Bisexual People’s Utilization of Sexual Health Services at an LGBTQ Community Center in Chicago

Abstract

Bisexual people are at increased risk for sexually transmitted infections (STIs), including HIV. In STI data collection, bisexual people are often miscategorized as or conflated with heterosexual or gay/lesbian people. Such poor data capture practices invisibilize bisexual people and prevent the tailoring of HIV and STI services to cater to bisexual populations. The Center on Halsted (COH) is an LGBTQ community center in Chicago. COH’s HIV & STD Services Department provides HIV testing to people who present for HIV screening services age 12 and older. COH also administers the State of Illinois AIDS, HIV, & STD Hotline. This manuscript reports HIV-related service access patterns of COH clients by sexual identity, with an emphasis on reporting patterns among bisexual and other non-monosexual (e.g., “bi+”) populations in comparison with other sexual minority populations. Among COH’s HIV testing clients who were sexual minorities in fiscal years 2018 and 2019, 15.42% in 2018 and 16.71% in 2019 identified as bisexual, respectively. Among sexual minority hotline callers, approximately one quarter (25.1% in 2018 and 28.8% in 2019) identified as bisexual. Given that bisexual individuals comprise over half of sexual minority populations, these findings indicate that bi + individuals may be under-represented in accessing HIV and STI services at COH. These results provide previously unknown insight into the sexual identities of populations accessing HIV- and STD-related services within a LGBTQ community setting. Funders of HIV and STI surveillance services should change reporting requirements to make visible the HIV services access patterns and outcomes of bisexual populations.

Keywords:

• bisexual
• program evaluation
• HIV
• sexually transmitted infection
• community engaged research

Acknowledgments

We acknowledge the guest editor of this Special Issue of the Journal of Bisexuality, Dr. Brian Feinstein, for his guidance and support throughout the process of creating and submitting the manuscript. We are grateful to the reviewers of this manuscript, whose feedback supported the improved course and content of the manuscript. We also acknowledge the work of the HIV & STI Services Team at Center on Halsted: Jill Dispenza, Director of HIV/STI Services; Erica Gafford (currently Director of HIV Testing/Prevention), serving as Data Specialist Manager in FY18 and FY19; Kristine Chapman (former Hotline Manager); Melvin Laureano (former HIV Services Manager); Javier Arellano (former PrEP navigator, former Chicago Department of Public Health Coordinator), and the FY18 and FY19 Full/Part-Time Health Educator Team, as the data reported in this manuscript could not have been collected without their efforts.

Additional information

Funding

We acknowledge funding received by the Chicago Department of Public Health, Gilead, and the Illinois Department of Public Health – Contract #65700002D. During the course of this study, Dr. Beach was supported by a K12 award (K12 HL143959) funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health and administered through the Third Coast Center for AIDS Research (TC CFAR) (P30 AI117943).

Notes on contributors

Nicole Holmes

Nicole Holmes (she/they), is a bisexual Black multi-gender woman who is the Manager of HIV/STD Resourcesat Center on Halsted. She received her Bachelor of Science in Health Education from Southern Illinois University Edwardsville. Her passion work is rooted in supporting sexual health/overall wellness in marginalized communities, including Black Women/Girls/Femmes by educating about healthdisparities. She is a Certified Health Education Specialist (CHES) and she is currently pursuing a Master of Public Health Degree from Northern Illinois University.

Lauren B. Beach

Lauren B. Beach (she/they) is a bisexual, ace spectrum, demigender person who is a Research Assistant Professor at Northwestern University’s Institute for Sexual and Gender Minority Health and Wellbeing. Scientifically, Dr. Beach investigates the epidemiology of chronic physical health conditions over the life course among diverse sexual and gender minority (SGM) populations and people living with HIV (PLWH). She also studies how multilevel health and identity related stigmas affect healthcare quality, chronic condition management, and health outcomes of marginalized populations. A longtime bi + advocate, they currently serve as Steering Committee Co-Chair of the Chicago Bisexual Health Task Force.