ABSTRACT
Since the start of the AIDS epidemic in France, men with homosexual and bisexual behaviour have formed the majority of recorded cases: constituting an absolute majority until 1988, then a relative majority, the progressive fall in their share of cases reflecting an increase among other groups (Réseau National de Santé Publique, 1994). The importance of efforts to prevent HIV transmission among behaviourally homosexual and bisexual men was clear, but the effectiveness of such measures depended on an accurate understanding of the characteristics of people for whom they were developed. The absence of such understanding triggered a series of studies on the socio-demographic characteristics, opinions, attitudes, beliefs and practices of gay men, conducted mainly through the gay press (Pollak and Schiltz, 1991a; Schiltz, 1993). However, as is suggested by the use of the category term ‘homo-bisexual’ in French AIDS statistics (Réseau National de Santé Publique, 1994) and in behavioural reports (e.g. Pollak and Schiltz, 1991a), the world of sex was divided —for males-into two: those who had sex with men, regardless of any coexisting heterosexual activity, and those who had not. This remained the case, even after epidemiologists drew attention to the possible consequences that bisexual activity among men could have with the AIDS epidemic (Chu et al., 1992; Lifson, 1992; Wood et al., 1993; Krijnen et al., 1994). Men having sex with both men and women offer a challenge for public health research, demanding urgent answers to the following among other questions (Messiah et al., 1994, 1995): are such men easily reached by gay-oriented prevention messages; does their behaviour play an important role in the heterosexual spread of HIV; and what role does male bisexual behaviour play in maintaining the HIV epidemic among gay men? At the start of the epidemic in France, the lack of data which could help to answer, even partly, these questions was surprising.
