Issue: November 2022
Fact checked byHeather Biele

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September 30, 2022
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Men who have sex with men twice as likely to be diagnosed with IBD

Issue: November 2022
Fact checked byHeather Biele
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Men who have sex with men were more than twice as likely to develop inflammatory bowel disease compared with men who have sex with women when engaging in “high-risk” sexual activity, according to research published in Gut.

“About 3 million Americans have IBD, with about 70,000 new cases being diagnosed per year. While there is extensive data on the epidemiology of IBD in the U.S., there is no data yet to our knowledge on the prevalence and natural history of IBD in the LGBTQIA+ population,” Emad Mansoor, MD, assistant professor of medicine at Case Western Reserve University and University Hospitals Cleveland Medical Center, told Healio. “This is an important issue to address since, according to a 2022 Gallup poll, up to 7.1% of Americans identify as LGBTQIA+, up from 5.6% in 2020.”

“MSM with high-risk homosexual activity with Crohn’s disease were more likely to have perianal and stricturing disease while ulcerative colitis patients were more likely to have a partial colectomy.” Emad Mansoor, MD

To evaluate the prevalence of Crohn’s disease and ulcerative colitis in this subset population, Mansoor and colleagues identified 11,845 individuals with a diagnosis of high-risk homosexual activity (1.25% UC and 0.77% CD) using data from 58 health care organizations over the past 20 years. Researchers noted 91% of the population were MSM, of whom 1.26% had UC and 0.8% CD.

They also compared the prevalence of IBD among 60,755 individuals (0.52% UC and 0.49% CD), which included MSM and men who have sex with women, who had a diagnosis of high-risk heterosexual activity.

Results showed MSM who participated in high-risk homosexual activity were more than twice as likely to be diagnosed with UC (OR = 2.45; 95% CI, 2.35-3.34) and CD (OR = 1.64; 95% CI, 1.29-2.09) compared with heterosexual men when both populations engaged in high-risk sexual activity.

“MSM with high-risk homosexual activity with Crohn’s disease were more likely to have perianal and stricturing disease while ulcerative colitis patients were more likely to have a partial colectomy,” Mansoor told Healio. “There was no significant difference in IBD-specific medication prescriptions between the two groups.”

According to Mansoor, a supplementary grant from NIH to the Cleveland Digestive Diseases Research Core Center will help fund a prospective study to confirm the increased prevalence of IBD in MSM individuals and investigate the potential role of gut microbiome composition and function as etiology for increased risk in this population.

“Based on this study and planned prospective study to evaluate the role of gut microbiome, our group’s overall objective is to develop personalized medical therapies and improve health care access for this important, underrepresented minority patient population,” he said.