Men who have sex with men and women (MSMW) have a much higher rate of sexually transmitted infections (STIs) when compared with gay or straight men, ScienceDaily Reports. Publishing their findings in American Journal of Preventive Medicine, researchers at the Centers for Disease Control and Prevention (CDC) conducted a review of studies pertaining to MSMW published between 2008 and 2013.

MSMW make up an estimated 2 percent of the sexually active males in the United States.

The researchers found that while the prevalence of HIV is lower among MSMW when compared with gay men, MSMW are more likely than straight men to be living with the virus. MSMW are also less likely to undergo HIV testing than either gay or straight men. Twenty-one percent of MSMW reported receiving treatment for STIs in the past year, compared with 12 percent of gay men and 2.3 percent of heterosexual men.

The investigators theorized that behavioral elements may account for the disproportionate rates of HIV and STIs among MSMW. When compared with gay or straight men, MSMW may use condoms less frequently, start having sex earlier, be more likely to experience rape, have more sexual partners, be more inclined toward substance abuse, be more likely to have sex for money or goods, and may be more likely to have sex with male or female partners who themselves have higher risk factors for HIV or STIs. In addition, social stigma toward bisexuals may play a role in the higher HIV and STI rates among MSMW, as may economic concerns and pressures to conform to a masculine ideal.

“MSMW’s attitudes toward pregnancy influence their sexual health. Qualitative data from black men suggest that desires to prevent pregnancy may prompt some MSMW to consistently use condoms with women,” William L. Jeffries IV, PhD, MPH, writes in the paper. “Yet, MSMW may avoid condom use when their female partners use other contraceptives or when female partners perceive condom use as a sign of relationship infidelity. Further, MSMW’s desires to produce offspring biologically may prompt sex without a condom with female partners. In this regard, desires for fatherhood may indirectly increase these men’s vulnerability to HIV/STIs and transmission of these infections within their sexual networks.”

To read the ScienceDaily story, click here.

To read the study abstract, click here.