Glick Jennifer L, Baugher Amy R, Morris Elana, German Danielle, Alexander Kamila A, Cha Susan, Sionean Catlainn
Community Health Science and Policy (CHSP), School of Public Health, Louisiana State University Health Sciences Center (LSUHSC), New Orleans, Louisiana, USA.
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
LGBT Health. 2025 Jul;12(5):350-362. doi: 10.1089/lgbt.2024.0098. Epub 2025 Apr 16.
Research suggests that sexual minority women (SMW) face elevated HIV risk compared with their heterosexual counterparts. This study examined the association between sexual minority status-defined by identity and behavior-and HIV-related vulnerabilities among heterosexually active low-income women. This analysis used National HIV Behavioral Surveillance data ( = 5542) collected in 2019 from heterosexually active low-income women in 23 U.S. urban areas. We examined sexual minority identity and behavior and a set of substance use, sexual behavior, health and health care, and social determinants of health indicators commonly associated with heightened HIV transmission risk. Log-linked Poisson regression models generated adjusted prevalence ratios and 95% confidence intervals. Among women who reported sexual minority identity (22.2%; = 1231), 34.6% ( = 426) reported past-year sex with only men. Of women who reported past-year sex with both women and men (17.8%; = 985), 18.3% ( = 180) identified as heterosexual. In adjusted models, SMW had significantly higher prevalence of nearly every HIV risk-associated factor examined than their heterosexual counterparts. Risk profiles by identity and behavior were similar. Notably, SMW defined by behavior had similar or higher prevalence of nearly every risk factor than those defined by identity. This study demonstrates disproportionate HIV-related vulnerabilities among SMW compared with their heterosexual counterparts. The findings underscore the importance of measuring multiple dimensions of sexual orientation (identity and behavior), as SMW and their associated risks show important nuances. Implications include tailoring HIV prevention and health promotion interventions to meet the needs of low-income SMW.
研究表明，性少数群体女性（SMW）相较于异性恋女性面临着更高的感染艾滋病毒风险。本研究调查了性少数群体身份（由身份认同和行为界定）与性活跃低收入女性中与艾滋病毒相关的脆弱性之间的关联。该分析使用了2019年从美国23个城市地区性活跃低收入女性中收集的全国艾滋病毒行为监测数据（n = 5542）。我们研究了性少数群体身份和行为以及一组与艾滋病毒传播风险增加通常相关的物质使用、性行为、健康与医疗保健以及健康的社会决定因素指标。对数链接泊松回归模型生成了调整后的患病率比值和95%置信区间。在报告有性少数群体身份的女性中（22.2%；n = 1231），34.6%（n = 426）报告过去一年仅与男性发生性行为。在报告过去一年与女性和男性都发生过性行为的女性中（17.8%；n = 985），18.3%（n = 180）认定为异性恋。在调整后的模型中，与异性恋女性相比，性少数群体女性几乎在每一项所检测的与艾滋病毒风险相关的因素上患病率都显著更高。按身份和行为划分的风险概况相似。值得注意的是，由行为界定的性少数群体女性几乎在每一项风险因素上的患病率都与由身份界定的性少数群体女性相似或更高。本研究表明，与异性恋女性相比，性少数群体女性在与艾滋病毒相关的脆弱性方面存在不成比例的情况。研究结果强调了衡量性取向多个维度（身份认同和行为）的重要性，因为性少数群体女性及其相关风险存在重要的细微差别。其影响包括调整艾滋病毒预防和健康促进干预措施以满足低收入性少数群体女性的需求。
