Country of Birth and Health Care Utilization Among Gay, Bisexual, and Other Men Who Have Sex with Men in the U.S.

Abstract: Differences in physical and behavioral health care utilization persist in the United States (U.S.) by country of birth and sexually minoritized status, but less is understood at the intersection of these experiences. We examined physical and behavioral health care utilization by country of birth among gay, bisexual, and other men who have sex with men (GBMSM) in the U.S. completing the 2021 online American Men's Internet Survey (AMIS) (n=8952). After adjusting for socio-demographic, social determinant, and behavioral covariates, being born outside of the U.S. was significantly associated with a lower likelihood of past-year use of behavioral health care services (aPR=0.89; 95% CI=0.79–0.99; p=.028). Country of birth was not significantly associated with physical health care utilization. Findings suggest the need for 1) intersectional analyses of health care access barriers for GBMSM born outside of the U.S., 2) strategies to overcome these barriers, and 3) tailored health care services.