O01 The health and wellbeing of people reporting a minority sexual identity during the first year of the COVID-19 pandemic in Britain: natsal-COVID wave 2

Introduction

Evidence shows that people identifying as a sexual minority experience worse health compared to heterosexual people. We estimated health inequalities by sexual identity in the first year of the COVID-19 pandemic in the general British population.

Methods

Our analysis included 6,016 sexually-experienced participants (18–59 years) participating in Natsal-COVID, a quasi-representative webpanel survey conducted 1-year following Britain’s first lockdown. We report age-adjusted odds ratios (aOR) and age and relationship status-adjusted ORs (aAOR) for general, mental, and sexual health outcomes among sexual minorities compared to their heterosexual-identifying counterparts.

Results

Altogether, 96.2% participants identified as heterosexual, 1.8% 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’. There were differences by subgroups; sexual minority women (aOR:2.5, 95% CI 1.5–3.7) and bisexual participants (aOR:2.6, 1.6–4.1) had the highest odds of reporting poor general health. Sexual minority participants were more likely to report poor mental health, with bisexual participants most like to screen positive for anxiety (GAD-2) (aOR:2.3, 1.7–3.0) and depression (PHQ-2) (aOR:1.7, 1.3–2.2), while gay/lesbian participants were most likely to report ‘always/often’ feeling lonely (aOR:1.5, 1.1–2.2).

Sexual minority men (aAOR

1.7, 1.2–2.3), gay/lesbian (aAOR:1.4, 1.1–1.9) and bisexual participants (aAOR:1.6, 1.1–2.1) had highest odds of reporting dissatisfaction with their sex life. Sexual minority men (aAOR:4.1, 2.6–6.4) were more likely to report successfully accessing STI services, and twice as likely to report having tried but failed to access STI services (aAOR:2.1, 1.1–3.9), both in the past year.

Discussion

These data, from a national general population survey, suggest that in the year following Britain’s first lockdown, sexual minorities experienced worse health than heterosexual-identifying people, and among men, an unmet need for STI services. Whether these findings reflect existing inequalities or were exacerbated by the pandemic is unknown, but mitigation is needed.