Background MSM continue to be disproportionately burdened by STIs and HIV, but sexual well-being is increasingly recognised as being broader than the absence of disease.
Aim To compare the sociodemographic, behavioural, and health profiles of MSM (reporting > = 1 male partner(s), past 5 years) in Britain with men reporting sex exclusively with women (MSEW) during this time, and with MSM a decade earlier, to consider changes over time.
Methods Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a probability survey, interviewed 15,162 people aged 16–74 years (6,293 men) during 2010–2012 using computer-assisted personal-interviewing with computer-assisted self-interviewing for the more sensitive questions. Natsal-2, completed a decade earlier used a similar methodology.
Results Among all men in Natsal-3, 2.6% (n = 190) were MSM, of whom 52.5% identified as gay. Relative to MSEW, MSM were more likely to report recreational drug use (38.4% vs. 15.7%), treatment for depression (14.2% vs. 5.8%), health condition (s) they perceived affected their sexual activity/enjoyment (26.1% vs. 15.3%), dissatisfaction with their sex life (26.3% vs. 16.2%), and STI diagnosis/es (past 5 years; 16.0% vs. 3.7%). MSM reported larger numbers of partners than MSEW in all timeframes considered, differences that remained in multivariable analyses. No changes in MSM prevalence, profile, or behaviour were observed between Natsal-2 and Natsal-3.
Conclusion Poor sexual and mental health is more common among MSM than MSEW. There is thus an urgent need for health promotion among MSM that includes, but goes beyond, focusing on STI/HIV risk reduction and which is appropriate regardless of sexual identity.
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