Jane Addams College of Social Work, University of Illinois at Chicago, Chicago, IL 60607, USA.
Int J Environ Res Public Health. 2019 Apr 18;16(8):1399. doi: 10.3390/ijerph16081399.
There have been limited studies assessing the differences in chronic health conditions between sexual minority (those who identify as lesbian or bisexual) and sexual majority (heterosexual) women. Research has primarily focused on overall physical and mental health or behavioral issues and not on specific health conditions. The addition of sexual orientation and attraction questions to the National Survey on Drug Use and Health (NSDUH) now allows for research regarding health conditions using a national survey that identifies participant sexual orientation and attraction. This study sought to compare the prevalence/odds of having 10 medical conditions/infectious diseases among women, assessing for differences associated with sexual identity, sexual attraction, and the degree of concordance between sexual identity and attraction. Data from 67,648 adult female participants in the 2015-2017 NSDUH survey were analyzed using bivariate and multivariable logistic regression models to assess for differences in prevalence/odds of seven medical conditions. Multivariable models adjusted for demographics, substance abuse/dependence, and mental illness. We found significant differences by sexual identity, but not sexual attraction or concordance. Compared with heterosexually identified women, women who identified as bisexual had significantly higher odds of having three medical conditions and two infectious diseases than heterosexual or lesbian women. The findings generally support those based on studies using more limited geographical samples. There are a number of potential associated and underlying factors that contribute to bisexual women reporting overall poorer health than heterosexual or lesbian women. The factors discussed include stigma, delays in seeking care, lack of insurance and access, and sexual minority women receiving poorer health care generally.
目前，评估性少数群体（包括同性恋或双性恋者）和性多数群体（异性恋者）女性之间慢性健康状况差异的研究有限。研究主要集中在整体身心健康或行为问题上，而不是特定的健康状况。国家药物使用和健康调查（NSDUH）现在增加了性取向和吸引力问题，这使得可以使用一项可以识别参与者性取向和吸引力的全国性调查来研究健康状况。本研究旨在比较 10 种女性疾病/传染病的患病率/几率，评估与性身份、性吸引力以及性身份和吸引力之间的一致性程度相关的差异。使用二元和多变量逻辑回归模型分析了来自 2015-2017 年 NSDUH 调查的 67648 名成年女性参与者的数据，以评估七种疾病的患病率/几率差异。多变量模型调整了人口统计学、药物滥用/依赖和精神疾病。我们发现了性身份的显著差异，但没有性吸引力或一致性的差异。与异性恋女性相比，认同双性恋的女性患三种疾病和两种传染病的几率明显更高，而同性恋或异性恋女性则不然。这些发现普遍支持那些基于使用更有限地理样本的研究。有许多潜在的相关和潜在因素导致双性恋女性报告的整体健康状况比异性恋或同性恋女性差。讨论的因素包括耻辱感、寻求护理的延迟、缺乏保险和获得护理的机会，以及性少数群体女性普遍获得较差的医疗保健。
