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To estimate the number of men in the U. We Military guys gay sex using hierarchical categories of gay, bisexual, and other MSM to compare proportions in the military and general population. We found that 4. When stratified, we found that 0. The proportion of men who identified as a gay was lower in the military than in the general population. This finding might have been influenced by historical military policies related to sexual orientation. DADT was implemented in to allow gay and bisexual men and women to serve in Military guys gay sex military[ 6 ].

But DADT had a negative impact on the health of troops and their communities [ 7 — 9 ]. Yet the need remains for an accurate estimate of the number of gay and bisexual military personnel for the U.

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Congress and the Department of Defense as they develop policies that effect the rights of and services for this population. Accurate estimates of the number of military personnel who are gay or bisexual are necessary to deliver optimal health services, including the provision of recommended HIV and STD prevention and care services, as well as other sexual, reproductive, and behavioral health services [ 8 ].

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In both the U. While all military personnel might be at risk of mental health Military guys gay sex substance abuse problems, especially those who serve on combat tours, gay and bisexual military personnel have been found to be at increased risk[ 15 — 20 ].

Gay and bisexual military personnel might also experience stigma and victimization while serving[ 321 ]. Few studies have estimated the percentage of U.

In this study, we used a nationally representative survey to calculate a direct estimate of the percentage of men who self-reported as gay, bisexual, or other MSM among men aged 18—44 years who had served in the military. NSFG was designed to include nationally representative multistage area probability samples of the household population of men and women aged 15—44 years in 50 states and the District of Columbia [ Military guys gay sex23 ].

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Recruitment consisted of 5 steps: To minimize the risk of identifying respondents, the data included no personal identifying information such as name and address, and geographic information was restricted to three categories of Metropolitan Statistical Area. The public use data also included several re-coded and re-categorized variables so that respondents could not be identified.

None of the authors of this study had access to any personal identifying information. To generate robust and reliable national estimates, we combined interview data from multiple years. In4, men were interviewed; in —, 10, were interviewed; and in —, 4, were interviewed. Computer-assisted personal interviewing was used to ask most questions, and Audio Computer-Assisted Self-Interviewing ACASI was used to ask sensitive questions, including those Military guys gay sex sexual orientation and sexual behavior.

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Only men aged 18—44 years were asked about their previous military service, so we restricted our analysis this gender and age group. Please count every partner, even those you had sex with only once in those 12 months.

Military guys gay sex calculated the proportion of all U. We also stratified the proportion of U.

We also performed bivariate analyses to compare the proportions of men who self-reported as gay, bisexual, or other MSM, respectively, among men who had served in military compared to men who had not served.

All analyses were conducted with SAS version 9. Interviews were conducted with a total of 17, men aged 18—44 years in the—, and — NSFG surveys combined. On average, among a weighted Demographic characteristics of U.

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About half the men were aged 18—30 years In response to questions about sexual orientation and behavior, Among men who served in military, the percentages who self-reported as gay, bisexual, or other MSM did Military guys gay sex differ between the — and — NSFG cycles, with 3. However, when stratified using a hierarchy of gay, bisexual, and other MSM categories, we found that 0.

In our analysis of national interview data, we found that from — on average 4.

Self-reported sexual orientation and sexual behavior using ACASI, with assurance of confidentiality, might provide more reliable measurement of gay, bisexual, or other MSM persons in a population than other methods [ 24 ]. Our estimate is higher than previously reported estimates of 1. Previous estimates were calculated using complicated methods that included U.

We found a similar percentage of gay, bisexual, or other MSM in the military and U. It is possible that men who self-identified as gay were discouraged from serving in the military because they feared Military guys gay sex or stigma Military guys gay sex from the DADT policy.

MSM who served in the military might have been less likely to self-report as gay even after they left service, possibly because of concern about losing Veterans Administration VA benefits despite confidentiality of NSFG and protected VA benefits for gay and bisexual men and women [ 25 ].

With the repeal of the DADT policy inmore gay men might serve and continued monitoring of the percentage of gay and bisexual men in the military will be necessary to understand these trends. Confidential, quality sexual health services are important for all sexually active MSM regardless of their sexual orientation, and our study has provided an updated and accurate Military guys gay sex of the size of this population.

The military healthcare system provides services to protect the health of its personnel, including HIV prevention and treatment services.

Treatment and care of HIV positive personnel is expensive for the military and results in restricted duty assignments of troops,[ 4 ] further underscoring the importance of HIV prevention.

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While the rate of new HIV diagnoses has been low among active duty personnel in the U. Our study had some limitations.

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NSFG asked men about their sexual orientation and behavior after discharge from the military and did not Military guys gay sex current active duty military personnel who lived on military bases or were stationed overseas; the most accurate and current estimates of numbers of gay, bisexual, or MSM would be obtained by asking active duty personnel about their sexual orientation and behavior.

However, assuming that the proportion of men who were gay, bisexual, or MSM has been constant over the past several years and across age groups, our estimates can be projected to estimate the current numbers. In addition, compared to sexual behavior change over time, self-reported sexual orientation is more stable among gay and bisexual men [ 33 ]. Second, the sample size of men who self-reported as gay, bisexual, or MSM was small, providing sufficient statistical power for only limited stratified analyses.

Third, NSFG did not query men about the details of their military service, such as branch or rank. Finally, NSFG did not include questions about depression, mental health, suicidal ideation, or suicide attempt that are prevalent health issues in the military. A recent study showed that LGB veterans were at higher risk of lifetime suicidal ideation than heterosexual veterans [ Military guys gay sex ]. Military guys gay sex is important to assess troops and veterans for risk of suicide, especially gay, bisexual, and other MSM, and to implement culturally-sensitive interventions for prevention of suicide.

It might be challenging for a military medical system to provide all the necessary clinical services to meet the unique needs of gay, bisexual, and transgender personnel [ 29 ]. But with recent policies that permit people to serve openly, an opportunity exists for the military medical system to provide culturally Military guys gay sex HIV prevention, sexual health, and mental health services required for persons in these populations to achieve optimal health.

Simple and reliable estimation of the numbers of gay, bisexual, and transgender military personnel will inform policies and procedures that ensure that the military operates healthcare systems with adequate capacity to meet the clinical needs of this population, and to support efforts to promote equality.

Analyses of NSFG data provide a simple, direct, and reliable method to estimate these numbers. National Center for Biotechnology InformationU. Published online Aug 1. Author information Article notes Copyright and License information Disclaimer. The authors have declared that no competing interests exist.

Received Mar 7; Accepted Jul This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Abstract Objectives To estimate the number of men in the U.

Results We found that 4. Conclusions The proportion of men who identified as a gay was lower in the military than in the general population.

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Results Interviews were conducted with a total of 17, men aged 18—44 years in the—, and — NSFG surveys combined. Table 1 Characteristics of men aged 18—44 years who self-reported as gay, bisexual, or other men who have sex with Military guys gay sex MSM in the United States, National Survey of Family Growth—, and — Open in a separate window. Percentage of men aged 18—44 years who self-reported as gay, bisexual, or other men who have sex with men MSM among men who served in the military compared to those who had not served in the military in the United States, National Military guys gay sex of Family Growth—, — Discussion In our analysis of national interview data, we found that from — on average 4.

PDF Click here for additional data file.

Funding Statement The authors received no specific funding for this work. Data Availability All relevant data are within the paper and its Supporting Information files.

Gay men and lesbians in the U. The Urban Institute; [cited August 26]. Homosexuality and the military: Miller K, Cray A. The Battles the Remain: Lesbian, gay, and bisexual men and women in the US military: Updated estimates [cited August 26]. Sexual orientation and US military personnel policy: Health hazards of "don't ask, don't tell".

N Engl J Med. Centers for Disease Control and Prevention.

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Sexually Transmitted Disease Surveillance, [cited August 26]. Incidence of syphilis, active component, U.


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