Variation in diet quality across sexual orientation in a cohort of U.S. women.

PURPOSE: Extensive prior research has shown that sexual minority women are more likely to have a number of cancer risk factors, thereby putting them at higher risk for cancer than heterosexual women. However, there has been little research evaluating the association between sexual orientation and diet quality. METHOD: Data come from participants (aged 24-54 years) enrolled in Nurses' Health Study 3, an ongoing, U.S.-based cohort study (N = 15,941). We measured diet using recommendations from the Dietary Approach to Stop Hypertension (DASH) and American Health Association (AHA) 2020 Strategic Impact Goals. RESULTS: We found limited evidence of differences across diet quality by sexual orientation. When examining predicted DASH scores, mostly heterosexual [predicted mean score (95% confidence interval), 24.0 (23.8, 24.3)] and lesbian [24.3 (23.8, 24.9)] women had healthier predicted DASH scores than the reference group of completely heterosexual women with no same-sex partners [23.6 (23.5, 23.7)]. Even though certain sexual minority women had overall healthier predict DASH scores, their consumption of certain food groups-low-fat dairy and fruit-was lower than completely heterosexual women with no same-sex partners. When measuring AHA scores, most sexual minority groups (completely heterosexual women with same-sex partners, mostly heterosexual women, and lesbian women) had higher diet quality compared to the reference group of completely heterosexual women with no same-sex partners. CONCLUSION: Sexual minority women, particularly mostly heterosexual women and lesbian women, had healthier diet quality than completely heterosexual women with no same-sex partners. These data suggest that cancer risk factors (e.g., smoking, drinking, and inactivity) other than diet would drive higher cancer rates among sexual minority compared to heterosexual women. Nonetheless, it is critical for all women to improve their diet quality since diet quality was poor among participants of all sexual orientations.

Alcohol, Tobacco, and Comorbid Psychiatric Disorders and Associations With Sexual Identity and Stress-Related Correlates.

OBJECTIVE: The authors examined psychiatric comorbidities associated with alcohol use disorders and tobacco use disorders among heterosexual, bisexual, and gay and lesbian men and women in the United States and whether stress-related factors were predictive of comorbidities. METHODS: The authors used data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012-2013, N=36,309) to examine the co-occurrence of past-year alcohol or tobacco use disorder with past-year anxiety disorders, mood disorders, and posttraumatic stress disorder by sexual identity (heterosexual, bisexual, gay or lesbian) and sex. The authors also examined the association of stress-related factors and social support with the presence of comorbidities. RESULTS: Comorbidities were more prevalent among women and sexual minorities, particularly bisexual women. More than half of bisexual (55%) and gay or lesbian (51%) individuals who met criteria for a past-year alcohol use disorder had a psychiatric comorbidity, while only one-third of heterosexual individuals who met criteria for a past-year alcohol use disorder did. Similar differences were found among those who met criteria for a past-year tobacco use disorder. Among sexual minorities, the frequency of sexual orientation discrimination (adjusted odds ratio range=1.08-1.10), number of stressful life events (adjusted odds ratio range=1.25-1.43), and number of adverse childhood experiences (adjusted odds ratio range=1.04-1.18) were significantly associated with greater odds of comorbidities. Greater social support was significantly inversely associated with tobacco use disorder comorbidities (adjusted odds ratio range=0.96-0.97). CONCLUSIONS: This research suggests that integrated substance use and mental health prevention and treatment programs are needed, particularly for individuals who identify as sexual minorities. The increased stressors experienced by sexual minority individuals may be important drivers of these high levels of comorbidities.

Dimensions of Sexual Orientation as Predictors of STI-Related Outcomes Among Women: An Examination of 2011-2017 National Survey of Family Growth Data.

Background: To estimate sexual orientation associated disparities in sexually transmitted infection (STI)-related outcomes across multiple dimensions of sexual orientation. Methods: Using pooled 2011-2017 National Survey of Family Growth data (N = 16,854), we performed bivariate and multivariable logistic and multinomial regression analyses to estimate associations between sexual identity, behavior in the past 12 months, and attraction, and past-year STI treatment, receipt of the human papillomavirus (HPV) vaccine, and age at first HPV vaccination in cisgender women. Results: Bisexual-identified women (adjusted odds ratio [AOR] = 1.53, 95% confidence interval [CI] = 1.10-2.14) and who were sexually active with both men and women in the past 12 months (AOR = 1.64, 95% CI = 1.03-2.55) had significantly higher odds of past-year STI treatment, compared with their nonsexual minority counterparts. Lesbian-identified women (AOR = 0.44, 95% CI = 0.27-0.75) and women with female partners only (AOR = 0.32, 95% CI = 0.12-0.87) had significantly decreased odds of having initiated the HPV vaccine compared with their heterosexual counterparts. Women with both male and female partners who initiated the HPV vaccine had significantly higher odds of having received the vaccine during the latest age range, 18-25 years old (AOR = 2.32, 95% CI = 1.21-4.45) compared with women with male partners only. Conclusions: Sexual minority women continue to be at risk for poor sexual health outcomes, and these outcomes differ by specific components of sexual orientation.

Disparities in Chronic Health Outcomes and Health Behaviors Between Lesbian and Heterosexual Adult Women in Pittsburgh: A Longitudinal Study.

Background: Compared to heterosexual women, lesbian women experience higher rates of many chronic diseases, including depression, obesity, hypertension, and diabetes. Lesbian women report higher rates of risky health behaviors such as hazardous drinking and cigarette smoking. However, little longitudinal research has been done to examine changes in disparities between lesbian and heterosexual adult women. Methods: A total of 1,084 women were initially recruited from Pittsburgh, PA to participate in the Epidemiologic Study of HEalth Risk in Women (ESTHER) study and completed a baseline survey between 2003 and 2006. In 2015 or 2016, N = 483 women, 270 of whom were lesbian, completed a follow-up survey. Participants completed a questionnaire at both baseline and follow-up and completed a clinic visit for the baseline study to provide biometric data. Results: At baseline, lesbian participants reported higher rates of obesity (p = 0.03), depression (p = 0.02), and smoking (p = 0.04). Lesbian participants had elevated measured C-reactive protein levels (p = 0.05). By the time of the follow-up survey 10 years later, lesbian women continued to have higher rates of smoking (p = 0.04), but the disparity in depression (p = 0.53) and obesity (p = 0.24) rates had resolved. We found no differences in any other outcomes of interest. Conclusions: To our knowledge, this is the first study to report a resolution in obesity or depression disparities between lesbian and heterosexual women. Future research is necessary to determine if other disparities, such as respiratory conditions, appear over time and how lesbian women's health may continue to improve relative to heterosexual women and stem this public health inequity.

Healthcare experiences of urban young adult lesbians.

PURPOSE: This cross-sectional study of young adult lesbians explores their healthcare experiences including having a primary care provider, forgone care, knowledge of where to obtain Pap testing, and sexually transmitted infection testing. METHODS: Quantitative surveys were conducted at lesbian, gay, bisexual, and transgender venues and events with a sample of 100 young adult lesbians in New York City between June and October 2016. Using the Andersen model of healthcare access, this study examined associations between sociodemographic characteristics and healthcare experiences using multivariable logistic regression models. RESULTS: Having a primary care provider was associated with having health insurance (adjusted odds ratio (AOR) = 4.9, p < 0.05). Both insurance (AOR = 0.2, p < 0.05) and employment (AOR = 0.2, p < 0.05) status were protective against foregone care among young adult lesbians. Disclosure of sexual orientation to a provider improved knowledge of where to access Pap testing (AOR = 7.5, p < 0.05). Disclosure of sexual orientation to friends and family improved knowledge of where to access sexually transmitted infection testing (AOR = 3.6, p < 0.05). CONCLUSION: Socioeconomic factors are significantly associated with healthcare access among young adult lesbians in New York City. Maintaining non-discrimination protections for both healthcare services and insurance coverage are important for this population. In addition, financial subsidies that lower the cost of health insurance coverage may also help improve healthcare access among young adult lesbians.

Sexual and gender minority young adults' smoking characteristics: Assessing differences by sexual orientation and gender identity.

INTRODUCTION: Sexual and gender minority (SGM) young adults have higher smoking prevalence than their non-SGM peers. Less is known about differences in smoking characteristics within the SGM community. METHODS: Participants were SGM young adult smokers age 18-25 (N = 165, M age = 21.8) enrolled in a clinical trial of the Put It Out Project, a Facebook smoking cessation intervention for SGM young adults. Analyses tested differences between 1) sexual orientation groups, and 2) gender identity groups, on the following smoking characteristics: cigarettes/day, daily smoker (yes/no), social smoker (yes/no), years of smoking, number of close friends who smoke (out of 5), age of initiation, age began smoking regularly, time to first cigarette (30 min or less/>30 min), lifetime quit attempts, past-year quit attempts, and stage of change for quitting smoking (precontemplation, contemplation, preparation). RESULTS: Participants were 56% bi/pansexual, 18% gay, 18% lesbian, 8% other (e.g., asexual, queer). The gender identity of the sample was 52% cisgender, 18% transgender, 30% gender non-binary. Lesbian women began smoking at an older age (M = 18.0, SD = 2.0) than "other" sexual orientation participants (M = 15.7, SD = 2.2), p < .05. Transgender participants smoked the most cigarettes per day (M = 11.3, SD = 6.7), followed by cisgender (M = 8.1, SD = 5.6), then non-binary (M = 5.7, SD = 3.5) participants (p < .001; pairwise comparisons p's < 0.05). No other constructs differed by sexual orientation or gender. CONCLUSIONS: Smoking characteristics were mostly similar across subgroups of young adult SGM smokers; however, transgender individuals were heavier smokers.

Vaccination differences among U.S. adults by their self-identified sexual orientation, National Health Interview Survey, 2013-2015.

INTRODUCTION: Very few studies have explored the associations between self-identified sexual orientation and comprehensive vaccination coverage. Most of the previous studies that reported health disparities among lesbian, gay and bisexual populations were not based on a nationally representative sample of U.S. adults, limiting the generalizability of the findings. Starting in 2013, the National Health Interview Survey (NHIS) included questions to ascertain the adult's self-identified sexual orientation that allowed national level vaccination estimation by sexual orientation. This study examined associations of self-reported vaccination coverage for selected vaccines among U.S. adults by their sexual orientation. METHODS: We analyzed combined data from 2013-2015 NHIS, a nationally representative probability-based health survey of the noninstitutionalized U.S. population ≥18 years. For vaccines other than influenza, weighted proportions were calculated. Influenza coverage was calculated using the Kaplan-Meier procedure. Multivariable logistic regression models were used to calculate adjusted prevalence differences for each vaccine overall and stratified by sexual orientation and to identify factors independently associated with vaccination. RESULTS: Significant differences were observed by sexual orientation for self-reported receipt of human papillomavirus (HPV), hepatitis A (HepA), hepatitis B (HepB), and influenza vaccination. Bisexual females (51.6%) had higher HPV coverage than heterosexual females (40.2%). Gay males (40.3% and 53.6%, respectively) had higher HepA and HepB coverage than heterosexual males (25.4% and 32.6%, respectively). Bisexual females (33.9% and 58.5%, respectively) had higher HepA and HepB coverage than heterosexual females (23.5% and 38.4%, respectively) and higher HepB coverage than lesbian females (45.4%). Bisexual adults (34.1%) had lower influenza coverage than gay/lesbian (48.5%) and heterosexual adults (43.8%). Except for the association of having self-identified as gay/lesbian orientation with greater likelihood of HepA, HepB, and influenza vaccination, sexual orientation was not associated with higher or lower likelihood of vaccination. Health status or other behavioral characteristics studied had no consistent relationship with vaccination among all populations. CONCLUSION: Differences were identified in vaccination coverage among the U.S. adult population by self-reported sexual orientation. This study is the first to assess associations of sexual orientation with a comprehensive list of vaccinations. Findings from this study can serve as a baseline for monitoring changes over time. All populations could benefit from improved vaccination.

Differences in Family Health History Knowledge Among Bisexual and Lesbian Women.

PURPOSE: We aimed to determine whether there are differences between sexual minority women and heterosexual women in family health history knowledge. METHODS: We used data from Dr. Susan Love Research Foundation's The Health of Women Study®. We included women who completed two of six online surveys between 2012 and 2015 (n = 22,410). RESULTS: Compared with heterosexual women, bisexual and lesbian women had consistently greater odds of not knowing their family health history (e.g., odds ratios of 2.59 and 1.56 for breast cancer, respectively). CONCLUSION: To avoid exacerbating existing health disparities, in the era of precision medicine, we must address gaps in knowledge of family health history.

Examining Partnership-Health Associations Among Lesbian Women and Gay Men Using Population-Level Data.

PURPOSE: The aim was to provide the first broad assessment of partnership-health associations across partnership statuses among lesbian and gay individuals. METHODS: Using population-level data from the 2016 U.S. Behavioral Risk Factor Surveillance System, specifically the 26 states/territories that assessed sexual orientation and gender identity, we ran analyses of covariance and logistic regressions to compare lesbian and gay individuals (N = 2963) of different partnership statuses in general health, physical health and health conditions, mental health, health behaviors, and health care access/utilization domains. RESULTS: All omnibus and logistic regression models were significant (p < 0.001). Follow-up pairwise comparisons of mean differences across partnership groups revealed that in at least one variable in the general health, mental health, health behaviors, and health care access/utilization domains, married lesbian and gay individuals reported the best health, followed by partnered, single, and then divorced, separated, and widowed lesbian and gay individuals (p < 0.001). Exceptions included variables in the physical health and health conditions domain, the health behaviors of smoking and heavy drinking, and ever having an HIV test. When stratifying by sex, for both gay men and lesbian women being married or partnered related to the best health in at least one variable in each health domain, and in the majority of all outcome variables. CONCLUSION: This article provides the first evidence for partnership-health associations among gay and lesbian individuals based on a large-scale, multidomain test of population-level data. Future research could examine temporal links between same-sex marriage legislation and health outcomes among sexual minority individuals.

Cardiovascular Disease Disparities in Sexual Minority Adults: An Examination of the Behavioral Risk Factor Surveillance System (2014-2016).

PURPOSE: Investigate sexual orientation differences in cardiovascular disease risk and cardiovascular disease. DESIGN: Cross-sectional. SETTING: The 2014 to 2016 Behavioral Risk Factor Surveillance System. PARTICIPANTS: A total of 395 154 participants. MEASURES: The exposure measure was sexual orientation. Self-report of cardiovascular disease risk factors and cardiovascular disease was assessed. ANALYSIS: Sex-stratified logistic regression analyses to examine sexual orientation differences in cardiovascular disease risk and cardiovascular disease (heterosexuals = reference group). RESULTS: Sexual minority men reported higher rates of mental distress (gay adjusted odds ratio [AOR]: 1.59; bisexual AOR: 1.88) and lifetime depression (gay AOR: 2.48; bisexual: AOR 2.67). Gay men reported higher rates of current smoking (AOR: 1.28), but lower rates of obesity (AOR: 0.82) compared to heterosexual men. Sexual minority women reported higher rates of several cardiovascular risk factors including mental distress (lesbian AOR: 1.37; bisexual AOR: 2.33), lifetime depression (lesbian AOR: 1.96; bisexual AOR: 3.26), current smoking (lesbian AOR: 1.65; bisexual AOR: 1.29), heavy drinking (lesbian AOR: 2.01; bisexual AOR: 2.04), and obesity (lesbian AOR: 1.50; bisexual AOR: 1.29), but were more likely to exercise than heterosexual women (lesbian AOR: 1.34; bisexual AOR: 1.24). Lesbian women reported lower rates of heart attack (AOR: 0.62), but bisexual women had higher rates of stroke than heterosexual women (AOR: 1.46). CONCLUSIONS: Findings can inform the development of prevention efforts to reduce cardiovascular disease risk in sexual minorities.

Association of Pregnancy History and Cervical Cancer Screening in a Community Sample of Sexual Minority Women.

BACKGROUND: Sexual minority women (SMW) face barriers to healthcare that may result in lower utilization of cervical cancer screening. Previous experiences with the healthcare system-specifically reproductive health-related encounters-have the potential to affect future use of screening services. This study aimed to examine the association between pregnancy history and cervical cancer screening in a diverse sample of SMW. Anderson's Behavioral Model of Health Services Use guided the selection of variables included in the study. METHODS: We performed a secondary analysis of cross-sectional data from the third wave of the Chicago Health and Life Experiences of Women (CHLEW) Study, a longitudinal study of SMW in the Midwestern United States. We performed multivariable logistic regression to address the study aims, restricting the sample to women ages 21-45 (n = 430). RESULTS: Reporting a previous pregnancy was consistently positively associated with past-year Pap testing. In the multivariable model, bisexual identity and disclosing one's sexual orientation to healthcare providers were also positively associated with past-year Pap test. CONCLUSIONS: This analysis provides preliminary evidence that SMW who have been pregnant are more likely to receive Pap testing and that multiple sociodemographic factors are likely to impact screening in this population. Clinicians should screen all patients with a cervix for cervical cancer and should encourage screening for all SMW. Future studies should prioritize longitudinal analyses to examine the temporality of reproductive history and healthcare seeking, focus on where SMW seek care, and understand how intersecting components of identity may shape the healthcare utilization of this population.

Prevalence of bacterial vaginosis and factors associated among women who have sex with women.

OBJECTIVE: to describe the prevalence of bacterial vaginosis and factors associated among women who have sex with women. METHOD: cross-sectional, descriptive and analytical study with 150 women. The vaginal microbiota profile was analyzed by microscopic examination of vaginal swabs according to the Gram method. Endocervical samples were collected with cytobrush for the investigation of endocervicitis by Chlamydia trachomatis. The polymerase chain reaction was used to diagnosis Human Papillomavirus infection. Socio-demographic data, sexual behavior and clinical history were obtained through an interview. Logistic regression was performed to identify risk factors independently associated with bacterial vaginosis. RESULTS: among the 150 participants, 71 (47.3%) presented some alteration in the vaginal microbiota, 54 (36.0%) bacterial vaginosis and 12 (8.0%) Flora II. The variable independently associated with bacterial vaginosis was the use of sexual accessories [2.37(1.13-4.97), p=0.022]. CONCLUSION: the high prevalence of bacterial vaginosis among women who have sex with women indicates the need for screening this population and association between use of sexual accessories and this disease suggests the possibility of transmission of sexual fluids between the partners during the sexual act, which demonstrates the need for educational actions on sexual and reproductive health.

Disparities in Health Care Access and Health Among Lesbians, Gay Men, and Bisexuals in California.

This policy brief examines differences in health care access, health behaviors, and health outcomes by sexual orientation among California adults. Using data from the California Health Interview Survey, the study finds that although lesbian, gay, and bisexual women and men have similar or better rates of insurance coverage compared to straight women and men, they are more likely to experience delays in getting needed health care. Lesbians, bisexual women, and bisexual men have higher rates of smoking and binge drinking than straight women and men; however, gay men are less likely to consume sugary beverages and to be physically inactive. Lesbians and bisexuals had poorer health status and higher rates of disability than straight adults. Future research is needed to explain these disparities, as well as to identify health care and structural interventions that will improve access to care and health outcomes for this population.

Cancer diagnoses among lesbian, gay, and bisexual adults: results from the 2013-2016 National Health Interview Survey.

PURPOSE: The objective of this study was to compare cancer diagnoses by age, gender, and sexual orientation. METHODS: This study used data on 129,431 heterosexual adults and 3,357 lesbian, gay, and bisexual (LGB) adults in the 2013-2016 National Health Interview Survey. Logistic regression models compared the prevalence of cancer diagnoses by sexual orientation while controlling for demographics, socioeconomic status, and health profiles. Then, using coefficients from fully adjusted models, we estimated average marginal effects to compare the probability of a cancer diagnosis by sexual orientation across five age categories. RESULTS: After controlling for demographic and socioeconomic characteristics, gay men (odds ratio [OR] 1.54; 95% confidence interval [CI] 1.10-2.18) were more likely to have been diagnosed with cancer compared to heterosexual men, and bisexual women (OR 1.70; 95% CI 1.16-2.48) were more likely to have been diagnosed with cancer compared to heterosexual women. Gay men aged 65 years and older were 6.0% points (p < 0.05) more likely to be diagnosed with cancer compared to heterosexual men of the same age. Bisexual women aged 65 years and older were 7.6% points (p < 0.05) more likely to be diagnosed with cancer compared to women of the same age. CONCLUSIONS: Some sexual minorities may be at greater risk for cancer (or having a personal history of cancer) compared to heterosexuals. More research on cancer detection, treatment, and survivorship in sexual minorities is critically needed. Health care providers and public health practitioners should be aware of the unique health care needs in LGB adults, including their elevated cancer risks.

Cardiovascular Disease Risk in Sexual Minority Women (18-59 Years Old): Findings from the National Health and Nutrition Examination Survey (2001-2012).

OBJECTIVE: Sexual minority women (lesbian and bisexual) experience significant stigma, which may increase their cardiovascular disease (CVD) risk. The purpose of this study was to examine the prevalence of modifiable risk factors for CVD (including mental distress, health behaviors, blood pressure, glycosylated hemoglobin, and total cholesterol) and CVD in sexual minority women compared with their heterosexual peers. MATERIALS AND METHODS: A secondary analysis of the National Health and Nutrition Examination Survey (2001-2012) was conducted. Multiple imputation with chained equations was performed. Logistic regression models adjusted for relevant covariates were run. Self-report (medical history and medication use) and biomarkers for hypertension, diabetes, and high total cholesterol were examined. RESULTS: The final analytic sample consisted of 7,503 that included 346 sexual minority women (4.6%). Sexual minority women were more likely to be younger, single, have a lower income, and lack health insurance. After covariate adjustment, sexual minority women exhibited excess CVD risk related to higher rates of frequent mental distress (adjusted odds ratio [AOR], 2.05; 95% confidence interval [CI], 1.45-2.88), current tobacco use (AOR, 2.11; 95% CI, 1.53-2.91), and binge drinking (AOR, 1.66; 95% CI, 1.17-2.34). Sexual minority women were more likely to be obese (AOR, 1.61; 95% CI, 1.23-2.33) and have glycosylated hemoglobin consistent with prediabetes (AOR, 1.56; 95% CI, 1.04-2.34). No differences were observed for other outcomes. CONCLUSIONS: Sexual minority women demonstrated increased modifiable risk factors for CVD, but no difference in CVD diagnoses. Several emerging areas of research are highlighted, in particular, the need for CVD prevention efforts that target modifiable CVD risk in sexual minority women.

Experiences and unmet needs of lesbian, gay, and bisexual people with cancer care: A systematic review and meta-synthesis.

OBJECTIVES: To explore the cancer care experiences and unmet needs of people who identify as a sexual or gender minority. METHODS: A qualitative systematic review and meta-synthesis was undertaken based on a registered protocol. Following literature searching and study selection, study quality was examined by using the Critical Appraisal Skill Programme Checklist. Qualitative data were extracted verbatim from included studies and synthesized by using thematic analysis. RESULTS: Fifteen studies that included lesbian, gay, and bisexual (LGB) people living with or beyond cancer were included in the review. Studies including gender minorities were not identified. Most of the study participants were sexual minority women with breast cancer or sexual minority men with prostate cancer. Meta-synthesis of 106 individual findings generated 6 overarching themes pertaining to sexual orientation disclosure, experiences and fear of homophobia, positive and negative health-care professional behaviors, heterocentric systems and care, inadequacy of available support groups, and unmet needs for patient-centered care and LGB-specific information. Lesbian, gay, and bisexual people often reported feelings of anxiety, invisibility, isolation, and frustration throughout the cancer care continuum. CONCLUSIONS: Analysis of the experiences of LGB people with cancer care shows that LGB people face numerous challenges due to their sexual orientation and receive care that does not adequately address their needs. Training and education of health-care professionals are strongly recommended to address some of these challenges and practice gaps. Culturally appropriate care includes avoiding heterosexual assumptions, use of inclusive language, the provision of tailored information, and involving partners in care.

Prevalence of bacterial vaginosis and factors associated among women who have sex with women / Prevalência de vaginose bacteriana e fatores associados em mulheres que fazem sexo com mulheres / Prevalencia de vaginosis bacteriana y factores asociados en mujeres que tienen sexo con mujeres

ABSTRACT Objective: to describe the prevalence of bacterial vaginosis and factors associated among women who have sex with women. Method: cross-sectional, descriptive and analytical study with 150 women. The vaginal microbiota profile was analyzed by microscopic examination of vaginal swabs according to the Gram method. Endocervical samples were collected with cytobrush for the investigation of endocervicitis by Chlamydia trachomatis. The polymerase chain reaction was used to diagnosis Human Papillomavirus infection. Socio-demographic data, sexual behavior and clinical history were obtained through an interview. Logistic regression was performed to identify risk factors independently associated with bacterial vaginosis. Results: among the 150 participants, 71 (47.3%) presented some alteration in the vaginal microbiota, 54 (36.0%) bacterial vaginosis and 12 (8.0%) Flora II. The variable independently associated with bacterial vaginosis was the use of sexual accessories [2.37(1.13-4.97), p=0.022]. Conclusion: the high prevalence of bacterial vaginosis among women who have sex with women indicates the need for screening this population and association between use of sexual accessories and this disease suggests the possibility of transmission of sexual fluids between the partners during the sexual act, which demonstrates the need for educational actions on sexual and reproductive health.

RESUMO Objetivo: descrever a prevalência de vaginose bacteriana e fatores associados em mulheres que fazem sexo com mulheres. Método: trata-se de estudo transversal, descritivo e analítico com 150 mulheres. O padrão de microbiota vaginal foi analisado por microscopia do conteúdo vaginal corado pelo método de Gram. Amostras de secreção endocervical foram coletadas com cytobrush para a pesquisa de endocervicites por Chlamydia trachomatis e para infecção por Papilomavírus Humano por meio de reação em cadeia da polimerase. Dados sociodemográficos, de comportamento sexual e de história clínica foram obtidos por entrevista. Regressão logística foi realizada para identificar fatores de risco independentemente associados à vaginose bacteriana. Resultados: dentre as 150 participantes, 71 (47,3%) tinham alguma alteração da microbiota vaginal, 54 (36,0%) vaginose bacteriana e 12 (8,0%) Flora II. A variável independentemente associada com vaginose bacteriana foi o uso de acessórios sexuais [2,37(1,13-4,97), p=0,022]. Conclusão: a elevada prevalência de vaginose bacteriana entre mulheres que fazem sexo com mulheres aponta a necessidade de rastreio nessa população. O uso de acessórios sexuais associado a esse agravo sugere a possibilidade de transmissão de fluidos sexuais entre as parceiras durante o ato sexual, o que demonstra necessidade de ações de educação em saúde sexual e reprodutiva.

RESUMEN Objetivo: describir la prevalencia de la vaginosis bacteriana y los factores asociados en mujeres que tienen sexo con mujeres. Método: se trata de un estudio transversal, descriptivo y analítico realizado entre 150 mujeres. El patrón de microbiota vaginal se analizó por microscopía del contenido vaginal teñido por el método de Gram. Se recolectaron muestras de secreción endocervical con un citocepillo para investigar la endocervicitis por Chlamydia trachomatis y la infección por el Virus del Papiloma Humano mediante la reacción en cadena de la polimerasa. De la entrevista se obtuvieron datos sociodemográficos, de comportamiento sexual y del historial clínico. Se llevó a cabo una regresión logística para identificar factores de riesgo asociados independientemente a la vaginosis bacteriana. Resultados: entre las 150 participantes, el 71 (47,3%) tenía alteración de la microbiota vaginal, el 54 (36,0%), vaginosis bacteriana y el 12 (8,0%), Flora II. La variable asociada independientemente a la vaginosis bacteriana se debió al uso de accesorios sexuales [2,37(1,13-4,97), p=0,022]. Conclusión: la prevalencia elevada de vaginosis bacteriana entre mujeres que tienen sexo con mujeres señala la necesidad de estudiar dicha población, y el uso de accesorios sexuales asociado a este agravante sugiere la posibilidad de transmisión de fluidos sexuales entre las compañeras durante el acto sexual, razón por la cual deben llevarse a cabo acciones de educación en salud sexual y reproductiva.

Health and healthcare disparities among U.S. women and men at the intersection of sexual orientation and race/ethnicity: a nationally representative cross-sectional study.

BACKGROUND: Research has shown that sexual minorities (SMs) (e.g. lesbian, gay, and bisexual individuals), compared to their heterosexual counterparts, may engage in riskier health behaviors, are at higher risk of some adverse health outcomes, and are more likely to experience reduced health care access and utilization. However, few studies have examined how the interplay between race and sexual orientation impacts a range of health measures in a nationally representative sample of the U.S. METHODS: To address these gaps in the literature, we sought to investigate associations between sexual orientation identity and health/healthcare outcomes among U.S. women and men within and across racial/ethnic groups. Using 2013-2015 National Health Interview Survey data (N = 91,913) we employed Poisson regression with robust variance to directly estimate prevalence ratios (PR) comparing health and healthcare outcomes among SMs of color to heterosexuals of color and white heterosexuals, stratified by gender and adjusting for potential confounders. RESULTS: The sample consisted of 52% women, with approximately 2% of each sex identifying as SMs. Compared to their heterosexual counterparts, white (PR = 1.25 [95% confidence interval (CI): 1.08-1.45]) and black (1.54 [1.07, 2.20]) SM women were more likely to report heavy drinking. Hispanic/Latino SM women and men were more likely to experience short sleep duration compared to white heterosexual women (1.33 [1.06, 1.66]) and men (1.51 [1.21, 1.90). Black SM women had a much higher prevalence of stroke compared to black heterosexual women (3.25 [1.63, 6.49]) and white heterosexual women (4.51 [2.16, 9.39]). White SM women were more likely than white heterosexual women to be obese (1.31 [1.15, 1.48]), report cancer (1.40 [1.07, 1.82]) and report stroke (1.91 [1.16, 3.15]. White (2.41 [2.24, 2.59]), black (1.40[1.20, 1.63]), and Hispanic/Latino SM (2.17 [1.98, 2.37]) men were more likely to have been tested for HIV than their heterosexual counterparts. CONCLUSIONS: Sexual minorities had a higher prevalence of some poor health behaviors, health outcomes, and healthcare access issues, and these disparities differed across racial groups. Further research is needed to investigate potential pathways, such as discrimination, in the social environment that may help explain the relationship between sexual orientation and health.

Medidas de salud mental y bienestar subjetivo en una muestra de hombres gays y mujeres lesbianas en Chile / Health and wellbeing of sexual minorities

Background: Most of the information in Chile about health and wellbeing of sexual minorities refers to risk behaviors. Aim: To assess health and wellbeing in a sample of Chilean homosexual men and women. Material and Methods: Spanish versions of the Satisfaction With Life Scale and Outcome Questionnaire-45 (OQ-45) were answered by 191 homosexual women and 256 homosexual men aged 18 to 67 years, from four Chilean cities. Results: Lesbian women have better levels of satisfaction with life and adjustment in personal relationships than homosexual men. Eight percent of respondents had suicidal thoughts in some moment of their life. Conclusions: The information gathered in this work could help in the development of mental health policies for sexual minorities.

Oversampling as a methodological strategy for the study of self-reported health among lesbian, gay and bisexual populations.

AIMS: Epidemiological research on lesbian, gay and bisexual populations raises concerns regarding self-selection and group sizes. The aim of this research was to present strategies used to overcome these challenges in a national population-based web survey of self-reported sexual orientation and living conditions-exemplified with a case of daily tobacco smoking. METHODS: The sample was extracted from pre-established national web panels. Utilizing an oversampling strategy, we established a sample including 315 gay men, 217 bisexual men, 789 heterosexual men, 197 lesbian women, 405 bisexual women and 979 heterosexual women. We compared daily smoking, representing three levels of differentiation of sexual orientation for each gender. RESULTS: The aggregation of all non-heterosexuals into one group yielded a higher odds ratio (OR) for non-heterosexuals being a daily smoker. The aggregation of lesbian and bisexual women indicated higher OR between this group and heterosexual women. The full differentiation yielded no differences between groups except for bisexual compared with heterosexual women. CONCLUSIONS: The analyses demonstrated the advantage of differentiation of sexual orientation and gender, in this case bisexual women were the main source of group differences. We recommend an oversampling procedure, making it possible to avoid self-recruitment and to increase the transferability of findings.