McNair Ruth, Pennay Amy, Hughes Tonda L, Love Scarlet, Valpied Jodie, Lubman Dan I
Honorary Associate Professor, Department of General Practice, University of Melbourne, Carlton, Australia.
Research Fellow, School of Psychology and Public Health, Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia.
BJGP Open. 2018 May 16;2(2):bjgpopen18X101565. doi: 10.3399/bjgpopen18X101565. eCollection 2018 Jul.
Same-sex attracted women (SSAW) have higher rates of alcohol and mental health problems than heterosexual women, but utilisation of and satisfaction with treatment is limited.
This study investigated the influences on health service use for alcohol and mental health problems among SSAW.
DESIGN & SETTING: The Gelberg-Andersen behavioural model of health service utilisation was used to generate outcome variables.
A convenience sample of 521 community-connected Australian SSAW completed an online survey. Health service use according to sexual identity was compared using χ analysis. Binary logistic regression examined associations between the independent variables with treatment utilisation.
Reports of alcohol treatment were very low. Only 41.1% of participants with service need had utilised mental health and alcohol treatment. Bisexual women (adjusted odds ratio [AOR] = 2.76) and those with 'other' identities (AOR = 2.38) were more likely to use services than lesbian women. Enablers to service use were having a regular GP (AOR = 3.02); disclosure of sexuality to the GP (AOR = 2.42); lesbian, gay, bisexual and transgender (LGBT) community-connectedness (AOR = 1.11); and intimate partner violence ([IPV] AOR = 2.51). Social support was associated with a reduction in treatment use (AOR = 0.97). Significant access barriers included not feeling ready for help, and previous negative experiences related to sexual identity.
Disclosing sexual identity to a regular, trusted GP correlated with improved utilisation of alcohol and mental health treatment for SSAW. The benefits of seeking help for alcohol use, and of accessing LGBT-inclusive GPs to do so, should be promoted to SSAW.
与异性恋女性相比，有同性吸引倾向的女性（SSAW）存在酒精和心理健康问题的比例更高，但治疗的利用率和满意度有限。
本研究调查了影响SSAW酒精和心理健康问题的医疗服务使用情况的因素。
采用Gelberg-Andersen医疗服务利用行为模型生成结果变量。
对521名与社区有联系的澳大利亚SSAW进行便利抽样，完成在线调查。使用χ分析比较了按性取向划分的医疗服务使用情况。二元逻辑回归分析了自变量与治疗利用率之间的关联。
酒精治疗的报告率非常低。只有41.1%有服务需求的参与者使用了心理健康和酒精治疗服务。双性恋女性（调整后的优势比[AOR]=2.76）和具有“其他”身份的女性（AOR=2.38）比女同性恋女性更有可能使用服务。促进服务使用的因素包括有固定的全科医生（AOR=3.02）；向全科医生披露性取向（AOR=2.42）；与女同性恋、男同性恋、双性恋和跨性别者（LGBT）社区有联系（AOR=1.11）；以及亲密伴侣暴力（[IPV]AOR=2.51）。社会支持与治疗使用减少有关（AOR=0.97）。重要的获取障碍包括感觉还没准备好寻求帮助，以及以前与性取向相关的负面经历。
向常规的、可信赖的全科医生披露性取向与SSAW酒精和心理健康治疗利用率的提高相关。应向SSAW宣传寻求酒精使用帮助的益处，以及寻求提供LGBT包容性服务的全科医生帮助的益处。
