O15.3 Heterogeneity among American Men who have sex with men and women: National Survey of Family Growth (NSFG) 2011–2019

Background Nearly 6% of American men report having had sex with another male since puberty. However, as men age, their sexual repertoires likely change. Recent sexual behaviors may be more important with respect to risk for bacterial STDs. We investigated recent sexual behaviors and STD/HIV testing among US men who report having had sex with both men and women in their lifetime (MSMW). Methods MSMW aged 15–44 years who participated in the National Survey of Family Growth during 2011–2019 were included. MSMW were further classified based on gender of recent (past 12 months) sex partners: (1) both men and women, (2) only men and (3) only women. Weighted percentages and corresponding 95% confidence intervals (CI) of behaviors were estimated. Results Among all MSMW (n=801), 23% (95% CI: 20–27) reported recent sex with both men and women, 21% (95% CI: 17–24) with only men and 56% (95% CI: 51–61) with only women. Among MSMW who recently had sex with both men and women, half (52%, 95% CI: 41–62) identified as bisexual and almost half (46%, 95% CI: 36–56) had 4+ sex partners in the past year, higher than MSMW who recently had sex with only men (29%, 95% CI: 20–38) or only women (6%, 95% CI: 4–9). Compared to MSMW who recently had sex with both men and women, MSMW who recently had sex with men only were more likely to have had a recent HIV test (57%, 95% CI: 49–68 versus 30%, 95% CI: 21–39) and a recent STD test (55%, 95% CI: 46–64 versus 45%, 95% CI: 35–55). Conclusion MSMW are a heterogeneous group with respect to recent sexual behaviors and may have different sexual health needs. The collection of sexual history at clinical visits is critical to ensuring culturally competent sexual health care for this population.