Background Sexual behavioural and health differences are known to exist between gay and bisexual men, but less is known about heterosexual-identifying men who have sex with men (MSM). We conducted a systematic review of articles reporting on this population to inform public health interventions.
Methods We searched six databases for articles reporting sexual behaviour and health outcomes in heterosexual-identifying MSM in Western Europe, Australia, New Zealand and North America, from 2008 to January 2018. All were screened by a primary reviewer, 10% were screened by a second independent reviewer.
Results From 3126 articles identified, 42 were quantitative and included in a narrative synthesis (40 reported on studies conducted in the USA). The majority reported data from MSM-focused studies; five were general population studies. HIV prevalence for heterosexual-identifying MSM (range across studies: 4.6–11.4%) was lower than for gay (11.2–43.8%) or bisexual (12.4–29.8%) MSM, however, fewer heterosexual-identifying MSM reported recent testing for HIV (40–49% vs 64–68% of gay men, 56–62% of bisexual men) or STIs. There was no difference by sexual identity in MSM’s reporting of recent condomless sex with casual male partners (42%–52% of those reporting recent sex with casual partners) or insertive condomless sex, however heterosexual-identifying MSM were less likely than gay MSM to report receptive condomless sex. They reported fewer recent male partners than gay or bisexual MSM, more recent female partners than gay MSM, and similar numbers of lifetime partners of either sex compared to gay or bisexual MSM.
Conclusion Heterosexual-identifying MSM report fewer male partners than gay or bisexual MSM, however similarities in risk behaviours indicate a group at risk of poorer sexual health than the general population. The data also suggest inadequate sexual health service use by these men such that additional targeted approaches to health promotion and infection control for this population may be warranted.
Disclosure No significant relationships.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.