Risk Reconsidered: Insights from a Data Saturation Analysis of sexual health research amongst gay, bisexual and other men who have sex with men

Objectives: This study explored how risk in the context of sexual health is conceptualised in research related to gay, bisexual, and other men who have sex with men (gbMSM), during a period of major biomedical change, including the scale-up of pre-exposure prophylaxis (PrEP) and the Undetectable = Untransmittable (U=U) campaign, prior to the COVID-19 pandemic. Methods: A systematic search across Medline (OVID), CINAHL, and Scopus identified studies published and/or with data collected between 2015 and 2020, from high-income countries in the Global North. A novel saturation-based approach, adapted from qualitative research, was used to determine when no new implicit or explicit conceptualisations of risk were emerging. Ten initial papers were reviewed, followed by sets of three, stopping after saturation was reached at 24 papers. Results: The word "risk" appeared 722 times across included studies. Hundreds of distinct implicit and explicit conceptualisations were identified and grouped into five interconnected dimensions: health outcome, biomedical, behavioural, interpersonal, and individual. Conclusions: Findings highlight the pervasive yet fragmented use of "risk" in sexual health literature, which may hinder clear communication between researchers, clinicians, and gbMSM. This study supports calls for more precise language. notReviewed other