Bisexual Research Articles

Mpox in the news: social representations, identity, stigma and coping

In May 2022, when the COVID-19 pandemic began to recede from public view, another infectious disease surprised the world—mpox (formerly monkeypox). It appeared to disproportionately affect gay, bisexual and other...

An Intersectional Analysis of Black Bisexual Men’s Internalized Stigmas

Despite existing research linking bisexuality to poorer health outcomes compared to gay and straight individuals, scholarship has largely neglected the unique vulnerabilities of Black bisexual men. The purpose of this research is to examine Black bisexual men’s reports of internalized stigma experiences with an intersectional framework. We utilize a purposive sampling method to target the engagement of Black bisexual men on a large anonymous social media platform. Our findings suggest that persisting stigmas of Black bisexual men, particularly related to hegemonic masculinity, heterosexism, and White supremacy, are underpinned by a matrix of domination seeking to retain the sub-status of Black sexualities. We end our article with a call for more intersectional models in Black LGBT mental health research. We extend the domains of stigma power as one possible strategy for future scholarship.

Bisexual Identity Concealment for Marital Harmony: Cultural and Religious Pressures in Malaysia

This study investigates the concealment of bisexual identity among married men in Malaysia, a country where homosexuality is both stigmatized and criminalized under Syariah law. The problem lies in the immense cultural, religious, and legal pressures that compel these men to hide their sexual orientation, leading to significant emotional and psychological challenges. The primary objective of this research is to explore how these men manage their bisexual identities while maintaining marital harmony within a conservative, heteronormative society. Using a qualitative phenomenological approach, in-depth interviews were conducted with 15 self-identified bisexual men married to heterosexual women. The data were analyzed through thematic analysis. The findings reveal that societal expectations, fear of divorce, and family reputation are key factors influencing their decision to hide their sexual orientation. Participants reported high levels of anxiety, guilt, and isolation due to the dual pressure of performing heteronormativity in public while concealing their true selves in private. This study contributes to understanding the challenges faced by bisexual men in mixed-orientation marriages in Malaysia, particularly the psychological toll of maintaining secrecy. The implications underscore the need for culturally sensitive mental health services and policy reforms to provide adequate support for bisexual individuals. Such interventions are critical to reducing stigma and promoting emotional well-being in conservative societies.

Secondary Syphilis with Human immunodeficiency Virus (HIV) Coinfection: A Case Report

Syphilis is a sexually transmitted disease caused by spirochete microorganism Treponema pallidum, the infection spreads in four stages: primary, secondary, latent, and tertiary. It can impact almost all organ systems in the body, even years or even decades after the initial infection. Syphilis is an infection that could be transmitted sexually with almost 21.000 new cases in Indonesia. The CDC also estimates that 44% of men who have sex with men and bisexual men who test positive for syphilis will also have HIV. The infection has also re-emerged in developed countries in homosexual population with high number of cases co-infected with HIV. Syphilis is also very common among people with multiple sexual partners, Significant risk factors include HIV infection, this coinfection is common, and the two diseases affect each other in several ways. HIV and syphilis each facilitate infection by the other, and aggravate one another’s clinical course. A 34year-old male was referred from public health center with red rashes found on the palm and soles bilaterally since 1 month before visit. Dermatological examination of the palms and soles showed multiple violaceous macules with clear boundaries, with varying sizes between 0.5cm-1cm,no alopecia,no abnormalities were found in oral mucosa, The result of VDRL examination the titer was 1:64, and TPHA result was Positif. Rapid HIV test showed positive result. Patient was prescribed Benzanthine Peniciline injection intra muscular 2.4 million IU, the patient experienced clinical improvement and decreased VDRL and TPHA titers after a two month of evaluation. Co-infection of syphilis and HIV , HIV and syphilis each facilitate infection by the other, and aggravate one another’s clinical course. The majority of persons with HIV infection respond appropriately to the recommended benzathine penicillin G treatment regimen for primary and secondary syphilis.

Control and Elimination of Hepatitis C Virus Among People With HIV in Australia: Extended Follow-up of the CEASE Cohort (2014-2023).

Approximately 10% of people with HIV in Australia had active hepatitis C virus (HCV) infection prior to availability of government-subsidized direct-acting antiviral (DAA) therapy in 2016. This analysis evaluated progress toward HCV elimination among people with HIV in Australia between 2014 and 2023. The CEASE cohort study enrolled adults with HIV with past or current HCV infection (anti-HCV antibody positive) from 14 primary and tertiary clinics. Biobehavioral, clinical, and virologic data were collected at enrollment (2014-2016), follow-up 1 (2017-2018), and follow-up 2 (2021-2023). HCV treatment uptake, outcome, and HCV RNA prevalence (current infection) were evaluated. Death and HCV reinfection incidence and risk were assessed. Of 402 participants, 341 (85%) had current HCV infection (RNA positive) at enrollment. Among the sample, 83% were gay and bisexual men, 13% had cirrhosis, and 80% had a history of injecting drug use (42%, past 6 months). DAA treatment was scaled up rapidly, with cumulative treatment uptake increasing from 12% in 2014 to 2015 to 92% in 2022 to 2023. HCV RNA prevalence declined from 85% (95% CI, 81%-88%) at enrollment (2014-2016) to 8% (95% CI, 6%-12%) at follow-up 1 (2017-2018) and 0.5% (95% CI, 0%-3%) at follow-up 2 (2020-2023). Sixteen reinfections occurred (incidence, 1.41 per 100 person-years; 95% CI, .81-2.29) as well as 30 deaths (incidence, 1.64 per 100 person-years; 95% CI, 1.11-2.34). HCV reinfection incidence declined over time while mortality remained stable. Universal access and rapid DAA uptake were associated with a dramatic reduction in HCV prevalence and reinfection incidence among people with HIV to levels consistent with microelimination. Registration: NCT02102451 (ClinicalTrials.gov).

Preparedness of Countries in Preventing Monkeypox in The Upcoming Mass Gathering Events: Status and Recommendations

A dangerous zoonotic illness call monkeypox (MPX) is endangering public health by spreading around the world. It is endemic to western and central Africa, particularly in the Democratic Republic of the Congo, where it was first reported in a human being. Concern is raised by the recent increase of incidence across several continents in non-endemic nations. Thus, there are 86746 confirmed cases as of 31 March 2023. MPX cases are significantly rising, with males seeing the highest rates of infection. Concise recommendations by World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) should be considered towards mass gatherings events(MG) to reduce the spreading of this disease. Football leagues and other sport matches, which attract a very large number of participants and audience, impose serious risks and public health consequences. Thus, with the beginning of vaccinations in July 2022, globally healthcare policymakers must make a difficult choice about the monkeypox vaccine at this point in the disease's progression. Since, CDC recommends that healthcare practitioners establish clinical guidelines that will help them recognize instances and give the appropriate monitoring, follow-up, and treatment updates. In the current global outbreak, gay, bisexual, and other men who have sex with men (MSM) are the most impacted demographic group. Therefore, it is essential to curb the spread of the monkeypox virus by increasing vaccine demand among local LGBTQIA+ community members and educating them about the value of immunization.

Increasing STI and HIV preventive behaviors and addressing community-prioritized social determinants of health among young GBQMSM and transgender women of color: Piloting a bilingual multilevel intervention

Abstract Background Sexually transmitted infections (STIs) and HIV disproportionately affect young people; gay, bisexual, queer, and other men who have sex with men (GBQMSM); transgender women; and persons of color. Our community-based participatory research partnership developed and implemented Impact Triad, a bilingual multilevel intervention harnessing peer navigation and mHealth to increase STI/HIV preventive behaviors and address four community-prioritized social determinants of health -- education, employment, social support, and discrimination -- among young African American/Black and Latine GBQMSM and transgender women. Methods Fifteen community-based peer navigators were trained to work within their social networks for 12 months. Each navigator engaged five social network members who completed baseline and immediate post-intervention assessments (retention rate = 97.3%). Regression modeling was used to assess changes in outcomes between baseline and follow-up. Results Among 74 enrolled social network members, the average age was 27.8; 61% identified as African American/Black, 31% as Latine, and 8% as multiracial/multiethnic. The majority self-identified as cisgender men and 8% as transgender women; 78% identified as gay. About half reported monthly income below $1,000. Compared to baseline, at follow-up, social network members increased: STI screening (P = .001), HIV testing (P = .001), condom use (P = .03), and PrEP use (P = .02). Knowledge of PrEP (P < .0001) and of community-based educational (P = .047), job-training (P = .002), and job-finding resources (P = .02) also increased. Social support increased (P < .0001) and perceived discrimination decreased (P < .01). Conclusions Pilot findings suggest that Impact Triad is promising in increasing STI/HIV protective behaviors and addressing social determinants of health among young GBQMSM and transgender women of color; further testing is warranted.

Tobacco, cannabis, alcohol, and polysubstance use disparities among sexual identity groups of US young adult women and men

BackgroundSexual minority young adults (SMYAs) display higher rates of polysubstance use (i.e., current use of multiple substances) than their heterosexual peers, but limited research has explored differences by gender and specific sexual identity. MethodsLatent class analyses (LCAs) examined past-month use of combustible tobacco (i.e., cigarettes, cigars, hookah), e-cigarettes, cannabis, and alcohol among 2,343 YAs (Mage = 24.69, SD = 4.70; 57.4 % women, 42.6 % men; 18.0 % bisexual, 9.4 % gay or lesbian; 36.2% racial/ethnic minority) residing in 6 US metropolitan areas. Multinomial logistic regressions examined associations among sexual identity (bisexual, gay/lesbian, heterosexual) and polysubstance use classes among women (n = 1,345) and men (n = 998), separately. ResultsLCA yielded a 5-class solution: primarily-alcohol use (29.5%), polysubstance use (i.e., use of all 4 substances, 24.3%), non-use (18.1%), cannabis and alcohol co-use (16.3%), and e-cigarette, cannabis, and alcohol co-use (11.8%). Bisexual and lesbian (vs. heterosexual) women displayed lower odds of primarily-alcohol use, whereas bisexual (vs. heterosexual) women displayed higher odds of polysubstance use, as well as e-cigarette, cannabis, and alcohol co-use. Bisexual (vs. heterosexual) men displayed lower odds of primarily-alcohol use, whereas gay (vs. heterosexual) men displayed lower odds of polysubstance use, as well as e-cigarette, cannabis, and alcohol co-use. ConclusionsBisexual women were at greatest risk for polysubstance use of combustible tobacco, e-cigarettes, cannabis, and alcohol, whereas bisexual and gay men were at lower risk than heterosexual men for polysubstance use. Results underscore the need for tailored interventions and campaigns to consider patterns of co-occurring tobacco, cannabis, and alcohol use, particularly for bisexual women.

Sexual Victimization Among Gay and Bisexual Emerging Adult Men: Multivariate Differences in Substance Use, Minority Stress and Relationship Characteristics

ABSTRACT This study documented between-group differences in factors associated with lifetime sexual victimization in a sample of young sexual minority men. Diverse samples of gay (N = 205, ageM = 24.33 years) and bisexual (N = 201, ageM = 23.31 years) men were recruited using the CloudResearch platform to assess recent experiences of intimate partner violence (IPV). Participants were categorized into four groups, cross-classified by dichotomous self-reports of (a) childhood sexual abuse (CSA) and (b) sexual IPV. Principal components analysis was used to reduce the number of variables associated with sexual IPV in three domains: Past-year substance use involvement, minority stress, and relationship characteristics, separately for each sample. Gay men reporting both CSA and sexual IPV reported significantly higher mean factor scores for a principal component with high loadings for recent substance use, daily discrimination, relational aggression and relational victimization, compared to other groups of gay men. Bisexual men who experienced sexual IPV reported significantly higher mean factor scores for a principal component with high loadings for five measures of minority stress, compared to counterparts with no history of sexual victimization. Adult sexual IPV among gay men reporting CSA appears to occur in conditions that include harmful substance use, daily discrimination experiences, and relationship violence. Sexual IPV among bisexual men is associated with multiple minority stressors. Our findings highlighted different patterns of risk factors for sexual IPV among sexual minority men, providing information for tailored risk reduction initiatives, including the need for trauma-informed services and specialized training for service providers.

HIV phylogenetic clusters point to unmet hiv prevention, testing and treatment needs among men who have sex with men in kenya

BackgroundThe HIV epidemic in Kenya remains a significant public health concern, particularly among gay, bisexual, and other men who have sex with men (GBMSM), who continue to bear a disproportionate burden of the epidemic. This study’s objective is to describe HIV phylogenetic clusters among different subgroups of Kenyan GBMSM, including those who use physical hotspots, virtual spaces, or a combination of both to find male sexual partners.MethodsDried blood spots (DBS) were collected from GBMSM in Kisumu, Mombasa, and Kiambu counties, Kenya, in 2019 (baseline) and 2020 (endline). HIV pol sequencing was attempted on all seropositive DBS. HIV phylogenetic clusters were inferred using a patristic distance cutoff of ≤ 0.02 nucleotide substitutions per site. We used descriptive statistics to analyze sociodemographic characteristics and risk behaviors stratified by clustering status.ResultsOf the 2,450 participants (baseline and endline), 453 (18.5%) were living with HIV. Only a small proportion of seropositive DBS specimens were successfully sequenced (n = 36/453; 7.9%), likely due to most study participants being virally suppressed (87.4%). Among these sequences, 13 (36.1%) formed eight distinct clusters comprised of seven dyads and one triad. The clusters mainly consisted of GBMSM seeking partners online (n = 10/13; 76.9%) and who tested less frequently than recommended by Kenyan guidelines (n = 11/13; 84.6%).ConclusionsOur study identified HIV phylogenetic clusters among Kenyan GBMSM who predominantly seek sexual partners online and test infrequently. These findings highlight potential unmet HIV prevention, testing, and treatment needs within this population. Furthermore, these results underscore the importance of tailoring HIV programs to address the diverse needs of GBMSM in Kenya across different venues, including both physical hotspots and online platforms, to ensure comprehensive prevention and care strategies.

Intraminority Gay Community Stress and Coping Responses Among Gay and Bisexual Men in Taiwan

ABSTRACT A proportion of gay and bisexual men (GBM) experience worse mental health when they encounter stress from problems within the gay community. This qualitative study examined the dominant standards held in the gay community in Taiwan, the intraminority-community stress experienced by GBM, and the strategies that GBM adopt to cope with such stress. Data from open and in-depth interviews with 26 GBM were subject to reflexive thematic analysis. The results found that appearance, sexual satisfaction, wealth and social status, being a member of gay groups, and youth were valued in the gay community in Taiwan. These standards resulted in a variety of stress responses, including concerns about not fitting in, diminished self-confidence, feelings of frustration due to unattainable standards and challenges in interpersonal relationships. The strategies adopted to cope with such stress involved acceptance and adherence, passive acceptance, rational thinking and critique, mental resilience, mutual support, and efforts to question and challenge norms. Our findings can provide mental health professionals with key insights into the intraminority gay community stress and coping responses in GBM.

Women's Experiences of Adult Sexual Assault, by Perpetrator Gender and Participant Sexual Orientation.

The vast majority of theoretical and empirical research assessing sexual assault (SA) focuses on man-against-woman SA (MWSA), leaving other forms such as woman-against-woman SA (WWSA) understudied. Relatively simple questions, such as the relative frequency of WWSA for women of different sexual orientations, the tactics (e.g., coercion, force), or forms (e.g., groping, vaginal penetration) employed in WWSA remain unanswered. To address these issues, 268 women (approximately one-third of each bisexual, lesbian, and heterosexual) completed an online survey reporting on whether or not they had experienced a variety of nonconsensual sexual experiences in their adult lifetime, asking specifically about perpetration by men and women. Results indicated that although SA perpetrated by men was far more common, a substantial minority of participants reported having experienced WWSA. In general, tactics and forms employed were similar, regardless of the gender of the perpetrator or the woman's sexual orientation, with two exceptions: bisexual women had experienced higher rates of MWSA, and lesbian women had experienced more SA in the form of oral sex compared to other groups. Implications for theory, empirical research, and especially community and clinical practice are discussed.

OCCURRENCE OF HUMAN PAPILLOMAVIRUS (HPV) IN WOMEN OF LGBTQIA+ COMMUNITY TREATED IN MANAUS, AMAZONAS

Human papillomavirus (HPV) is a significant etiological factor for several types of cancer, including cervical carcinoma, with 80% of cases of cervical cancer occurring in Latin America. In Brazil, cervical carcinoma is the third most prevalent cancer among women, and the northern region and the state of Amazonas have the highest incidence in the country. However, not all women benefit from cervical cancer screening measures. Most women in the LGBTQIA+ community do not seek gynecological health services since they often face barriers related to female homosexuality when accesing sexual health services. Using PCR, this study perfomed the molecular detection and genotyping of HPV in thirty-six patients (20 homosexual and 16 bisexual women) from Manaus, Amazonas, Brazil. Samples of the cervical epithelium were taken during the preventive examination and genotyping was perfomed to detect HPV 16, 18, 31 and 58. Of the thirty-six patients analyzed in this study, 88% of bisexual women (n=14) and 60% of homosexual women (n=12) tested positive for HPV. The HPV 18 genotype was the most frequent among the findings. The results indicate that homosexual and bisexual women are more vulnerable to HPV infections due to the lack of more specific gynecological care directed to this group, which includes the lack of training of professionals to deal with the particularities of this population group. Therefore, more HPV screening studies for LGBTQIA+ women and improved training for specialized health professionals are needed.

Recognising and responding to the community needs of gay and bisexual men around mpox.

In May 2022, a global surge in mpox cases, typically endemic to Western and Central Africa, particularly affected gay, bisexual, and other men who have sex with men (gbMSM). This study examines gbMSM communities' experiences and perceptions around Ireland's public health response to the outbreak. A cross-sectional mixed-methods online survey was conducted. Qualitative data were analysed using reflexive thematic analysis informed by critical realism. A total of 163 gay and bisexual men took part in the survey. Participants accessed information from diverse sources, reporting varying levels of trustworthiness. Overall, participants were well-informed. Four themes were developed from the qualitative data: (1) Perceptions of the mpox response: divergence in urgency, priority, and care; (2) The mpox outbreak as a sign of otherness for gbMSM; (3) The potential for othering through mpox prevention practices; and (4) mpox, memory and fear. While community-led initiatives were effective, significant challenges included stigmatisation, discrimination, and mistrust towards public health institutions, influenced by institutionalised homophobia. The study underscores the need for inclusive, culturally sensitive, and transparent public health strategies. The mpox outbreak highlights the importance of robust community collaboration in public health interventions. Future strategies must ensure equitable access to information, vaccination, and care, and address broader structural inequalities to foster trust and engagement within affected communities.

Perceptions, experiences and concerns with sexually transmitted infections among current and former PrEP users: a longitudinal qualitative study of gay, bisexual and queer men in Canada.

Background Pre-exposure prophylaxis (PrEP) use has been attributed to heightened rates of sexually transmitted infections (STIs), ostensibly due to increased condomless anal sex (CAS) and greater frequency of STI testing. Few qualitative studies have assessed how gay, bisexual and queer men (GBQM) who use PrEP perceive STIs and how these attitudes have evolved post-PrEP uptake. We investigated the perspectives of current and former PrEP users on STIs. Methods Annual, in-depth longitudinal interviews were conducted with 38 current and former PrEP users in Ontario (n =18) and British Columbia (n =20), Canada, as part of a mixed-methods implementation science study (2020-2022). Over 3years, 109 interviews were conducted. Data analysis included reflexive thematic coding and longitudinal recurrent cross-sectional analysis using NVivo 12. Results Four STI-related themes emerged: (1) lack of STI-related concerns due to treatment and prevention optimism, (2) stigma-related concerns, (3) perceived risk among other PrEP users due to increased CAS, and (4) inconsistent testing concerns among non-PrEP users. Over time, some STI-related anxieties decreased with increased knowledge and reduced stigma. However, concerns persisted for other participants due to perceived risky sexual behaviours among other PrEP users and non-PrEP users. Both current and former PrEP users who expressed STI-related apprehensions consistently indicated adopting risk-reduction strategies, including condom use and having fewer sexual partners throughout the study. Conclusions Findings show how varied STI perceptions and experiences among current and former PrEP users shaped sexual decision-making over time. Providers, public health experts, and policymakers should develop a more comprehensive strategy to address STI concerns among GBQM.

"Because of HIV, It Opened My Mind": Intersectional Stigma Experiences Among Filipino Gay and Bisexual Men Living With HIV.

Previous work has demonstrated that gay, bisexual men, and other men who have sex with men (GBM) living with HIV are likely to experience intersectional stigma. However, mainstream systems often fail to recognize how power and privilege shape this experience. Such a complex psychological phenomenon requires an in-depth reflective inquiry that acknowledges individuals as experts in their own experiences. To explicate this matter, this study aimed to develop an understanding of how intersectional stigma impacts the experiences of GBM living with HIV and to illuminate how contexts (un)fuel inequities. The semi-structured interviews with five Filipino GBM living with HIV were analyzed using interpretative phenomenological analysis (IPA). Exploration of their accounts elucidated how cultural elements fueled power dynamics and privilege, which in turn shaped intersectional stigma and their experiences. Narratives accentuated how Filipino GBM living with HIV situate themselves from victims to agents of change who empower and liberate others in the community. Insights from this study underscore the critical role of collective actions in bridging gaps in inequities and guiding the improvement of policies and interventions that are well-suited to the context and culturally appropriate for people living with HIV and other multiply marginalized populations.

Harm reduction techniques among cisgender gay, bisexual, and queer men using anabolic androgenic steroids: a qualitative study

BackgroundAnabolic androgenic steroids (AAS) are synthetic forms of testosterone frequently used as performance enhancing drugs among gay, bisexual, and queer (GBQ) men. Despite widespread use, associated harms, and the likely existence of an AAS use disorder, there is no medical consensus on standards of care for people who use AAS, with most medical providers focusing exclusively on abstinence. Individuals using AAS have developed community-based harm reduction strategies to mitigate these harms.MethodsThis paper is a sub-analysis of qualitative data obtained through semi-structured interviews with GBQ men using AAS for 8 or more weeks recruited through convenience and snowball sampling from clinical sites and LGBTQ + venues in New York City as well as through social media. Interviews were coded with themes developed using reflexive thematic analysis. Data related to harm reduction techniques were then re-analyzed through a prevention strategies framework lens of primary, secondary, and tertiary harm prevention.ResultsThematic saturation was reached at twelve interviews in the primary analysis, with men reporting frequent use of multiple harm reduction techniques. For primary prevention, men avoided oral steroids and simultaneous substance use, tried to obtain AAS from reputable sources, used “cycling” to dose steroids, and practiced sterile injection techniques. Secondary prevention methods included patient-directed lab testing for hematocrit, liver and kidney function, cholesterol, prostate specific antigen, testosterone, and self-performed blood pressure checks. Tertiary prevention included donating blood and the use of medications without a prescription, including aromatase inhibitors, selective estrogen receptor blockers, aspirin, statins, angiotensin receptor blockers, clomiphene, and human chorionic gonadotropin.ConclusionsDespite many GBQ men experiencing harms from anabolic androgenic steroids, community members have often sought harm reduction techniques in lieu of abstinence. Though many of these techniques embrace clinical reasoning and may be more broadly applicable, additional research is needed to understand the impact of each intervention on the overall health of individuals using AAS.

Individual & joint associations of sexual stigma and mental distress with PrEP uptake, adherence and persistence among US gay and bisexual men

BackgroundSexual stigma, mental health disorders, and socioeconomic disparities present important yet incompletely understood barriers to PrEP adoption among gay men and other men who have sex with men (MSM). This study examines how these factors interact and affect PrEP uptake, adherence, and persistence among MSM. MethodsData from the 2018 and 2019 American Men's Internet Survey cycles, involving 6907 adult MSM eligible for PrEP, were analyzed. We assessed sexual stigma heterogeneity among this group using latent class analysis and investigated individual relationships between i) stigma class membership, ii) mental distress, and PrEP engagement (past-year use, adherence, and persistence) using Poisson regression with a robust error variance, considering potential variations based on poverty status. The combined associations of sexual stigma and mental distress with PrEP engagement was evaluated using inverse probability weighting. ResultsFour distinct sexual stigma classes were identified, each exhibiting varied associations with PrEP engagement. Associations with mental distress lost statistical significance after adjusting for confounders. However, having both mental distress and sexual stigma was associated with lower past-year PrEP use, with the strongest association observed for those with anticipated healthcare stigma class membership and mental distress (aPR 0.53 [95% CI: 0.37, 0.76]). Sexual stigma accompanied by mental distress was also associated with significantly increased poor PrEP adherence, particularly among those with family and general social stigma class membership (aPR 2.31 [95% CI: 1.08, 4.97]). ConclusionsPsychosocial factors exert synergistic impacts on PrEP engagement among MSM. Tailored interventions addressing these subtleties may effectively optimize PrEP uptake and improve consistency of use among MSM.

Cancer disparities by age: a focus on sexual and gender minorities.

The purpose of this study is to examine the age at which sexual and gender minorities are diagnosed with cancer relative to heterosexual cisgender individuals. We use population-based representative Behavioral Risk Factor Surveillance Survey data with self-reported sexual orientation, gender identity, cancer diagnoses, and the age at diagnosis. We determined the mean age at diagnosis and used logistic regression modeling to obtain odds ratios, reporting significant differences defined as p < 0.05. Separately, we adjusted for race/ethnicity and corrected for underlying differences in the age of survey respondents. Compared to heterosexual cisgender populations, sexual and gender minorities are diagnosed about 4-11years earlier, with bisexual women and transgender individuals reporting the youngest age, 43.9 and 52.1years, respectively. When focusing on select cancer types, lesbian and bisexual women are diagnosed earlier with breast, melanoma, other skin cancers, and leukemia & lymphoma. Gay and bisexual men are diagnosed earlier with colorectal cancers, and transgender individuals earlier with breast, prostate, melanoma, and other skin cancers compared to heterosexual men and women. These findings suggest that sexual and gender minorities experience earlier onset of cancer and many of these age differences remained even after adjustments were made. These findings need to be confirmed in oncology settings that have cancer incidence and sexual orientation and gender identity data and call for greater attention to sexual and gender minorities in cancer research.

Exploring Sexual Satisfaction in Lesbian and Bisexual Women from a Minority Stress Perspective

Sexual health among lesbian and bisexual (LB) women has largely been studied in the context of sexual health behaviors. Less is known about aspects of sexual health such as sexual satisfaction and minority stress processes as possible predictors of sexual satisfaction. This study explored sexual satisfaction and minority stress in LB women. Single and partnered cisgender LB women (N = 627) were compared on measures of sexual satisfaction and proximal minority stress (i.e., internalized homonegativity and outness/concealment). The proximal minority stress variables were tested as predictors of sexual satisfaction in a regression analysis. Multigroup analyses were also conducted to explore differences between lesbian and bisexual women in the regression analysis. Participants were recruited through LGBT+ websites and other social media platforms in Norway. Results showed that lesbian women were more open about their sexual orientation, reported greater identification with the LGBT+ community, and were more sexually satisfied than bisexual women. Those with a steady partner were also more sexually satisfied than those who were single. Being younger, partnered and experiencing less internalized homonegativity (IH) predicted greater satisfaction in LB women overall, and no differences in the predictors across sexual orientation were found in the multigroup analysis.