears that bisexuals were a conduit for transmitting the virus from the gay to the heterosexual community. Impressionistic data suggested that a combination of inaccurate information about HIV transmission, unfounded trust of partners, poor assertiveness skills, and guilt may result in sexual risk taking. Suggestions for prevention included providing explicit information in ethnic and mainstream media, emphasizing risks of heterosexual transmission, providing electronic interactive learning situations that allow privacy rather than face‐to‐face interaction, and organizing support groups that affirm the men's dual identity as Asian‐American and gay or bisexual.     

Latino Sexual Styles: Developing a Nuanced Understanding of Risk

The commencement of bisexual behavior and the ontogenesis of a bisexual orientation was studied in order to aid in the better understanding of how sexual behavior patterns begin and change. The investigation was conducted through in‐depth interviews held in California, Oregon, and Washington with the first 50 female volunteers gathered from a variety of sources who met the study requirements. Those requirements were that each subject, at the time of her first sexual contact with another female, (a) was married; (b) was at least 30 years of age; (c) was engaged in swinging; (d) was enjoying sex with males; and (e) had no history, prior to age 30, of a sexual attraction to females. “Multi‐female” and “multi‐male” sexual activity are terms introduced to remove the ambiguity and mislabeling which results from defining sexual activity between all persons of the same sex as necessarily homosexual. Subjects typically revealed a high incidence of early and continuing autosexual and heterosexual activity and current high frequencies of sexual activity with each sex. Influences facilitating a typical subject's initial and subsequent sexual activity with females were found to be her husband, other swingers, and the general swinging environment—the husband's influence usually being of paramount importance. It was concluded that those influences, perhaps together with a predisposition toward gaining perceived fulfillment of felt needs through sexual activity, will result in some heterosexual females engaging in multi‐female sexual activity and eventually adopting a self‐identified bisexual orientation.     

Minority Stress Theory: An Examination of Factors Surrounding Sexual Risk Behavior Among Gay and Bisexual Men Who Use Club Drugs

Background: Few studies have examined the impact of minority stress theory (MST) upon sexual risk behavior among gay and bisexual men using club drugs. Similar studies have focused on ethnic minorities and women; however, gay and bisexual men demonstrate greater likelihood for risk behaviors leading to HIV/AIDS. Objective: This study examines sexual risk behavior from the perspective of minority stress theory upon substance-using gay and bisexual men and their partners. Methods: Multivariable logistic regression analysis examined minority stress associations with participant sexual risk behaviors, drug use, and partner type, controlling for demographics. Results: 396 gay and 54 bisexual respondents, ages 18–67, reported at least one-time drug use while engaging in sexual risk behavior. In the adjusted model, expectations of rejection associated with lower odds of sexual risk behavior, while older age approached significance. Conclusions: Theoretical origins for examining risk behavior among gay and bisexual men may underscore risk and protective factors, while ultimately holding implications for prevention and treatment interventions.     

The assessment of sexual practices relevant to the transmission of AIDS: A global perspective

Despite global similarities between the immunologic and pathogenic properties of HIV infection, there are substantial cultural and geographical variations in the transmission dynamics of HIV infection/AIDS. In the United States and Europe, for example, HIV infection/AIDS is predominantly evident among homosexual men and intravenous drug abusers. However, in Central Africa, the data indicate that HIV infections/AIDS is heterosexually acquired. Thus, the purpose of the present paper is to suggest some basic strategies and raise some critical issues for collecting data on sexual practices relevant to the transmission of HIV infection/AIDS throughout the world. Topics include assessment strategies, language and meta‐language, cross‐cultural and intra‐cultural comparability, general methodological issues, and constraints for the assessment of anal intercourse.     

Contributions of Qualitative Research in Informing HIV/AIDS Interventions Targeting Black MSM in the United States

This article presents a systematic review of qualitative studies focusing on human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) among Black men who have sex with men (BMSM) in the United States. We reviewed studies that were published between 1980 and 2014. Qualitative methods employed in the studies reviewed include in-depth interviews, focus groups, participant observation, and ethnography. We searched several databases (PubMed, PsychINFO, JSTOR, ERIC, Sociological Abstracts, and Google Scholar) for relevant articles using the following broad terms: “Black men” “Black gay/bisexual” or “Black men who have sex with men,” and “qualitative” and/or “ethnography.” We include 70 studies in this review. The key themes observed across studies were (1) heterogeneity, (2) layered stigma and intersectionality, (3) risk behaviors, (4) mental health, (5) resilience, and (6) community engagement. The review suggests that sexual behavior and HIV-status disclosure, sexual risk taking, substance use, and psychological well-being were contextually situated. Interventions occurring at multiple levels and within multiple contexts are needed to reduce stigma within the Black community. Similarly, structural interventions targeting religious groups, schools, and health care systems are needed to improve the health outcomes among BMSM. Community engagement and using community-based participatory research methods may facilitate the development and implementation of culturally appropriate HIV/AIDS interventions targeting BMSM.     

CULTURAL RELATIVISM AND THE STUDY OF DEVIANCE

In this work I argue that the study of deviance as distinct from crime is no longer a productive specialty in sociology. I attribute the cause of the demise of the field to its over reliance on the assumption of cultural relativity. In contrast to the relativist position, I argue that behavior that causes harm will be more likely to be condemned by public opinion and that there will be less variation in attitudes toward behaviors that cause more harm. Using data from the General Social Survey, I find support for the hypothesis that a “deviant” sexual behavior that can have a victim, extramarital sex, will be more consensually condemned than “deviant” sexual behaviors that do not have victims, premarital sex and homosexual sex. I recommend that future research focus on the study of values, as the validity of cultural relativity can be empirically evaluated.     

Getting “Bi” in the Family: Bisexual People's Disclosure Experiences

There are many similarities in gay, lesbian, and bisexual individuals' coming out experiences, but bisexual people face unique challenges. Despite this, an explicit focus on bisexual people is missing from family research. Using family systems and cultural sociological perspectives, the authors analyzed how social and cultural factors shape disclosure processes for bisexuals as they come out to multiple family members. After analyzing qualitative data from a diverse group of 45 individuals, they found that bisexual people navigate monosexist and heterosexist expectations in their family relationships. Cultural constructions of bisexuality shape the ways that bisexual people disclose their identities, including how they use language to influence family members' responses in desirable ways. Relationship status also influences bisexual people's disclosure strategies, as a romantic partner's gender is meaningful to family members' understandings of their sexual orientation. The findings highlight the importance of addressing cultural and social contexts in understanding sexual minority people's coming out processes.     

LG(BT) Families and Counting

Counting and understanding lesbian and gay families have gained attention over the last decade in popular culture, policy, and academic research. Contentious debates on family values and same‐sex marriage, increasing rates of social tolerance for homosexuality, and a greater general academic attention on issues of sexual orientation have partially spurred this attention in demographic analysis of lesbian and gay families. It is becoming increasingly clear that sexual orientation and gender identity have an effect on demographic processes and life outcomes. Although not perfect, practically speaking, drawing on nationally representative survey data has allowed us to illuminate the presence of same‐sex families and their children. These findings have an iterative relationship with social change, public policy, and increasing tolerance for diversity. This article reviews the recent demographic contributions related to lesbian, gay, bisexual, and transgender (LGBT) families. Due to research concentrations, the content of this article not only mostly addresses what is known about gay and lesbian families but also offers future directions to fill research voids including a call for greater attention to and visibility for families with bisexual and transgender members.     

Sexual diversity in urban Norwegians

The purpose of this study is to describe homosexual and heterosexual experiences in terms of sexual fantasies, sexual attraction, sexual conduct, and falling in love in an urban Norwegian population. In 1997, a random sample of 5,000 persons (18-49 years) was drawn from the population register in Oslo to participate in a sexual behavior survey. Data collection was carried out by means of postal questionnaires and 45% responded. The results indicated that exclusive homosexuality was rare in the population. One exception was the prevalence of homosexual fantasies in women. Compared to respondents who had had exclusively heterosexual contact, respondents reporting bisexual contacts had a significantly higher number of lifetime sex partners, higher frequency of anal and oral sex and masturbation, and lower age at orgasm and masturbation debut. What significantly separated the groups of exclusive heterosexuals, bisexuals, and exclusive homosexuals were attitudes towards various expressions of sexuality and number of lifetime sex partners.     

Sexual diversity in Urban Norwegians

The purpose of this study is to describe homosexual and heterosexual experiences in terms of sexual fantasies, sexual attraction, sexual conduct, and falling in love in an urban Norwegian population. In 1997, a randam sample of 5,000 persons (18–49 years) was drawn from the population register in Oslo to participate in a sexual behavior survey. Data collection was carried out by means of postal questionnaires and 45% responded. The results indicated that exclusive homosexuality was rare in the population. One exception was the prevalence of homosexual fantasies in women. Compared to respondents who had had exclusively heterosexual contact, respondents reporting bisexual contacts had a significantly higher number of lifetime sex partners, higher frequency of anal and oral sex and masturbation, and lower age at orgasm and masturbation debut. What significantly separated the groups of exclusive heterosexuals, bisexuals, and exclusive homosexuals were attitudes towards various expressions of sexuality and number of lifetime sex partners.