Community Based Research in "Hidden" Communities: Understanding Individual and Social Health Concerns among Bisexual Men

Introduction: Research has not yet explored the potential impact of social stress, biphobia (stigma, prejudice and discrimination from both heterosexual and homosexual individuals and communities) and other factors on the health of bisexual men. Given the clear linkages with HIV risk behavior, this research aimed to explore individual and social health issues among bisexual men in an understudied and underserved community in the Midwestern United States. Methods: Using a community-based participatory research approach, in-depth interviews were conducted with a diverse sample of 75 behaviorally bisexual men. Interviewers explored potential health stressors and supports, including the potential role of community involvement. Text data were coded and organized using N-Vivo software. Results: Many participants reported personal and social challenges associated with bisexuality, which in turn influenced their mental health, in particular. Reported instances of stigma toward bisexuality, from both homosexual and heterosexual individuals, impacted participants' feelings toward their own sexualities. Participants' sexual identities, and disclosure of their sexual identities, varied depending on context. Most participants reported feeling socially isolated due to the lack of a sense of belonging in any community. A lack of bisexual spaces and a visible bisexual community was reported by all participants. Discussion: Programs are greatly needed that focus on the specific mental health and other concerns voiced by these men. Based on our study findings, such programs should emphasize self-acceptance, social network and community building, and ways to maximize available social support, similar to community-level empowerment interventions that have shown success among gay-identified men.