Psychosocial factors that influence and contribute to sexual minority women's health behavior: A qualitative interview study

Background: Sexual minority women (SMW) have unique experiences with stress and social support that could inform documented disparities in health behavior. However, there is a dearth of evidence that documents the meanings SMW ascribe to their psychosocial experiences and how their experiences relate to health behaviors.

Methods: In-depth interviews were conducted with 10 SMW, aged 45-60, to explore perceptions about psychosocial experiences and their relationship to SMW’s health and health behaviors.  Interviews were audio-recorded and transcribed verbatim.  Framework analysis was used to code transcriptions and 20% of transcripts were coded twice for reliability. 

Results: SMW reported that an internal sense of personal responsibility for health, social support, and stress, were the most relevant to their health and health behaviors.  Friendship and social support encouraged positive health behaviors, buffered against daily hassles, and provided healthcare referrals to SMW-friendly providers.  Conversely, physical activity, healthy eating, and receipt of preventive screenings were diminished when social support came from friends who did not value positive health behaviors. In the absence of positive social support stress was a barrier to preventive health behaviors.  SMW rarely referenced institutional barriers related to sexual orientation as a source of stress or as an explanation for poor health, but described the shared experience of institutional barriers and societal hardship as a source of understanding and comfort between SMW.

Conclusions: Positive sources of social support were the most important to SMW's preventive health behaviors.  Interventions designed to reduce behavioral disparities among SMW may be improved by strengthening positive social support.