Bisexual men with HIV reported greater levels of self-stigma, worse self-image and poorer emotional wellbeing compared to gay men. Sadly, they also reported less social support and fewer connections to the LGBTQIA community and to other people living with HIV (PLHIV), so that they expressed feelings of social isolation and highlighted fears of rejection associated with their HIV diagnoses.
This is according to a study – “Bisexual Men Living with HIV: Wellbeing, Connectedness and the Impact of Stigma” by Power, J. et al – that appeared in AIDS and Behavior.
As it is, men who have sex with men (MSM) – including bisexual men – are the most affected population by HIV.
In the Philippines, for instance, in February 2021, 855 newly-confirmed HIV-positive individuals were reported to the HIV/AIDS & ART Registry of the Philippines (HARP). Ninety-four percent (804) of the reported cases were male. Also, among the newly-reported cases of people infected with HIV through sexual contact, most (86%, 708) were males who have sex with males (MSM).
When Power, et al conducted their study in Australia, they noted that most HIV-related research tends to group all MSM together and does not differentiate between gay and bisexual men. Due to this, the unique experiences of bisexual men living with HIV are often marginalized and incorporated under the broader MSM umbrella, even though they may have different experiences. Power and colleagues wanted to investigate the unique challenges that these men face, specifically related to stigma, social connectedness and mental health.
Data for the study was taken from the 2015-2016 HIV Futures 8 survey, conducted with a sample of 872 adults living with HIV in Australia. This survey asked varied questions related to the participants’ lives, including physical and mental health, HIV stigma, social support and connections to the LGBTQ community. An open-text question regarding experiences of feeling guilty, shameful or fearful about HIV was also included.
The authors focused on a subset of 48 men who identified as bisexual (6%) and compared these responses to the cis and transgender men who identified as gay (681 men, 87% of the sample).
Some of the key findings include:
- Bisexual men were on average older than gay men (55 vs 49 years old) and were more likely to report their annual income to be half the average household income.
- For those in relationships, bisexual men reported that their primary partner was female.
- Thought bisexual and gay men did not significantly differ in terms of HIV-related areas (such as years living with HIV, use of treatment or viral load detectability), bisexual men were nearly three times more likely to report poorer general health, twice as likely to report poorer emotional wellbeing, and were also significantly more likely to have used medication for a mental health condition in the previous six months.
- Bisexual men were less likely to report recreational drug use than gay men.
- Bisexual men were four times more likely to report lower social support than gay men. They were also less likely to spend time with other people living with HIV.
- Bisexual men were nearly four times more likely to report higher perceived levels of HIV-related stigma in all areas, including disclosure and concern about public attitudes.
- Some bisexual men also spoke about the need to be vigilant and guarded regarding their status, as they feared the consequences of HIV disclosure particularly in settings such as the workplace. This made them fearful about sharing their status with others. Presumably, being ‘outed’ regarding their HIV status could also lead to being outed about their sexuality.
“It is notable that bisexual men in this survey reported poorer emotional wellbeing, less social connection and higher perceived levels of HIV-related stigma than gay men,” said the researchers, adding that this suggests “that bisexual men living with HIV may have unique support needs that are not adequately addressed through existing programs, and that social and community connection remains a crucial and unmet need for bisexual men living with HIV.”
To remedy the situation, they suggested establishing “mechanisms to increase social connection. This most likely includes dedicated initiatives run by and for bisexual people living with HIV given their unique experiences with respect to connecting with both the LGBTQIA and HIV communities.”