LGBT health最新文献

{"title":"Associations of Social Determinants of Health with Overall Health and Quality of Life Among Sexual and Gender Minority People in New York State.","authors":"Redd Driver, James M Tesoriero, Thea Shengelaia, Kraig Pannell","doi":"10.1089/lgbt.2024.0209","DOIUrl":"10.1089/lgbt.2024.0209","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study examined associations between social determinants of health (SDOH) and overall health and quality of life (QOL) among sexual and gender minority (SGM) people in New York State. <b><i>Methods:</i></b> SGM individuals (<i>N</i> = 2342) completed a community needs assessment survey in 2021. Among an analytic sample (<i>N</i> = 2279), hierarchical regression models examined the relative strength of the association between primary SDOH barriers (i.e., food insecurity, unstable housing, economic insecurity) and overall health and QOL relative to secondary SDOH barriers (i.e., medical mistrust, social isolation, SGM health-related structural barriers) and psychosocial barriers to engaging in care (i.e., depressive symptoms, lack of SGM community connectedness). Path models explored significant secondary barriers to care as potential explanatory mechanisms between primary SDOH barriers and outcomes. <b><i>Results:</i></b> In hierarchical regression models, depressive symptoms were most strongly associated with overall health, whereas primary SDOH barriers were associated with poor QOL over other factors considered. In path models, a statistically significant path for depressive symptoms was found for both overall health and QOL. Social isolation and SGM health related structural barriers were also significant paths between primary SDOH barriers and both outcomes. <b><i>Conclusion:</i></b> This study demonstrates the complex relationships that exist between SDOH-related barriers and critical health outcomes for SGM people. Entities seeking to improve these outcomes should focus attention on advancing structural competency to assess and address a broader than traditionally considered range of barriers that are likely present at elevated levels for SGM populations.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"447-457"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Identity and Cardiovascular Disease Among Adults in the United States.","authors":"Emma M Federico, Fares Qeadan","doi":"10.1089/lgbt.2024.0292","DOIUrl":"10.1089/lgbt.2024.0292","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> The purpose of this study was to examine associations across gender identity subgroups and cardiovascular disease (CVD) subsets including myocardial infarction (MI), stroke, and coronary heart disease/angina. <b><i>Methods:</i></b> Nationally representative cross-sectional data from the Behavioral Risk Factor Surveillance System years 2019 and 2021 were analyzed. Multivariable logistic regression was conducted to assess the odds ratios of CVD and disease subsets for transgender women, transgender men, and gender nonconforming individuals compared to cisgender men and cisgender women. <b><i>Results:</i></b> In total, 2108 survey participants identified as transgender of which 35.0% were transgender women, 34.1% were transgender men, and 30.9% were gender nonconforming individuals. Compared to cisgender women, transgender men (adjusted odds ratio [aOR]: 1.62; 95% confidence interval [CI]: 1.02-2.58) and cisgender men (aOR: 1.85; 95% CI: 1.76-1.94) had increased odds of CVD. Transgender women (aOR: 2.25; 95% CI: 1.07-4.73), transgender men (aOR: 1.97; 95% CI: 1.06-3.65), gender nonconforming individuals (aOR: 2.47; 95% CI: 1.08-5.61), and cisgender men (aOR: 2.55; 95% CI: 2.37-2.73) all had higher odds of MI when compared to cisgender women. Transgender men (aOR: 2.05; 95% CI: 1.01-4.16) and cisgender men (aOR: 2.07; 95% CI: 1.94-2.21) had higher odds of heart disease/angina than cisgender women. <b><i>Conclusion:</i></b> This study revealed variability in self-reported CVD among transgender men, transgender women, and gender nonconforming individuals compared with cisgender men and cisgender women. This emphasizes the need for targeted research and interventions to improve health outcomes in these populations.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"416-427"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Analysis of Gender-Affirming Care Offerings on United States Pediatric Hospital Websites: Exploring the Impact of State Legislative Bans.","authors":"Isabelle C Band, Bethany Dubois, Atoosa Ghofranian, Katrina S Nietsch, Joseph A Lee, Jenna Friedenthal, Alan B Copperman, Samantha L Estevez","doi":"10.1089/lgbt.2024.0214","DOIUrl":"10.1089/lgbt.2024.0214","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This longitudinal study compared the presence of information about gender-affirming care (GAC) on U.S. pediatric hospital websites in March 2022, when bans on the provision of pediatric GAC had been passed in two states, versus in October 2023, when bans had been passed in 22 states and implemented in 15 states without court blockage. <b><i>Methods:</i></b> All U.S. pediatric hospitals, sourced from online databases, excluding specialty hospitals (e.g., rehabilitation) were included (<i>n</i> = 149). In March 2022 and October 2023, two independent reviewers systematically reviewed each hospital website for GAC information. The presence of GAC information on websites was analyzed based on: 1) GAC legal status (legal, banned, or proposed ban blocked by court) in the hospital's state, (2) geographic location using the U.S. Census regions (Northeast, Midwest, South, and West), (3) the presence of hospital affiliation with a U.S. medical school, and (4) presence of hospital religious affiliation. <b><i>Results:</i></b> A total of 149 pediatric hospital websites were surveyed. In 2022, 105 (70%) hospital websites published content about GAC offerings versus 87 (58%) in 2023 (<i>p</i> = 0.001). This decrease in available information was significant in states where GAC bans had been passed without court blockage (60% vs. 29%, <i>p</i> = 0.001) and in the Southern region (63% vs. 39%, <i>p</i> = 0.004). Academic and secular hospitals were also more likely to include GAC information on websites. <b><i>Conclusion:</i></b> Legislation may hinder the ability of transgender youth and/or their parents to access previously available information about GAC and to identify local transgender care providers.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"458-467"},"PeriodicalIF":3.5,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Social Media Campaign Promoting Pre-Exposure Prophylaxis for Young Black and Latino Men Who Have Sex with Men: Focus Group Findings from the Social Media and Sexual Health Campaign.","authors":"Alan Chen, Tatiana Gonzalez-Argoti, Laurie J Bauman, Asa E Radix, William J Nazareth, Joanne E Mantell","doi":"10.1089/lgbt.2024.0002","DOIUrl":"10.1089/lgbt.2024.0002","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> The Social Media and Sexual Health (SMASH) campaign, a multi-component study, aimed to address disparities in pre-exposure prophylaxis (PrEP) use among young Black and Latino men, ages 18-29, who have sex with men (YBLMSM) by using social media influencers and short videos to promote awareness and uptake. To inform the campaign's content and strategy, we conducted focus groups to explore YBLMSM's social media behaviors and perceptions of social influencers as PrEP messengers, including preferences for content, messaging, length, selection of appropriate influencers, and delivery methods that resonated with the target audience, and aligned with the SMASH campaign's goals. <b><i>Methods:</i></b> Between January and March 2021, we conducted five virtual focus groups with 22 YBLMSM to identify their preferred social media platforms, how they engage with social media, and their views on the potential of influencers to be effective PrEP messengers. Focus groups were audio-recorded, transcribed, and analyzed using template analysis. <b><i>Results:</i></b> Instagram was the most frequently used platform, considered a \"jack-of-all-trades,\" while Facebook was viewed as outdated, and TikTok as catering to a younger audience. Participants emphasized several key factors for effective messaging: (1) authenticity, (2) lived experience, (3) targeted marketing versus broad reach, (4) sex positivity, and (5) balance of humor with seriousness. <b><i>Conclusions:</i></b> These findings shaped the casting and content creation for the SMASH campaign, providing valuable guidance for health promotion initiatives aimed at engaging YBLMSM with PrEP through social media.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"468-475"},"PeriodicalIF":3.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Health Care Discrimination and Medical Mistrust Among Black Assigned Female at Birth Adults with Minoritized Sexual and Gender Identities in the United States.","authors":"Madeline Noh, Neil Mehta, Chloe Kim, Keosha Bond, Megan Threats, John W Jackson, Nkiru Nnawulezi, Madina Agénor","doi":"10.1089/lgbt.2024.0263","DOIUrl":"10.1089/lgbt.2024.0263","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Black sexually and gender minoritized (SGM) people who were assigned female at birth (AFAB) experience compounding health care inequities, barriers to equitable care, and disproportionately adverse health outcomes. Given prior literature indicating that both experienced and/or anticipated reported health care discrimination and medical mistrust may shape these health care experiences of Black SGM AFAB people, we sought to investigate the specific interplay between these two factors to bolster understanding of their relationship. <b><i>Methods:</i></b> In January and February 2023, we conducted a cross-sectional online survey of 156 Black SGM AFAB adults in the United States (U.S.) assessing their reported lifetime experiences of all-cause and gender-, race/ethnicity-, and weight-based discrimination in health care settings, in addition to their ratings of medical mistrust on the Medical Mistrust Index (MMI). Univariate statistics, analysis of variance, <i>post hoc</i> pairwise tests, and multivariable linear regression were conducted to assess measures of health care discrimination, medical mistrust, and covariates and their associations among the analytic sample (<i>n</i> = 130). <b><i>Results:</i></b> Most participants reported prior experiences of health care discrimination. Adjusting for demographic, socioeconomic, and health care factors, we identified an association between experiencing any-cause-, race/ethnicity-, or weight-based discrimination and significantly higher MMI scores. The association for gender-based discrimination was not statistically significant. <b><i>Conclusion:</i></b> Black SGM AFAB people who experience any-cause-, race/ethnicity-, or weight-based discrimination may be more likely to experience higher levels of medical mistrust. Identifying interventions and pathways to tackle health care discrimination and the systemic and structural drivers of medical mistrust will be critical to augmenting health care outcomes and experiences of Black SGM communities.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"340-349"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating Transgender and Gender-Diverse Veterans in the Veterans Health Administration: 23 Years of Findings.","authors":"Laurel A Copeland, Hill L Wolfe, Sarah S Jackson, Neda Buljubasic, Michael R Kauth, Leila Hashemi","doi":"10.1089/lgbt.2024.0314","DOIUrl":"10.1089/lgbt.2024.0314","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Many transgender and gender-diverse (TGD) people experience significant barriers to health care access, facing disparities in care, limited payments for gender-affirming services, or insufficient training and knowledge among providers. Given validation studies reporting increasing rates of TGD-related status, we documented health care types used by TGD veterans to signal whether engagement in Veterans Health Administration (VHA) care increased or decreased following documentation of a TGD-related diagnosis code. <b><i>Methods:</i></b> The cohort was defined by receipt of a TGD-related diagnosis code in the VHA Corporate Data Warehouse from October 1, 1999, through September 30, 2021 (fiscal years 2000 through 2021). Data were summarized in two 1-year periods before and after TGD-related diagnosis. Logistic regression estimated predictors of VHA care post-TGD-related diagnosis as well as filling gender-affirming prescriptions in the VHA. <b><i>Results:</i></b> Over the 23-year study period, 9894 transgender veterans were identified. Among the 91% using VHA both before and after TGD diagnosis, visits for primary, specialty, and mental and behavioral health care increased whereas emergency care did not change. Factors associated with discontinuing VHA care were Black/African American and another race, married status, older age, and service in recent versus earlier eras. Younger, highly disabled from military service veterans and those in the West (vs. South) were more likely to fill gender-affirming prescriptions in the VHA. <b><i>Conclusion:</i></b> This study established high levels of disability and apparent willingness to continue with care in the VHA following establishment of TGD status. The role of interpersonal, provider, and policy in VHA retention remains to be examined.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"363-371"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minority Stress Clusters and Health and Cancer Care Outcomes of Sexual and Gender Minority Cancer Survivors.","authors":"Oscar Y Franco-Rocha, Ashley M Henneghan, Shelli R Kesler, Christopher W Wheldon","doi":"10.1089/lgbt.2024.0311","DOIUrl":"10.1089/lgbt.2024.0311","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Structural factors affect the health of sexual and gender minority (SGM) cancer survivors, yet how people experience minority stress within their social and health care systems remains unclear. We explored experiences of minority stress across health care and sociocultural contexts and their impact on health and cancer outcomes. <b><i>Methods:</i></b> We conducted a K-medoid cluster analysis (grouping technique) using data from 2519 participants (training subset = 2015, testing subset = 504) from OUT: The National Cancer Survey (2020-2021). Cluster differences in the testing subset were assessed using chi-square, analysis of variance, and nonparametric tests. Regression models examined associations between cluster membership and health (mentally unhealthy days) and cancer outcomes (perceived welcomeness after identity disclosure and treatment satisfaction), adjusting for demographic and clinical factors. <b><i>Results:</i></b> Five clusters emerged, differing in demographics, mental and social health outcomes, SGM identity disclosure, and perceived welcomeness after disclosure (0.017 < <i>p</i> < 0.001). Cluster one experienced poorer mental health than cluster five (odds ratio [OR] = 1.182, 95% confidence interval [CI] = 1.003-1.392), lower cancer care satisfaction than all other clusters (1.177 < OR <1.265; 1.091 < 95% CI <1.389), and perceived less welcoming or unchanged environments after SGM identity disclosure than all other clusters (1.278 < OR <1.314; 1.161 < 95% CI <1.431). <b><i>Conclusion:</i></b> The study highlights the impact of minority stress across different contexts. The findings emphasize the need for targeted interventions to address the unique vulnerabilities of SGM individuals, particularly in health care contexts, to improve their overall health and cancer care experiences.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"329-339"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Reliability of Assessing Gender Minority Status Based on Gender Identity and Sex Assigned at Birth in the African Context: Findings from the HIV Prevention Trials Network 075 Study.","authors":"Theo G M Sandfort, Karen Dominguez, Yamikani Chimwaza, Calvin Mbeda, Jonathan Lucas, erica I hamilton","doi":"10.1089/lgbt.2024.0221","DOIUrl":"10.1089/lgbt.2024.0221","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study evaluated the reliability of assessing transgender status in African populations using questions about current gender identification and sex assigned at birth. <b><i>Methods:</i></b> Data were obtained from the HIV Prevention Trials Network 075, a study designed to assess the feasibility of recruiting and retaining 400 men who have sex with men (MSM) in a 1-year prospective cohort study in Kenya, Malawi, and South Africa and conducted from 2015 to 2017. We compared responses of 401 participants to questions about gender identity obtained at the screening and enrollment visits and, for a subset of participants, in open interviews 6-9 months after enrollment. <b><i>Results:</i></b> One hundred and eleven of the 401 persons reported to identify as female or transgender at either the screening visit and/or the enrollment visit. Of those 111 persons, 42 (37.8%) switched between the two assessment moments from male to female or transgender, or vice versa. Furthermore, most transgender women were sexually attracted to men and identified as gay. In the follow-up interview with a subset of participants, almost all persons categorized as transgender identified as MSM. <b><i>Conclusion:</i></b> Categorizing persons as transgender based on self-identified gender and sex assigned at birth has limited reliability in African populations. Possible explanations for the observed inconsistencies in the responses to gender-related questions are discussed. For future studies, an understanding is needed of what specific words and labels such as gender, female, or transgender mean to study participants.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"378-385"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breaking Down Barriers for Same-Sex Female Couples Building Families: <i>In Vitro</i> Fertilization Utilization Following the Enactment of 2021 Legislation in New York State.","authors":"Katrina S Nietsch, Bethany Dubois, Isabelle Band, Shawn Kripalani, Dmitry Gounko, Joseph A Lee, Eric Flisser, Alan B Copperman, Samantha L Estevez","doi":"10.1089/lgbt.2024.0199","DOIUrl":"10.1089/lgbt.2024.0199","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> In 2021, New York State passed legislation that eliminated the requirement that same-sex female couples needed up to 12 months of intrauterine insemination with donor sperm to meet the medical definition of infertility and qualify for insurance coverage. This study compared the duration of time from consultation to utilization of <i>in vitro</i> fertilization (IVF) by same-sex female couples before and after the New York legislative change. <b><i>Methods:</i></b> Same-sex female couples who underwent IVF or reciprocal IVF between 2010 and 2023 in New York City were categorized into pre- and postlegislation cohorts based on when they sought initial treatment. The primary outcome was time from consultation to initiation of IVF or reciprocal IVF. Secondary outcomes included time from consultation to clinical pregnancy with discharge to obstetrical care. <b><i>Results:</i></b> Overall, 239 couples were included. The postlegislation cohort had a shorter median length of time from consultation to initiation of IVF (173 vs. 297 days, <i>p</i> < 0.001; hazard ratio 2.36, <i>p</i> < 0.001) and a significant increase in the proportion of couples initiating treatment less than 1 year after consultation (86% vs. 57%, <i>p</i> = 0.01). They also had a decreased median time to discharge with ongoing pregnancy (383 vs. 535 days, <i>p</i> = 0.006). Same-sex female couples had 136% increased chances of initiating IVF after consultation compared with before the legislation. <b><i>Conclusion:</i></b> After the expansion of fertility insurance coverage, same-sex couples at a single New York City institution initiated IVF treatment and achieved pregnancy more rapidly after consultation than prior to the expansion.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"386-393"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring HIV Risk Among Sexual Minority Women by Identity and Behavior in a Population-Based Sample of Low-Income Heterosexually Active Women.","authors":"Jennifer L Glick, Amy R Baugher, Elana Morris, Danielle German, Kamila A Alexander, Susan Cha, Catlainn Sionean","doi":"10.1089/lgbt.2024.0098","DOIUrl":"10.1089/lgbt.2024.0098","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Research suggests that sexual minority women (SMW) face elevated HIV risk compared with their heterosexual counterparts. This study examined the association between sexual minority status-defined by identity and behavior-and HIV-related vulnerabilities among heterosexually active low-income women. <b><i>Methods:</i></b> This analysis used National HIV Behavioral Surveillance data (<i>n</i> = 5542) collected in 2019 from heterosexually active low-income women in 23 U.S. urban areas. We examined sexual minority identity and behavior and a set of substance use, sexual behavior, health and health care, and social determinants of health indicators commonly associated with heightened HIV transmission risk. Log-linked Poisson regression models generated adjusted prevalence ratios and 95% confidence intervals. <b><i>Results:</i></b> Among women who reported sexual minority identity (22.2%; <i>n</i> = 1231), 34.6% (<i>n</i> = 426) reported past-year sex with only men. Of women who reported past-year sex with both women and men (17.8%; <i>n</i> = 985), 18.3% (<i>n</i> = 180) identified as heterosexual. In adjusted models, SMW had significantly higher prevalence of nearly every HIV risk-associated factor examined than their heterosexual counterparts. Risk profiles by identity and behavior were similar. Notably, SMW defined by behavior had similar or higher prevalence of nearly every risk factor than those defined by identity. <b><i>Conclusions:</i></b> This study demonstrates disproportionate HIV-related vulnerabilities among SMW compared with their heterosexual counterparts. The findings underscore the importance of measuring multiple dimensions of sexual orientation (identity and behavior), as SMW and their associated risks show important nuances. Implications include tailoring HIV prevention and health promotion interventions to meet the needs of low-income SMW.</p>","PeriodicalId":18062,"journal":{"name":"LGBT health","volume":" ","pages":"350-362"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}