Understanding the Association Between Medical Mistrust and Unmet Medical Care Need in Gender and Sexually Diverse People of Color Assigned Female at Birth.

IF 3.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
LGBT health Pub Date : 2024-08-16 DOI:10.1089/lgbt.2023.0443
Lindsay J Wegner, Elissa L Sarno, Sarah W Whitton
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Abstract

Purpose: The present study investigated associations of sexual orientation and/or gender identity-based medical mistrust and racial/ethnic-based medical mistrust, respectively, with unmet medical care need among lesbian, gay, bisexual, transgender, queer, and/or sexually or gender diverse (LGBTQ+) people of color (POC) assigned female at birth (AFAB). We also tested the interaction of the two types of medical mistrust on unmet medical care need. Methods: Participants were 266 LGBTQ+ POC AFAB. Participants completed measures of medical mistrust based on race/ethnicity and LGBTQ+ identity. Unmet medical care need was assessed using the item: "During the past 12 months, was there ever a time where you felt that you needed health care but you didn't receive it?" Multivariate logistic regression models were run with either type of medical mistrust, as well as their interaction, as the predictor and unmet medical care need as the outcome variable. Results: There were no significant main effects of either type of medical mistrust on unmet medical care need. However, there was an interaction between the two types of medical mistrust, such that associations between each type of medical mistrust and unmet medical care needs were stronger at higher levels of the other type of medical mistrust. Racial/ethnic medical mistrust was associated with a greater likelihood of unmet medical needs at high, but not low, levels of LGBTQ+ medical mistrust. Conclusions: Racial/ethnic medical mistrust and LGBTQ+ medical mistrust exacerbate each other's influence on unmet medical care need. These results underscore the need for inclusive clinical practices for LGBTQ+ POC.

了解出生时被指定为女性的性别和性取向多元化有色人种的医疗不信任与未满足的医疗护理需求之间的关联。
目的:本研究分别调查了基于性取向和/或性别认同的医疗不信任以及基于种族/民族的医疗不信任与女同性恋者、男同性恋者、双性恋者、变性者、同性恋者和/或出生时被分配为女性(AFAB)的有色人种(POC)中未满足的医疗护理需求之间的关联。我们还测试了这两种医疗不信任与未满足的医疗护理需求之间的交互作用。研究方法参与者为 266 名 LGBTQ+ POC AFAB。参与者完成了基于种族/族裔和 LGBTQ+ 身份的医疗不信任测量。未满足的医疗需求通过以下项目进行评估:"在过去的 12 个月中,您是否曾有过需要医疗服务却没有得到满足的经历?多变量逻辑回归模型以医疗不信任的任一种类型及其交互作用作为预测变量,以未满足的医疗需求作为结果变量。结果显示任何一种医疗不信任对未满足的医疗需求都没有明显的主效应。但是,两种医疗不信任之间存在交互作用,即每种类型的医疗不信任与未满足的医疗护理需求之间的关联在另一种类型的医疗不信任程度越高时越强。在LGBTQ+医疗不信任程度较高(而非较低)的情况下,种族/族裔医疗不信任与医疗需求未得到满足的可能性更大。结论种族/族裔医疗不信任和 LGBTQ+ 医疗不信任会加剧彼此对未满足医疗需求的影响。这些结果突显了为 LGBTQ+ POC 提供包容性临床实践的必要性。
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来源期刊
LGBT health
LGBT health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
6.60
自引率
6.20%
发文量
80
期刊介绍: LGBT Health is the premier peer-reviewed journal dedicated to promoting optimal healthcare for millions of sexual and gender minority persons worldwide by focusing specifically on health while maintaining sufficient breadth to encompass the full range of relevant biopsychosocial and health policy issues. This Journal aims to promote greater awareness of the health concerns particular to each sexual minority population, and to improve availability and delivery of culturally appropriate healthcare services. LGBT Health also encourages further research and increased funding in this critical but currently underserved domain. The Journal provides a much-needed authoritative source and international forum in all areas pertinent to LGBT health and healthcare services. Contributions from all continents are solicited including Asia and Africa which are currently underrepresented in sex research.
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