Sexual and Mental Health Inequalities across Gender Identity and Sex-Assigned-at-Birth among Men-Who-Have-Sex-with-Men in Europe: Findings from EMIS-2017

Abstract

Some men who have sex with men (MSM) were assigned female at birth (AFB) and/or identify as trans men. Little is known about how these men differ from other MSM. We compared sexual and mental health indicators from the European MSM Internet Survey (EMIS-2017), comparing men AFB and/or currently identifying as trans men with those assigned male at birth (AMB) who identified as men. EMIS-2017 was an opportunistic 33-language online sexual health survey for MSM recruiting throughout Europe. We used regression models adjusting for age, country of residence and employment status to examine differences across groups. An analytic sample of 125,720 men living in 45 countries was used, of which 674 (0.5%) were AFB and 871 (0.7%) identified as trans men. The two sub-groups were not coterminous, forming three minority groups: AFB men, AFB trans men and AMB trans men. Minority groups were younger and more likely unemployed. Anxiety, depression, alcohol dependence and sexual unhappiness were more prevalent in sex/gender minority men. Conversely HIV and STI diagnoses were less common. AMB trans men were most likely to have sexual risk behavior with steady partners and to have unmet health promotion needs, and were least likely to be reached by interventions. Sex assigned at birth and trans identification were associated with different sexual and mental health needs. To facilitate service planning and to foster inclusion, sex-assigned-at-birth and current gender identity should be routinely collected in health surveys.

Changes in STI and HIV testing and testing need among men who have sex with men during the UK’s COVID-19 pandemic response

“…Given the small number of migrants and participants from ethnic minority groups (despite attempts to boost the number of participants from these groups by using different images and social media platforms to promote our survey), we needed to categorise country of birth and ethnicity as binary variables thereby overlooking substantive differences in sexual health within these groups 13 19. Likewise, as the majority of participants were cisgender MSM, we were unable to make meaningful inferences on barriers to access and sexual health needs of gender minorities 24 25. The variables we derived to try and capture unmet STI/HIV testing need were informed by national guidelines,1 which advise quarterly STI and HIV testing in MSM engaging in certain risk behaviours.…”

‘Stay at home …’: exploring the impact of the COVID-19 public health response on sexual behaviour and health service use among men who have sex with men: findings from a large online survey in the UK

“…We explored changes in sexual behaviour and use of SHS among cisgender men, transgender and gender-diverse people who have sex with men in the UK, during the UK COVID-19 response to understand service need. The paucity of evidence on sexual risk behaviours among transgender and gender-diverse people in the UK [10][11][12] underlines the importance of identifying the sexual health needs of these groups. 13 Previous research demonstrated the feasibility and acceptability of rapid risk assessment methods to enhance existing surveillance measures in response to public health incidents and outbreaks.…”

An Outbreak of Hepatitis A among Young Adult Men in Cyprus

“…From this and other data, it seems clear that all patients on PrEP should be shown to be Hepatitis A immune or vaccinated. Although hepatitis A vaccination coverage among MSM in Cyprus is not known, according to the recently published results of the EMIS (European men-who-have-sex-with-men Internet survey) survey, hepatitis A vaccination (at least one dose) was reported by approximately 40% of participants [ 15 ]. It is also important to note that a national recommendation for vaccination against hepatitis A in MSM was not in effect in Cyprus before the outbreak.…”