Living a Dual Life: Multiplicity of Sexual Risks among Men Who Have Sex with Men "and" Women

Shrikant Singh, International Institute for Population Sciences (IIPS)

Bisexuality driven risks engender spectrum of vulnerabilities for both genders, yet, remains poorly understood and inconsistently measured. We aim to map this overlapping HIV risk from hetero-homosexual partnership of MSM-SW. Study employs qualitative data along with quantitative filed insights from size estimation of MSM in Bhutan during 2012. Sexual overlap is rampant as three-fourths of MSM confirmed being MSM-SW in last 6 months. Further overlap emerged as three-fifths MSM-SW reporting unprotected homosexual partnership (70 percent) also reported so with heterosexual partner. MSM-SW reporting multiple female partners in last 6 months reported considerably lower prevalence of consistent condom use in all partnerships, which is making them 8.8 times more likely to suffer with STI. Difficult terrain, lack of structural networks and societal stigma were identified as major barriers; whereas, client sensitive services, partner counseling for positive prevention and building-up formal network was identified as thrust areas for effective implementation of programmes.