Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; Department of Social and Behavioral Sciences and Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
J Adolesc Health. 2017 Nov;61(5):555-561. doi: 10.1016/j.jadohealth.2017.05.032. Epub 2017 Aug 19.
Physician screening and advice on health-related behaviors are an integral part of adolescent health care. Sexual minority adolescents encounter more barriers to health services; yet, no prior research has examined whether they also experience disparity in physician screening and advice. We examined possible sexual orientation disparities in health care access, physician screening, and advice on six health-related behaviors.
Data were from a national sample of U.S. adolescents who participated in wave 2 of the NEXT Generation Health Study (n = 2023). Poisson regressions were conducted separately for males and females to estimate sexual orientation differences in health care access and health-related screening and advice.
Compared with heterosexual males, sexual minority males were more likely to report unmet medical needs in the past year (adjusted relative risk [ARR] = 2.23) but did not differ with respect to receiving physician advice concerning health-related behaviors. Compared with heterosexual females, sexual minority females were more likely to report no routine physical checkup in the past year (ARR = 1.67) but were more likely to receive physician advice to reduce or stop drinking, smoking, drug use, increase physical activity, and improve diet (ARRs = 1.56-1.99), even after controlling for corresponding health-related behaviors. Sexual minority females were also more likely to receive advice about risk associated with sexual behavior (ARR = 1.35) and advice to avoid sexually transmitted diseases (ARR = 1.49).
Both sexual minority males and females experienced disparities in some aspects of health care access. Improved health-promoting advice would better serve sexual minority males.
医生对健康相关行为的筛查和建议是青少年保健的一个组成部分。性少数群体青少年在获得卫生服务方面面临更多障碍；然而，先前的研究尚未探讨他们是否也在医生筛查和建议方面存在差异。我们研究了健康相关行为的六个方面，即医疗保健服务的获得、医生的筛查和建议方面，是否存在可能的性取向差异。
数据来自美国青少年下一代健康研究（NEXT Generation Health Study）的全国样本，该研究的第二波（n=2023）参与了该研究。为了估计性取向在医疗保健服务获得和健康相关筛查和建议方面的差异，我们分别对男性和女性进行了泊松回归。
与异性恋男性相比，男同性恋者在过去一年中更有可能报告存在未满足的医疗需求（调整后的相对风险[ARR]为 2.23），但在接受有关健康相关行为的医生建议方面没有差异。与异性恋女性相比，女同性恋者在过去一年中更有可能没有定期进行身体检查（ARR 为 1.67），但更有可能收到减少或停止饮酒、吸烟、吸毒、增加体育锻炼和改善饮食的医生建议（ARR 为 1.56-1.99），即使在控制了相应的健康相关行为后也是如此。女同性恋者也更有可能收到与性行为相关风险的建议（ARR 为 1.35）和避免性传播疾病的建议（ARR 为 1.49）。
男同性恋者和女同性恋者在医疗保健服务获得的某些方面都存在差异。提高促进健康的建议将更好地服务于男同性恋者。
