Social Support, Loneliness, and Inflammation in LGB+ Subgroups: Health Disparities in a Partnered US Cohort.

Abstract

Objective: To examine differences in social support, loneliness, and immune function by sexual orientation and to explore whether social support and loneliness mediate immune outcomes.

Methods: Participants (394 heterosexual, 144 gay/lesbian, 144 plurisexual) completed the Perceived Social Support Questionnaire and the UCLA Loneliness short-form and provided dried blood spot samples to index i mmune markers [Epstein-Barr virus (EBV) titers, C-reactive protein (CRP), interleukin-6 (IL-6)] between September 2020 and November 2021.

Results: Plurisexual (Cohen's d =-0.80) and heterosexual ( d =-0.64) males had lower friend support than gay males ( p' s < .0015), plurisexual ( d =-0.42) and gay/lesbian ( d =-0.40) adults reported lower family support than their heterosexual peers ( p' s < .001), and plurisexual people had higher CRP levels compared with gay/lesbian ( d =0.37) and heterosexual people ( d =0.22) ( p 's < .039). Lower social support did not explain plurisexual adults' higher inflammation, but BMI partially explained plurisexual adults' higher IL-6 [indirect effect: 0.15 (0.04 to 0.26)] and CRP [indirect effect: 0.21 (0.04 to 0.38)], compared with heterosexual adults.

Conclusions: Partnered plurisexual individuals face lower social support and greater inflammation-suggesting that partnered status alone does not ensure health equity. These findings underscore the need to better understand and address the unique social and biological vulnerabilities of plurisexual people. BMI may partially explain plurisexuals' higher inflammation, but further longitudinal research is warranted.