1 Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania.
2 Center for Sexuality & Health Disparities, School of Public Health, University of Michigan , Ann Arbor, Michigan.
LGBT Health. 2015 Sep;2(3):250-7. doi: 10.1089/lgbt.2014.0063. Epub 2015 Apr 13.
Syndemics, or the co-occurrence and interaction of health problems, have been examined extensively among young men who have sex with men, but their existence remain unexamined, to our knowledge, among sexual-minority (i.e., lesbian, gay, and bisexual) women. Thus, we investigated if syndemics were present among young sexual-minority women, and if sexual-orientation discrimination was an independent variable of syndemic production.
A total of 467 sexual-minority women between the ages of 18 and 24 completed a cross-sectional online survey regarding their substance use, mental health, sexual behaviors, height, weight, and experiences of discrimination. We used structural equation modeling to investigate the presence of syndemics and their relationship to sexual-orientation discrimination.
Heavy episodic drinking, marijuana use, ecstasy use, hallucinogen use, depressive symptoms, multiple sexual partners, and history of sexually transmitted infections (STIs) comprised syndemics in this population (chi-square=24.989, P=.201; comparative fit index [CFI]=0.946; root mean square error of approximation [RMSEA]=0.023). Sexual-orientation discrimination is significantly and positively associated with the latent syndemic variable (unstandardized coefficient=0.095, P<.05), and this model fit the data well (chi-square=33.558, P=.059; CFI=0.914; RMSEA=0.029). The reverse causal model showed syndemics is not an independent variable of sexual-orientation discrimination (unstandardized coefficient=0.602, P>.05).
Syndemics appear to be present and associated with sexual-orientation discrimination among young sexual-minority women. Interventions aimed at reducing discrimination or increasing healthy coping may help reduce substance use, depressive symptoms, and sexual risk behaviors in this population.
综合征,即健康问题的同时发生和相互作用,在与男性发生性关系的男性青年中已经得到了广泛研究,但据我们所知,在性少数群体(即女同性恋、男同性恋和双性恋)女性中,它们的存在尚未得到研究。因此,我们调查了综合征是否存在于年轻的性少数女性中,以及性取向歧视是否是综合征产生的一个独立变量。
共有 467 名年龄在 18 至 24 岁之间的性少数女性完成了一项关于她们的物质使用、心理健康、性行为、身高、体重和歧视经历的横断面在线调查。我们使用结构方程模型来调查综合征的存在及其与性取向歧视的关系。
在该人群中,重度间歇性饮酒、大麻使用、摇头丸使用、迷幻剂使用、抑郁症状、多个性伴侣和性传播感染(STI)史构成了综合征(卡方=24.989,P=.201;比较拟合指数[CFI]=0.946;近似均方根误差[RMSEA]=0.023)。性取向歧视与潜在的综合征变量显著正相关(未标准化系数=0.095,P<.05),并且该模型很好地拟合了数据(卡方=33.558,P=.059;CFI=0.914;RMSEA=0.029)。反向因果模型表明,综合征不是性取向歧视的独立变量(未标准化系数=0.602,P>.05)。
综合征似乎存在于年轻的性少数女性中,并与性取向歧视相关。旨在减少歧视或增加健康应对的干预措施可能有助于减少该人群中的物质使用、抑郁症状和性风险行为。