Background It is unclear why gonorrhoea and syphilis rates are increasing among women in Australia. One possible reason is transmission to women from men who have sex with men and women (MSMW). We aimed to explore sexual practices and healthcare use of MSMW and men who have sex with men only (MSMO).

Methods Semi-structured interviews were conducted. Participants were recruited from a public sexual health clinic and via community advertisements in Melbourne, Australia. Men were eligible if they were cisgender, aged 18+ years and had sex with either men or men and women in the last 12 months. Data were analysed thematically.

Results 28 interviews were conducted (15 MSMO, 13 MSMW). Half of MSMW reported predominantly male partners and half predominantly female. MSMO viewed STIs as “an annoying reality of life” and both groups had positive perceptions of STI testing; however, MSMW described more STI stigma and less frequent testing. MSMO and MSMW who were more involved with the queer community had better sexual health knowledge. Many MSMW noted it was easier to have sexual health discussions with male partners; however, many also described the pressure of condom use, “with men, [was] to not use a condom a fair bit of time and probably by women, [was] to use a condom.” There was significant fear in both groups about disclosing sexual practices to general practitioners and some MSMW preferred the anonymity of specialist sexual health clinics. Biphobia and bisexual erasure were frequently discussed by both groups.

Conclusion MSMW described less comprehensive sexual health knowledge and more barriers to accessing sexual health care. Service provision and health promotion messaging must be broadened to capture the reality of increasing sexual fluidity. Destigmatising MSM behaviour and sexual health discussions, particularly in primary care, is crucial to ensuring all people receive appropriate sexual health care.

Disclosure No significant relationships.