Objectives. I examined sociodemographic, sexual, and HIV/sexually trasmitted infection (STI) risk differences among gay- and non-gay-identified (NGI) men who have sex with men (MSM) in the United States.

Methods. Using a nationally-representative, probabilistic sample, I employed logistic regression to predict non-gay identification and its association with MSM’s sexual and risk practices.

Results. Among the 202 MSM, 52% were NGI. Being African American, Latino, young, of low socioeconomic status, heterosexually married or cohabiting, religious, small town- or rural-dwelling, and ever incarcerated were positively associated with being NGI. Relative to gay MSM, NGI MSM had more female partners, fewer male partners, a greater preference for only oral sex with men, and a lower preference for both insertive and receptive intercourse with men. Despite them being more likely to contract syphilis, not have an HIV test, and have sex while intoxicated, NGI MSM had more condom use with females.

Conclusions. Non-gay identification acts as both a protective and risk factor among MSM.  HIV/STI risk reduction strategies should be attentive to sociodemographic factors distinguishing NGI from gay MSM.