Recorded presentation

Judith Bradford, PhD, The Fenway Institute, Fenway Community Health, 7 Haviland St., Boston, MA 02115, 804-828-4990, jbbradfo@vcu.edu and Tri D. Do, MD, MPH, Center for AIDS Prevention Studies, University of California, San Francisco, 74 New Montgomery Street, San Francisco, CA 94105, 415-597-9261, tdd@cognisynth.org.

Context: Sexual minority men and women, including lesbian, gay, bisexual, and transgender (LGBT) people, face significant barriers to receiving culturally appropriate health care and experience documented health disparities in a number of health outcomes.

Design: In 2003, we administered surveys to attendees at LGBT pride events in ten U.S. cities. The questionnaire included modules for demographics, health care utilization, sexuality-based bias from providers, preventive and risk behaviors, and family/household characteristics.

Results: 1,084 women and 529 men completed the survey, most of whom self-identified as gay or lesbian. Only 66% of women and 63% of men reported they had disclosed their sexual orientation to their physicians, and 26% and 16% respectively reported discrimination by their provider on this basis. 47% of women and 40% of men reported smoking at least 100 cigarettes in their lifetime, of whom 50% began smoking regularly before the age of 18. Using standard methods to calculate BMI, 27% of women met criteria for obesity and 25% were overweight. 27% of those who had pap smears reported one or more abnormal results. Among men, 23% reported prior substance use. Unprotected anal intercourse while high on drugs was highly associated with HIV infection (OR 3.3, 95% CI 1.8 – 6.0), with a 10.2% self-reported HIV prevalence.

Conclusions: LGBT populations experience high rates of discrimination in health care, tobacco use, substance use, obesity, and HIV risk. Much work is needed to identify the causes of these health disparities and to focus prevention and health services to reduce these disparities.

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