Disparity of Health Status and Preventive Service Between General Population and Individuals with Homosexual Behaviors

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Background: Eliminating health disparities in the United States by sexual orientation is one of the goals of Healthy People 2010. We compared self-reported health status and access to or utilization of preventive service between general population and individuals who have same-sex sexual behavior.

Method: The National Health and Nutrition Examination Survey, 1999-2006.

Results: Interviews of 10,494 individuals aged 20-59 who had sex experience were conducted in 1999-2006 as a part of the National Health and Nutrition Examination Survey (NHANES), a national survey of civilian, non-institutionalized U.S. population. The Audio Computer Assisted Self Interview (ACASI) was performed in a private room in either English or Spanish regarding sexual behaviors. The ACASI enabled the respondents both to hear questions through earphones and read questions on the computer and to move at their own speed as they touch the screen to indicate their response. No proxies or translators were permitted.

Conclusion: A total of 248 men and 332 women reported that they have had sex contacts with same-sex individuals in their lifetime, representing 3.3 million men and 4.3 million women aged 20-59 years who had ever have same-sex sexual behavior (SSSB). For both men and women, no significant difference was observed for self-rated health status between SSSB individuals and non-SSSB individuals. The percentages of men who thought that their health status were getting worse or better compared with 1 year ago were almost same between SSSB men and non-SSSB men. However, SSSB women than non-SSSB women were more likely to say that their overall health were getting better compared with health status 1 year ago, 27.42% vs 19.02%, respectively. No significant difference in the overall health insurance coverage was observed between SSSB individuals and non-SSSB individuals for either men or women. However, individuals with SSSB were more likely to be covered by government-sponsored programs, i.e. Medicaid and CHIP. Higher than non-SSSB men (39.21%), 73.05% of the SSSB men had blood tested for HIV. The percentages of having been tested for HIV were 65.02% and 47.14% respectively for SSSB women and non-SSSB women. Only 28.29% men and 38.94 women who had SSSB were fully immunized against hepatitis B, for which sexual transmission plays an important role.

No significant disparities of general health and utilization of preventive service were observed between individuals with SSSB and the general population. However, utilization of or access to preventive service, e.g, HIV test, and hepatitis B vaccination, was insufficient among this sexual minority to address the increased risks posted by same-sex sexual behaviors. Positive psychological impacts of SSSB should be investigated equally and thoroughly as did with the risks associated with SSSB.


National HIV Prevention Conference (NHPC)


Atlanta, GA