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The health and well-being of men who have sex with men (MSM) in Britain: Evidence from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

Mercer, CH; Prah, P; Field, N; Tanton, C; Macdowall, W; Clifton, S; Hughes, G; ... Sonnenberg, P; + view all (2016) The health and well-being of men who have sex with men (MSM) in Britain: Evidence from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). BMC Public Health , 16 , Article 525. 10.1186/s12889-016-3149-z. Green open access

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Abstract

BACKGROUND: To date, research on men who have sex with men (MSM) has largely focused on their sexual health needs and on men recruited from gay-orientated venues. National probability survey data provide a rare opportunity to examine the broader sociodemographic, behavioural, and health profiles of MSM, defined as men who reported ≥1 male sexual partner(s) in the past 5 years, and thus regardless of their sexual identity, in comparison to men reporting sex exclusively with women (MSEW) during this time, and also the extent that health inequalities cluster. METHODS: Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a probability sample survey, interviewed 15,162 people aged 16–74 years (6,293 men) during 2010–2012 using computer-assisted personal-interviewing with a computer-assisted self-interview. We used multivariable regression to compare MSM relative to MSEW in their reporting of variables, individually and collectively, corresponding to three domains: physical, mental, and sexual health. RESULTS: Among all men, 2.6 % (n = 190) were defined as MSM, of whom 52.5 % (95 % CI: 43.6 %–61.2 %) identified as gay. MSM were as likely as MSEW (n = 5,069) to perceive their health was ‘bad’/’very bad’, despite MSM being more likely to report a long-standing illness/disability/infirmity (adjusted odds ratio, AOR: 1.46, 95 % CI:1.02–2.09), treatment for depression/past year (2.75, 1.69–4.47), and substance use (e.g., recreational drug use/past year: 3.46, 2.22–5.40). MSM were more likely to report harmful sexual health behaviours, e.g., condomless sex with ≥2 partners/past year (3.52, 2.13–5.83), and poor sexual health outcomes, including STI diagnosis/es (5.67, 2.67–12.04), poorer sexual function (2.28, 1.57–3.33), both past year, and ever-experience of attempted non-volitional sex (6.51, 4.22–10.06). MSM were also more likely than MSEW to report poor health behaviours and outcomes both within and across the three health domains considered. Of all MSM, 8.4 % had experienced poor health outcomes in all three domains – physical, mental, and sexual health - in contrast to 1.5 % of all MSEW. CONCLUSIONS: MSM are disproportionately affected by a broad range of harmful health behaviours and poor health outcomes. Although often observed for a minority of MSM, many health inequalities were seen in combination such that policies and practices aimed at improving the health and well-being of MSM require a holistic approach, regardless of clinical specialty.

Type: Article
Title: The health and well-being of men who have sex with men (MSM) in Britain: Evidence from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12889-016-3149-z
Publisher version: http://dx.doi.org/10.1186/s12889-016-3149-z
Language: English
Additional information: Copyright © 2016 Mercer et al. Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0 (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1504528
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