In 2023, approximately 85.5 percent of people aged between 16 and 24 in the United Kingdom identified as being heterosexual, the lowest among the provided age groups. In this year, 7.5 percent of people in this age group identified as being Bisexual, compared with just 0.2 percent of people aged 65 or over.

In 2022, about 72 percent of male-male couples in the United States were White, compared to 6.4 percent of gay couples who were Black or African American.

Gay marriage in the United States

In the mid-1990s, a majority of the U.S. population believed that same-sex couples should not be recognized by law, although this figure has been on the decline since then. In 2011, more than 50 percent of Americans believed the opposite, saying that homosexual couples should be recognized by law. 2015 saw a spike in support, and on June 26 of that year, the United States Supreme Court legalized same-sex marriage in all 50 states in the case of Obergefell v. Hodges.

Being LGBT in America

The share of Americans who identify as lesbian, gay, bisexual, or transgender (LGBT) has been on the rise since 2012 and it is estimated that there are about one million same-sex couples in the U.S. Additionally, about half of surveyed people in 2019 believe that one is born gay or lesbian – a significant increase from 1977, when only 13 percent of respondents said the same.

ObjectivesTo assess ecological, structural, community and individual level correlates of health services utilization along a continuum of HIV care, and sexual health and support services among gay and bisexual men worldwide.MethodsUsing a nonprobability internet sample of 6,135 gay and bisexual men, we assessed correlates of utilization of health services. Chi-Square Tests of Independence were performed to assess drop off along a continuum of HIV care. Multivariable logistic regression analyses using generalized estimating equation models were conducted adjusting for geographic region and clustering by country. In multivariable analyses, we determined the association between utilization outcomes, and ecologic, structural, community and individual correlates by fitting separate generalized estimating equation (GEE) logistic regression models for each of the outcomes, fitted with robust SEs, and accounting for clustering by country. Stratified by sexual identity, analyses adjusted for variables that could influence HIV-related health outcomes including racial/ethnic minority status, participant age, insurance, ability to make ends meet, as well as country-level income (income of country of residence defined by the World Bank).ResultsAmong men living with HIV (n = 1001), being in HIV care (n = 867) was associated with being on ART (X2 = 191.17, p < .001), and viral load suppression (X2 = 14.03, p < .001); and using ART (n = 840) was associated viral load suppression (X2 = 21.66, p < .001). Overall, the pattern of utilization outcomes were similar for both gay and bisexual men. For example, utilization of PrEP, being in HIV care and utilization of most of the sexual health and support services were negatively associated with sexual stigma. Whereas, utilization of most HIV prevention, and sexual health and support services were positively associated with provider discrimination. Utilization of all HIV prevention and all sexual health services were positively associated with greater community engagement, and receiving services from LGBT-led organizations. Bisexual men had higher odds of reporting provider discrimination when utilizing condom services (gay: AOR = 1.14, [0.95–1.36]; bisexual: 1.58, [1.10–2.28]), PrEP (gay: AOR = 1.06, [0.77–1.45]; bisexual: AOR = 2.14, [1.18–3.89], mental health services (gay: AOR = 1.03, [0.86–1.23]; bisexual: AOR = 1.32, [1.07–1.64]), and community-based support (gay: AOR = 1.23, [1.05–1.45]; bisexual: AOR = 1.49, [1.14–1.93]) than gay men. Bisexual men also reported higher odds of accessing services from LGBT-led organizations when utilizing PrEP (gay: AOR = 5.26, [2.50–11.05]; bisexual: AOR = 7.12, [3.16–16.04]), and community-based support/self-help groups/individual counseling (gay: AOR = 2.63, [1.72–4.01]; bisexual: AOR = 3.35, [2.30–4.88].ConclusionsIt is essential that barriers to health services utilization be addressed at structural and community levels. Structural interventions should be designed to reduce sexual stigma, as well as train and sensitize healthcare providers; and strengthen community level interventions that bring gay and bisexual men together to lead comprehensive health services.

This pilot project from the Pilot and Developmental Funding Core of the UNC Center for Regulatory Research on Tobacco Communication implements a novel, probability-based oversample of LGBT adults, their partners, and identifies within-LGBT predictors of tobacco use as part of the parent grant’s national phone survey. Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health and Food and Drug Administration Center for Tobacco Products under Award Number P50CA180907. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Food and Drug Administration. The funder had no role in the design of the study or in data collection, data analysis, interpretation, and writing of the manuscript.

Demographic and psychosocial correlates of HIV testing, PrEP use, familiarity and PrEP, and attitudes toward PrEP among HIV-negative gay/bisexual men, U.S. population, by age cohort (N = 470).

OBJECTIVE: High rates of syphilis have been reported among men who have sex with men (MSM) internationally. Guidelines recommend presumptive treatment of sexual contacts of individuals with syphilis at the point of care. The aim of this study was to determine among men reporting contact with a man with syphilis the proportion who were infected with syphilis and the factors predictive of infection. DESIGN: Contacts who were syphilis infected (cases) were compared with those who were uninfected (controls). SETTING: This study was conducted at the main public sexually transmitted diseases clinic in Victoria, Australia. PARTICIPANTS: One hundred and seventy two MSM presenting as sexual contacts of men with syphilis at a sexual health service in Melbourne, Australia, between July 2007 and October 2011 were assessed for syphilis. OUTCOME MEASURES: Proportion of MSM who are infected with syphilis and factors associated with infection. RESULTS: Of 172 men who presented reporting contact with syphilis, 26 (15%, 95% CI: 10-20%) had syphilis. One man had primary syphilis, four had secondary syphilis, while the remaining 21 had early latent syphilis. Infection was associated with unprotected anal sex over the prior 3 months (adjusted odds ratio 6.1, 95% CI 1.4-26.8). CONCLUSION: One in seven men presenting as contacts of syphilis had syphilis infection, most of whom were latently infected. Contacts reporting recent unprotected anal sex were more likely to have syphilis.

BackgroundAcquired syphilis continues to affect millions of people around the world. It is crucial to study it in the context of HIV Pre-Exposure Prophylaxis (PrEP) to achieve the goals set out in the 2030 Agenda since the literature suggests increased risk behaviors for sexually transmitted infections. This study aimed to investigate the incidence and factors associated with acquired syphilis among PrEP users.Materials and methodsThis retrospective cohort included data on PrEP users from all over Brazil from 2018 to 2020, retrieved from the national antiretroviral logistics system. We calculated the proportion of syphilis before PrEP, the incidence during the user’s follow-up, reinfections, and their possible associated factors. We conducted descriptive, bivariate, and multivariate analysis, estimating the crude Relative Risk, adjusted Odds Ratio (aOR), and their respective confidence intervals (95%CI).ResultsMost of the 34,000 individuals who started PrEP were male (89.0%), white (53.7%), self-identified as male (85.2%), homosexual, gay, or lesbian (72.2%), and had 12 schooling years or more (67.8%). Of these, 8.3% had syphilis in the six months before starting PrEP, and 4% had it in the first 30 days of using the prophylaxis. We identified a loss-to-follow-up rate of 41.7%, although the loss and the cohort shared similar characteristics. The proportion of missed syphilis tests was high: 33.4% in the 30 days and 38.8% in the follow-up period. In the 19,820 individuals effectively monitored, the incidence of acquired syphilis was 19.1 cases per 100 person-years, and 1.9% of users had reinfection. The rate of missed syphilis tests at the 30-day follow-up was 33.4%, and the total follow-up test period was 38.8%. The multivariate analysis identified female gender (aOR 0.3; 95%CI 0.2–0.5), being white or Black (aOR 0.9; 95%CI 0.7–0.9 and aOR 0.7; 95%CI 0.7–0.99, respectively) as protective factors for syphilis. Being homosexual, gay, lesbian (aOR 2.7; 95%CI 2.0–3.7), or having a history of syphilis in the six months before PrEP (aOR 2.2; 95%CI 1.9–2.5) were risk factors for syphilis during PrEP use. Behaviors related to the risk of syphilis included accepting something in exchange for sex (aOR 1.6; 95%CI 1.3–1.9), irregular condom use (use in less than half of sexual intercourse sessions; aOR 1.7; 95%CI 1.53–2.1) and recreational drug use (poppers; aOR 1.5; 95%CI 1.53–2.1).ConclusionSyphilis in the context of PrEP has high rates and is associated with sociodemographic and behavioral factors. We recommend additional studies targeting prevention in this population to curb these figures.

BackgroundIn the Republic of Ireland, the COVID-19 crisis led to sexual health service closures while clinical staff were redeployed to the pandemic response. Gay, bisexual and other men who have sex with men (gbMSM) face pre-existing sexual health inequalities which may have been exacerbated. The aim of this study is to understand sexual health service accessibility for gbMSM in Ireland during the COVID-19 crisis.MethodsEMERGE recruited 980 gbMSM in Ireland (June-July 2021) to an anonymous online survey investigating well-being and service access through geo-location sexual networking apps (Grindr/Growlr), social media (Facebook/Instagram/Twitter) and collaborators. We fit multiple regression models reporting odds ratios (ORs) to understand how demographic and behavioural characteristics (age, sexual orientation, HIV testing history/status, region of residence, region of birth and education) were associated with ability to access services.ResultsOf the respondents, 410 gbMSM accessed sexual health services with some or no difficulty and 176 attempted but were unable to access services during the COVID-19 crisis. A further 382 gbMSM did not attempt to access services and were excluded from this sample and analysis.Baseline: mean age 35.4 years, 88% gay, 83% previously tested for HIV, 69% Dublin-based, 71% born in Ireland and 74% with high level of education.In multiple regression, gbMSM aged 56+ years (aOR = 0.38, 95%CI:0.16, 0.88), not previously tested for HIV (aOR = 0.46, 95%CI:0.23, 0.93) and with medium and low education (aOR = 0.55 95%CI:0.35, 0.85) had lowest odds of successfully accessing services.GbMSM with HIV were most likely to be able to access services successfully (aOR = 2.68 95%CI:1.83, 6.08).Most disrupted services were: STI testing, HIV testing and PrEP.ConclusionsService access difficulties were found to largely map onto pre-existing sexual health inequalities for gbMSM. Future service development efforts should prioritise (re)engaging older gbMSM, those who have not previously tested for HIV and those without high levels of education.

Associations of anxiety and depressive symptoms (regression coefficients (β), and 95% confidence intervals) with sleep and food related problems; and of sharing of stress and increased frequency of calling family members (adjusted odds rations (AOR, 95% confidence intervals) with the quality of social relationships and social empathy among Indian adults.

Historical context for the definition of three cohorts of sexual minorities in the United States.

Study characteristics of randomised controlled trials included in this review, grouped by intervention type.

Factors associated with engagement in sexualised drug use in the previous 12 months among gbMSM with a diagnosis of HIV who took part in EMIS-2017 and were included in the study sample (n = 141).

Baseline characteristics of gbMSM with a diagnosis of HIV who took part in EMIS-2017 and were included in the study sample, by engagement in recreational drug use (excluding poppers) and sexualised drug use in the previous 12 months (n = 141).

Transition probabilities for sexual risk behaviour among 542 GBMSM in the AURAH2 study.