This lack of adequate data and resulting resource allocation might account for the increased mortality and morbidity among men living with HIV in countries with generalized HIV epidemics [ 17 ]. Given the need to reliably estimate the proportion of the male population who do not identify as heterosexual, or who are not exclusively behaviorally heterosexual, this study compares UNAIDS estimates where available to estimates of members of Hornet a social app geared towards gay men [ 19 ] and Facebook members with specific interests associated with GBMSM in 13 countries across five continents.
The overarching goal of this study was to assess the utility of using data on users of mobile phone apps and social media communities to obtain estimates of GBMSM population sizes. The number of unique active gay app users in who resided in each country were provided by the Hornet Gay Social Network Hornet [ 19 ]. Specifically, Facebook defines these variables as interests and behaviors [ 24 ]. While it is feasible to use both interests and behaviors to assess population size, this study used interests.
Specifically, the following keywords were used to identify same-sex interests: Identified same-sex interests were subsequently assigned to one of eight thematic groups, representing men who have expressed an interest in or liked pages related to at least one included same-sex interest Multimedia Appendix 4. Only same-sex interests endorsed by at least , Facebook users across all of Facebook were included in the analysis. No ads were created. During the process of planning advertisements, the Facebook Ads Manager interface displays an estimated number of users in the geographic area with those interests.
Recent UNAIDS and national estimates are less than those reported by active Hornet app users in Brazil, Thailand, and Ukraine, with differences in estimates of 1,,, ,, and 66,, respectively. Gay, bisexual, and other cisgender men who have sex with men. The proportion of men reporting a same-sex interest within the category of Relationships ranged from 1. Distribution of Facebook-identified same-sex interests by country. The proportion of males aged years reporting same-sex interests ranged from 4. Although there are several limitations to our approach, there is a clear signal towards higher estimates of GBMSM when digital approaches are utilized.
While several studies have focused on the role dating apps and websites play in risk-taking behaviors among GBMSM [ 25 ], only recently has there been interest in leveraging apps to serve the HIV prevention, treatment, and care needs among GBMSM.
Our data suggest that same-sex dating apps and social media networks are promising data sources for designing population estimates and programmatic targets for GBMSM. The usage of the Internet is becoming increasingly normalized throughout the world, and this trend will only continue.
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Empirical and market-research data, generally derived from higher income settings, demonstrate that GBMSM are high utilizers of the Internet, often using the Internet to find partners, given limited venues and significant social stigma [ 26 - 30 ]. This trend towards online spaces has largely been attributed to stigma that same-sex behaviors face and the confidentiality that is afforded in online spaces [ 32 - 34 ], which enable users to more accurately report their attraction or in some instances, trace their behavior and eliminate biases in self-reported data.
Although these studies were predominantly completed in higher income settings, similar results have been observed among GBMSM in Southern Africa and Nigeria [ 35 , 36 ]. Given the significant usage of the Internet, online spaces likely represent an important approach for collecting same-sex attraction and behavioral data, especially in more stigmatizing settings.
However, most men have their first sexual encounters with other men before the age of 18, and HIV incidence has been shown to be high among young GBMSM across settings [ 38 , 39 ]. Moreover, men under the age of 18 are generally not included in surveys or HIV prevention, treatment, and care programs, given the challenges in achieving consent [ 40 ]. Given that younger GBMSM are more likely to leverage virtual spaces, as evidenced by these data, the use of digital data for size estimation represents a strategy to inform the numbers and HIV prevention, treatment, and care needs of young GBMSM [ 41 ].
While the legal challenges of consent remain, especially in settings where same-sex practices are criminalized, there is a clear need to scale up evidence-based and human rights-affirming HIV prevention strategies for younger GBMSM, including condoms, lubricants, and preexposure prophylaxis PrEP. There are several limitations in the methods and results presented here. Moreover, the extent of specificity is likely subject to specific cultural contexts, thereby leading to overestimating the numbers of GBMSM with this metric. The metric used for Hornet was unique users with only one account allowed per device.
While it is feasible to create multiple accounts on Facebook with unique email addresses, this likely represents a very low proportion of users. Although Internet usage is increasing rapidly, there is less access in many lower- and middle-income countries, which may underestimate the numbers of GBMSM.
Gay Britain: what do the statistics say?
However, Internet access around the world continues to increase, especially due to the rapid increase in affordable smartphones, suggesting that the utility of social media-based estimates of population size will increase over time. Moreover, some of the respondents captured online in low- and middle-income countries may be expatriates rather than GBMSM from that country. The contribution of expatriates to these estimates is considered to be low, given the limited number of expatriates, and only people who noted the country as their country of residence were included.
Additional research studying appropriate search strategies according to each social media platform, including large platforms not studied in these analyses, are required. Building collaborations with social media platforms may also facilitate improved estimates of population size along with insights into appropriate strategies to deliver interventions that leverage these platforms.
Taken together, these data clearly suggest a significant discrepancy between size estimates of GBMSM reported by normative agencies and estimates from digital sources. Over four decades of the HIV pandemic, GBMSM have been well known to bear a disproportionate burden of HIV due to the biology of the virus, which is compounded by criminalization, intersectional stigma, discrimination, and violence.
Deriving estimates of the numbers of people at risk of acquiring and living with HIV is complex, and other studies have highlighted these challenges for other populations. Developing common methods of counting GBMSM, especially the use of central data collection with consistent approaches, provides an additional data source that is directly comparable across settings.
Although these additional approaches have biases, they are complementary to the biases of existing methods. The approach presented here that leverages social media is imperfect, but is relatively low cost to implement and provides comparable estimates across a large range of countries, including some with no extant estimates. Triangulating multiple data sources including social media may facilitate optimal estimations of the numbers of GBMSM for program planning, evaluation, and estimates of HIV epidemic dynamics.
These methods also allow for the estimation of numbers of GBMSM in settings where stigma and risks of violence are too great to even report in this paper [ 44 ]. The practice of pointing to no data in this instance nonexistent GBMSM size estimates to justify not funding or grossly underresourcing programs for GBMSM has long been identified by advocates, and should be challenged. Not doing so runs the risk of having evidence-based and human rights-affirming programs that address specific needs of GBMSM disappear. Ultimately, we cannot overstate the importance of understanding the characteristics and numbers of those most affected by HIV to truly achieve an AIDS-free generation.
The funders had no role in study design, data collection and analyses, decision to publish, or preparation of the manuscript.
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Distribution of Facebook identified same-sex interests by country — expanded Table 2. Conflicts of Interest: All other authors declare no conflicts of interest. National Center for Biotechnology Information , U. Published online Feb 8. Reviewed by Teymur Noori and Elizabeth Fearon. Author information Article notes Copyright and License information Disclaimer. Corresponding author.
Corresponding Author: Stefan Baral ude. But I have a theory which I have the audacity to think important. My firm belief is that in trying to categorise sex, sexuality and — yes — even gender, the late 19th, 20th and early 21st centuries have taken the medical and social sciences down a massive blind alley. No such categories exist.
Being from a kindly, liberal family, I was taught that sympathy, understanding and tolerance were called for, and these things were not a moral question and not a matter for the police. Growing up in the s, I had no idea how recently this prism had been applied to sexuality, splitting white sunlight into colour-bands; or that a century beforehand these rigid categories had not existed. But before the Victorians, sex was described more by verbs than nouns — as something people did rather than were — and sexual leanings, mainstream as well as minority, were appetites to which almost anyone might on occasion be prey.
Those earlier ages had been vicious in their approach to morally disapproved behaviour but relaxed in their understanding that many, perhaps most, could feel the pull. Then came an age in which the moral disapproval and legal sanctions were to fade — a good thing — but paddocks were to be constructed with pseudo-scientific names; and we were all to be badged, placed in one paddock or another, and later offered assistance and counselling if we wished to change paddock. To my surprise on re-reading , the first and still the most important such survey — undertaken in America by Alfred Kinsey and colleagues in the midth century — was the most enlightened.
Kinsey distrusted brutal categorisation but, wishing to count, constructed what came close to a sliding scale containing seven gradations between exclusive heterosexuality and exclusive homosexuality.
He found that almost half his male interviewees had reacted sexually to both genders; more than a third had had a homosexual encounter; and more than one in ten reported roughly equally strong sexual responses to both men and women. Meanwhile, the first paragraph of a YouGov survey in is worth quoting: The important thing to note about this apparent variance, though, is that it may be more apparent than real, arising from the available menu of words offered to people.
Words create categories. Some of the men I slept with have gone straight despite a strong cultural barrier to a gay man doing this.
Is 10% of the population really gay? | Society | The Guardian
Indeed, hordes are: Straight men are equally reluctant to admit the converse. There exist strong reasons for this taboo among gays: Secondly, if sexuality really is modifiable for some, how long before someone suggests cognitive behavioural therapy minus or even plus the Hallelujahs? Damn the Hallelujahs.
The coming age may extend that from sexuality to gender. The term ally is generally used for any member of a dominant group who is a friend, advocate or activist for people in an oppressed group i. White Ally for People of Color. Asexual A sexual orientation generally characterized by not feeling sexual attraction or desire for partnered sexuality.
Asexuality is distinct from celibacy, which is the deliberate abstention from sexual activity. Some asexual people do have sex.
There are many diverse ways of being asexual. Biphobia The fear, hatred, or intolerance of bisexual people. Bisexuals need not have had sexual experience with both men and women; in fact, they need not have had any sexual experience at all to identify as bisexual. Cisgender a term used to describe people who, for the most part, identify as the gender they were assigned at birth.
People forge a lesbian, gay, bisexual or transgender identity first to themselves and then may reveal it to others. Down Low Pop-culture term used to describe men who identify as heterosexual but engage in sexual activity with other men. Often these men are in committed sexual relationships or marriages with a female partner. This term is almost exclusively used to describe men of color.
Drag queens typically have everyday lives as men. Drag shows are popular in some gay, lesbian, and bisexual environments. Unless they are drag performers, most Trans people would be offended by being confused with drag queens or drag kings. In contemporary contexts, lesbian n. This is often paired with hormone treatment and psychological assistance. Also straight.
Homosexual see Offensive Terms to Avoid Outdated clinical term considered derogatory and offensive by many gay and lesbian people. Homophobia Fear of lesbians and gay men.