(:title The Variability of the Sexual Behaviors of Homosexuals and Bisexuals:)
(:description The sexual behavior of homosexuals and bisexuals is remarkably variable.:)
(:keywords homosexuals, MSM, variability of sexual behavior, promiscuity, prostitution, National AIDS Behavioral Surveys, bisexual, project SIGMA:)
The sexual behaviors of nonheterosexual individual tend to be highly variable, not just in terms of types of practices indulged in, but also in regard to variability with respect to sex with men or women and promiscuity.  
!!Female homosexuals and female bisexuals
Some homosexual women come in the form of man-hating feminists who would vomit at the idea of even touching a man, but interestingly, homosexual and bisexual women are also overrepresented among prostitutes and promiscuous women:

-<In a sample of 339 homosexual, 108 bisexual, and 51 self-identified heterosexual or unsure women who had had sex with women, sampled from public venues in San Francisco and Berkeley, California, during 1993, 1.2% were HIV-positive.[^G. F. Lemp  et al. , Am J Public Health 85 , 1549 (Nov, 1995).^] This compares with an average of 0.2% for childbearing women or 0.4% for women sampled through population-based household surveys. 10% reported injecting drugs since 1978, and 4% within the past 3 years. 25% had engaged in vaginal fisting. 15% reported participating in piercing, cutting, or whipping to the point of bleeding (S&M ) with female partners since 1978 and 6% with male partners. 405 women reported sex with men in the past 3 years, and 40% reported unprotected heterosexual sex. 39% reported unprotected vaginal sex and 11% reported unprotected anal sex. 10% reported unprotected sex with homosexual and bisexual men, and 6% with male injection drug users.

-<In 1998, out of 774 women in contact with the homosexual and bisexual communities in Sydney, Australia, two-thirds (503) labeled themselves as homosexual, 13% (100) as bisexual, and 17% (133) as heterosexual.[^J. Richters, S. Bergin, S. Lubowitz, G. Prestage, AIDS Care 14 , 193 (Apr, 2002).^] 212 (27%) women reported ever having sex with a homosexual or bisexual man and 51 (7%) had done so within the past six months. Recent sex with a homosexual/bisexual man was reported by 2% of the homosexual women, 8% of the heterosexual women, and 25% of the bisexual women. 25 women had recently had unprotected vaginal or anal intercourse with a homosexual/bisexual man and 48 (6%) women had prostituted themselves. 61 (8%) had injected drugs within the past six months, 23 had shared injecting equipment with someone, and 5 had shared needles with a homosexual/bisexual man. Hence, “For a case of so-called ‘heterosexual' transmission of HIV to occur, neither person need be heterosexual.”

-<Baker and Bellis compared 368 women with homosexual experience to 2,812 women without any homosexual experience.[^R. R. Baker, M. A. Bellis, in Human sperm competition: copulation, masturbation and infidelity.  (Chapman & Hall, London, New York, 1995) Box 5.13.^] The women with some homosexual experience were not different from the controls in their heterosexual copulation rates, likelihood of experiencing an orgasm during copulation, or rate of nocturnal orgasm. However, they were significantly more likely to: time their orgasm during sex in a way that maximized sperm retention, masturbate more often (86% vs. 17%), have a higher rate of non-copulatory orgasms (50-400% higher, depending on age), have more than one concurrent male sexual partner, and have sex with different men within a time frame of a few days.

-<Comparing 298 women with homosexual experience to 2,032 women without homosexual experience, Baker and Bellis noted that women with homosexual experience were significantly more likely to have genital tract irritation by age 20, abnormal cervical cells by age 25, and cervical cancer by age 30 years, likely a result of heterosexually transmitted human papilloma viruses.[^R. R. Baker, M. A. Bellis, in Human sperm competition: copulation, masturbation and infidelity.  (Chapman & Hall, London, New York, 1995) Box 5.15.^]

-<Rankow and Tessaro reported a greater risk of cervical cancer in homosexual and bisexual women compared to heterosexual women as a result of multiple past or current sexual partners (both male and female), early age at first coitus, history of sexually transmitted diseases, and cigarette smoking.[^E. J. Rankow, I. Tessaro, J Fam Pract 47 , 139 (Aug, 1998).^]

-<Bell et al reported that in a sample of white women, homosexual and heterosexual women had their first heterosexual encounter at a mean age of 9.7 years and 11.4 years, respectively.[^A. P. Bell, M. S. Weinberg, S. K. Hammersmith, in Sexual preference: its development in men and women.  (Indiana Univ Press, Bloomington, 1981) pp. 173-174.^] The first encounter of the homosexual women was also more likely to include genital contact or coitus, and their pre-adult heterosexual experiences (not necessarily the first contact) were likely to have been less enjoyable than those of heterosexual women. Likewise, van Wyk and Geist reported an elevated pre-pubertal heterosexual contact rate among homosexual women compared to heterosexual women.[^P. H. van Wyk, C. S. Geist, Arch Sex Behav 13 , 505 (1984).^]

-<Among 36,284 students surveyed in Minnesota, aged 12-19, 18,444 were girls. 13 of these girls identified as 100% homosexual and 169 as either mostly homosexual or bisexual, i.e., 182 had a homosexual component to their desires or behavior. 1,753 girls were unsure of their sexual orientation.[^E. M. Saewyc, L. H. Bearinger, R. W. Blum, M. D. Resnick, Fam Plann Perspect 31 , 127 (May-Jun, 1999).^] Saewyc et al compared the 182 homosexual or bisexual girls (HB) with 1,881 heterosexual girls (HT). Overall, 12.3% of HB had been pregnant ever compared to 5.3% of HT, and 5.9% of HB had recently engaged in prostitution compared to 0.7% of HT. Among sexually experienced respondents, 62.1% of HB had had their first sexual intercourse before age 14 vs. 45% of HT, 22% of HB girls had sex daily or greater than or equal to twice a week versus 14.8% of HT, and 9.7% of HB had recently engaged in prostitution versus 1.9% of HT. Among respondents that had ever been pregnant, 23.5% of HB had had two or more pregnancies versus 9.8% of HT, and 44.4% of HB had recently engaged in prostitution versus 5.5% of HT. In addition, 6.6% of HB versus 2.1% of HT reported 5-7 risky activities related to sexual activity whereas there was no difference between these groups for those who reported less than 3 risky activities. All the above differences are statistically significant except for the statistic concerning two or more pregnancies. Among the 13, 100% homosexual girls, 5 had experienced physical abuse, 5 had experienced unwanted touching or genital contact, 2 had recently indulged in prostitution, 9 had had sexual intercourse with males, 7 had had first sexual intercourse with males before age 14, 4 had frequent sexual intercourse with males, 6 had been pregnant ever, 3 had had more than one pregnancy, 3 had had miscarriages or infant death, and 10 reported more than one risk factors related to sexual behavior. The girls who were unsure about their orientation also reported higher pregnancy-related risk factors compared to heterosexual girls.

-<Fethers et al compared 1,432 homosexual and bisexual (HB) women that attended an STD clinic between March 1991 and December 1998 in Sydney, Australia to heterosexual women that attended the same STD clinic.[^K. Fethers, C. Marks, A. Mindel, C. S. Estcourt, Sex Transm Infect 76 , 345 (Oct, 2000).^] 93% of the HB women had had at least one heterosexual experience. Among HB women, 80% reported 5 or fewer female lifetime partners, while 8% reported more than 10 lifetime female partners. Among women reporting exclusive homosexual behavior in the previous year, 75% had had at least one heterosexual contact in lifetime, 4% had had sex with over 50 men, 16% had indulged in prostitution, and 22% had injected drugs. Table 1 shows further details.

(:html:)
<table width="650"  border="1" cellpadding="3" cellspacing="0" align="center">

  <tr>

    <td><strong>Table 1</strong>: Sexual history of a female sample</td>

    <td><strong>HB </strong> </td>

    <td><strong>Heterosexual </strong> </td>

  </tr>

  <tr>

    <td> Age range </td>

    <td> 14-56 </td>

    <td> 16-78 </td>

  </tr>

  <tr>

    <td> Median number of male sex partners </td>

    <td> 12 </td>

    <td>6</td>

  </tr>

  <tr>

    <td>&gt; 50 male partners in lifetime </td>

    <td> 9%*</td>

    <td> 2% </td>

  </tr>

  <tr>

    <td> Sex with homosexual/bisexual men </td>

    <td> 15% </td>

    <td> 5% </td>

  </tr>

  <tr>

    <td> Sex with injection-drug users </td>

    <td> 21% </td>

    <td> 6% </td>

  </tr>

  <tr>

    <td> Sex with heterosexual men with many partners </td>

    <td> 19% </td>

    <td> 17% </td>

  </tr>

  <tr>

    <td> Exclusive sex with women in past year </td>

    <td> 20% </td>

    <td> 0% </td>

  </tr>

  <tr>

    <td> Smoker </td>

    <td> 49% </td>

    <td>38%</td>

  </tr>

  <tr>

    <td> Ever injected drugs </td>

    <td>23%</td>

    <td>4%</td>

  </tr>

  <tr>

    <td> Indulged in prostitution </td>

    <td> 22% </td>

    <td>11%</td>

  </tr>

  <tr>

    <td> Drank excessive alcohol </td>

    <td>12%</td>

    <td>10%</td>

  </tr>

  <tr>

    <td> Abortions </td>

    <td>38%</td>

    <td>27%</td>

  </tr>

  <tr>

    <td> Bacterial vaginosis </td>

    <td> 8%**</td>

    <td> 5% </td>

  </tr>

  <tr>

    <td> Hepatitis C </td>

    <td>5%</td>

    <td>1%</td>

  </tr>

  <tr>

    <td> Hepatitis B </td>

    <td>5%</td>

    <td>3%</td>

  </tr>

  <tr>

    <td> Genital warts***</td>

    <td>8%</td>

    <td>11%</td>

  </tr>

  <tr>

    <td colspan="3"> Notes: HB = homosexual and bisexual women. * 4% for those who reported exclusive homosexual sex in past year, **10% for those who reported exclusive homosexual sex in past year, ***HB women were more apt to report a history of genital warts. </td>

  </tr>

</table>
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-<Women with a homosexual component to their attractions are not only overrepresented among prostitutes and non-prostitute polyandrous women, but also among adult-movie female actors and female strippers, as shown for example in a study of 35 female strippers, 9 (26%) of whom reported indulgence in homosexual behavior, and when the strippers were asked to estimate the prevalence of homosexual behavior among strippers, their estimates ranged from 15% to 100%, but most of them estimated it in the range 50-75%.[^C. H. McCaghy, J. K. Skipper, Jr., Soc Probl 17 , 262 (1969).^] A belief of elevated lesbianism among strippers has been reported among female prisoners, and frequent homosexual behavior has been reported among female prostitutes.[^D. A. Ward, G. G. Kassebaum, Women's prison: sex and social structure  (Aldine, Chicago, 1965).^]

-<It is also interesting to note that nonheterosexual women are more likely to have multiple sexual orientation identities than nonheterosexual men. In a sample of nonheterosexuals that were not lifetime-exclusive homosexuals (the ISBICIP sample; a sample of over 900 men and women in the International Study of Bisexual Identities, Communities, Ideologies, and Politics. The participants had experienced any degree of both same- and opposite-sex sexual or romantic contacts, sexual attraction, and/or bisexual identity at any point in their past), on average, women chose 2.7 identities, whereas men chose 2.4; 27% of women vs. 20% of men chose 4 or more identities; and 58% of women who identified as lesbian also identified as bisexuals, whereas 35% of men who identified as gay also identified as bisexuals.[^P. C. Rust, Annu Rev Sex Res 13 , 180 (2002).^] Among nonheterosexuals, women are more likely to report a sexual preference inconsistent with sexual behavior than men. For instance, in a probability sample of Australians, 4.2% of men and 8.2% of women reported sexual attraction that was inconsistent with sexual behavior.[^A. M. A. Smith, C. E. Rissel, J. Richters, A. E. Grulich, R. O. de Visser, Aust NZ J Public Health 27 , 138–45 (2003).^] In the ISBICIP sample, only 9.1% of those that answered “yes” to “are you a lesbian?” reported exclusive attraction to women and 27.7% reported current involvement with men. In this sample, when women were asked to pick one among several sexual orientation categories that described them, only 17.2% of those who picked lesbian reported exclusive attraction to women and 13.5% reported current involvement with men. Lastly, when these women were asked to pick one or more sexual orientation categories that described them, only 31.9% of those who picked lesbian only were exclusively attracted to women and 5.4% reported current involvement with men. Therefore, any way one looks at it, sexual preference inconsistent with sexual behavior characterizes several nonheterosexual women.
!!Male homosexuals and male bisexuals 
The study discussed below (Table 2) depicts male homosexuality in a better light than many others. However, one should note the high variability of sexual behavior in a sample of only 245 men. The selected sample is drawn from the beginnings of the First-World AIDS epidemic to reveal behavior more natural of male homosexuals.  Some other studies cited on this page that focus on male samples use datasets from the late 1980s to early 1990s, and these datasets underestimate the promiscuity of homosexual and bisexual men because by the mid 1980s AIDS had killed many of the more promiscuous homosexuals and the huge number of deaths made surviving homosexuals panic and voluntarily reduce their promiscuity.[^Ostrow DG. The role of drugs in the sexual lives of men who have sex with men: continuing barriers to researching this question. AIDS Behav 2000;4(2):205-19.^]

-<O'Brien et al reported a longitudinal cohort study of 245 homosexual men (21-65 years old with a median age of 33) from New York City (NYC) and Washington, D.C. (D.C.).[^T. R. O'Brien  et al. , J Infect Dis 180 , 1010 (Oct, 1999).^] AIDS-free men were selected in 1982 from the clientele of primary care physicians in NYC and D.C., and over 90% of them agreed to participate. The study was discontinued in 1990; 60 had died and another 37 were unavailable for follow-up. Let us consider their sexual behavior prior to the study. 238 men reported the number of their partners from 1980 to 1982. The number of partners varied from 1 to over 2,000 (median = 50, interquartile range: 20-140). Table 2 lists the major practices of the homosexuals and the accompanying rewards.

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<table width="650"  border="1" cellpadding="3" cellspacing="0" align="center">

  <tr>

    <td colspan="8"><strong>Table 2</strong>: Major Sexual Practices of 245 Male Homosexuals </td>

  </tr>

  <tr>

    <td colspan="8"> Number of male sex partners (1980-1982) reported by 238 men: 1 to over 2,000 (median = 50, interquartile range: 20-140) </td>

  </tr>

  <tr>

    <td rowspan="9"> Number of Subjects reporting various practices*</td>

    <td><strong># Episodes </strong> </td>

    <td> 0 </td>

    <td> 1-4 </td>

    <td>5-9</td>

    <td>10-19</td>

    <td>20-49</td>

    <td>50+</td>

  </tr>

  <tr>

    <td> Fellatio (R) </td>

    <td>17</td>

    <td>42</td>

    <td>43</td>

    <td>57</td>

    <td>47</td>

    <td>29</td>

  </tr>

  <tr>

    <td> Fellatio (I) </td>

    <td>15</td>

    <td>34</td>

    <td>40</td>

    <td>55</td>

    <td>56</td>

    <td>35</td>

  </tr>

  <tr>

    <td> Anal sex (R) </td>

    <td>28</td>

    <td>44</td>

    <td>33</td>

    <td>52</td>

    <td>37</td>

    <td>42</td>

  </tr>

  <tr>

    <td> Anal sex (I) </td>

    <td>28</td>

    <td>41</td>

    <td>38</td>

    <td>45</td>

    <td>47</td>

    <td>37</td>

  </tr>

  <tr>

    <td> Rimming (R) </td>

    <td>51</td>

    <td>55</td>

    <td>43</td>

    <td>46</td>

    <td>28</td>

    <td>13</td>

  </tr>

  <tr>

    <td> Rimming (I) </td>

    <td>83</td>

    <td>48</td>

    <td>43</td>

    <td>29</td>

    <td>21</td>

    <td>12</td>

  </tr>

  <tr>

    <td> Fisting (R) </td>

    <td>212</td>

    <td>14</td>

    <td>6</td>

    <td colspan="3">6</td>

  </tr>

  <tr>

    <td> Fisting (I) </td>

    <td>182</td>

    <td>29</td>

    <td>14</td>

    <td colspan="3">13</td>

  </tr>

  <tr>

    <td colspan="5" rowspan="2"> HIV prevalence in 1982 </td>

    <td>NYC</td>

    <td colspan="2">48.8%</td>

  </tr>

  <tr>

    <td>D.C.</td>

    <td colspan="2">34%</td>

  </tr>

  <tr>

    <td colspan="5" rowspan="2"><p>HHV-8 (Human herpes virus-8) prevalence in 1982 </p></td>

    <td>NYC</td>

    <td colspan="2">34.1%</td>

  </tr>

  <tr>

    <td>D.C.</td>

    <td colspan="2">13.1%</td>

  </tr>

  <tr>

    <td colspan="6"> STD diagnosis*,**</td>

    <td colspan="2">63.3%</td>

  </tr>

  <tr>

    <td colspan="6"> Hepatitis-B*</td>

    <td colspan="2"> 73.8% </td>

  </tr>

  <tr>

    <td colspan="6"> Amoebiasis*</td>

    <td colspan="2"> 7.5% </td>

  </tr>

  <tr>

    <td colspan="6"> Syphilis*</td>

    <td colspan="2"> 26% </td>

  </tr>

  <tr>

    <td colspan="8"> Notes: *for 12 months prior to enrollment in study; **gonorrhea , nongonococcal urethritis, syphilis, or herpes genitalis. R = receptive, I = insertive, NYC = New York City, D.C. = Washington, D.C.</td>

  </tr>

</table>

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-<In a study of 2,182 British MSM (Project SIGMA, 1987-1992), a third reported engaging in anal sex during the time period of a month, and among those who engaged in anal sex, whereas 60% engaged in anal sex once or twice a month, 10% were responsible for half the anal sex occurring in this group.[^A. P. Coxon, T. J. McManus, J Sex Res 37 , 1 (2000).^]

-<Even among HIV-positive individuals, the variability of the sexual behavior of MSM is greater than that of heterosexual men. For instance, in a study of U.S. military personnel that had been recently infected with HIV, the number of lifetime sexual partners among heterosexual men ranged from 1 to 400, with a median of 20 partners, whereas that among MSM ranged from 2 to 1,500, with a median of 28.[^N. F. Crum  et al. , Sex Transm Dis 30 , 713 (Sep, 2003).^] See Table 3 below for another example of increased variability of sexual behavior among MSM.

-<Remafedi described a sample of 29 male homosexual and bisexual (white, Christian, and middle class) adolescents, aged 15-19.[^16. G. Remafedi, Pediatrics 79 , 331 (Mar, 1987).^] 3 participants reported no homosexual experience in the previous year, one had more than 200 partners; the mean number of homosexual partners for the remaining was 7 in the previous year. 15 had had some heterosexual experience during the previous year, with a mean of 5.6 partners; the number of female partners ranged from 1 to 25. Note the variability of sexual behavior. The subjects were recruited from a wide variety of settings, maximizing the diversity of respondents. No participants were solicited from mental health settings. The demographic characteristics of the subjects closely resembled that of the general population in the community from which they were sampled, as would be expected in a random sample of homosexual individuals. Therefore, the sample is a good approximation of a probability sample, and it is unlikely that selection bias skewed the sample toward dysfunctional adolescents.

-<In a sample of British men, those who reported homosexual behavior inseminated as many different female partners over a lifetime as did men who only reported heterosexual behavior.[^S. M. Blower, Philos Trans R Soc Lond B Biol Sci 339 , 33 (Jan 29, 1993).^] In addition, men who reported a high number of same-sex partners also reported a high number of female partners.
!!Some other studies
In a representative sample of 34,706 Minnesota junior and senior high school students (grades 7 through 12), both self-identified homosexuals and heterosexuals reported heterosexual behavior with equal frequency.[^G. Remafedi, M. Resnick, R. Blum, L. Harris, Pediatrics 89 , 714 (Apr, 1992).^]

In an investigation of 205 homosexual and 310 bisexual men, 33.58% of homosexuals and 42.64% of bisexuals had recently behaved in a bisexual manner. [^J. P. Stokes, P. Vanable, D. J. McKirnan, Arch Sex Behav 26 , 383 (Aug, 1997).^]

Note that lifetime-exclusive homosexual behavior is rare. See Figures 1 and 2.

%center%Attach:Origin.HomePage/lau.gif"Prevalence of homosexual behavior, homosexual desire, and homosexual/bisexual identity in a U.S. probability sample." | Fig. 1: Prevalence of homosexual behavior (B), homosexual desire (D), or homosexual/bisexual identity (I), and combinations of the three since age 18 in a 1992 U.S. probability sample.[^Laumann EO, Gagnon JH, Michael RT, et al. The social organization of sexuality: sexual practices in the United States. Chicago: University of Chicago Press, 1994.^] Values are in percent of total sample. 2% of men and 0.9% of women self-identified as homosexual; 0.8% of men and 0.5% of women self-identified as bisexual. Note that whereas 0.9% of women identified as homosexual, only 0.3% of women reported exclusive attraction to women.

%center%Attach:rog.gif"Sex partner(s) of men reporting homosexual behavior in a U.S. probability sample." | Fig. 2: Sex partner(s) of men reporting homosexual behavior in a U.S. probability sample.[^S. M. Rogers, C. F. Turner, J Sex Res 28 , 491 (1991).^] Values are in percent of total sample.

In the National AIDS Behavioral Surveys, the variability in number of partners in the year prior to the interview was greater among MSM than among heterosexuals; MSM were overrepresented among both individuals without any partner in the previous year and among those with two or more partners in the previous year (see Table 3).[^D. Binson  et al. , J Sex Res 32 , 245 (1995).^]'^,^' [^M. M. Dolcini et al. , Fam Plann Perspect 25 , 208 (1993).^] However, note that extended periods of no sex among MSM do not necessarily imply voluntary refraining from sex; bouts of venereal diseases -- think of a wart- or pustule-laden penis or anorectal region -- would put MSM temporarily out of action.  The dataset is also from a time period when the more promiscuous MSM had died of AIDS.

(:html:)
<table width="650"  border="1" cellpadding="3" cellspacing="0">

  <tr>

    <td colspan="4"><strong>Table 3</strong>: Number of partners in probability samples (around 1990) of MSM and heterosexuals in the U.S. (age: 18-49) </td>

  </tr>

  <tr>

    <td>Number of Partners in year before interview </td>

    <td>0</td>

    <td>1</td>

    <td>2+</td>

  </tr>

  <tr>

    <td>MSM (n = 190; from large cities) </td>

    <td>24% </td>

    <td>41% </td>

    <td>35% </td>

  </tr>

  <tr>

    <td>Heterosexual men and heterosexual women (n = 1,782, national Sample) </td>

    <td>8.4%</td>

    <td>80.4% </td>

    <td>11.3%</td>

  </tr>

  <tr>

    <td>Heterosexual men and heterosexual women (n = 5,346, from large cities) </td>

    <td>10.3% </td>

    <td>74.1% </td>

    <td>15.6% </td>

  </tr>

</table>
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There are additional studies like the ones on this page cited elsewhere within this site.
!!References
[^#^]