COVID-19 vulnerability among Brazilian sexual and gender minorities: a cross-sectional study

Abstract

Minority groups are more prone to worsen their personal and social vulnerabilities during the COVID-19 pandemic. This study aimed to identify factors associated with the highest COVID-19 vulnerability in the Brazilian sexual and gender minorities. This is a cross-sectional study based on 826 respondents of the Brazilian LGBT+ Health Survey, conducted online from August to November 2020. The COVID-19 vulnerability was based on a previous vulnerability index created by an LGBT+ institution, which comprises three dimensions (income, COVID-19 exposure, and health). The outcome was the highest score quartile. Statistical analysis was based on logistic regression models. The COVID-19 vulnerability was higher in heterosexual and other scarce sexual orientations (OR = 2.34; 95%CI: 1.01-9.20, vs. homosexual), cisgender men (OR = 3.52; 95%CI: 1.35-4.44, vs. cisgender women), and those aged ≥ 50 years (OR = 3.74; 95%CI: 1.24-11.25, vs. 18-29 years old). A negative association was found with complete graduate education (OR = 0.06; 95%CI: 0.02-0.22, vs. complete high school), being white (OR = 0.44; 95%CI: 0.23-0.83), and proper facemask use (OR = 0.31; 95%CI: 0.13-0.76). Except for proper facemask use, factors associated with higher COVID-19 vulnerability are structural determinate and suggest overlapping vulnerabilities, as described by the syndemic model. It guides strategies to deal with the pandemic, which includes a joint approach to the common epidemic that affects sexual and gender minorities, broadening the intersectoral approach to decrease inequalities.

Using a Syndemics Perspective to (Re)conceptualize Vulnerability during the COVID-19 Pandemic: A Scoping Review

“…Out of the 13 original research studies identified in this review, eight (8) collected primary data [23,35,37,38,49,54,56,57], four (4) relied exclusively on secondary data [24][25][26]34], and one (1) combined secondary and primary data [45]. None of the identified publications intended to demonstrate the existence of a particular syndemic; instead, they used syndemic theory as an interpretative lens (an approach, a theory, a concept, or a framework) to conceptualize and analyse emerging data.…”

“…Finally, gender-differentiated impacts of COVID-19 were studied by Neto et al [56] and Duby et al [57]. The former [56] argued that COVID-19 could have been experienced as a syndemic by gender and sexual minorities in Brazil due to various forms of vulnerability they have historically faced, including racial and gender discrimination, low education levels, precarious working conditions, and reliance on social support systems. The latter [57] took a similar approach to study the impacts of COVID-19 on adolescents, girls, and young women (AGYW) in six districts in South Africa.…”

Formas de vulnerabilidade de pessoas LGBTQIAPN+ no Brasil

“…No âmbito da saúde, o cenário gerado pela rápida disseminação do novo coronavírus, somado à demora de iniciativas governamentais e ao contexto de estigmatização da população LGBTQIAPN+, gerou ainda mais dificuldades para o acesso à saúde, principalmente para aqueles que vivem e dependem do Sistema Único de Saúde para o tratamento de IST, deixando necessidades específicas em segundo plano 29 .…”

Formas de vulnerabilidad de las personas LGBTQIAPN+ en Brasil

“…En el ámbito de la salud, el escenario generado por la rápida propagación del nuevo coronavirus, sumado al retraso en las iniciativas gubernamentales y al contexto de estigmatización de la población LGBTQIAPN+, generó aún más dificultades en el acceso a la salud, sobre todo para quienes viven y dependen del Sistema Único de Salud para el tratamiento ITS, dejando en un segundo plano las necesidades específicas 29 .…”