Understanding and reducing HIV risk behavior and substance use among self-identified bisexual adolescent men

  • Feinstein, Brian (PD/PI)

Project: Research project

Project Details


Young gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by HIV. Despite this burden, existing HIV prevention interventions target adult MSM (most of whom identify as gay) and heterosexual youth, creating an urgent need for interventions for gay and bisexual adolescents. Further, self-identified bisexual men, especially adolescents, have been neglected in research. This is a critical problem because: (1) there are as many, if not more, bisexual adolescent men than gay adolescent men; (2) bisexual adolescent men engage in several HIV risk behaviors more than gay adolescent men; and (3) bisexual adolescent men are at increased risk for substance use, which is a robust risk factor for HIV. Bisexual men also face unique HIV prevention issues (e.g., lack of testing, inadequate sexual health education). However, given that most research has focused on behaviorally bisexual adult men, little is known about factors that drive engagement in risk behavior among self-identified bisexual adolescent men. Attending to bisexual identity is critical to reducing HIV and substance use among adolescents, because bisexuality is highly stigmatized and stigma-related stressors (e.g., concerns about disclosing one’s bisexual identity) impact sexual behavior, substance use, and healthcare utilization. While there have been attempts to develop HIV prevention interventions for behaviorally bisexual adult men, they do not address challenges related to bisexual identity and sexual decision-making as an adolescent. Interventions are also more effective when tailored to populations, underscoring the need for a tailored intervention for self-identified bisexual adolescent men. Therefore, the goals of this study are to: (1) examine factors that drive engagement in HIV risk behavior and substance use among self-identified bisexual adolescent men; and (2) develop and pilot test an HIV and substance use prevention intervention for this population. In Phase 1, interviews will be conducted with 60 bisexual adolescent men (ages 14-17) to explore issues related to sexual identity, sexual decision-making, motivations for substance use, and intervention preferences. In Phase 2, an HIV and substance use prevention intervention will be developed for self-identified bisexual adolescent men using findings from Phase 1. In Phase 3, feasibility, acceptability, and preliminary efficacy will be tested in a pilot randomized trial (N = 60) with a waitlist control and a one-month follow-up. This award also provides the applicant with training in adolescent health, qualitative methods, and intervention development, all of which are necessary to launch his career as an independent investigator. In sum, self-identified bisexual adolescent men are at increased risk for HIV and substance use, but little is known about factors that drive their engagement in risk behavior and how to tailor interventions to their unique needs. By focusing on self-identified bisexual adolescent men–an underrepresented, health disparity population–this study can identify prevention targets and reduce disparities in HIV and substance use.
Effective start/end date3/1/188/31/20


  • National Institute on Drug Abuse (5K08DA045575-03)


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