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Advanced Neurology

SHORT COMMUNICATION
Sexual behavior and risk of diagnosis with

multiple sclerosis: A retrospective case–control
study

Matthew Kennis*, Katherine Thompson, and Elijah W. Hale

School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado, United
States of America

Abstract

Adolescence is a critical window during which psychosocial factors have significant
effects on the lifetime risk of multiple sclerosis (MS). Sexual behavior is relevant
early in adulthood and has not been described in its relationship to MS. Using a
retrospective secondary analysis of cross-sectional data in the TriNetX database, we
investigated the connection between orientation of sexual behavior and MS risk. We
identified 13,595 males and 9,589 females with same-sex behavior and 64,409 males
and 137,450 females with opposite-sex behavior. Cohorts were balanced on age,
race, and ethnicity. Males engaging in same-sex behavior had a 2.80-fold higher risk
of MS diagnosis (95% confidence interval [CI]: 1.66 – 4.73), and females engaging in
same-sex behavior had a 2.30-fold higher risk of MS diagnosis (95% CI: 1.65 – 3.20).
Our findings thus advance the understanding of MS risk in the context of social
determinants of health.
*Corresponding author:
Matthew Kennis Keywords: Multiple sclerosis; Sexual behavior; Adverse childhood experiences;
(matthew.kennis@cuanschutz.edu)
Adolescence
Citation: Kennis M, Thompson K,
Hale EW, 2023, Sexual behavior
and risk of diagnosis with
multiple sclerosis: A retrospective
case–control study. Adv Neuro, 1. Introduction
2(4): 1383.
https://doi.org/10.36922/an.1383 Multiple sclerosis (MS) is a demyelinating disease of the central nervous system
[1]
Received: July 27, 2023 with heterogenous symptomatology due to variably affected neuronal tracts . While
some factors such as Epstein–Barr virus (EBV) infection are well established as being
Accepted: November 28, 2023 associated with an increased risk of MS, certain factors such as adolescent obesity and
Published Online: December 12, 2023 sunlight exposure have been identified recently, reinforcing the importance of continued
[2]
Copyright: © 2023 Author(s). research into MS risk factors . Many studies have recently focused on adolescence, as it
This is an Open-Access article has been identified as a particular time window during which lifestyle and environmental
distributed under the terms of the [3]
Creative Commons Attribution factors seem to have the greatest effect on the lifetime risk of MS .
License, permitting distribution, Adolescence and young adulthood are also associated with the development of
and reproduction in any medium,
[4]
provided the original work is patterns of sexual behavior and identity formation . While personal identities such as
properly cited. gay, lesbian, bisexual, or queer may arise later in life, sexual behavior with individuals of
[5]
Publisher’s Note: AccScience the same sex often initially occurs in adolescence . Despite the known impact of same-
Publishing remains neutral with sex behavior on other neurologic conditions, such as amyotrophic lateral sclerosis and
regard to jurisdictional claims in [6,7]
published maps and institutional dementia , research into the intersection between MS and sexual behavior has been
[8]
affiliations. limited .
Volume 2 Issue 4 (2023) 1 https://doi.org/10.36922/an.1383