Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, USA.
Women's College Research Institute, Women's College Hospital, Toronto, ON, USA.
AIDS Behav. 2018 Jun;22(6):1987-2001. doi: 10.1007/s10461-017-1781-y.
Sexual orientation differences in health and wellbeing among women living with HIV (WLH) are underexplored. Limited research available, however, suggests that sexual minority WLH may experience barriers to HIV care. Cross-sectional baseline data was analyzed from a Canadian cohort study with WLH (sexual minority women [SMW]: n = 180; heterosexual women: n = 1240). SMW (median age 38 years, IQR 13) included bisexual (58.9%), lesbian (17.8%) and other sexualities (23.3%). In multivariable analyses adjusting for age, poverty, education, and ethnicity, SMW identity was associated with increased odds of: clinical (80% vs. 100% antiretroviral adherence), intrapersonal (previous/current injection drug use [IDU] vs. no IDU history, depression, lower resilience), interpersonal (childhood abuse, sex work, adulthood abuse), and structural (HIV support services barriers, unstable housing, racial discrimination, gender discrimination) factors in comparison with heterosexual identity. Sexual minority WLH experience social and health disparities relative to heterosexual WLH, highlighting the need for interventions to promote health equity.
性取向差异对 HIV 感染者（PLWH）的健康和福祉的影响尚未得到充分研究。然而，有限的研究表明，性少数群体的 PLWH 可能面临 HIV 护理方面的障碍。本研究分析了加拿大队列研究中 PLWH（性少数群体女性[SMW]：n=180；异性恋女性：n=1240）的横断面基线数据。SMW（中位年龄 38 岁，IQR 13）包括双性恋（58.9%）、女同性恋（17.8%）和其他性取向（23.3%）。在调整年龄、贫困、教育和种族因素的多变量分析中，SMW 身份与以下因素的比值比增加有关：临床（80% vs. 100% 抗逆转录病毒药物依从性）、个体内（既往/当前注射吸毒[IDU]与无 IDU 史、抑郁、较低的韧性）、人际间（儿童期虐待、性工作、成年期虐待）和结构（HIV 支持服务障碍、不稳定住房、种族歧视、性别歧视）因素，与异性恋身份相比。性少数群体的 PLWH 经历着与异性恋 PLWH 相比的社会和健康差距，这凸显了需要采取干预措施促进健康公平。
