(P36) Inequalities in health and wellbeing of people reporting a minority sexual identity in the first year of the COVID-19 pandemic in Britain: a quasi-representative webpanel survey (Natsal-COVID Wave 2)

Background

Prior to the COVID-19 pandemic, people identifying as a sexual minority (gay/lesbian, bisexual, or other) experienced worse health compared to heterosexual people. We examined health inequalities by sexual identity in the first year of the COVID-19 pandemic in the British general population.

Methods

Our analysis included sexually experienced participants aged 18-59 years who took part in Natsal-COVID, a quasi-representative webpanel survey conducted one year after Britain’s first lockdown. We report age-adjusted odds ratios (aAOR) and age- and relationship status-adjusted odds ratios (AOR) for general, mental, and sexual health outcomes among sexual minority participants compared to their heterosexual-identifying counterparts.

Results

Among sexually experienced participants (n=5,694), 96.0% identified as heterosexual, 1.9% as gay/lesbian, 1.4% as bisexual and 0.7% as other. Sexual minorities were more likely to report their general health as ‘bad’/‘very bad’ (aAOR 2.3, 95%CI 1.6-3.3). There were differences by subgroups; sexual minority women (aAOR 2.5, 1.6-3.9), bisexual participants (aAOR 2.5, 1.6-4.0), and participants who identified as other (aAOR 6.0, 2.9-12.6) had the highest odds of reporting poor general health.

Overall, sexual minority participants were more likely to report poor mental health, with bisexual participants having the highest odds of screening positive for severe anxiety (GAD-2) (aAOR 2.3, 1.7-3.1) and depression (PHQ-2) (aAOR 1.7, 1.3-2.3), while gay/lesbian participants were most likely to report feeling lonely (aAOR 1.6, 1.1-2.3).

Sexual minority men (AOR 1.4, 1.0-1.9) and bisexual participants (AOR 1.7, 1.2-2.3) had the highest odds of reporting being dissatisfied with their sex life. Sexual minority men (AOR 4.5, 2.8-7.2) were also more likely to report accessing at least one STI service, but twice as likely to report having tried but been unable to access at least one STI service (AOR 2.8, 1.5-5.3), both in the past year.

Conclusion

During the year following Britain’s first lockdown, people identifying as a sexual minority were more likely to report worse health outcomes compared to heterosexual-identifying people. There was evidence for unmet STI service access need among a subset of sexual minority men. Whether these findings reflect inequalities that were exacerbated by the pandemic is currently unknown, but these inequalities need attention and mitigation.