The For the Assessment of Individualized Risk (FAIR) framework, introduced by NHS Blood and Transplant (NHSBT) in 2021, aims to reduce stigma and improve equity in blood donor selection, particularly for gay, bisexual and other men who have sex with men (GBMSM). While pre-exposure prophylaxis (PrEP) is highly effective at preventing sexual transmission of human immunodeficiency virus, its declared use excludes individuals from blood donation. This study examined PrEP use among male blood donors with current or past syphilis in England to evaluate guideline compliance and implications for blood safety. Residual plasma samples from syphilis-positive male blood donors collected in 2023 were tested for PrEP. These data were combined with two previous studies of syphilis-positive donors conducted between July 2018 and June 2024, incorporating demographics and reported PrEP use. The rate of syphilis-positive blood donations increased from 4.09 to 10.32 per 100,000 donations between 2018 and 2024 (p = 0.048, Mann-Kendall trend test) with a rising proportion of past syphilis cases attributed to GBMSM (18%-37%; p = 0.004, Fisher's test, p = 0.001 Mann-Kendall test); 7.1% of syphilis-positive blood samples from male blood donors tested positive for PrEP in 2023, indicating frequent non-compliance with donation guidelines. Persistent PrEP use among syphilis-positive donors since 2018 suggests gaps in donor education regarding eligibility. Targeted public health interventions, particularly for younger GBMSM, are needed to strengthen sexual health education, PrEP messaging and awareness of donation criteria. Further research into other infections associated with high-risk sexual behaviour is warranted.

The COVID-19 pandemic has profoundly reshaped everyday life, with long-term effects across multiple domains. While much existing scholarship has emphasised the negative consequences of the crisis, this article highlights its unexpected potentials by examining how single gay men in mainland China used Blued, the country’s largest gay dating app, during lockdown. Grounded in domestication theory, we used in-depth interviews to explore how users appropriated these platforms under conditions of restricted mobility, and how such practices generated new understandings of digital intimacy and sexuality. Our findings reveal that dating apps, typically associated with casual hook-ups, were re-domesticated into three distinct functions during the pandemic: as a “sexual laboratory” for experimenting with desire; as an “emotional space” for coping with isolation and as a “community support network” for mutual help. These context-specific practices not only enrich the study of gay social media use but also prompt a broader reconsideration of how technology mediates sexual and affective life under conditions of crisis. Taken together, these findings suggest that inclusive pandemic preparedness must account for how everyday platforms can become informal infrastructures of care, information, and connection when mobility is restricted and offline services are disrupted.

HIV pre-exposure prophylaxis (PrEP) is proven effective for HIV prevention and recommended for individuals at ongoing and high risk of HIV, including gay, bisexual, and other men who have sex with men (GBMSM) and people who inject drugs (PWID). We used existing national survey data to measure PrEP need in both populations and calculate percentages of use among those meeting indications within each group. We conducted a secondary data analysis of nationally representative data to estimate the percentage of GBMSM and PWID meeting PrEP indications based on 2017 Canadian guidelines. We applied these percentages to recent population size estimates for both groups to estimate the number of people having PrEP indications in each group. Where available, we also used survey data to determine the percentage of people with indications who were not taking PrEP at the time of the survey. An estimated 24.1% (95% CI 13.3-39.7%) or 99,300 (95% CI 54,800-163,600) of GBMSM had PrEP indications in Canada as of 2021. The corresponding percentage and number for PWID were 22.3% (20.8-22.8%) and 22,400 (20,900-23,900). Two-thirds of GBMSM participants (Sex Now 2019 and 2021) who had PrEP indications were not taking PrEP at the time of the surveys. None of the participants with PrEP indication in the Tracks survey (2017-2019) among PWID reported PrEP use. In Canada, the estimated number of people with PrEP indications among GBMSM and PWID far exceeded documented levels of use. Uptake of PrEP was lower among PWID compared to GBMSM. Efforts to improve PrEP access and uptake could help reduce HIV transmission in Canada.

To identify contextual factors that harm and protect the mental health of Black and Latinx gay and bisexual men, this study examined (a) associations between dating app use and psychological distress over time mediated by sexual racism, with (b) moderation by different sources of supportive social connections (i.e., general social support, gay community connection, and racial/ethnic community connection). Using three waves of the Healthy Young Men's Cohort Study with Black and Latinx gay and bisexual men (N = 412), multiple moderated mediation path analyses were tested. Dating app use was associated with more sexual racism, and sexual racism was positively associated with psychological distress. High, but not low, racial/ethnic community connection diminished the effects of sexual racism on psychological distress, and social support from family and friends and gay community connection did not. Furthermore, the indirect effect of dating app use on psychological symptoms through sexual racism was significant. All social support indicators modified this indirect effect, such that the indirect effects were significant only at low values of general social support and at low racial/ethnic and gay community connection. For Black and Latinx gay and bisexual men, the impact of dating app use on psychological distress may occur through elevated experiences of sexual racism. These associations may be diminished with greater access to general social support and community connection. Findings highlight the dual need for reducing racism on dating apps and for increasing access to general and community-specific forms of social connection and support. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Racial disparities in HIV incidence and PrEP non-adherence among gay, bisexual and other Men who have Sex with Men (MSM) and transgender women using oral PrEP in Brazil: Results from the ImPrEP study.

Gay, bisexual and other men who have sex with men's (GBMSM) sexualised drug use, defined as taking psychoactive drugs before or during sex, is the focus of public health concern globally. 'Hi-fun' in Thailand (similar to the practice of 'chemsex' in Western settings) is a subset of sexualised drug use. Much harm reduction programming relies on Western chemsex definitions, obscuring critical variation related to local cultures, drug markets and legislative contexts. We aimed to develop, informed by transnational queer sociology, a locally grounded definition of hi-fun compared to other sexualised drug use types practiced among GBMSM in Thailand. To delineate sexualised drug use types and explore structural and social influences on how hi-fun is practiced and organised, focus groups and in-depth interviews (April-Sept 2024) were conducted with GBMSM (with sexualised drug use experience within prior 12-months) recruited from community organisations in Bangkok, Khon Kaen and Pattaya. Data were transcribed, translated where necessary and analysed with a thematic framework. Participants (n = 30) were aged 25-47 years, 25 gay, ten living with HIV, seven born outside Thailand. Most (n = 23) used crystal methamphetamine (ice) before/during sex in preceding 12-months, with fewer taking other drugs (ecstasy/MDMA= 14, ketamine = 12, cocaine = 10, GHB/GBL = 5). Participants' accounts coalesced around three main sexualised drug use types: hi-fun, sex at homepas (medium to large parties where men socialise, usually while wearing only underwear) and incidental sex with drugs (spontaneous and situational combining sex with drugs, often after a night out). Hi-fun was delineated from other sexualised drug use types based on participant motivations to increase wellbeing through pleasure and intimacy, in contrast to homepas and incidental sex with drugs which were linked more to socialising. Crystal methamphetamine (ice) was considered foundational to hi-fun, whereas other drugs (e.g. cocaine, ecstasy/MDMA, ketamine and GHB/GBL) were more common in homepas and incidental sex with drugs. Technology, especially geolocation social/sexual networking apps, were central to hi-fun organisation, but potentially less important for other sexualised drug use types. Both hi-fun and homepas primarily took place in private settings, whereas incidental sex with drugs happened in a wider range of venues. Hi-fun in Thailand can be defined as the intentional combination of sex and crystal methamphetamine (ice) to enhance intimacy and pleasure with one or more other man/men, facilitated by technology and usually in a private setting. This definition will be useful for those supporting GBMSM in Thailand through policy, research and service provision.

With the development of digital interaction, there is a need to control the information distributed by users so that it complies with legal requirements. The study proposes a technique for classifying Russian-language texts by considering both the biological sex of the authors (male and female) and gender-related distinctions, including heterosexual and homosexual groups as well as specific LGBT categories such as gay men, lesbian women, bisexual, and transgender authors. The article proposes a technique for identifying the sex and gender of authors of Russian-language texts by utilizing an ensemble of methods, including Support Vector Machines (SVM), Convolutional Neural Networks (CNN), and the Russian Bidirectional Encoder Representations from Transformers (RuBERT). This research is introducing a technique for gender identification in Russian texts, as prior studies have only addressed the automatic determination of an author’s sex. To conduct the study, custom datasets of user comments from social networks were created and annotated with both sex and gender labels. In tasks related to identifying the author’s sex, the proposed technique achieved an accuracy exceeding 90 %. This includes the classification of heterosexual men and women as well as a mixed dataset comprising both heterosexual and homosexual individuals. When distinguishing individuals of the same sex based on sexual orientation, the results showed that homosexual and heterosexual women display uncommon writing styles in contrast to men of different orientations, with accuracy rates of 93 % for women and 85 % for men. Additionally, an experiment focused on identifying LGBT individuals and their gender identities based on writing style achieved an accuracy of 93 %. The key takeaway from this study is that combining CNN, RuBERT, and SVM leads to a more robust model for gender classification. The method has been tested on varying numbers of samples. In the basic experiments for determining sex, the method achieves an accuracy of 92 %. When addressing the task of detecting the author’s LGBT affiliation, the method achieves 93 % accuracy. The proposed technique can be applied for automated monitoring of social networks to detect and analyze the gender identity of text authors. It is also promising for use in content moderation systems as well as in sociological and linguistic research.

Pre-exposure prophylaxis (PrEP) is the cornerstone of HIV prevention in the United States, yet uptake remains low among bisexual men compared to gay men. Theory-driven communication interventions have promise for addressing this disparity. Prior research among gay and bisexual men has shown that the Reasoned Action Approach (RAA) can predict PrEP intentions through attitudes, norms, and perceived behavioral control, while other studies highlight the influence of sexual identity-related stressors on prevention behaviors. However, bisexual men remain underrepresented in this work. This study sought to address this gap by exploring modifiable socio-cultural influences on bisexual men's PrEP use that can inform the development of PrEP promotion messages. Through an online survey of N = 276 US bisexual men, this study examined the relative impact of RAA factors (e.g., attitudes, perceived norms, and control beliefs) and identity-related stressors (e.g., concealment, masculine consciousness, and identity conflict) on intentions to use PrEP. The results revealed that, in contrast to previous work, only experiential attitudes toward PrEP (e.g., worry over HIV risk) were significantly associated with intentions, while instrumental attitudes, norms, and control beliefs were not. Regarding identity-related stressors, concealment from family was negatively associated with intentions, but masculine consciousness and identity conflict were not. Findings suggest that bisexual men's PrEP decisions may be shaped less by the cognitive predictors and more by affective and concealment-related processes. The results underscore the risk of generalizing findings from studies of gay men to bisexual men and highlight the need for more research to understand bisexual men's PrEP use motivations.

Researchers have consistently found that gay men are more likely to be sexually assaulted than their heterosexual counterparts. After an individual is sexually assaulted, they may decide to report the assault to the reporting authorities. While homophobia has been identified as a barrier to reporting sexual assault among male sexual assault survivors, little attention has been devoted to illuminating the intersections of racism and homophobia in the reporting process. This study aimed to determine the ways in which the racial/ethnic and sexual identity of gay Latino sexual assault survivors affects the decision-making process to report sexual assault. Fourteen men (N = 14) participated in the study from six cities in the United States. Participants were recruited through a newspaper, a geosocial networking app, and personal contacts. In-depth, semi-structured interviews were conducted either in English or Spanish, audio-recorded, and subsequently translated (when in Spanish) and transcribed verbatim. Coding methods consistent with thematic analysis were conducted. Results from the interviews revealed three major themes related to how racism and homophobia impact the decision for Gay Latino men to report sexual assault to authorities: (a) gendered stereotypes, (b) fears of homophobic reactions by reporting authorities, and (c) effects of various stigmas on the reporting process. Findings provide rich and unique insight into how race, ethnicity, gender, and sexual orientation affect the decision-making process for gay Latino male sexual assault survivors. Results lend themselves to providing survivor-centered support to gay Latino sexual assault survivors in a culturally responsive fashion.

Erectile dysfunction (ED) is a condition characterized by difficulty in achieving or maintaining an erection, consequently affecting sexual performance. ED is often a symptom of underlying health conditions such as cardiovascular heart disease and can lead to psychological distress. Previous studies show an association between marijuana use and ED through its potential impact on the endocannabinoid pathways. However, few studies have explored this relationship among sexual minority men (SMM). Considering this knowledge gap, this study aims to assess the association between marijuana use and erectile dysfunction in a sample of SMM in the United States. A secondary analysis of the Men's Body Project (MBP)-a cross-sectional study involving an online survey assessing SMM health outcomes-data was conducted. Multivariable logistic regression and bivariate analyses were used to examine the association between marijuana use and ED. Participants provided demographic information, self-reported ED, erection confidence, erection difficulty, and history of substance use. A total of 549 participants completed the survey (52.1% gay and 47.9% bisexual). The prevalence of ED was higher in bisexual men compared to gay men. Results from the adjusted logistic regression analysis suggested that people who use marijuana had 1.83 times the odds (95% CI: 1.23, 2.74) of reporting erectile dysfunction compared to non-users. Our results suggest a significant association between marijuana use and elevated odds of experiencing erectile dysfunction. These findings highlight the importance of integrating sexual health screening into primary care and considering substance use during sexual health assessments to support early identification and management of ED. Additional research is needed to explore temporal and causal relationships between marijuana use frequency and erectile function.

Clinical guidelines recommend monitoring of serum creatinine concentrations in users of tenofovir disoproxil/emtricitabine for HIV pre-exposure prophylaxis (PrEP) due to its potential nephrotoxicity. Cystatin C might aid clinicians in determining whether creatinine elevations reflect true kidney injury. We reviewed the use of Cystatin C in our practice. Clinic records from Gay Men's Health Service were reviewed until March 2024, and those from St. James's Hospital were reviewed until October 2024, specifically for patients who had a cystatin C test requested due to concerns regarding their renal function. Descriptive statistics were used to analyse the data. Seventy PrEP users, with a median age of 39 years (IQR 34-45), were included. Data on body mass index (BMI) and blood pressure were available in 57/70 (81.4%) and 41/70 (58.6%), respectively; 37/57 (64.9%) had a BMI≥ 25 kg/m2 and 14/41 (34.1%) had hypertension. Protein supplements, creatine and anabolic agents were used by 43/70 (61.4%), 29/70 (41.4%) and 11/70 (15.7%), respectively. Recreational drugs were used by 17/70 (24.3%).The median cystatin C was 0.87 mg/L (IQR 0.81-0.99); 21/70 (30%) had a result above the upper limit of normality. At this time, the median creatinine was 106.5 µmol/L (97-114). An estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 according to Modification of Diet in Renal Disease, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) (2021), CKD-EPI creatinine-cystatin (2021) and CKD-EPI cystatin C (2012) was found in 11/70 (15.7%), 1/70 (1.4%), 0/70 (0%) and 1/70 (1.4%), respectively. Median eGFR was 67 (61-74), 78 (70-86), 90.5 (82-96), 102.5 (84-111) mL/min/1.73m2, respectively. Urinary protein-to-creatinine ratio was <15 mg/mmol in 65/70 (92.9%), and nobody had significant proteinuria of >50 mg/mmol. In this review, the addition of cystatin C to calculate eGFR lessened concerns regarding renal dysfunction, facilitating safe ongoing PrEP prescribing and potentially avoiding unnecessary referral to nephrology services.

Gay, bisexual, and other men who have sex with men (GBMSM) in the United States (U.S.) are disproportionately impacted by the HIV epidemic. Long-acting injectable pre-exposure prophylaxis (LAI-PrEP) represents a novel HIV prevention strategy. However, stigma remains a barrier to HIV-related prevention and care. We investigated the role of intersectional stigma in LAI-PrEP preferences among past-year PrEP naïve, HIV-negative U.S. cisgender GBMSM. The 2022 American Men's Internet Survey (AMIS) enrolled cisgender GBMSM online between October 2022 and October 2023. Using bivariate and multivariable adjusted Poisson regression with robust variance and a modified Intersectional Discrimination Index to examine associations between several forms of stigma-anticipated, day-to-day, social systems exclusion, and violence and harassment-and LAI-PrEP willingness and preference. Among participants (N=1196), 705 (59.0%) were willing to use any PrEP modality and 393 (32.9%) were willing to use LAI-PrEP, among whom 211 (29.9%) reported a preference for LAI-PrEP. On average, participants experienced 1.8 of 7 anticipated discrimination items, 3.9 of 7 day-to-day discrimination items, 0.2 of 3 social systems exclusion items, and 0.9 of 4 violence/harassment items. Willingness to use LAI-PrEP was associated with anticipated stigma (aPR=1.06; 95% CI=1.02-1.10; p<0.01). Preference for LAI-PrEP was associated with anticipated stigma (aPR=1.06; 95% CI=1.00-1.12; p=0.04), day-to-day (aPR=1.09; 95% CI=1.02-1.15; p=0.01) stigma, and violence/harassment (aPR=1.09; 95% CI=1.01-1.18; p-0.03). Given disproportionate HIV burden among GBMSM, a range of HIV PrEP modality options combined with efforts to address intersectional anticipated and enacted stigma among GBMSM is critical to ensure PrEP access, uptake, and adherence.

ABSTRACT Lesbian, gay, bisexual, transgender, queer, and other gender and sexuality diverse (LGBTQ+) students encounter hostile school environments characterised by discrimination, exclusion, and victimisation. Teachers are central to fostering inclusive school climates, yet few validated instruments exist to assess their engagement in promoting LGBTQ+ affirmation in schools. This study developed and validated the LGBTQ+-Affirmative Educational Practices Scale. A total of 305 secondary school teachers in China participated in it. An initial set of items was evaluated using exploratory and confirmatory factor analyses, resulting in an 8-item scale with two factors. Instructional and environmental inclusion captures structured and visible efforts to support LGBTQ+ students, while interpersonal affirmation reflects responsive and relational practices within classroom interactions. The two factors demonstrated strong internal consistency. Construct validity was supported by significant negative correlations with attitudes towards gay men. The results also showed that teachers with greater contact with sexuality and gender minority individuals, more exposure to LGBTQ+ media, and more positive perceptions of student attitudes towards sexuality and gender diversity scored higher on affirmative educational practices. The scale is a psychometrically sound instrument that reliably and validly measures the frequency of LGBTQ+-affirmative education practices in Chinese school settings.

This study aims to understand the social representations on the quality of life and the COVID-19 pandemic among Brazilian older gay men. The research has the participation of 21 Brazilian men, at an average age of 64 years old. Two instruments were used to the research: a sociodemographic questionnaire and a structured interview; those were analyzed through the software spss and iramuteq, respectively. A total of 4 classes of words were collected: Older Gay: Double Difficulty; COVID-19: Necessary Care; COVID-19: Implications of the Pandemic; Quality of Life: Definition and Reality in the Old Age. The SR showed a positive view and adhesion to the protective measures against COVID-19, and the impacts of the pandemic in the lives of the participants and their quality of life, concerning the measures of social distancing. The participants also demonstrated the perception that the old age becomes a more difficult phase among gay men. The group present a positive understanding of their own quality of life.

Migration Status and HIV Pre-exposure Prophylaxis (PrEP) Uptake Among Gay and Bisexual Men and Non-binary People in Australia: Results of a National Cross-Sectional Survey.

ABSTRACT Previous research has highlighted that in China, the development of digital technologies has expanded the living spaces of Gender and Sexual Minorities (GSMs) and People with Disabilities (PWDs). However, limited attention has been paid to the digital practices of individuals with intersectional identities—specifically, GSMs with disabilities. To address this gap, the present study focuses on disabled gay men, exploring their encounters, actions, and experiences in online dating, as well as the broader impacts on their everyday lives. Through thematic analysis of 18 interviews, three key themes emerged: “Broken Reciprocity,” “Labelling vs. Speaking Out Disability,” and “Paradoxical Empowerment.” Drawing on these empirical findings, this study seeks to advance our understanding of the global digital experiences of GSMs with disabilities by highlighting two specific dilemmas: “Intersectional Hiding” and “Highly Accurate Identifiability.”

Sexual education in the United States is rich and complex, yet it has centered heterosexual sexual practices with parents and schools playing a critical, and often judgmental role. This study aimed to explore the different ways that gay men learned about their sexual orientation and sexual behaviors, outside the traditional mechanisms. Data from N = 19 one-on-one interviews were analyzed using the iterative procedures associated with inductive qualitative content analysis. Findings showed the use of four major (discussions with friends, internet use, viewing pornography, and conversations with sexual partners), and four minor (viewing media, talking to professionals, discussions with trusted family members, and conversations with social acquaintances) learning mechanisms that helped them learn in detail about their sexual orientation, and sexual behaviors. These mechanisms occurred in two frameworks (in-person and digital media). Ultimately, these avenues facilitated opportunities for open, honest, uninhibited, and judgement free discussions and learning about sexual orientation and sexual behaviors.

This study examined how male rape myths, racial/ethnicity biases, and sexuality stereotypes influence verdicts in male-on-male rape trials-an area that is currently under-researched. A sample of 463 participants read a mock rape trial, where both the defendant and complainant were male, with defendant ethnicity (White, Black, Asian) and complainant sexuality (homosexual, heterosexual) manipulated across conditions. Participants completed the Male Rape Myth Acceptance Scale (MRMAS) before the trial and the Juror Decision Scale (JDS) afterwards. Results showed that defendant and complainant believability (subscales of the JDS) mediated the relationship between rape myth acceptance and verdicts, indicating that pre-trial biases shape jurors' story formation and verdict-making. Qualitative data demonstrates divergent narrative logics between high and low MRMA participants. Further, it was also found that both defendant ethnicity and complainant sexuality did not significantly influence verdicts. Findings highlight how underlying biases affect juror judgements and underscore the implications of this research are considered in the context of jury-reform initiatives already underway across the UK. Limitations and future research discussed within.

ABSTRACT Intersectionality and lesbian, gay, bisexual, transgender, and queer (LGBTQ) issues have a significant and overlapping history. However, little is known concerning how adversarial arenas, such as online conservative news media, may condemn intersectionality and LGBTQ issues simultaneously. Using grounded theory methods, I examined how 427 online conservative news media reports, from nine widely searched websites in the U.S., linked intersectionality with LGBTQ issues to position both in negative ways. The reports connected intersectionality with LGBTQ people of color to narrow its relevance, constructing multiply-marginalized groups as specific rather than expansive and drawing on understandings of people of color and LGBTQ individuals as specialized. Further, the reports constructed intersectionality as helping LGBTQ people of color and transgender individuals, but as harming other marginalized groups, including cisgender women, men of color, and white gay men. These findings indicate that online conservative news media are strategically using LGBTQ people of color and transgender individuals to attract those with more privilege into conservativism.

BackgroundSexual health concerns following prostate cancer treatment are common yet often insufficiently addressed in clinical practice, particularly among men who have sex with men. These individuals may face additional barriers stemming from heteronormative assumptions, limited disclosure, and a lack of culturally tailored information. As generative artificial intelligence (GenAI) chatbots become increasingly accessible, patients are using these systems to seek sensitive health information outside traditional care settings. While prior research has focused on the accuracy and safety of chatbot-generated health advice, less attention has been paid to how responses are framed and experienced in sexual minority contexts.ObjectiveThis study aimed to describe and compare how 4 GenAI chatbots respond to questions about sexual health following prostate cancer treatment, with a focus on the needs of a gay man, and to interpret these responses using netnographic and actor-network theory perspectives.MethodsA qualitative exploratory study using auto-netnography was conducted. In February–March 2025, the first author interacted once with 4 widely used GenAI chatbots—ChatGPT (GPT-4o; Open AI), Claude (3.5 Sonnet; Anthropic), Copilot (GPT-4 Turbo; Microsoft), and Gemini (2.0 Flash; Google)—while assuming the role of a simulated “mock patient.” Two standardized prompts were used verbatim across all platforms: an initial prompt addressing sexual health concerns after prostate cancer treatment and a supplementary prompt focusing on sexual minority–specific issues, including same-sex practices. Chatbot outputs were treated as system-generated data and analyzed qualitatively, integrating system-generated text with reflexive experiential engagement and attention to interactional framing, emotional attunement, specificity, and performative features. The analysis did not assess clinical effectiveness, safety, or generalizability.ResultsAcross platforms, chatbot responses addressed treatment-related sexual health concerns using generally inclusive language, with variation in emotional tone, specificity, and cultural sensitivity. Interactional features included the scope and framing of clinical information, encouragement of dialogue, self-care advice, and explicit discussion of same-sex sexual practices. No obvious fabricated claims were identified; however, contextual inaccuracies were observed. Responses were mapped along 2 intersecting continua—logical-to-empathetic orientation and general-to-specific framing—yielding 4 interactional styles: structured overview, rational clarity, compassionate perspective, and compassionate precision. This 4-quadrant framework served as an interpretive heuristic and does not constitute an evaluation of quality or effectiveness.ConclusionsThe findings indicate that contemporary GenAI chatbots, when used as digital adjuncts, may enact communication styles that can be perceived as supportive, culturally sensitive, and LGBTQI+ (lesbian, gay, bisexual, transgender, queer, and intersex)-inclusive in specific sexual health interactions. Although these systems lack ethical consciousness and cannot replace professional care, their performative responses may complement clinical practice by facilitating reflection and access to sensitive information. The study highlights how care-like meanings may emerge through sociomaterial interactions between users and artificial intelligence systems rather than demonstrating generalized performance or clinical reliability.