Sexual Orientation and the Incidence of COVID-19: Evidence from Understanding Society in the UK Longitudinal Household Study

COVID-19 infection rates and severity are worse in marginalised groups, although, for sexual and gender minorities, there are no data on infections, hospitalisations or deaths, but there may be worse rates. This study uses information from Understanding Society: The UK Household Longitudinal Study (UKHLS) to derive COVID-19 symptoms and positive tests by sexual orientation. Data came from all seven UKHLS COVID-19 survey waves in 2020 and 2021, and sexual orientation in main UKHLS waves 3 and 9. Numbers ranged from 17,800 to 12,000. Covariates in the regression models were gender, age, highest educational qualification, ethnicity, diagnosed medical condition, and key worker status. Compared to heterosexual individuals, more sexual minorities experienced symptoms, and bisexual individuals reported a greater number of symptoms. Gays and lesbians were no more or less likely to have been tested, but a larger proportion of bisexual individuals were tested. Regression models showed that differences mostly disappeared when other characteristics were considered. A small sample size means that principal questions remain, so health inequalities have been largely unnoticed and therefore not addressed. Suitable action should be taken to minimise their future risks. Why sexual and gender minorities have been omitted needs to be explored, and action needs to be taken to ensure this does not happen again.