Should we screen less frequently for chlamydia and gonorrhoea in gay and bisexual men who have sex with men? Findings from a global crowdsourcing exercise with experts.

Differences in weight stigma between gay, bisexual, and heterosexual men

Previous body image research often grouped both gay and bisexual men into a single category: sexual minoritised men, limiting our understanding of how sexual identity influences body image. However, there is strong reason to believe that bisexual and gay men experience distinct body image concerns. Here, we explored motivations to alter one’s leanness and muscularity, as well as (dis)satisfaction with body fat, muscularity, height and penis size, and functionality appreciation across gay, bisexual, and straight cisgender men. We sampled 378 white participants aged 18 to 85 (nbisexual = 125, ngay = 128, nstraight = 125). We found that bisexual men were significantly less motivated to be lean and showed lower muscularity dissatisfaction relative to gay men but showed comparable levels to straight men. Our findings demonstrate that despite research perceiving the body image of bisexual and gay men as homogenous, they experience differences in their body image concerning leanness and muscularity dissatisfaction. Future body image research should incorporate this understanding by not artificially grouping bisexual and gay cisgender men and instead acknowledging the potential uniqueness in their experiences.

BackgroundAround the world, rates of sexually transmissible infections (STIs) continue to rise among gay and bisexual men. To respond to these increases, information is needed on the sociocultural realities underpinning...

Recent legal and social changes in marriage equality, parenting among same-sex couples, and fatherhood discourses may prompt more US gay and bisexual men to desire fatherhood. However, scholars know little about fatherhood desires among these men. Therefore, we investigated temporal changes in fatherhood desires and perceptions of being bothered by future childlessness among US gay, bisexual, and heterosexual men. The sample included childless men participating in 5 cycles of the National Survey of Family Growth. Adjusted Wald tests and Pearson’s chi-square tests examined temporal changes in future fatherhood desires and being bothered by future childlessness, and they compared the men along these outcomes. We used logistic regression for multivariable analyses. The proportion of gay, bisexual, and heterosexual men who desired fatherhood remained stable from 2002 to 2013–2015. Most gay, bisexual, and heterosexual men desired fatherhood, but gay men had the lowest likelihood of doing so. Gay and bisexual men were less likely than heterosexual men to be bothered by future childlessness. Although the prevalence of fatherhood desires among these men did not increase during 2002–2015, the relatively high prevalence of fatherhood desires warrants research and data collection to understand factors influencing these desires, especially among gay and bisexual men.

On Jan 27 2022, the UK Health Security Agency (UKHSA) reported an increase in extensively drug resistant Shigella sonnei infections, primarily affecting gay, bisexual, and other men who have sex with men (GBMSM). Between Sept 1, 2021, and Jan 10, 2022, UKHSA documented 47 cases of extensively drug resistant S sonnei infections. Between April 1, 2020, and Aug 31, 2021, surveillance teams recorded only 16 cases that did not display multidrug resistance, highlighting the rapid increase in resistance over a short time.

ObjectivesDespite rises in sexually transmitted infection (STI) notifications among Australian women in the previous decade, limited STI surveillance data exists for women by sexual orientation. This study aimed to compare...

Purpose: Recent research suggests that the benefits of minimized structural stigma experienced by gay men are not matched in bisexual men. The purpose of this study was to explore how bisexual men perceive structural stigma compared with gay men in hopes of understanding why improvements in structural stigma among sexual minority individuals may not equally benefit bisexual people. Methods: In 2020-2021, we conducted in-depth interviews with 19 bisexual men and 40 gay men recruited from a larger longitudinal cohort study of 502 men. Interviews were conducted by phone or Zoom (camera off). The interview guides for gay and bisexual men were nearly identical, except that bisexual men were asked specifically about structural stigma related to bisexuality. All interviews were recorded digitally, transcribed verbatim, and analyzed using grounded theory as an analytic strategy. Results: Emergent findings show that three interrelated forces complicate the relationship between structural stigma and outcomes for bisexual men: assumed heterosexuality, invisibility and erasure of bisexuality, and the blurring of interpersonal and structural stigma. In particular, bisexual men had trouble identifying structural stigma, reflecting the difficulty of fully pinning down this type of stigma. Conclusion: To understand the disparate effects of structural stigma for bisexual and gay men, we encourage scholars to take these dynamics into account. We suggest new concrete ways to measure structural stigma against bisexual people and better incorporate perspectives from bisexual men into future structural stigma research and interventions.

Homosexual and bisexual men with acquired immunodeficiency syndrome (AIDS) differ, and bisexual men play an important role in the sexual transmission of human immunodeficiency virus (HIV) to women. To describe AIDS in these groups, we examined AIDS cases reported nationally through June 1990. Among 65 389 men who reported having had sex with men since 1977, 26% were bisexual. More Black (41%) and Hispanic men (31%) than White men (21%) reported bisexual behavior. Bisexual men were twice as likely to report intravenous drug use (20%) as were homosexual men (9%), regardless of race or ethnicity. Among 3555 women with heterosexually acquired AIDS, 11% reported sexual contact with a bisexual man and no other risk factor, although in some states approximately half reported such contact. In 1989, the AIDS rate due to sex with a bisexual man was three and five times higher among Hispanic and Black women, respectively, than among White women. Differences between bisexual and homosexual men with AIDS and the relative importance of AIDS in women due to sexual contact with bisexual men should be considered in the development of HIV prevention programs.

Use of doxycycline prophylaxis among gay and bisexual men in Melbourne

Young men who have sex with men (MSM) are disproportionately affected by HIV, but it remains unclear whether there are differences in HIV risk behaviors between self-identified gay and bisexual young men. To address this, the current study examined differences in condomless sex and substance use before sex with male partners between self-identified gay and bisexual young men who are HIV-negative. Additionally, we examined differences in HIV risk behaviors with male versus female partners among the bisexual men. We used four waves of data spanning 24months from a cohort of young MSM ages 16-29. At each wave, participants reported on up to four partners, allowing us to examine within-person associations. Compared to gay men, bisexual men reported more insertive condomless anal sex (CAS) with casual partners, they were more likely to report marijuana use before sex, and they were less likely to report lifetime HIV testing and PrEP use. Alcohol and marijuana use before sex were associated with CAS for both gay and bisexual men, but the association between marijuana use and insertive CAS was stronger for bisexual men. Bisexual men reported more condomless sex with female partners compared to male partners, but this was not significant after accounting for alcohol and marijuana use. Bisexual men were more likely to report alcohol and marijuana use with female partners compared to male partners, but both alcohol and marijuana use were associated with condomless sex regardless of partner gender. Findings support the need for tailored HIV prevention for self-identified bisexual men to address their lack of preventive behaviors, their increased engagement in certain risk behaviors with male partners, and their engagement in risk behaviors with female partners.

Emerging evidence suggests that risk of bacterial sexually transmitted infections (STIs) increases among gay and bisexual men following initiation of HIV preexposure prophylaxis (PrEP). To describe STI incidence and behavioral risk factors among a cohort of predominantly gay and bisexual men who use PrEP, and to explore changes in STI incidence following PrEP commencement. The Pre-exposure Prophylaxis Expanded (PrEPX) Study, a multisite, open-label intervention study, was nested within the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) clinic network. A total of 4275 participants were enrolled (July 26, 2016-April 1, 2018) in Victoria, Australia. Of these, 2981 enrolled at 5 ACCESS clinics (3 primary care, 1 sexual health, and 1 community-based HIV rapid testing service), had at least 1 follow-up visit, and were monitored until April 30, 2018. Upon enrollment, participants received daily oral tenofovir disoproxil fumurate and emtricitabine for HIV PrEP, quarterly HIV and STI testing, and clinical monitoring. The primary outcome was incidence of chlamydia, gonorrhea, or syphilis. Incidence rates and hazard ratios describing behavioral risk factors of STI diagnosis were calculated. Incidence rate ratios (IRRs), adjusted for change in testing frequency, described changes in STI incidence from 1-year preenrollment to study follow-up among participants with preenrollment testing data (n = 1378). Among the 2981 individuals (median age, 34 years [interquartile range, 28-42]), 98.5% identified as gay or bisexual males, 29% used PrEP prior to enrollment, 89 (3%) withdrew and were censored at date of withdrawal, leaving 2892 (97.0%) enrolled at final follow-up. During a mean follow-up of 1.1 years (3185.0 person-years), 2928 STIs were diagnosed among 1427 (48%) participants (1434 chlamydia, 1242 gonorrhea, 252 syphilis). STI incidence was 91.9 per 100 person-years, with 736 participants (25%) accounting for 2237 (76%) of all STIs. Among 2058 participants with complete data for multivariable analysis, younger age, greater partner number, and group sex were associated with greater STI risk, but condom use was not. Among 1378 participants with preenrollment testing data, STI incidence increased from 69.5 per 100 person-years prior to enrollment to 98.4 per 100 person-years during follow-up (IRR, 1.41 [95% CI, 1.29-1.56]). After adjusting for testing frequency, the increase in incidence from 1 year preenrollment to follow-up was significant for any STI (adjusted IRR, 1.12 [95% CI, 1.02-1.23]) and for chlamydia (adjusted IRR, 1.17 [95% CI, 1.04-1.33]). Among gay and bisexual men using PrEP, STIs were highly concentrated among a subset, and receipt of PrEP after study enrollment was associated with an increased incidence of STIs compared with preenrollment. These findings highlight the importance of frequent STI testing among gay and bisexual men using PrEP.

ObjectivesTo analyse changes in testing for sexually transmissible infections (STI) among gay and bisexual men in Melbourne, Sydney and Queensland, Australia, particularly comprehensive STI testing (at least four tests from...

Bisexual men are one of the least studied populations within the sexual intimate partner violence (SIPV) literature, despite the prevalence of SIPV being equivalent between bisexual and gay men, and greater in bisexual than heterosexual men. Consequently, it remains unclear as to what factors contribute to SIPV–related victim blame toward bisexual men. The current study utilized a mixed–methods design to investigate prejudiced attitudes toward bisexual and gay men as predictors of victim blame in the context of SIPV. Participants (N = 124) were randomly assigned to read a vignette wherein a bisexual or gay man disclosed an experience of SIPV. Participants then completed measures of victim blame and prejudiced attitudes toward bisexual or gay men. As a means of contextualizing the quantitative analyses, participants also completed a qualitative stereotype task. Results indicated that prejudiced attitudes toward both bisexual and gay men predicted victim blame, and that victim blame attributions toward bisexual and gay men did not differ. Qualitative findings indicated that there was overlap between the stereotypes attributed to bisexual and gay men, which may explain the lack of difference in victim blame toward the two groups. These results implicate prejudice reduction and controlled stereotype processing strategies as a means of reducing victim blame attributions toward sexual minority men.

While advances in HIV prevention and treatment have changed the epidemic for gay and bisexual men, another epidemic faces this population. Gay and bisexual men represent one of the highest risk groups for depression, which potentially poses quality-of-life and public health challenges comparable to those of HIV. The present study seeks to inform comprehensive care for sexual minority men by estimating and comparing the morbidity of HIV and depression for US gay and bisexual men. In 2018, weighted counts of gay and bisexual men living with HIV and depression were derived from the CDC's Medical Monitoring Project and the National Survey on Drug Use and Health, respectively. Years lived with disability for HIV and depression were calculated using the Global Burden of Disease Study's disability weights. Among gay and bisexual adult men in the US, the prevalence of past-year major depressive episodes is 14.17%, while the prevalence of HIV is 11.52%. We estimate that in calendar year 2015, major depressive episodes imposed 85,361 (95% CI 58,293-112,212) years lived with disability among US adult gay and bisexual men, whereas HIV posed 42,981 (95% CI 36,221-49,722) years lived with disability. This analysis shows that depression morbidity currently exceeds that for HIV among US adult gay and bisexual men. While gay and bisexual men are frequently understood to be a high-risk population for HIV, including in guidelines for HIV prevention and treatment, the present analysis suggests that this population should also be considered high-risk for depression.

The right comparisons in testing the minority stress hypothesis: comment on Savin-Williams, Cohen, Joyner, and Rieger (2010).