What's in a name: Assessing access to care across diverse sexual minority populations

Sexual identity and behavior are increasingly recognized as separate (but linked) social determinants of health. Collection of representative data for lesbian, gay, bisexual, and other sexual minority populations is of critical importance in the effort to document, understand, and confront barriers to health care and other health disparities in these populations. Attempts to measure sexual identity and behavior have increased in recent years in US surveys designed to capture information about population health. However, the methodology and language to best describe LGB-identified individuals and non-identified individuals with same gender partners are still evolving. This presentation uses aggregated cross-sectional data from the 2006 and 2008 Southeastern Pennsylvania Household Health Survey (combined n=20,107), a random digit dial telephone survey conducted biennially in Philadelphia and the surrounding four PA counties. 255 respondents (1.3%) identified as gay or lesbian; 137 respondents (0.7%) identified as bisexual. Additional respondents reported same gender partners but not an LGB identity: 150 (0.7%) reported only same gender partners; and 63 (0.3%) reported both gender partners. We examine key access to care indicators, by gender, among self-identified lesbian and gay adults, bisexual adults, and non-LGB-identified adults who report previous year same gender sexual partners. Access to care among these population groups is compared with self-identified heterosexual adults with no previous year same gender partners. By analyzing both identity-based and behavior-based groups, this presentation will present a broad picture of access to care among diverse sexual minority populations and test the appropriateness of using these categories for health-related analysis.