Larsson Markus, Ross Michael W, Tumwine Gilbert, Agardh Anette
Division for Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden;
Program in Human Sexuality, Department of Family Medicine, University of Minnesota, Minneapolis, MN, USA.
Glob Health Action. 2016 Mar 30;9:30790. doi: 10.3402/gha.v9.30790. eCollection 2016.
Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited.
To identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality.
In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about, or sexually engaged with someone of the same sex.
Findings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs, respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual coercion (OR 3.9, 95% confidence intervals [CI]: 2.7-5.7; OR 2.0, 95% CI: 1.3-3.0, respectively). Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI: 2.1-4.8), exposure to sexual coercion (OR 2.6, 95% CI: 1.7-3.9), frequent heavy episodic drinking (OR 3.3, 95% CI: 1.9-5.8), and number of sexual partners (OR 1.9, 95% CI: 1.04-3.3). The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.1-8.5; AOR 2.8, 95% CI: 1.3-5.8) and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.6-7.1; AOR 2.7, 95% CI: 1.4-5.4) persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking.
These findings indicate that exposure to sexual coercion and poor mental health may influence healthcare seeking behaviours of same-sex sexuality experienced students. Targeted interventions that integrate mental health and trauma response are critical to meet the health needs of this population.
撒哈拉以南非洲地区的研究表明，有同性性行为经历的人由于性行为冒险、污名化和歧视，健康状况不佳的风险较高。然而，该地区有同性性行为经历的年轻人寻求医疗保健的研究有限。
分别确定有同性性行为经历的乌干达大学生未满足的医疗保健需求和性健康咨询需求的决定因素。
2010年，1954名乌干达大学生完成了一份问卷，评估社会人口学因素、心理健康、饮酒情况、性行为和寻求医疗保健情况。研究人群包括570名报告曾与同性恋爱、被同性吸引、对同性有性幻想或与同性发生性行为的学生。
研究结果显示，分别有56%和30%的人报告有未满足的医疗保健需求和性健康咨询需求。未满足的医疗保健需求与心理健康不佳和遭受性胁迫有关（比值比分别为3.9，95%置信区间[CI]：2.7 - 5.7；2.0，95% CI：1.3 - 3.0）。未满足的性健康咨询需求与心理健康不佳（比值比3.2，95% CI：2.1 - 4.8）、遭受性胁迫（比值比2.6，95% CI：1.7 - 3.9）、频繁大量饮酒（比值比3.3，95% CI：1.9 - 5.8）以及性伴侣数量（比值比1.9，95% CI：1.04 - 3.3）显著相关。在对社会人口学因素、性伴侣数量和频繁大量饮酒进行调整后，心理健康不佳、性胁迫与未满足的医疗保健需求（调整后比值比4.2，95% CI：2.1 - 8.5；调整后比值比2.8，95% CI：1.3 - 5.8）以及未满足的性健康咨询需求（调整后比值比3.3，95% CI：1.6 - 7.1；调整后比值比2.7，95% CI：1.4 - 5.4）之间的关联仍然存在。
这些研究结果表明，遭受性胁迫和心理健康不佳可能会影响有同性性行为经历的学生的就医行为。整合心理健康和创伤应对的针对性干预措施对于满足这一人群的健康需求至关重要。
