Advertisement

Archives of Sexual Behavior

, Volume 48, Issue 1, pp 261–275 | Cite as

Differences in HIV Risk Behaviors Between Self-Identified Gay and Bisexual Young Men Who are HIV-Negative

  • Brian A. FeinsteinEmail author
  • Kevin O. Moran
  • Michael E. Newcomb
  • Brian Mustanski
Special Section: Bisexual Health

Abstract

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 24 months 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.

Keywords

Bisexual Gay Identity HIV Condom use Substance use before sex Sexual orientation 

Notes

Funding

This research was supported by a grant from the National Institute on Drug Abuse (U01DA036939; PI: Mustanski). Brian A. Feinstein was also supported by a grant from the National Institute on Drug Abuse (F32DA042708). We acknowledge the research infrastructure provided by the NIH-funded Third Coast Center for AIDS Research (CFAR) (P30 AI117943) and the NIH-funded Northwestern University Clinical and Translational Sciences Institute (UL1TR001422). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

Compliance with Ethical Standards

Conflict of interest

All the authors declare that they have no conflict of interest.

References

  1. Agronick, G., O’Donnell, L., Stueve, A., Doval, A. S., Duran, R., & Vargo, S. (2004). Sexual behaviors and risks among bisexually- and gay-identified young Latino men. AIDS and Behavior, 8(2), 185–197.  https://doi.org/10.1023/B:AIBE.0000030249.11679.d0.CrossRefPubMedGoogle Scholar
  2. Arnett, J. J. (2000). Emerging adulthood. A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469–480.  https://doi.org/10.1037/0003-066X.55.5.469.CrossRefPubMedGoogle Scholar
  3. Balsam, K. F., & Mohr, J. J. (2007). Adaptation to sexual orientation stigma: A comparison of bisexual and lesbian/gay adults. Journal of Counseling Psychology, 54, 306–319.CrossRefGoogle Scholar
  4. Baral, S. D., Poteat, T., Stromdahl, S., Wirtz, A. L., Guadamuz, T. E., & Beyrer, C. (2013). Worldwide burden of HIV in transgender women: A systematic review and meta-analysis. Lancet Infectious Diseases, 13(3), 214–222.  https://doi.org/10.1016/S1473-3099(12)70315-8.CrossRefPubMedGoogle Scholar
  5. Bauer, G. R., & Brennan, D. J. (2013). The problem with “behavioral bisexuality”: Assessing sexual orientation in survey research. Journal of Bisexuality, 13, 148–165.CrossRefGoogle Scholar
  6. Carliner, H., Mauro, P. M., Brown, Q. L., Shmulewitz, D., Rahim-Juwel, R., Sarvet, A. L., … Hasin, D. S. (2017). The widening gender gap in marijuana use prevalence in the U.S. during a period of economic change, 2002–2014. Drug and Alcohol Dependence, 170, 51–58.  https://doi.org/10.1016/j.drugalcdep.2016.10.042.CrossRefPubMedGoogle Scholar
  7. CDC. (2015). HIV among gay and bisexual men. Retrieved from http://www.cdc.gov/hiv/group/msm/index.html.
  8. CDC. (2016). HIV Surveillance Report, 2015. Retrieved from http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html.
  9. Cooper, M. L. (2010). Toward a person × situation model of sexual risk-taking behaviors: Illuminating the conditional effects of traits across sexual situations and relationship contexts. Journal of Personality and Social Psychology, 98(2), 319–341.  https://doi.org/10.1037/a0017785.CrossRefPubMedGoogle Scholar
  10. Cox, N., Vanden Berghe, W., Dewaele, A., & Vincke, J. (2010). Acculturation strategies and mental health in gay, lesbian, and bisexual youth. Journal of Youth and Adolescence, 39(10), 1199–1210.  https://doi.org/10.1007/s10964-009-9435-7.CrossRefPubMedGoogle Scholar
  11. Delker, E., Brown, Q., & Hasin, D. S. (2016). Alcohol consumption in demographic subpopulations: An epidemiologic overview. Alcohol Research, 38(1), 7–15.PubMedGoogle Scholar
  12. Dodge, B., Jeffries, W. L., & Sandfort, T. G. (2008). Beyond the down low: Sexual risk, protection, and disclosure among at-risk Black men who have sex with both men and women (MSMW). Archives of Sexual Behavior, 37(5), 683–696.  https://doi.org/10.1007/s10508-008-9356-7.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Dodge, B., Schnarrs, P. W., Goncalves, G., Malebranche, D., Martinez, O., Reece, M., … Fortenberry, J. D. (2012a). The significance of privacy and trust in providing health-related services to behaviorally bisexual men in the United States. AIDS Education and Prevention, 24(3), 242–256.  https://doi.org/10.1521/aeap.2012.24.3.242.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Dodge, B., Schnarrs, P. W., Reece, M., Martinez, O., Goncalves, G., Malebranche, D., … Fortenberry, J. D. (2013). Sexual behaviors and experiences among behaviorally bisexual men in the midwestern United States. Archives of Sexual Behavior, 42(2), 247–256.  https://doi.org/10.1007/s10508-011-9878-2.CrossRefPubMedGoogle Scholar
  15. Dodge, B., Van Der Pol, B., Reece, M., Malebranche, D., Martinez, O., Goncalves, G., … Fortenberry, J. D. (2012b). Rectal self-sampling in non-clinical venues for detection of sexually transmissible infections among behaviourally bisexual men. Sexual Health, 9(2), 190–191.  https://doi.org/10.1071/sh11068.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Doll, L. S., & Beeker, C. (1996). Male bisexual behavior and HIV risk in the United States: Synthesis of research with implications for behavioral interventions. AIDS Education and Prevention, 8(3), 205–225.PubMedGoogle Scholar
  17. Doll, L., Myers, T., Kennedy, M., & Allman, D. (1997). Bisexuality and HIV risk: Experiences in Canada and the United States. Annual Review of Sex Research, 8, 102–147.PubMedGoogle Scholar
  18. Doll, L. S., Petersen, L. R., White, C. R., Johnson, E. S., Ward, J. W., & The Blood Donor Study Group. (1992). Homosexually and nonhomosexually identified men who have sex with men: A behavioral comparison. Journal of Sex Research, 29, 1–14.CrossRefGoogle Scholar
  19. Drumright, L. N., Patterson, T. L., & Strathdee, S. A. (2006). Club drugs as causal risk factors for HIV acquisition among men who have sex with men: A review. Substance Use and Misuse, 41(10–12), 1551–1601.  https://doi.org/10.1080/10826080600847894.CrossRefPubMedGoogle Scholar
  20. Duncan, S. C., Duncan, T. E., & Hops, H. (1996). Analysis of longitudinal data within accelerated longitudinal designs. Psychological Methods, 1, 236–248.CrossRefGoogle Scholar
  21. Dunlap, A. (2016). Changes in coming out milestones across five age cohorts. Journal of Gay & Lesbian Social Services, 28, 20–38.CrossRefGoogle Scholar
  22. Eady, A., Dobinson, C., & Ross, L. E. (2011). Bisexual people’s experiences with mental health services: A qualitative investigation. Community Mental Health Journal, 47(4), 378–389.  https://doi.org/10.1007/s10597-010-9329-x.CrossRefPubMedGoogle Scholar
  23. Everett, B. G., Schnarrs, P. W., Rosario, M., Garofalo, R., & Mustanski, B. (2014). Sexual orientation disparities in sexually transmitted infection risk behaviors and risk determinants among sexually active adolescent males: Results from a school-based sample. American Journal of Public Health, 104(6), 1107–1112.  https://doi.org/10.2105/AJPH.2013.301759.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Feinstein, B. A., & Dyar, C. (2017). Bisexuality, minority stress, and health. Current Sexual Health Reports, 9, 42–49.CrossRefGoogle Scholar
  25. Feinstein, B. A., Dyar, C., & London, B. (2017). Are outness and community involvement risk or protective factors for alcohol and drug abuse among sexual minority women? Archives of Sexual Behavior, 46, 1411–1423.CrossRefGoogle Scholar
  26. Feinstein, B. A., & Newcomb, M. E. (2016). The role of substance use motives in the associations between minority stressors and substance use problems among young men who have sex with men. Psychology of Sexual Orientation and Gender Diversity, 3(3), 357–366.  https://doi.org/10.1037/sgd0000185.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Friedman, M. R., Wei, C., Klem, M. L., Silvestre, A. J., Markovic, N., & Stall, R. (2014). HIV infection and sexual risk among men who have sex with men and women (MSMW): A systematic review and meta-analysis. PLoS ONE, 9(1), e87139.  https://doi.org/10.1371/journal.pone.0087139.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Grant, B. F., Dawson, D. A., Stinson, F. S., Chou, S. P., Dufour, M. C., & Pickering, R. P. (2004). The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991–1992 and 2001–2002. Drug and Alcohol Dependence, 74(3), 223–234.  https://doi.org/10.1016/j.drugalcdep.2004.02.004.CrossRefPubMedGoogle Scholar
  29. Grov, C., Rendina, H. J., Jimenez, R., & Parsons, J. T. (2016). Using online settings to identify gay and bisexual men willing to take or with experience taking PrEP: Implications for researchers and providers. AIDS Education and Prevention, 28(5), 378–392.  https://doi.org/10.1521/aeap.2016.28.5.378.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Harawa, N. T., Williams, J. K., Ramamurthi, H. C., Manago, C., Avina, S., & Jones, M. (2008). Sexual behavior, sexual identity, and substance abuse among low-income bisexual and non-gay-identifying African American men who have sex with men. Archives of Sexual Behavior, 37(5), 748–762.  https://doi.org/10.1007/s10508-008-9361-x.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Herbst, J. H., Jacobs, E. D., Finlayson, T. J., McKleroy, V. S., Neumann, M. S., Crepaz, N., & HIV/AIDS Prevention Research Synthesis Team. (2008). Estimating HIV prevalence and risk behaviors of transgender persons in the United States: A systematic review. AIDS and Behavior, 12(1), 1–17.  https://doi.org/10.1007/s10461-007-9299-3.CrossRefPubMedGoogle Scholar
  32. Hergenrather, K. C., Emmanuel, D., Durant, S., & Rhodes, S. D. (2016). Enhancing HIV prevention among young men who have sex with men: A systematic review of HIV behavioral interventions for young gay and bisexual men. AIDS Education and Prevention, 28(3), 252–271.  https://doi.org/10.1521/aeap.2016.28.3.252.CrossRefPubMedGoogle Scholar
  33. Herrick, A. L., Marshal, M. P., Smith, H. A., Sucato, G., & Stall, R. D. (2011). Sex while intoxicated: A meta-analysis comparing heterosexual and sexual minority youth. Journal of Adolescent Health, 48(3), 306–309.  https://doi.org/10.1016/j.jadohealth.2010.07.008.CrossRefPubMedGoogle Scholar
  34. Hogan, B., Melville, J. R., Philips, G. L., 2nd, Janulis, P., Contractor, N., Mustanski, B. S., & Birkett, M. (2016). Evaluating the paper-to-screen translation of participant-aided sociograms with high-risk participants. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, 2016, 5360–5371.  https://doi.org/10.1145/2858036.2858368.CrossRefPubMedGoogle Scholar
  35. Hubach, R. D., Dodge, B., Goncalves, G., Malebranche, D., Reece, M., Van Der Pol, B., … Fortenberry, J. D. (2014). Gender matters: Condom use and nonuse among behaviorally bisexual men. Archives of Sexual Behavior, 43(4), 707–717.  https://doi.org/10.1007/s10508-013-0147-4.CrossRefPubMedGoogle Scholar
  36. Janulis, P., Feinstein, B. A., Phillips, G., Newcomb, M. E., Birkett, M., & Mustanski, B. (2018). Sexual partner typologies and the association between drug use and sexual risk behavior among young men who have sex with men. Archives of Sexual Behavior, 47, 259–271.CrossRefGoogle Scholar
  37. Jeffries, W. L. (2010). HIV testing among bisexual men in the United States. AIDS Education and Prevention, 22(4), 356–370.  https://doi.org/10.1521/aeap.2010.22.4.356.CrossRefPubMedGoogle Scholar
  38. Jeffries, W. L. (2014). Beyond the bisexual bridge: Sexual health among U.S. men who have sex with men and women. American Journal of Preventive Medicine, 47(3), 320–329.  https://doi.org/10.1016/j.amepre.2014.05.002.CrossRefPubMedGoogle Scholar
  39. Jeffries, W. L., & Dodge, B. (2007). Male bisexuality and condom use at last sexual encounter: Results from a national survey. Journal of Sex Research, 44(3), 278–289.CrossRefGoogle Scholar
  40. Jessor, R. (1992). Risk behavior in adolescence: A psychosocial framework for understanding and action. Developmental Review, 12(4), 374–390.CrossRefGoogle Scholar
  41. Jin, F. Y., Prestage, G., Law, M. G., Kippax, S., Van de Ven, P., Rawsthorne, P., … Grulich, A. E. (2002). Predictors of recent HIV testing in homosexual men in Australia. HIV Medicine, 3(4), 271–276.CrossRefGoogle Scholar
  42. Kennedy, M., & Doll, L. S. (2001). Male bisexuality and HIV risk. Journal of Bisexuality, 1, 111–135.Google Scholar
  43. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602.  https://doi.org/10.1001/archpsyc.62.6.593.CrossRefPubMedGoogle Scholar
  44. Lachowsky, N. J., Saxton, P. J., Hughes, A. J., Dickson, N. P., Summerlee, A. J., Milhausen, R. R., & Dewey, C. E. (2015). Younger gay and bisexual men’s condom use with main regular sexual partner in New Zealand. AIDS Education and Prevention, 27(3), 257–274.  https://doi.org/10.1521/aeap.2015.27.3.257.CrossRefPubMedGoogle Scholar
  45. Lever, J., Kanouse, D. E., Rogers, W. H., Carson, S., & Hertz, R. (1992). Behavior patterns and sexual identity of bisexual males. Journal of Sex Research, 29, 141–167.CrossRefGoogle Scholar
  46. Magnusson, A., Skaug, H., Nielsen, A., Berg, C., Kristensen, K., Maechler, M., … Brooks, M. (2016). glmmTMB: Generalized linear mixed models using template model builder. Retrieved from https://github.com/glmmTMB/.
  47. Malebranche, D. J., Arriola, K. J., Jenkins, T. R., Dauria, E., & Patel, S. N. (2010). Exploring the “bisexual bridge”: A qualitative study of risk behavior and disclosure of same-sex behavior among black bisexual men. American Journal of Public Health, 100(1), 159–164.  https://doi.org/10.2105/AJPH.2008.158725.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Martinez, O., Dodge, B., Goncalves, G., Schnarrs, P., Munoz-Laboy, M., Reece, M., … Fortenberry, J. D. (2012). Sexual behaviors and experiences among behaviorally bisexual Latino men in the midwestern United States: Implications for sexual health interventions. Journal of Bisexuality, 12(2), 283–310.  https://doi.org/10.1080/15299716.2012.674865.CrossRefPubMedPubMedCentralGoogle Scholar
  49. Martos, A., Nezhad, S., & Meyer, I. H. (2015). Variations in sexual identity milestones among lesbians, gay men and bisexuals. Sexuality Research and Social Policy, 12(1), 24–33.  https://doi.org/10.1007/s13178-014-0167-4.CrossRefPubMedGoogle Scholar
  50. McKechnie, M. L., Bavinton, B. R., & Zablotska, I. B. (2013). Understanding of norms regarding sexual practices among gay men: Literature review. AIDS and Behavior, 17(4), 1245–1254.  https://doi.org/10.1007/s10461-012-0309-8.CrossRefPubMedGoogle Scholar
  51. Munoz-Laboy, M., & Dodge, B. (2007). Bisexual Latino men and HIV and sexually transmitted infections risk: An exploratory analysis. American Journal of Public Health, 97(6), 1102–1106.  https://doi.org/10.2105/AJPH.2005.078345.CrossRefPubMedPubMedCentralGoogle Scholar
  52. Mustanski, B. (2011). Ethical and regulatory issues with conducting sexuality research with LGBT adolescents: A call to action for a scientifically informed approach. Archives of Sexual Behavior, 40, 673–686.  https://doi.org/10.1007/s10508-011-9745-1.CrossRefPubMedGoogle Scholar
  53. Mustanski, B., Kuper, L., & Greene, G. J. (2014a). Development of sexual orientation and identity. In D. L. Tolman & L. M. Diamond (Eds.), Handbook of sexuality and psychology (pp. 597–628). Washington, DC: American Psychological Association.Google Scholar
  54. Mustanski, B., Newcomb, M. E., & Clerkin, E. M. (2011a). Relationship characteristics and sexual risk-taking in young men who have sex with men. Health Psychology, 30(5), 597–605.  https://doi.org/10.1037/a0023858.CrossRefPubMedPubMedCentralGoogle Scholar
  55. Mustanski, B. S., Newcomb, M., Du Bois, S. N., Garcia, S. C., & Grov, C. (2011b). HIV in young men who have sex with men: A review of epidemiology, risk and protective factors, and interventions. Journal of Sex Research, 48(2–3), 218–253.  https://doi.org/10.1080/00224499.2011.558645.CrossRefPubMedPubMedCentralGoogle Scholar
  56. Mustanski, B., Ryan, D. T., & Garofalo, R. (2014b). Associations of sexually transmitted infections with condom problems among young men who have sex with men. Sexually Transmitted Diseases, 41(7), 427–432.  https://doi.org/10.1097/OLQ.0000000000000150.CrossRefPubMedPubMedCentralGoogle Scholar
  57. Mustanski, B., Starks, T., & Newcomb, M. E. (2014c). Methods for the design and analysis of relationship and partner effects on sexual health. Archives of Sexual Behavior, 43(1), 21–33.  https://doi.org/10.1007/s10508-013-0215-9.CrossRefPubMedPubMedCentralGoogle Scholar
  58. Mustanski, B., Swann, G., Newcomb, M. E., & Prachand, N. (2017). Effects of parental monitoring and knowledge on substance use and HIV risk behaviors among young men who have sex with men: Results from three studies. AIDS and Behavior, 21, 2046–2058.CrossRefGoogle Scholar
  59. Newcomb, M. E., & Mustanski, B. (2013). Racial differences in same-race partnering and the effects of sexual partnership characteristics on HIV Risk in MSM: A prospective sexual diary study. Journal of Acquired Immune Deficiency Syndromes, 62(3), 329–333.  https://doi.org/10.1097/QAI.0b013e31827e5f8c.CrossRefPubMedGoogle Scholar
  60. Newcomb, M. E., Ryan, D. T., Greene, G. J., Garofalo, R., & Mustanski, B. (2014). Prevalence and patterns of smoking, alcohol use, and illicit drug use in young men who have sex with men. Drug and Alcohol Dependence, 141, 65–71.  https://doi.org/10.1016/j.drugalcdep.2014.05.005.CrossRefPubMedPubMedCentralGoogle Scholar
  61. Ontario Public Health Association. (2003). Improving the access and quality of public health services for bisexuals. Toronto, ON: Author.Google Scholar
  62. Ott, M. Q., Wypij, D., Corliss, H. L., Rosario, M., Reisner, S. L., Gordon, A. R., & Austin, S. B. (2013). Repeated changes in reported sexual orientation identity linked to substance use behaviors in youth. Journal of Adolescent Health, 52(4), 465–472.  https://doi.org/10.1016/j.jadohealth.2012.08.004.CrossRefPubMedGoogle Scholar
  63. Page, E. H. (2004). Mental health services experiences of bisexual women and bisexual men: An empirical study. Journal of Bisexuality, 4, 137–160.CrossRefGoogle Scholar
  64. Parsons, J. T., Siegel, A. W., & Cousins, J. H. (1997). Late adolescent risk-taking: Effects of perceived benefits and perceived risks on behavioral intentions and behavioral change. Journal of Adolescence, 20(4), 381–392.  https://doi.org/10.1006/jado.1997.0094.CrossRefPubMedGoogle Scholar
  65. R Core Team. (2017). R: A language and environment for statistical computing. Retrieved from https://www.R-project.org/.
  66. Ross, L. E., Dobinson, C., & Eady, A. (2010). Perceived determinants of mental health for bisexual people: A qualitative examination. American Journal of Public Health, 100(3), 496–502.  https://doi.org/10.2105/AJPH.2008.156307.CrossRefPubMedPubMedCentralGoogle Scholar
  67. Siegel, A. W., Cuccaro, P., Parsons, J. T., Wall, J., & Weinberg, A. D. (1993). Adolescents’ thinking about emotions and risk-taking. In J. M. Puckett & H. W. Reese (Eds.), Mechanisms of everyday cognition (pp. 155–175). Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
  68. Simons, J., Correia, C. J., & Carey, K. B. (2000). A comparison of motives for marijuana and alcohol use among experienced users. Addictive Behaviors, 25(1), 153–160.CrossRefGoogle Scholar
  69. Stokes, J. P., McKirnan, D., & Burzette, R. (1993). Sexual behavior, condom use, disclosure of sexuality, and stability of sexual orientation in bisexual men. Journal of Sex Research, 30, 203–213.CrossRefGoogle Scholar
  70. Stokes, J. P., Vanable, P., & McKirnan, D. J. (1997). Comparing gay and bisexual men on sexual behavior, condom use, and psychosocial variables related to HIV/AIDS. Archives of Sexual Behavior, 26(4), 383–397.CrossRefGoogle Scholar
  71. Swann, G., Newcomb, M. E., & Mustanski, B. (2018). Validation of the HIV Risk Assessment of Sexual Partnerships (H-RASP): Comparison to a 2-month prospective diary study. Archives of Sexual Behavior, 47, 121–131.CrossRefGoogle Scholar
  72. Thompson, R. G., Eaton, N. R., Hu, M. C., Grant, B. F., & Hasin, D. S. (2014). Regularly drinking alcohol before sex in the United States: Effects of relationship status and alcohol use disorders. Drug and Alcohol Dependence, 141, 167–170.  https://doi.org/10.1016/j.drugalcdep.2014.05.021.CrossRefPubMedPubMedCentralGoogle Scholar
  73. Vosburgh, H. W., Mansergh, G., Sullivan, P. S., & Purcell, D. W. (2012). A review of the literature on event-level substance use and sexual risk behavior among men who have sex with men. AIDS and Behavior, 16(6), 1394–1410.  https://doi.org/10.1007/s10461-011-0131-8.CrossRefPubMedGoogle Scholar
  74. Young, R. M., & Meyer, I. H. (2005). The trouble with “MSM” and “WSW”: Erasure of the sexual-minority person in public health discourse. American Journal of Public Health, 95(7), 1144–1149.  https://doi.org/10.2105/ajph.2004.046714.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Medical Social Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  2. 2.Institute for Sexual and Gender Minority Health and WellbeingNorthwestern UniversityChicagoUSA

Personalised recommendations