Correlates of overweight and obesity among lesbian and bisexual women

BACKGROUND: Recent studies find lesbians at greater risk for overweight and obesity than heterosexual women. While this may reflect differences in attitudes concerning weight and body shape, little is actually known about risk factors within this group. This study examines correlates of obesity and exercise frequency among lesbians and bisexual women. METHODS: Data from a snowball sample (n = 1209) of lesbians/bisexual women living in Los Angeles Country were utilized. Overweight was defined as BMI >/= 25 kg/m(2); obesity as BMI >/= 30. Associations between sociodemographic characteristics, exercise frequency, health indicators, and weight-related measures were evaluated to identify independent predictors of BMI and exercise frequency. RESULTS: Prevalence of overweight and obesity among lesbians varied by racial/ethnic background. Higher BMI was associated with older age, poorer health status, lower educational attainment, relationship cohabitation, and lower exercise frequency. Higher BMI, perceptions of being overweight, and reporting a limiting health condition were identified as independent predictors of infrequent exercise. Women were generally quite accurate in self-perceptions of weight status. CONCLUSIONS: Correlates of overweight and obesity among lesbians and bisexual women are generally comparable to those observed in studies of heterosexual women. Evidence that lesbians' higher BMI is associated with higher levels of fitness is not supported.     

Health beliefs and attitudes associated with HPV vaccine intention among young gay and bisexual men in the southeastern United States

Gay and bisexual men are at increased risk of anal cancer as a result of human papillomavirus (HPV) infection. Prophylactic vaccination is a potentially effective strategy for preventing anal cancer in this population. The purpose of this study was to identify factors associated with gay and bisexual men's intention to receive HPV vaccine. In the fall of 2010, 179 self-identified gay and bisexual men (mean age 22 years) completed an Internet-based questionnaire assessing beliefs and attitudes toward HPV vaccination. Men were recruited from college-based and Internet venues throughout the southeastern United States. The probability of intent to receive HPV vaccine was modeled using logistic regression. A majority of men (93%) had heard of HPV prior to participation but were generally unaware of the association of HPV with anal, penile, and oral cancers. Only 26% were aware of an HPV vaccine for males. Of the 179 participants, 64 (36%) were likely to be vaccinated. Men most likely to receive HPV vaccine perceived stronger physical and psychological benefits from vaccination and had more positive attitudes toward the vaccine. Conversely, intent to be vaccinated was negatively associated with concern over the financial cost of vaccination. Findings from this study can inform college-based health education programs aimed at increasing vaccine uptake among gay and bisexual men.     

Smoking characteristics among lesbian,gay, and bisexual adults

ObjectiveCigarette smoking is the leading preventable cause of death and disease in the United States. Sexual minorities (lesbians, gay men, and bisexuals), smoke at higher rates than the general population. However, little else is known about sexual minority smokers. Furthermore, the sexual minority population is diverse and little research exists to determine whether subgroups, such as lesbians, gay men, and female and male bisexuals, differ on smoker characteristics. We examine differences in smoking characteristics (advertising receptivity, age of first cigarette, non-daily smoking, cigarettes per day, nicotine dependence, desire to quit and past quit attempts) among lesbians, gay men, and female and male bisexual adults in the United States.MethodsSecondary analysis of the CDC's (Centers for Disease Control and Prevention) 2009–2010 National Adult Tobacco Survey (N = 118,590).ResultsControlling for age, race, socioeconomic status and geographic region, identifying as a female bisexual was associated with fewer past quit attempts, lower age at first cigarette, and higher nicotine dependence when compared to heterosexual women. There were no differences in desire to quit between male or female sexual minorities and their heterosexual counterparts.ConclusionSexual minority individuals smoke at higher rates than heterosexuals and yet similarly desire to quit. Tailored efforts may be needed to address smoking among bisexual women.     

有自杀意念的男同性爱者/双性爱者滋病高危行为研究

目的 探讨男同性爱者(gay)与双性爱者(Bi)中有自杀意念者的艾滋病高危行为特征,并分析其与自杀意念相关的危险因素.方法 采用定向抽样法对gay/Bi人群进行横断面调查.从有效问卷中获取有自杀意念者,并依照自杀意念组的年龄情况在无此意念者中选取比较组进行比较.结果 调查的gay/Bi中有自杀意念者占20.2％.自杀意念组性向为同性、婚姻状况为未婚者多于比较组(P＜0.05).自杀意念组在曾经向同性买性、近一年性交时曾出过血、曾去外地与陌生同性性交、16岁前曾遭受成年同性性虐待、有性施虐与受虐行为、有过主动或被动吻肛行为、有过主动或被动指交行为、每周饮酒至少一次或更多、曾因性向和/或同性性活动受到gay伤害、曾因性向和/或同性性活动受到异性爱者伤害等方面的比例显著高于对照组(P＜0.05).多因素logistic回归模型提示曾因性向和/或同性性活动受到gay( Waldx2=6.637,P=0.010)及异性爱者(Waldx2=5.835,P=0.016)伤害是导致自杀意念产生的危险因素.结论 有自杀意念的gay/Bi与艾滋病相关的高危性行为显著多于无此意念者.减少社会对gay与Bi人群的歧视及伤害可能对遏制艾滋病的流行有一定作用.     

Chasing the rainbow: lesbian,gay, bisexual,transgender and queer youth and pride semiotics

Abstract

While the pride rainbow has been part of political and social intervention for decades, few have researched how lesbian, gay, bisexual, transgender and queer young people perceive and use the symbol. How do lesbian, gay, bisexual, transgender and queer youth who experience greater feelings of isolation and discrimination than heterosexual youth recognise and deploy the symbol? As part of a larger study on supportive lesbian, gay, bisexual, transgender and queer youth environments, we conducted 66 go-along interviews with lesbian, gay, bisexual, transgender and queer youth people from Massachusetts, Minnesota and British Columbia. During interviews, young people identified visible symbols of support, including recognition and the use of the pride rainbow. A semiotic analysis reveals that young people use the rainbow to construct meanings related to affiliation and positive feelings about themselves, different communities and their futures. Constructed and shared meanings help make the symbol a useful tool for navigating social and physical surroundings. As part of this process, however, young people also recognize that there are limits to the symbolism; it is useful for navigation but its display does not always guarantee supportive places and people. Thus, the pride rainbow connotes safety and support, but using it as a tool for navigation is a learned activity that requires caution.     

LGBT health and vaccinations: Findings from a community health survey of Lexington-Fayette County,Kentucky, USA

Data on adult immunization coverage at the state level and for LGBT Americans in particular are sparse. This study reports the results of a 2012 Lexington-Fayette County, Kentucky, community health assessment's results asking about eight adult vaccinations among 218 lesbian, gay, bisexual, and transgendered (LGBT) respondents. Researchers collected data using an online survey distributed through LGBT social media, posters, and LGBT print media. The LGBT sample largely matches the demographics of the county as a whole except this group reports higher level of education and fewer uninsured individuals. Among LGBT respondents, immunization prevalence reaches 68.0% (annual Influenza), 65.7% (Hepatitis B), 58.8% (Chickenpox/Varicella), 55.9% (Hepatitis A), 41.2% (Smallpox), and 25.8% (Pneumonia). Among respondents who are currently within the recommended 19–26 years age range for the Human Papillomavirus (HPV) vaccine, the LGBT females are less likely to report receiving the vaccine (15.4%) compared to the national coverage percentage of 34.5%. Males, however, are more likely to have received the vaccine (10.3%) than the national percentage of 2.3%. The small number of LGBT seniors in the study report a much higher prevalence of the Shingles (Herpes Zoster) vaccines than for U.S. seniors 60 and older (71.4% compared to 20.1% nationally). LGBT respondents report higher percentages of adult vaccination.     

Minority stress and community connectedness among gay,lesbian and bisexual Australians: a comparison of rural and metropolitan localities

Objective: To determine whether lesbian, gay and bisexual (LGB) Australians residing in rural‐remote and other non‐inner metropolitan localities experience increased levels of minority stress and reduced social support relative to their inner metropolitan counterparts. Methods: A convenience sample of (n=1306) LGB Australians completed an online survey that assessed minority stressors, level of connection with other LGB individuals and social isolation. Postcodes provided were coded into three metropolitan and two rural zones. A series of hierarchical regression analyses were undertaken to examine the effect of locality on minority stress and social support independent of sex, age, ethnicity, education and income. Results: Those residing in rural‐remote localities reported significantly increased concealment of sexuality from friends, more concern regarding disclosure of sexuality, less LGB community involvement, fewer friendships with other LGB people and, among men, higher levels of internalised homophobia than those residing in inner metropolitan areas. Unexpectedly, those residing in outer metropolitan areas of major cities experienced comparable levels of minority stress and LGB disconnection to those in rural and remote Australia. Conclusions: LGB individuals in rural‐remote and outer metropolitan areas of major cities face increased exposure to a number of minority stressors and less LGB community connectedness. These are risk factors associated with psychiatric morbidity in LGB populations. Implications: Health promotion targeted at reducing homophobia and discrimination in rural‐remote and outer metropolitan communities and additional services to assist LGB Australians struggling with stigma and isolation in non‐inner city areas may help mitigate the disadvantages faced by these LGB populations.     

High tobacco use among lesbian, gay, and bisexual populations in West Virginian bars and community festivals

With no information on tobacco use for lesbian, gay, or bisexual (LGB) populations in West Virginia (WV), it is unclear if nationally-identified LGB tobacco disparities also exist in this State. To address this data gap, we conducted a community tobacco survey in bars and events associated with the WV Pride Parade and Festival. Trained community surveyors used electronic and paper survey instruments in bars (n = 6) in three WV cities and community events associated with the WV Pride Parade and Festival. We analyzed results from 386 completed surveys from self-identified LGB individuals. Tobacco use among LGB bar patrons and LGB attendees at Pride-affiliated events was elevated (45%), as was current cigarette use (41%). Users of cigars and chewing tobacco were frequently dual users of cigarettes, with 80% and 60% reporting dual use, respectively. A substantial disparity likely exists in tobacco use among LGB West Virginians. Targeted interventions addressing tobacco use among LGB West Virginians are warranted in these venues, and the addition of a demographic question on sexual orientation would improve data collection and monitoring of this disparity.     

Disability among lesbian, gay, and bisexual adults: disparities in prevalence and risk

Objectives. We used population-based data to comprehensively examine disability among lesbian, gay, and bisexual adults.Methods. We estimated prevalence of disability and its covariates and compared by sexual orientation by utilizing data from the Washington State Behavioral Risk Factor Surveillance System (n = 82 531) collected in 2003, 2005, 2007, and 2009. We used multivariate logistic regression to examine the relationship between disability and sexual orientation, after we controlled for covariates of disability.Results. Findings indicated that the prevalence of disability is higher among lesbian, gay, and bisexual adults compared with their heterosexual counterparts; lesbian, gay, and bisexual adults with disabilities are significantly younger than heterosexual adults with disabilities. Higher disability prevalence among lesbians and among bisexual women and men remained significant after we controlled for covariates of disability.Conclusions. Higher rates of disability among lesbian, gay, and bisexual adults are of major concern. Efforts are needed to prevent, delay, and reduce disabilities as well as to improve the quality of life for lesbian, gay, and bisexual adults with disabilities. Future prevention and intervention efforts need to address the unique concerns of these groups.Disability is a critical and growing public health issue that must be addressed as part of this nation''s blueprint to improve health.1 Public health data reveal that the number of adults living with disabilities continues to increase.2 Nearly 50 million American adults aged 18 years and older are affected by disabilities,3 with more than 10 million persons living with physical or mental disabilities necessitating ongoing assistance with day-to-day or other instrumental activities.4 Costs exceed more than $300 billion annually as a result of medical care and lost productivity related to disabilities.3 Although disabilities can have a major impact on health, quality of life, and full participation in society, people with disabilities remain one of the most underserved populations in the United States.5The Centers for Disease Control and Prevention''s (CDC''s) Health Disparities and Inequalities Report—United States, 2011 identifies disparities related to disability and sexual orientation as the 2 main gaps in current health disparities research.6 To date, existing research has not comprehensively examined the prevalence and covariates of disability among lesbian, gay, and bisexual (LGB) adults. Multiple health-related behaviors such as smoking, lack of exercise, obesity, health conditions (including arthritis and asthma), and mental distress have been found to be associated with limitations in physical functioning and disabilities among the general population.7–12 Previous studies have also consistently found that LGB adults experience disparities in smoking.13,14 Furthermore, higher rates of asthma, arthritis, and obesity among lesbians and bisexual women and frequent mental distress among LGB adults are of concern.14–19 A few studies examining correlates of poor health among LGB adults have documented that, compared with their heterosexual counterparts, these groups may be more likely to experience some physical limitations.16,17 Although such findings suggest that LGB adults may be at an elevated risk for disability, the prevalence and covariates of disability within these groups have not been comprehensively examined with population-based data.Adults living with disabilities are also at risk for health disparities because they tend to receive fewer preventive health services and have poorer health than do those without disabilities.2 Because LGB adults are a health-disparate population1 and those living with disabilities often do not have access to adequate health care services, LGB adults with disabilities may face multiple and serious health risks. The early detection and identification of the most at-risk groups will enable public health initiatives to expand the reach of strategies and interventions to prevent the progression to disability as well as to tailor disability management programs to meet the unique needs of such diverse populations.We analyzed disability among LGB adults by utilizing standardized measures developed by the CDC and assessed in the Behavioral Risk Factor Surveillance System (BRFSS). We disaggregated data (n = 82 531) from the Washington State BRFSS by gender and examined patterns of disability by sexual orientation. Based on this population-based sample, we examined the following: (1) prevalence of disability by sexual orientation; (2) the age-adjusted relationship between sexual orientation and covariates of disability, including chronic health conditions, health risk behaviors, and physical and mental health status; and (3) the relationship between disability and sexual orientation after we controlled for covariates of disability.     

HIV-related syndemic pathways and risk subjectivities among gay and bisexual men: a qualitative investigation

Abstract

Life history interviews were conducted with 40 gay and bisexual men to identify modes of syndemic experience and risk practice. Out of the interview narratives emerged one major and two minor modes of developmental pathway whereby syndemic conditions are navigated and expressed: (1) a combination of adverse childhood events with later episodes of depression and/or substantial substance use; (2) personal disruption that led to periods of depression and anxiety associated with the stresses of migration; and (3) a disorientation and an unravelling of life trajectory in the transition from family of origin to college or work. Risk practices fell into three high-risk modes: active and frequent engagement in condomless sex; unassertive deferment to a partner’s initiation of condomless sex; and episodic risk combined with a risk reduction strategy. Three low risk modes were also identified: no recent condomlessness but multiple risk history in interview; a trajectory over time from high to low risk; and consistent low risk practice. These different modes of syndemic experience and risk management may have implications for identification of the effective HIV prevention tools that work best for different sets of men.     

Preventing sexual risk behaviors among gay, lesbian, and bisexual adolescents: the benefits of gay-sensitive HIV instruction in schools

OBJECTIVES: This study compared sexual risk behaviors of gay, lesbian, and bisexual (GLB) and heterosexual adolescents and evaluated associations between gay-sensitive HIV instruction and risk behaviors of GLB youths. METHODS: A random sample of high school students and HIV education teachers completed surveys. Self-reported risk behaviors of heterosexual and GLB adolescents were compared, with control for student and community demographic characteristics. Sexual risk behaviors of GLB youths in schools with and without gay-sensitive instruction were compared. RESULTS: GLB youths reported more substance use, high-risk sexual behaviors, suicidal thoughts or attempts, and personal safety issues than did heterosexual youths (P < .001). Among those who were sexually active, GLB youths reported more lifetime and recent sexual partners than did heterosexuals (P < .001), and more of them reported alcohol use before last sex (P < .01) and a history of pregnancy (P < .001). GLB youths in schools with gay-sensitive instruction reported fewer sexual partners, less recent sex, and less substance use before last sex than did GLB youths in other schools (P < .05). CONCLUSIONS: The findings document increased risk behaviors among GLB youths and demonstrate the potential benefits of providing gay-sensitive HIV instruction in schools.     

Perceived health concerns among sexual minority women in Mumbai,India: an exploratory qualitative study

The experiences of sexual minority women (i.e., women who do not identify as ‘heterosexual’) in India have largely been absent in scientific literature. In partnership with India’s oldest and largest sexual and gender minority-advocacy organisation, the Humsafar Trust, our study used community-based participatory research principles to explore the lived experiences and health concerns of sexual minority women in Mumbai. Study methodologies included interviews with key informants, a focus group comprised of six women, and an additional 12 in-person interviews with sexual minority women to identify important physical, mental, social and other health priorities from these women’s perspectives. Thematic data are organised within the framework offered by the social ecological model, including individual, interpersonal, micro and macro levels. Findings from this study are important in providing the groundwork for future research and intervention involving sexual minority women in India, a dramatically underserved population.     

Population-level evaluation of school-based interventions to prevent problem substance use among gay,lesbian and bisexual adolescents in Canada

Objective

This study examined whether students' odds of recent substance use were lower in the presence of gay-straight alliances or explicit anti-homophobia policy that had been established at their school recently, or at least 3 years prior.

Methods

We analyzed a population-based sample of students in grades 8 through 12 from the British Columbia Adolescent Health Survey of 2008 (weighted N = 21,708). We used multi-nomial logistic regressions to test the hypothesized effects of gay-straight alliances and policies on substance use outcomes for lesbian, gay and bisexual students, and heterosexual students separately.

Results

Results indicated that gay-straight alliances and anti-homophobic bullying policies were linked to significantly lower odds of some but not all types of recent risky alcohol use, and past-year harms from alcohol or drug use, but almost exclusively in schools where the policies or gay-straight alliances had been established for at least 3 years; and among lesbian, gay and bisexual adolescents, only for girls.

Conclusions

Our findings suggest that these school-based strategies (gay-straight alliances and anti-homophobia policies) to reduce homophobia and foster school inclusion may be beneficial in reducing problem alcohol use among all students, not just sexual minority students.     

Neighborhood-Level Factors Associated with Physical Dating Violence Perpetration: Results of a Representative Survey Conducted in Boston, MA

Neighborhood-level characteristics have been found to be associated with different forms of interpersonal violence, but studies of the relationship between these characteristics and adolescent dating violence are limited. We examined 6 neighborhood-level factors in relation to adolescent physical dating violence perpetration using both adolescent and adult assessments of neighborhood characteristics, each of which was aggregated across respondents to the neighborhood level. Data came from an in-school survey of 1,530 public high school students and a random-digit-dial telephone survey of 1,710 adult residents of 38 neighborhoods in Boston. Approximately 14.3% of the youth sample reported one or more acts of physical aggression toward a dating partner in the month preceding the survey. We calculated the odds of past-month physical dating violence by each neighborhood-level factor, adjusting for school clustering, gender, race, and nativity. In our first 6 models, we used the adolescent assessment of neighborhood factors and then repeated our procedures using the adult assessment data. Using the adolescent assessment data, lower collective efficacy (AOR = 1.95, 95% CI = 1.09–3.52), lower social control (AOR = 1.92, 95% CI = 1.07–3.43), and neighborhood disorder (AOR = 1.19, 95% CI = 1.05–1.35) were each associated with increased likelihood of physical dating violence perpetration. However, when we used the adult version of the neighborhood assessment data, no neighborhood factor predicted dating violence. The implications and limitations of these findings are discussed.     

Physical health indicators among lesbian,gay, and bisexual U.S. veterans

PurposeTo provide information about lesbian, gay, and bisexual (LGB) veterans' health status, diagnoses, and health screening behaviors compared with heterosexual veterans.MethodsData are from 10 states' 2010 Behavioral Risk Factor Surveillance System surveys that contained sexual orientation data for veterans (n = 11,665). χ² tests and multiple logistic regression were used to examine outcomes among LGB and heterosexual veterans.ResultsMore LGB than heterosexual veterans reported current smoking, not seeking medical care owing to cost, and activity limitations. Compared with heterosexual veterans, LGB veterans had greater odds of ever having an human immunodeficiency virus test (odds ratio [OR], 5.42; 95% confidence interval [CI], 3.28–8.96) but lower odds of diabetes diagnosis (OR, 0.55; 95% CI, 0.34–0.89).ConclusionsFindings from this sample suggest patterns of health behaviors and outcomes among LGB veterans that are both unique from and similar to results from general samples of LGB persons. With the formal end of the “Don't Ask, Don't Tell” policy that discriminated against LGB people in the military, institutions such as the Department of Veterans Affairs are likely to see an increase in its current population of LGB veterans. The Department of Veterans Affairs stands in a unique place to meet the health equity needs of this minority population.     

Adolescent Relationship Violence: Help-Seeking and Help-Giving Behaviors among Peers

Young people tend to disclose relationship violence experiences to their peers, if they disclose at all, yet little is known about the nature and frequency of adolescent help-seeking and help-giving behaviors. Conducted within a sample of 1,312 young people from four New York City high schools, this is the first paper to ask adolescent help-givers about the various forms of help they provide and among the first to examine how ethnicity and nativity impact help-seeking behaviors. Relationship violence victims who had ever disclosed (61 %) were more likely to choose their friends for informal support. Ethnicity was predictive of adolescent disclosure outlets, whereas gender and nativity were not. Latinos were significantly less likely than non-Latinos to ever disclose to only friends, as compared to disclosing to at least one adult. The likelihood of a young person giving help to their friend in a violent relationship is associated with gender, ethnicity, and nativity, with males being significantly less likely than females to give all forms of help to their friends (talking to their friends about the violence, suggesting options, and taking action). Foreign-born adolescents are less likely to talk or suggest options to friends in violent relationships. This study also found that Latinos were significantly more likely than non-Latinos to report taking action with or on behalf of a friend in a violent relationship. This research shows that adolescents often rely on each other to address relationship violence, underlining the importance of adolescents’ receipt of training and education on how to support their friends, including when to seek help from more formal services. To further understand the valuable role played by adolescent peers of victims, future research should explore both which forms of help are perceived by the victim to be most helpful and which are associated with more positive outcomes.     

Eating disorders in diverse lesbian, gay, and bisexual populations

OBJECTIVE: This study estimates the prevalence of eating disorders in lesbian, gay, and bisexual (LGB) men and women, and examines the association between participation in the gay community and eating disorder prevalence in gay and bisexual men. METHOD: One hundred and twenty six white heterosexuals and 388 white, black, Latino LGB men and women were sampled from community venues. DSM-IV diagnoses of anorexia, bulimia, and binge eating disorder were assessed using the World Health Organization's Composite International Diagnostic Interview. RESULTS: Gay and bisexual men had significantly higher prevalence estimates of eating disorders than heterosexual men. There were no differences in eating disorder prevalence between lesbian and bisexual women and heterosexual women, or across gender or racial groups. Attending a gay recreational group was significantly related to eating disorder prevalence in gay and bisexual men. CONCLUSION: Researchers should study the causes of the high prevalence of eating disorders among gay and bisexual men.     

End-of-life care for gay,lesbian, bisexual and transgender people

There is little understanding in Australia of the special issues faced by gay, lesbian, bisexual and transgender people in end-of-life care and advance care planning. This exploratory study aimed to achieve an initial understanding of these issues to inform the development of a larger study involving gay, lesbian, bisexual and transgender service users. Consultations were carried out with 19 service providers and 6 gay, lesbian, bisexual and transgender community members in the Northern Rivers and metropolitan Sydney areas of New South Wales, Australia. Participants reported barriers to health care service access due to discrimination, inappropriate care and lack of knowledge among both consumers and health care workers of legal rights at the end of life. While advance care planning can assist with improving end-of-life care, respondents reported a number of obstacles. These included a lack of knowledge and absence of perceived need and the additional obstacle of social isolation, leading to difficulties identifying alternative decision-makers. The study highlighted the need for education for gay, lesbian, bisexual and transgender people and health and aged care providers on existing legal provisions to prevent discrimination in end-of-life care.