Abstract

A number of health problems are more common in the population of men who have sex with men (MSM) as compared with the general population. At the same time, research reveals that the MSM population is far from homogeneous, and that subcultural affiliation is one of the characteristics that should be taken into account in health analyses of this group. One of the subcultures among MSM that has received growing interest from researchers in recent years, is the Bear community. It originated in the USA and comprises men - mostly homosexual or bisexual - who are characterized by larger, massive or muscular figure, and by distinctive male phenotypic traits - especially body hair pattern, including facial hair. The most significant health determinants in this group include a higher prevalence of behaviors contributing to negative health outcomes as compared with other MSM, elevated BMI values, as well as exposure to multiple stigma - both sexual minority and weight stigma. Research to date has shown that these characteristics of Bears have significant implications for their mental and sexual health. The article aims to review the literature, and to discuss the practical and the clinical implications of the studies conducted thus far in this population. The summary gives practical recommendations regarding both the support for Bear men in clinical practice, and the design of adequate and effective health promotion interventions for members of this unique community.

Highlights

  • Determinants of health in the men who have sex with men (MSM) populationMen who have sex with men (MSM), including homosexual and bisexual men, constitute a key population from the public health’s perspective [1, 2]

  • Studies to date point to more frequent health problems in MSM population, covering more than one of the traditionally distinguished areas of physical, mental and sexual health, compared with men reporting sex exclusively with women [6]

  • Sexual minority men are characterized by higher rates of substance use [7, 8], smoking [5, 9, 10], and heavy alcohol use [5, 11]

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Summary

Introduction

Determinants of health in the MSM populationMen who have sex with men (MSM), including homosexual and bisexual men, constitute a key population from the public health’s perspective [1, 2]. Studies to date point to more frequent health problems in MSM population, covering more than one of the traditionally distinguished areas of physical, mental and sexual health, compared with men reporting sex exclusively with women [6]. The MSM population reports more frequently sexual contacts without a condom [6, 12] and is disproportionately burdened with sexually transmitted infections [13, 14]. Men of this group face more barriers in accessing health care [5, 15]

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