Editor’s Note: Our guest blogger for this post on bisexuality and health care disparities – a significant issue for HIV prevention efforts – is Lillian Klasen, a 2014 summer intern from Temple University’s Department of Public Health in the ActionAIDS Prevention Department. Lillian is now working as a Benefits Outreach Specialist, screening and applying for seniors’ benefits at Benefits Data Trust.

The challenges and health disparities that face the LGBT community won’t come as a surprise to ActionAIDS employees – or in general to readers of this blog. However, it is worth noting that data and research confirm the heightened risk for a range of negative health and social outcomes thatbisexual-identifying individuals face when compared to their gay and lesbian peers.

According to a 2013 report by the federal Centers for Disease Control and Prevention, bisexual women are at the highest risk for sexual violence: “a staggering 61 percent of bisexual women experience rape, physical violence, and/or stalking by an intimate partner,” while 35 percent of heterosexual women and 43 percent of lesbian women reported this type of violence. Further, Healthy People 2020 notes that bisexual women are less likely to have health insurance and more likely to have difficulty obtaining medical care, experience higher rates of breast cancer and heart disease, and report a lower quality of life. Bisexual men are 50 percent more likely to live in poverty than gay men and thus face challenges in gaining access to needed health care.

Finally, the National Gay and Lesbian Task Force has noted that “many, if not most, bisexual people do not come out to their health care providers or to researchers due to judgments that silence, stereotypes that shame, and assumptions that erase bisexual identity.” Similarly, a keyconclusion of the Ontario Public Health Association is that those who identify as bisexual are less likely to come out to their healthcare provider than their gay or lesbian peers. As such, importantly, there are missed opportunities to talk about a client/patient’s sexual behavior and discuss options for reducing their risk for HIV and STIs.

One way to create a more inclusive environment is to ensure that providers understand some of the misconceptions that surround bisexuality and result in biphobia and bi-invisibility. Some of these errors include:

  • Only considering a person’s sexual orientation based on their current partner’s gender
  • Believing bisexuality is just a phase or that people who identify as bisexual are confused
  • People who identify as bisexual are promiscuous or do not want to have monogamous relationship

Finally, some people just dismiss bisexuality entirely, believing that a person who comes out as bisexual will inevitably come out as “fully gay.”

While more research focused specifically on the health care issues facing bisexual individuals is needed, the data we do have is quite compelling and should give greater urgency for strategies ensure that we take appropriate steps to prevent and treat HIV in this population. Given its individualized, comprehensive approach to care, ActionAIDS is well positioned to support this population and reduce the burden of HIV among its bisexual clients by ensuring an inclusive environment for people to discuss their sexual behaviors. Hopefully, we can inspire others to do the same.

–Lillian Klasen