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City Life Poses Health Risks for Gay, Bisexual Men Fleeing Hometowns, YSPH Study Finds

April 25, 2016
by Jennifer Kaylin

Many young gay and bisexual men leave their hometowns and move to cities in search of greater social and sexual freedom. But the change in address often comes with of host of health problems.

John Pachankis, associate professor at the Yale School of Public Health, and his research team conducted one of the most comprehensive studies to date on the migration of young gay and bisexual men and its physical and emotional health implications.

They found that when these men moved from hometowns where homophobia and discrimination were present to New York City, they experienced mental health issues, substance abuse and engaged in HIV-risk behavior.

The research also found that higher incomes upon moving were associated with lower HIV and mental health risks, but with more alcohol use. The findings are published today in the journal Annals of Behavioral Medicine.

“We know that young gay and bisexual men currently represent the highest-risk group for new HIV infections,” Pachankis said. Because these men might be moving from homophobic hometowns where they experienced stress related to discrimination or not fitting in, they might be particularly likely to seek connections or support in the easiest ways available in a big city. “Unfortunately, this might include things like excessive alcohol or drug use and sex without condoms with casual partners.”

Pachankis said that there has been surprisingly little research exploring the health challenges of young gay and bisexual men who move to cities. While only migrants to New York City were studied, Pachankis said the findings could be relevant to other large major urban areas in the United States. Findings were largely similar whether participants were international migrants or moving from other places in the U.S.

We know that young gay and bisexual men currently represent the highest-risk group for new HIV infections.

John Pachankis, PhD

The study also found that the men studied had, within the past few months since their arrival in the city, engaged in frequent behaviors that placed them at higher risk for HIV, suggesting that one of the ways migrants seek connections in their new home is by forming fleeting, but high-risk sexual contacts.

Pachankis and his team used popular mobile apps that gay and bisexual men use for meeting other men to recruit 273 men, ages 18 to 29, who had come to New York in the past year. The long-term goal of the research is to identify ways to support young migrants both during and after their move to ensure that they maintain good health despite the potential temptations of big city gay life.

“The results of our study suggest that providing avenues for healthy positive socializing outside traditional high-risk scenes is a promising direction for such an intervention,” he said.

Pachankis was assisted by Adam Eldahan, M.P.H. ’15, who was responsible for participant recruitment and data management, Sarit Golub, a professor of psychology at Hunter College of the City University of New York and several members of The Esteem Program at Yale.

To learn more about the team’s work, visit

Submitted by Denise Meyer on April 25, 2016