Sexual health studies in gay and lesbian people: A critical review of the literature

BACKGROUND: The subject of gay and lesbian sexual health seems to be highly understudied, at least partially due to general limitations inherent in the studies of sexuality as well as heteronormative bias and difficulties in reaching out to these populations. AIM: To critically review the studies on gay and lesbian sexual health in order to identify the existing gaps and biases in the scope and general construction of the published research. METHODS: The dataset comprised 556 peer-reviewed articles identified through Medline search. Key studies characteristics were extracted according to the codebook developed for this study and analyzed descriptively. OUTCOMES: The outcomes included: research methodology, study design, sampling, research topic and diversity inclusion in studied populations. RESULTS: The majority of the studies were quantitative (70.5%), cross-sectional (83.6%) and used convenience sampling (83.2%). Most papers focused on HIV/STI risk behaviors, vulnerabilities and risk navigation (26.3%). The least often found topic captured the sexual function of gay and lesbian participants in older age (0.5%). Over 68% of papers relied on male samples and studies on female-only samples comprised less than 13%. Most studies did not recruit a specific age group (77.7%) and included information about ethnicity of study participants (62%). Information about education (58.7%) or other indicators of socioeconomic status (52.8%) was less often reported. CLINICAL TRANSLATION: The methodological limitations of prevailing study designs, sampling procedures and the composition of samples, as well as extensive areas of omission confine the clinical utility of existing research. STRENGTHS & LIMITATIONS: This study offers critical insights into the most significant challenges associated with studies on gay and lesbian sexual health. Medline-only database search, the inclusion of English-written papers exclusively and limited scope (gay and lesbian sexuality only) of the review constitute the most significant limitations. CONCLUSIONS: Gay and lesbian sexual health is an understudied field characterized by primary focus on HIV/STI and paucity of higher quality research including diverse subpopulations.

• Epidemiology and Determinants of Health
  • Determinants of Health
• Determinants of Health
  • Health services
• Population(s)
  • General HIV+ population
  • General HIV- population
• Prevention, Engagement and Care Cascade
  • Prevention
• Prevention
  • Sexual risk behaviour