Assessing Bear/Cub/Otter identity and history of cardiovascular disease among gay, bisexual, and other men who have sex with men in Metro Vancouver

Abstract

Bear identity exists as an understudied subgroup among gay, bisexual and other men who have sex with men (gbMSM). Given associations between Body Mass Index (BMI) and Bear identity, we examined prevalence estimates and effect modification between Bear identity, BMI, and cardiovascular health. Data is from February 2012–February 2018 and comes from a longitudinal-cohort of gbMSM in Metro Vancouver, recruited using respondent-driven sampling (RDS). We conducted univariable and multivariable logistic regression using RDS weighting. A total of 161 (21.3%) gbMSM self-identified as a Bear/Cub/Otter (BCO) and 48 (7.2%) gbMSM who identified as a BCO had a measured BMI ≥ 30. Multivariable results found non-BCO identity and a BMI ≥ 30 (aOR = 11.27; 95% CI = 2.88, 44.07) was associated with greater odds of history of cardiovascular health condition and/or associated risk factors compared to gbMSM who did not identify as a BCO and had a BMI < 30. The majority of gbMSM with BMI ≥ 30 identified as a BCO. However, BCO identity was not the most significant effect modifier for BMI on a history of a cardiovascular health condition and/or associated risk factors. Interventions should target all gbMSM with increased risk for cardiovascular disease and clinicians should be mindful of culturally sensitive prevention and care for gbMSM who identify as a BCO.