Sexual Orientation Identity Disparities Research Articles

Sexual Orientation Identity Disparities in Mammography Among White, Black, and Latina U.S. Women.

Purpose: Our goal was to examine sexual orientation identity disparities in mammography in relationship to race/ethnicity among U.S. women. Methods: Using nationally representative 2013-2017 National Health Interview Survey data, we used multivariable logistic regression to estimate the odds of receiving a mammogram in the past year in relationship to sexual orientation identity among White, Black, and Latina U.S. women 40-75 years of age (N = 45,031) separately, adjusting for demographic factors. We also assessed whether socioeconomic and health care factors attenuated sexual orientation identity disparities in mammography across racial/ethnic groups. Results: Among White women, bisexual women had significantly lower adjusted odds of mammography compared to heterosexual women (odds ratio = 0.70, 95% confidence interval: 0.50-0.99). Among Black women, the adjusted odds of mammography were significantly higher among bisexual women relative to heterosexual women (2.53, 1.08-5.92). Black lesbian women appeared to have lower adjusted odds of mammography compared to their heterosexual counterparts; however, this difference was not statistically significant (0.80, 0.46-1.38). Similarly, among Latina women, lesbian women also seemed to have lower adjusted odds of mammography relative to heterosexual women, but this disparity was also not statistically significant (0.64, 0.37-1.13). Adding socioeconomic factors completely attenuated the disparity between White bisexual and heterosexual women (0.76, 0.52-1.10). Conclusions: Sexual orientation identity disparities in receiving a mammogram in the past year differed in relationship to race/ethnicity among White, Black, and Latina U.S. women. Additional research with larger samples of Black and Latina lesbian and bisexual women is needed to more accurately estimate and explain observed differences.

Sexual orientation identity disparities in health behaviors, outcomes, and services use among men and women in the United States: a cross-sectional study.

BackgroundResearch shows that sexual minorities (e.g., lesbian, gay, and bisexual individuals) experience higher levels of discrimination, stigma, and stress and are at higher risk of some poor health outcomes and health behaviors compared to their heterosexual counterparts. However, the majority of studies have examined sexual orientation disparities in a narrow range of health outcomes and behaviors using convenience samples comprised of either men or women living in restricted geographic areas.MethodsTo investigate the relationship between sexual orientation identity and health among U.S. women and men, we used Poisson regression with robust variance to estimate prevalence ratios for health behaviors, outcomes, and services use comparing sexual minorities to heterosexual individuals using 2013 and 2014 National Health Interview Survey data (N = 69,270).ResultsThree percent of the sample identified as sexual minorities. Compared to heterosexual women, lesbian (prevalence ratio (PR) = 1.65 [95 % confidence interval (CI): 1.14, 2.37]) and bisexual (PR = 2.16 [1.46, 3.18]) women were more likely to report heavy drinking. Lesbians had a higher prevalence of obesity (PR = 1.20 [1.02, 1.42]), stroke (PR = 1.96 [1.14, 3.39]), and functional limitation (PR = 1.17 [1.02, 1.34] than heterosexual women. Gay men were more likely to have hypertension (PR = 1.21 [1.03, 1.43]) and heart disease (PR = 1.39 [1.02, 1.88]). Despite no difference in health insurance status, sexual minorities were more likely than heterosexual individuals to delay seeking healthcare because of cost; however, members of this group were also more likely to have received an HIV test and initiated HPV vaccination.ConclusionSexual minorities had a higher prevalence of some poor health behaviors and outcomes.

Sexual orientation identity disparities in human papillomavirus vaccination initiation and completion among young adult US women and men.

To examine the association between sexual orientation identity and human papillomavirus (HPV) vaccination initiation and completion among both women and men. Using data from the 2013 and 2014 National Health Interview Survey, we estimated logistic regression models for the association between sexual orientation identity and HPV vaccination initiation (≥1 dose) and completion (≥3 doses) among US women and men in relation to sociodemographic and healthcare factors. Analyses were restricted to individuals for whom the HPV vaccine was recommended at some point in their lives, namely women aged 18-34years (n=9,734) and men aged 18-31years (n=6,812). Among all women, bisexual women had higher adjusted odds of HPV vaccination initiation [(odds ratio) 1.71; (95% confidence interval) 1.20-2.45] and completion (1.59; 1.05-2.42) than heterosexual women. No difference was observed in the odds of HPV vaccination initiation or completion between lesbian and heterosexual women. Among women who had initiated HPV vaccination, lesbians had lower adjusted odds of completion than heterosexual women (0.41; 0.19-0.90). Among all men, gay men had higher adjusted odds of initiating (2.07; 1.17-3.52) and completing (3.90; 1.68-9.06) HPV vaccination than heterosexual men. No difference was observed in the odds of HPV vaccination initiation or completion between bisexual and heterosexual men. Among men who had initiated HPV vaccination, gay (4.36; 1.28-14.83) and bisexual (20.92; 2.34-186.73) men had higher adjusted odds of completion than heterosexual men, although these results are unreliable and should be interpreted with caution. Interventions are needed to promote HPV vaccination among all US women and men, regardless of sexual orientation identity.

Sexual Orientation Identity Disparities in Human Papillomavirus Vaccination Initiation and Completion in a National Sample of Young Adult U.S. Women and Men

SEXUAL ORIENTATION IDENTITY DISPARITIES IN HUMAN PAPILLOMAVIRUS VACCINATION INITIATION AND COMPLETION IN A NATIONAL SAMPLE OF YOUNG ADULT U.S. WOMEN AND MEN Madina Agenor, ScD , Sarah M. Peitzmeier, MPH , Allegra R. Gordon, ScD , Brittany M. Charlton, ScD , Sebastien JPA. Haneuse, PhD , Jennifer E. Potter, MD , S. Bryn Austin, ScD . Harvard T.H. Chan School of Public Health; Johns Hopkins Bloomberg School of Public Health; Boston Children’s Hospital; Harvard Medical School; Beth Israel Deaconess Medical Center.

Sexual Orientation Identity Disparities in Awareness and Initiation of the Human Papillomavirus Vaccine Among U.S. Women and Girls: A National Survey.

Lesbians and bisexual women are at risk for human papillomavirus (HPV) infection from female and male sexual partners. To examine the association between sexual orientation identity and HPV vaccination among U.S. women and girls. Cross-sectional, using 2006-2010 National Survey of Family Growth data. U.S. civilian noninstitutionalized population. The 2006-2010 National Survey of Family Growth used stratified cluster sampling to establish a national probability sample of 12,279 U.S. women and girls aged 15 to 44 years. Analyses were restricted to 3253 women and girls aged 15 to 25 years who were asked about HPV vaccination. Multivariable logistic regression was used to obtain prevalence estimates of HPV vaccine awareness and initiation adjusted for sociodemographic and health care factors for each sexual orientation identity group. Among U.S. women and girls aged 15 to 25 years, 84.4% reported having heard of the HPV vaccine; of these, 28.5% had initiated HPV vaccination. The adjusted prevalence of vaccine awareness was similar among heterosexual, bisexual, and lesbian respondents. After adjustment for covariates, 8.5% (P = 0.007) of lesbians and 33.2% (P = 0.33) of bisexual women and girls who had heard of the vaccine had initiated vaccination compared with 28.4% of their heterosexual counterparts. Self-reported, cross-sectional data, and findings may not be generalizable to periods after 2006 to 2010 or all U.S. lesbians aged 15 to 25 years (because of the small sample size for this group). Adolescent and young adult lesbians may be less likely to initiate HPV vaccination than their heterosexual counterparts. Programs should facilitate access to HPV vaccination services among young lesbians. National Cancer Institute.

Sexual-orientation disparities in school: the mediational role of indicators of victimization in achievement and truancy because of feeling unsafe.

We examined sexual-orientation identity disparities in truancy and academic achievement, and the mediational role of victimization in a large high-school sample. We utilized pooled data, measuring sexual identity, from the 2005 and 2007 Youth Risk Behavioral Surveillance System Surveys. Multilevel logistic regression modeling estimated the odds of low grades and truancy because of feeling unsafe comparing lesbian/gay, bisexual, (LGB) and unsure students to heterosexuals. We stratified models by gender. Indicators of victimization were examined to mediate the relationship between identifying as a sexual minority and school achievement or truancy. LGB-identified youths reported significantly elevated odds of truancy and low grades (odds ratios = 1.6-3.2; all P < .05). Additionally, both genders noting uncertainty about their sexual identity showed increased odds of truancy. Victimization indicators mediated the relationship between identifying as a sexual minority and experiencing negative school outcomes, with greater victimization indicators being associated with increased truancy and lower grades, and the extent of mediation differed by gender. As early disparities in academic achievement and school engagement have indicated a lifetime of increased health and behavioral risk factors, early intervention targeting school victimization is necessary.

Disparities in Safety Belt Use by Sexual Orientation Identity Among US High School Students

We examined associations between adolescents' safety belt use and sexual orientation identity. We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys (n = 26,468 weighted; mean age = 15.9 years; 35.4% White, 24.7% Black, 23.5% Latino, 16.4% other). We compared lesbian and gay (1.2%), bisexual (3.5%), and unsure (2.6%) youths with heterosexuals (92.7%) on a binary indicator of passenger safety belt use. We stratified weighted multivariable logistic regression models by sex and adjusted for survey wave and sampling design. Overall, 12.6% of high school students reported "rarely" or "never" wearing safety belts. Sexual minority youths had increased odds of reporting nonuse relative to heterosexuals (48% higher for male bisexuals, 85% for lesbians, 46% for female bisexuals, and 51% for female unsure youths; P < .05), after adjustment for demographic (age, race/ethnicity), individual (body mass index, depression, bullying, binge drinking, riding with a drunk driver, academic achievement), and contextual (living in jurisdictions with secondary or primary safety belt laws, percentage below poverty, percentage same-sex households) risk factors. Public health interventions should address sexual orientation identity disparities in safety belt use.