The relationship between self-reported sexual orientation and behavior in a sample of middle-aged male injection drug users

Thomas Alex Washington, Noya Galai, Sylvia Cohn, David D. Celentano, David Vlahov, Steffanie A. Strathdee

Research output: Contribution to journalArticlepeer-review


Data are sparse on injection drug using (IDU) men who have sex with men (MSM). Previous literature suggests perceived taboos can result in an underreporting of atypical sexual orientation (i.e., bisexuality, homosexuality). As a result, HIV prevention programs have been difficult to mount, particularly programs for IDU-MSM. The association between self-reported sexual orientation and sexual behavior at semi-annual study visits was longitudinally assessed in a population of 1300 male IDUs in Baltimore during the period 1993 to 1998. Overall, a small minority (5%) of the male IDUs inconsistently reported their sexual orientation over time. Logistic regression analyses were performed, which yielded five significant predictors. These men tended to be older, to have been incarcerated, to have attended shooting galleries during follow-up, and were more than twice as likely to be HIV-seropositive (OR, 2.66; 95% CI, 1.62-4.36) compared with those who consistently reported their sexual orientation. Furthermore, men reporting inconsistent sexual orientation tended to engage in higher risk behaviors, suggesting that these men should be especially targeted for interventions.

Original languageEnglish
Pages (from-to)67-74
Number of pages8
JournalArchives of Sexual Behavior
Issue number1
StatePublished - Feb 2006
Externally publishedYes

Bibliographical note

Funding Information:
The authors would like to thank all the participants in the ALIVE study for their cooperation and involvement. Likewise, the authors would like to thank the ALIVE staff who have worked diligently over the many years. Dr. Washington would like to especially thank Drs. Celentano, Strathdee, and Vlahov for providing mentoring and training, and Dr. Galai and Ms. Cohn for their statistical support, throughout the writing of this paper. An earlier version of this article was presented at the 2004 International AIDS Conference in Bangkok, Thailand. Funding for the development of this study was provided by the National Institutes on Drug Abuse (Grant Numbers: DA04334 and DA12568).


  • Human immunodeficiency virus
  • Injection drug users
  • Sex behavior
  • Sexual orientation
  • Substance abuse

ASJC Scopus subject areas

  • General Psychology
  • Arts and Humanities (miscellaneous)


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