A Comparative Analysis of Lifetime Medical Conditions and Infectious Diseases by Sexual Identity, Attraction, and Concordance: Results from a National U.S. Survey

BACKGROUND. There have been relatively few studies of potential disparities in the prevalence/risk for health conditions or infectious diseases other than HIV/AIDs and other sexually transmitted infections (STIs) among sexual minority men (e.g., men who self-identify as gay or bisexual or who have sex with other men). The recent addition of sexual orientation questions to the National Survey on Drug Use and Health (NSDUH) and other general population surveys now allows for health-related research using national surveys that identify participant sexual orientation.

OBJECTIVES. We sought to: compare the prevalences/odds of having ten medical conditions/infectious diseases for sexual majority and sexual minority men and assess for differences associated with sexual identity, sexual attraction, and the degree of concordance between identity and attraction.

METHOD. Data from 18,718 adult (18 and over) male participants in the 2015 NSDUH survey were analyzed using bivariate and multivariable logistic regression models to assess for differences in the prevalence/adjusted odds of seven medical conditions (asthma, heart condition, hypertension, diabetes, chronic bronchitis or chronic obstructive pulmonary disease, kidney disease, cancer of any kind) and three infectious diseases (hepatitis B or C; STIs, and HIV/AIDS). Multivariable models adjusted for demographics, substance abuse/dependence, and mental illness.

RESULTS. Except for HIV/AIDS, there were no significant associations between sexual identity and any medical condition in the multivariable models nor were there any significant associations with sexual attraction or concordance.

CONCLUSION. The findings diverge from prior studies that used non-national samples and which found modest health differences for gay and bisexual men for some conditions other than HIV or STIs. The divergent findings highlight the importance of having nationally representative data for health research related to sexual minorities.