Sexual and Behavioral Health Disparities Among Sexual Minority Hispanics/Latinos: Findings From the National Health and Nutrition Examination Survey, 2001–2014

Abstract

Introduction Hispanics/Latinos (henceforth, Latinos) are the largest minority group in the U.S. With growing health disparities among this group, the highest burden remains among sexual and gender minority Latinos. Differences regarding sexual orientation have not been fully explored within this group using national representative samples. This study analyzed sexual and behavioral health disparities associated with sexual minority status among Latinos in the U.S. Methods The study included data from 5,598 Latino adults who participated in the 2001–2014 waves of the National Health and Nutrition Examination Survey. Data analysis was conducted in 2016. Bivariate and multivariable logistic regression analyses examined the prevalence of HIV, sexually transmitted infections, mental health problems, cigarette smoking, and alcohol/illicit drug use among sexual minorities and heterosexual Latino adults. Sexual minorities were defined as “gay, lesbian, and bisexual” (GLB) and “other” non-heterosexual groups. Results GLB Latinos reported higher prevalence of mental health problems and cigarette smoking compared with heterosexuals. After adjusting for covariates, GLB Latinos had greater odds of testing positive for HIV, lifetime diagnosis of sexually transmitted infections, poor mental health outcomes, cigarette smoking (including lifetime and current smoking status), and illicit drug use than heterosexuals. Conclusions The disproportionate impact of health disparities among Latinos varies significantly by sexual orientation, with GLB individuals facing elevated prevalence. In particular, elevated odds for HIV/sexually transmitted infections, mental health problems, smoking, and illicit substance use were found. Further research, including longitudinal studies to understand the trajectories of risks, is needed to identify intervention opportunities in this population.

Intersectionality and Health Behaviors Among US High School Students: Examining Race/Ethnicity, Sexual Identity, and Sex

“…Our analysis found that BSM and HSM reported the highest rates of sexual risk behaviors, including being least likely to use condoms among BSM, and among both BSM and HSM, 4 or more sex partners, using drugs/alcohol during last sexual encounter, and sexual violence. Considering that existing literature indicates an increased risk for HIV and other sexually transmitted infections among young Hispanic and black sexual minority adults, these results were not surprising. However, because these findings indicate that racial/ethnic sexual minority adolescents are engaging in sexually risky behaviors at very young ages, they demonstrate a need for culturally tailored sexual health preventive educational interventions before young adulthood.…”

HIV/AIDS: Risk & protective behaviors among adults ages 21 to 40 in the U.S., 2004-2017

“…With ACASI, the interviewer is unaware of the highly sensitive questions as they are asked or of the answers being given, thus providing respondents with a high level of privacy similar to self-administered questionnaires like those used in MTF (Brener et al, 2006). Studies using NHANES data have focused on HIV testing (Guo & Sims, 2017) and prevalence (McQuillan et al, 2006), as well as characteristics of sub-groups at high risk for sexuallytransmitted diseases (e.g., Esie et al, 2018;Martinez et al, 2017;Xu et al, 2010). NHANES is the only national survey that collects and tests blood samples from participants aged 18-49 for the HIV antibody (CDC, 2016b).…”

Physical Health Disparities Across Dimensions of Sexual Orientation, Race/Ethnicity, and Sex: Evidence for Increased Risk Among Bisexual Adults

“…Third, though often overlooked, it is critical to take intersecting minority identities (i.e., sexual minority, gender, race/ethnicity) into account when examining physical health disparities. Growing research indicates poorer physical health among sexual minority individuals of color (Hsieh & Ruther, 2016; Katz-Wise et al, 2014; Martinez et al, 2017), and this increased risk is likely conferred by the synergistic impact of minority stress experiences based on their multiple marginalized identities (Greene, 1996). For instance, sexual minority individuals of color may not be accepted by their racial/ethnic communities because of their sexual identity (Malebranche, Fields, Bryant, & Harper, 2007; Mays, Cochran, & Rhue, 1993) and also experience racism within the sexual minority community (Balsam, Molina, Beadnell, Simoni, & Walters, 2011).…”