Sexual Orientation Measurement, Bisexuality, and Mental Health in a Sample of Men Who Have Sex with Men in Vancouver, Canada

abstract

This cross-sectional study used a validated index (i.e., Hospital Anxiety and Depression Scale) to measure anxiety and depression (caseness score: ≥8) among men who have sex with men recruited via respondent-driven sampling in Vancouver, Canada (N = 774) and investigated whether differences in mental health outcomes varied by sexual orientation measure (i.e., identity, attraction, behavior). Of the sample, 15.5% identified as bisexual, 33.4% reported any bisexual attraction, and 22.7% reported any bisexual sexual activity. More bisexual than gay men met the case definition for anxiety and depression, across all sexual orientation measures. In adjusted multivariable models, bisexual men had higher odds of anxiety by attraction and identity and higher odds of depression by identity. Findings highlight the value of measuring multiple sexual orientation dimensions in surveys and routine surveillance, and the need to ensure sexual minority groups and sexual orientation dimensions are not considered commensurate for mental health prevention and treatment.

Keywords:

• Bisexuality
• measurement
• men who have sex with men
• anxiety
• depression

Acknowledgements

We thank the research participants for sharing their important data with the Momentum Health Study. We also thank our community-based partners on the Momentum Health Study Community Advisory Board for their input in this work, including representatives from the Health Initiative for Men, YouthCO HIV & Hep C Society of BC, and Positive Living Society of BC.

Additional information

Funding

This work was supported by the Canadian Institutes for Health Research [MOP-107544, FDN-143342, PJT-153139] and the National Institute for Drug Abuse at the National Institutes for Health [R01DA031055-01A1]. AJR is supported by a Frederick Banting and Charles Best Doctoral Research Award from the Canadian Institutes of Health Research (#152382). HLA is supported by a Postdoctoral Fellowship Award from the Canadian Institutes of Health Research (#MFE-152443). DMM and NJL are supported by Scholar Awards (#5209, #16863) from the Michael Smith Foundation for Health Research. NJL was also supported by a CANFAR/CTN Postdoctoral Fellowship Award.

Notes on contributors

Ashleigh J. Rich

Ashleigh J Rich, MPH, is a doctoral fellow at the British Columbia Centre for Excellence in HIV/AIDS in Vancouver, Canada and a doctoral candidate in the School of Population and Public Health at the University of British Columbia. She holds a Masters in Public Health degree from the University of British Columbia.

Heather L. Armstrong

Heather L. Armstrong, PhD, is a Postdoctoral Fellow at the British Columbia Centre for Excellence in HIV/AIDS and holds a PhD in Experimental Psychology from the University of Ottawa.

Zishan Cui

Zishan Cui, MSc, is a biostatistician with the British Columbia Centre for Excellence in HIV/AIDS and holds a masters degree in statistics from the University of British Columbia.

Paul Sereda

Paul Sereda, BA, is Lead Data Analyst at the British Columbia Centre for Excellence in HIV/AIDS and holds a Bachelor of Arts (Honours) focused on sociology and economics from the University of Calgary.

Nathan J. Lachowsky

Nathan J. Lachowsky, PhD, is an Assistant Professor in the University of Victoria School of Public Health and Social Policy. He holds a PhD in epidemiology from the University of Guelph.

David M. Moore

David M. Moore, MDCM, MHSc, FRCP(C), is a physician researcher at the British Columbia Centre for Excellence in HIV/AIDS, and an Associate Professor in the Department of Medicine at the University of British Columbia.

Robert S. Hogg

Robert S. Hogg, PhD, is a Professor in the Faculty of Health Sciences at Simon Fraser University, British Columbia Centre for Excellence in HIV/AIDS and Senior Research Scientist at the British Columbia Centre for Excellence in HIV/AIDS. His academic training includes graduate degrees anthropology from the University of Victoria and Demography from the Australian National University.

Eric A. Roth

Eric A. Roth, PhD, is Professor in the Department of Anthropology at the University of Victoria and holds a PhD in anthropology from the University of Toronto.