Sexually Transmted Diseas Among Gay and Bisexual Men | CDC

Contents:

• IS TE THAT GAY SEX HAS A HIGHER RISK OF STDS?
• HOW MANY PEOPLE ARE LBIAN, GAY, BISEXUAL, AND TRANSGENR?
• DIFFERENT HIV RAT AMONG GAY MEN AND STRAIGHT PEOPLE NOT FULLY EXPLAED BY SEXUAL BEHAVR
• STD FACTS – WHAT GAY, BISEXUAL AND OTHER MEN WHO HAVE SEX WH MEN NEED TO KNOW ABOUT SEXUALLY TRANSMTED DISEAS
• LBIAN, GAY, BISEXUAL, AND TRANSGENR HEALTH
• HIV NOW FECTS MORE HETEROSEXUAL PEOPLE THAN GAY OR BISEXUAL MEN – WE NEED A NEW STRATEGY
• HIV AND ALL GAY AND BISEXUAL MEN
• NST T="UNFED"!=TYPEOF HTMLIMAGEELEMENT&&"LOADG" HTMLIMAGEELEMENT.PROTOTYPE;IF(T){NST T=DOCUMENT.QUERYSELECTORALL("IMG[DATA-MA-IMAGE]");FOR(LET E OF T){(E.SETATTRIBUTE("SRC",),E.REMOVEATTRIBUTE("DATA-SRC")),(E.SETATTRIBUTE("SRCSET",),E.REMOVEATTRIBUTE("DATA-SRCSET"));NST T=E.PARENTNO.QUERYSELECTORALL("SOURCE[DATA-SRCSET]");FOR(LET E OF T)E.SETATTRIBUTE("SRCSET",),E.REMOVEATTRIBUTE("DATA-SRCSET");PLETE&&(,E.PARENTNO.PARENTNO.QUERYSELECTOR("[DATA-PLACEHOLR-IMAGE]"))}}HIV BASICSOVERVIEWABOUT HIV & AIDSWHAT ARE HIV AND AIDS?HOW IS HIV TRANSMTED?WHO IS AT RISK FOR HIV?SYMPTOMS OF HIVDATA & TRENDSU.S. STATISTICSIMPACT ON RACIAL AND ETHNIC MORIGLOBAL STATISTICSHISTORYHIV AND AIDS TIMELEMAKG A DIFFERENCESUPPORTG SOMEONE LIVG WH HIVSTANDG UP TO STIGMAGETTG INVOLVEDHIV PREVENTNUSG HIV MEDITN TO RCE RISKHIV TREATMENT AS PREVENTNPRE-EXPOSURE PROPHYLAXIS (PREP)POST-EXPOSURE PROPHYLAXIS (PEP)RCG SEXUAL RISKPREVENTG SEXUAL TRANSMISSN OF HIVRCG RISK OM ALHOL & DG USEALHOL AND HIV RISKSUBSTANCE USE AND HIV RISKRCG RISK OF PERATAL TRANSMISSNPREVENTG PERATAL TRANSMISSN OF HIVPOTENTIAL FUTURE OPTNSHIV VACCLONG-ACTG HIV PREVENTN TOOLSMICROBICISHIV TTGLEARN ABOUT HIV TTGWHO SHOULD GET TTED?HIV TTG LOTNSHIV TTG OVERVIEWUNRSTANDG HIV TT RULTSJT DIAGNOSED: WHAT'S NEXT?LIVG WH HIVTALKG ABOUT YOUR HIV STATSTARTG HIV CAREFD A PROVIRLOTE AN HIV CARE PROVIRTYP OF PROVIRSTAKE CHARGE OF YOUR CAREGETTG READY FOR YOUR FIRST VISWHAT TO EXPECT AT YOUR FIRST HIV CARE VISSTAYG HIV CAREPROVIR VISS AND LAB TTSMAKG CARE WORK FOR YOUSEEG YOUR HEALTH CARE PROVIRHIV LAB TTS AND RULTSRETURNG TO CAREHIV TREATMENTHIV TREATMENT OVERVIEWVIRAL SUPPRSN AND UNTECTABLE VIRAL LOAD TAKG YOUR HIV MEDICE AS PRCRIBEDTIPS ON TAKG YOUR HIV MEDITN EVERY DAYPAYG FOR HIV CARE AND TREATMENTOTHER RELATED HEALTH ISSUOTHER HEALTH ISSU OF SPECIAL CONCERN FOR PEOPLE LIVG WH HIVALHOL AND DG USECORONAVIS (COVID-19) AND PEOPLE WH HIVHEPATIS B & CIMMUNIZATNS AND PEOPLE WH HIVFLU AND PEOPLE WH HIVMENTAL HEALTHMPOX AND PEOPLE WH HIVOPPORTUNISTIC INFECTNSSEXUALLY TRANSMTED INFECTNSSMOKGHIV AND WOMEN'S HEALTH ISSULIVG WELL WH HIVTAKG CARE OF YOURSELFAGG WH HIVEMERGENCI AND DISASTERS AND HIVEMPLOYMENT AND HEALTHEXERCISE AND PHYSIL ACTIVYFOOD SAFETY AND NUTRNHOG AND HEALTHTRAVELG OUTSI THE U.S.YOUR LEGAL RIGHTSCIVIL RIGHTSWORKPLACE RIGHTSLIMS ON CONFINTIALYFERAL RPONSENATNAL HIV/AIDS STRATEGYNATNAL HIV/AIDS STRATEGY (2022-2025)PRR NATNAL HIV/AIDS STRATEGI (2010-2021)IMPLEMENTG THE NATNAL HIV/AIDS STRATEGYENDG THE HIV EPIMICABOUT ENDG THE HIV EPIMIC THE U.S.OVERVIEWKEY STRATEGIPRRY JURISDICTNSHHS AGENCI INVOLVEDFUNDGTIMELELEARN MORE ABOUT EHEREADY, SET, PREPREADY, SET, PREPREADY, SET, PREP PHARMACIREADY, SET, PREP ROURCAHEADAHEAD: AMERI’S HIV EPIMIC ANALYSIS DASHBOARDFERAL ACTIVI & AGENCIHIV PREVENTN ACTIVIHIV TTG ACTIVIHIV CARE AND TREATMENT ACTIVIHIV REARCH ACTIVIACTIVI COMBATG HIV STIGMA AND DISCRIMATNPOLICI & ISSUTHE AFFORDABLE CARE ACT AND HIV/AIDSHIV CARE CONTUUMSYRGE SERVIC PROGRAMSFUNDGBUDGETFERAL FUNDG FOR HIV/AIDSMORY HIV/AIDS FUNDOVERVIEWBACKGROUNDFUND ACTIVITHE FUND ACTNPACHAABOUT PACHACHARTERMEMBERS & STAFFSUBMTEPRR PACHA MEETGS AND REMENDATNSCAMPAIGNSI AM A WORK OF ART CAMPAIGNAWARENS CAMPAIGNSPEPFAR & GLOBAL AIDSGLOBAL HIV/AIDS OVERVIEWPEPFARU.S. GOVERNMENT GLOBAL HIV/AIDS ACTIVIGLOBAL HIV/AIDS ORGANIZATNSEVENTSAWARENS DAYSNATNAL BLACK HIV/AIDS AWARENS DAY FEBARY 7HIV IS NOT A CRIME AWARENS DAY FEBARY 28NATNAL WOMEN AND GIRLS HIV/AIDS AWARENS DAY MARCH 10NATNAL NATIVE HIV/AIDS AWARENS DAY MARCH 20NATNAL YOUTH HIV & AIDS AWARENS DAY APRIL 10HIV VACCE AWARENS DAY MAY 18NATNAL ASIAN & PACIFIC ISLANR HIV/AIDS AWARENS DAY MAY 19HIV LONG-TERM SURVIVORS AWARENS DAY JUNE 5NATNAL HIV TTG DAY JUNE 27ZERO HIV STIGMA JULY 21SOUTHERN HIV/AIDS AWARENS DAY AUGT 20NATNAL FAH HIV/AIDS AWARENS DAY AUGT 27NATNAL HIV/AIDS AND AGG AWARENS DAY SEPTEMPBER 18NATNAL GAY MEN'S HIV/AIDS AWARENS DAY SEPTEMBER 27NATNAL LATX AIDS AWARENS DAY OCTOBER 15WORLD AIDS DAY DECEMBER 1EVENT PLANNG GUI CONFERENCU.S. CONFERENCE ON HIV/AIDS (USCHA) NATNAL RYAN WHE CONFERENCE ON HIV CARE & TREATMENT AIDS 2020 (23RD INTERNATNAL AIDS CONFERENCE VIRTUAL) LEARNG OPPORTUNILEARNG OPPORTUNILEARNG OPPORTUNIWANT TO STAY ABREAST OF CHANG PREVENTN, RE, TREATMENT OR REARCH OR OTHER PUBLIC HEALTH ARENAS THAT AFFECT OUR LLECTIVE RPONSE TO THE HIV EPIMIC? OR ARE YOU NEW TO THIS FIELD? CURAT LEARNG OPPORTUNI FOR YOU, AND THE PEOPLE YOU SERVE AND LLABORATE WH.STAY UP TO DATE WH THE WEBARS, TWTER CHATS, NFERENC AND MORE THIS SECTN.MORE LEARNG OPPORTUNIBLOGGET TTED. FD SERVIC + PREPSEARCHGOESPAñOL ESPAñOL ES GET TTED. FD SERVIC + PREPSEARCHOPEN LOTOR SEARCHHIV SERVICES LOCATORSEARCH⨯CLOSEHOMEHIV BASICSOVERVIEWDATA AND TRENDSU.S. STATISTICSSECTN MENUGET TTED. FIND SERVICES + PREP.DATA & TRENDSU.S. STATISTICSIMPACT ON RACIAL AND ETHNIC MORIGLOBAL STATISTICSSEARCHDATA & TRENDSU.S. STATISTICSIMPACT ON RACIAL AND ETHNIC MORIGLOBAL STATISTICSU.S. STATISTICS

IS TE THAT GAY SEX HAS A HIGHER RISK OF STDS?

Get Vaccated: Gay, bisexual, and other men who have sex wh men have a greater chance of gettg Hepatis A, Hepatis B, and HPV. The overall number of reported STDs has been on the rise sce 2014 and shows no sign of slowg, wh fectns disproportnately affectg young people unr the age of 25, racial and ethnic mory groups, and gay or bisexual men.

CDC is fundg a monstratn project 4 jurisdictns to intify active HIV transmissn works and implement HIV terventns for Hispanic/Lato gay, bisexual, and other men who have sex wh men. In 2017, CDC award nearly $11 ln per year for five years to 30 CBOs to provi HIV ttg to young gay and bisexual men of lor and transgenr youth of lor, wh the goal of intifyg undiagnosed HIV fectns and lkg those who have HIV to re and preventn servic. Is te that if you have gay sex you have more of a chance of ntractg an STD.

A gay person’s chance of fectn is no different om a straight person’s.

HOW MANY PEOPLE ARE LBIAN, GAY, BISEXUAL, AND TRANSGENR?

Gay, straight, or somewhere between, ’s important to practice safer sex. Comparative prevalence rat of sexually transmted diseas heterosexual and homosexual men. This study pared prevalence rat of most mon sexually transmted diseas (STD) heterosexual and homosexual men who ma rpectively 12, 201 and 5324 viss to an STD clic over 18 months.

DIFFERENT HIV RAT AMONG GAY MEN AND STRAIGHT PEOPLE NOT FULLY EXPLAED BY SEXUAL BEHAVR

Comparative rat of sexually transmted diseas among heterosexual men, homosexual men, and heterosexual women.

As through a glass, darkly: the future of sexually transmissible fectns among gay, bisexual and other men who have sex wh men. Answerg Parents' Qutns About Homosexualy: Helpg parents to accept their child's sexual orientatn. STI risk was found to be elevated among heterosexual-WSW and bisexual women, whether they report same-sex partners or not, whereas gay-intified WSW were ls likely to report an STI pared to heterosexual women wh oppose sex relatnships only.

Among mal, heterosexual-intified MSM did not have a greater likelihood of reportg an STI diagnosis; rather, STI risk was ncentrated among gay and bisexual intified men who reported both male and female sexual partners. For example, g the Natnal Health and Nutrnal Survey 2001–2006, Xu, Maya, and Markowz (2010a) showed that jt over 7% of women reported a same-sex sexual relatnship, of which 50% reported a heterosexual inty, 32% intified as bisexual, and 18% intify as gay or lbian. Usg the same data, Xu, Sternberg, and Markowz (2010b) showed roughly 5% of mal reported a same-sex relatnship, of which 40% intified as heterosexual, 22% intified as bisexual, and 38% intified as gay.

STD FACTS – WHAT GAY, BISEXUAL AND OTHER MEN WHO HAVE SEX WH MEN NEED TO KNOW ABOUT SEXUALLY TRANSMTED DISEAS

Some rearch has suggted that gay-MSM report more sexual partners and a higher prevalence of HIV than heterosexual-MSM (Wolski, Jon, Wasserman, & Smh, 2006; Xu et al., 2010b).

LBIAN, GAY, BISEXUAL, AND TRANSGENR HEALTH

(2009) exmed differenc self-reported STIs and STI risk by behavr and inty among Latos and found that, pared to heterosexual-MSW, heterosexual-MSM were more likely to report unprotected sex and had been diagnosed wh an STI, but there were no signifint differenc bisexual-MSMW and gay-MSM’s likelihood of reportg an STI pared to heterosexual-MSW. A sexual mory inty may “flag” gay, lbian, or bisexual intified persons as targets for victimizatn.

HIV NOW FECTS MORE HETEROSEXUAL PEOPLE THAN GAY OR BISEXUAL MEN – WE NEED A NEW STRATEGY

Ined, several studi have shown that gay, lbian, and bisexual persons experience higher rat of physil and sexual victimizatn both adolcence and adulthood (At, Roberts, Corliss, & Molnar, 2008; Doll et al. Participants were asked to choose “the scriptn that bt fs how you thk about yourself: 100% heterosexual (straight), mostly heterosexual (straight), but somewhat attracted to your own sex; bisexual, that is, attracted to men and women equally; mostly homosexual (mostly gay), but somewhat attracted to the oppose sex; or 100% homosexual (gay). 3 For women, one variable was created that intified women who reported a gay or mostly gay inty and have engaged same-sex sexual relatnship(s) (Gay-WSMW, N = 133).

Among mal, 56% of the 100% gay or mostly gay intified participants reported only havg had same-sex sexual relatnship(s) and 44% reported both same- and oppose-sex sexual relatnship(s). Th, two tegori were created: gay-MSM (Gay-MSM, N = 94) and gay-MSMW (Gay-MSMW, N = 75).

While the efficients were signifint, they are far om perfect rrelatns, suggtg that same-sex sex do not necsarily predict a gay or bisexual STIs STI diagnosis was rived om a qutn that asked participants if a doctor, nurse, or other health profsnal had rmed them that they have had a sexually transmted fectn.

HIV AND ALL GAY AND BISEXUAL MEN

8% of femal intified as gay or mostly 1Dcriptive Statistics of variat by sex and sexual orientatn, U. Femal aged 24–32TotalSample100% HeterosexualMostlyStraight/BisexualMostlyGay/100%GayOp. Three percent of male participants reported a gay or mostly gay inty, of which 55.

NST T="UNFED"!=TYPEOF HTMLIMAGEELEMENT&&"LOADG" HTMLIMAGEELEMENT.PROTOTYPE;IF(T){NST T=DOCUMENT.QUERYSELECTORALL("IMG[DATA-MA-IMAGE]");FOR(LET E OF T){(E.SETATTRIBUTE("SRC",),E.REMOVEATTRIBUTE("DATA-SRC")),(E.SETATTRIBUTE("SRCSET",),E.REMOVEATTRIBUTE("DATA-SRCSET"));NST T=E.PARENTNO.QUERYSELECTORALL("SOURCE[DATA-SRCSET]");FOR(LET E OF T)E.SETATTRIBUTE("SRCSET",),E.REMOVEATTRIBUTE("DATA-SRCSET");PLETE&&(,E.PARENTNO.PARENTNO.QUERYSELECTOR("[DATA-PLACEHOLR-IMAGE]"))}}HIV BASICSOVERVIEWABOUT HIV & AIDSWHAT ARE HIV AND AIDS?HOW IS HIV TRANSMTED?WHO IS AT RISK FOR HIV?SYMPTOMS OF HIVDATA & TRENDSU.S. STATISTICSIMPACT ON RACIAL AND ETHNIC MORIGLOBAL STATISTICSHISTORYHIV AND AIDS TIMELEMAKG A DIFFERENCESUPPORTG SOMEONE LIVG WH HIVSTANDG UP TO STIGMAGETTG INVOLVEDHIV PREVENTNUSG HIV MEDITN TO RCE RISKHIV TREATMENT AS PREVENTNPRE-EXPOSURE PROPHYLAXIS (PREP)POST-EXPOSURE PROPHYLAXIS (PEP)RCG SEXUAL RISKPREVENTG SEXUAL TRANSMISSN OF HIVRCG RISK OM ALHOL & DG USEALHOL AND HIV RISKSUBSTANCE USE AND HIV RISKRCG RISK OF PERATAL TRANSMISSNPREVENTG PERATAL TRANSMISSN OF HIVPOTENTIAL FUTURE OPTNSHIV VACCLONG-ACTG HIV PREVENTN TOOLSMICROBICISHIV TTGLEARN ABOUT HIV TTGWHO SHOULD GET TTED?HIV TTG LOTNSHIV TTG OVERVIEWUNRSTANDG HIV TT RULTSJT DIAGNOSED: WHAT'S NEXT?LIVG WH HIVTALKG ABOUT YOUR HIV STATSTARTG HIV CAREFD A PROVIRLOTE AN HIV CARE PROVIRTYP OF PROVIRSTAKE CHARGE OF YOUR CAREGETTG READY FOR YOUR FIRST VISWHAT TO EXPECT AT YOUR FIRST HIV CARE VISSTAYG HIV CAREPROVIR VISS AND LAB TTSMAKG CARE WORK FOR YOUSEEG YOUR HEALTH CARE PROVIRHIV LAB TTS AND RULTSRETURNG TO CAREHIV TREATMENTHIV TREATMENT OVERVIEWVIRAL SUPPRSN AND UNTECTABLE VIRAL LOAD TAKG YOUR HIV MEDICE AS PRCRIBEDTIPS ON TAKG YOUR HIV MEDITN EVERY DAYPAYG FOR HIV CARE AND TREATMENTOTHER RELATED HEALTH ISSUOTHER HEALTH ISSU OF SPECIAL CONCERN FOR PEOPLE LIVG WH HIVALHOL AND DG USECORONAVIS (COVID-19) AND PEOPLE WH HIVHEPATIS B & CIMMUNIZATNS AND PEOPLE WH HIVFLU AND PEOPLE WH HIVMENTAL HEALTHMPOX AND PEOPLE WH HIVOPPORTUNISTIC INFECTNSSEXUALLY TRANSMTED INFECTNSSMOKGHIV AND WOMEN'S HEALTH ISSULIVG WELL WH HIVTAKG CARE OF YOURSELFAGG WH HIVEMERGENCI AND DISASTERS AND HIVEMPLOYMENT AND HEALTHEXERCISE AND PHYSIL ACTIVYFOOD SAFETY AND NUTRNHOG AND HEALTHTRAVELG OUTSI THE U.S.YOUR LEGAL RIGHTSCIVIL RIGHTSWORKPLACE RIGHTSLIMS ON CONFINTIALYFERAL RPONSENATNAL HIV/AIDS STRATEGYNATNAL HIV/AIDS STRATEGY (2022-2025)PRR NATNAL HIV/AIDS STRATEGI (2010-2021)IMPLEMENTG THE NATNAL HIV/AIDS STRATEGYENDG THE HIV EPIMICABOUT ENDG THE HIV EPIMIC THE U.S.OVERVIEWKEY STRATEGIPRRY JURISDICTNSHHS AGENCI INVOLVEDFUNDGTIMELELEARN MORE ABOUT EHEREADY, SET, PREPREADY, SET, PREPREADY, SET, PREP PHARMACIREADY, SET, PREP ROURCAHEADAHEAD: AMERI’S HIV EPIMIC ANALYSIS DASHBOARDFERAL ACTIVI & AGENCIHIV PREVENTN ACTIVIHIV TTG ACTIVIHIV CARE AND TREATMENT ACTIVIHIV REARCH ACTIVIACTIVI COMBATG HIV STIGMA AND DISCRIMATNPOLICI & ISSUTHE AFFORDABLE CARE ACT AND HIV/AIDSHIV CARE CONTUUMSYRGE SERVIC PROGRAMSFUNDGBUDGETFERAL FUNDG FOR HIV/AIDSMORY HIV/AIDS FUNDOVERVIEWBACKGROUNDFUND ACTIVITHE FUND ACTNPACHAABOUT PACHACHARTERMEMBERS & STAFFSUBMTEPRR PACHA MEETGS AND REMENDATNSCAMPAIGNSI AM A WORK OF ART CAMPAIGNAWARENS CAMPAIGNSPEPFAR & GLOBAL AIDSGLOBAL HIV/AIDS OVERVIEWPEPFARU.S. GOVERNMENT GLOBAL HIV/AIDS ACTIVIGLOBAL HIV/AIDS ORGANIZATNSEVENTSAWARENS DAYSNATNAL BLACK HIV/AIDS AWARENS DAY FEBARY 7HIV IS NOT A CRIME AWARENS DAY FEBARY 28NATNAL WOMEN AND GIRLS HIV/AIDS AWARENS DAY MARCH 10NATNAL NATIVE HIV/AIDS AWARENS DAY MARCH 20NATNAL YOUTH HIV & AIDS AWARENS DAY APRIL 10HIV VACCE AWARENS DAY MAY 18NATNAL ASIAN & PACIFIC ISLANR HIV/AIDS AWARENS DAY MAY 19HIV LONG-TERM SURVIVORS AWARENS DAY JUNE 5NATNAL HIV TTG DAY JUNE 27ZERO HIV STIGMA JULY 21SOUTHERN HIV/AIDS AWARENS DAY AUGT 20NATNAL FAH HIV/AIDS AWARENS DAY AUGT 27NATNAL HIV/AIDS AND AGG AWARENS DAY SEPTEMPBER 18NATNAL GAY MEN'S HIV/AIDS AWARENS DAY SEPTEMBER 27NATNAL LATX AIDS AWARENS DAY OCTOBER 15WORLD AIDS DAY DECEMBER 1EVENT PLANNG GUI CONFERENCU.S. CONFERENCE ON HIV/AIDS (USCHA) NATNAL RYAN WHE CONFERENCE ON HIV CARE & TREATMENT AIDS 2020 (23RD INTERNATNAL AIDS CONFERENCE VIRTUAL) LEARNG OPPORTUNILEARNG OPPORTUNILEARNG OPPORTUNIWANT TO STAY ABREAST OF CHANG PREVENTN, RE, TREATMENT OR REARCH OR OTHER PUBLIC HEALTH ARENAS THAT AFFECT OUR LLECTIVE RPONSE TO THE HIV EPIMIC? OR ARE YOU NEW TO THIS FIELD? CURAT LEARNG OPPORTUNI FOR YOU, AND THE PEOPLE YOU SERVE AND LLABORATE WH.STAY UP TO DATE WH THE WEBARS, TWTER CHATS, NFERENC AND MORE THIS SECTN.MORE LEARNG OPPORTUNIBLOGGET TTED. FD SERVIC + PREPSEARCHGOESPAñOL ESPAñOL ES GET TTED. FD SERVIC + PREPSEARCHOPEN LOTOR SEARCHHIV SERVICES LOCATORSEARCH⨯CLOSEHOMEHIV BASICSOVERVIEWDATA AND TRENDSU.S. STATISTICSSECTN MENUGET TTED. FIND SERVICES + PREP.DATA & TRENDSU.S. STATISTICSIMPACT ON RACIAL AND ETHNIC MORIGLOBAL STATISTICSSEARCHDATA & TRENDSU.S. STATISTICSIMPACT ON RACIAL AND ETHNIC MORIGLOBAL STATISTICSU.S. STATISTICS

Mal aged 24–32Total Sample100% HeterosexualMostlyStraight/BisexualMostlyGay/100%GayMostlyGay/100% GayOp.

All bisexual and gay intified mal, cludg bisexual mal who did not report same-sex sex, had a higher prevalence of reported anal sex pared to Dispari by Sexual Orientatn Among FemalThe rults om logistic regrsns that regrsed inty-behavr subgroups on self-reported STI diagnosis for femal are shown Table 3. Gay women were signifintly ls likely to report an STI than heterosexual-WSM (OR = 0.

Further, Mol 3, the dispary between gay-WMSW and heterosexual-WSM beme larger, such that gay-WMSW (OR = 0. Consistent wh Mol 3, ntrollg for both victimizatn and sexual behavrs Mol 4 fully mediated the relatnship between heterosexual-WSMW, bisexual-WSM, and bisexual-WSMW, and showed that gay-WSMW (OR = 0.