American Journal of Public Health Highlights
- Gay and lesbian health issues getting short shrift at U.S. schools of public health
- Early condom use bodes well for adolescents’ sexual health
- Survivors of childhood sexual abuse more likely to engage in risky behaviors
- Racial/ethnic disparities persist in HIV’s impact on homosexual men
- Lesbians more likely to be overweight or obese
Gay, lesbian, bisexual and transgender health issues getting short shrift at U.S. schools of public health
Aside from HIV/AIDS, health issues affecting the lesbian, gay, bisexual and transgender population are not likely to show up in research and lesson plans offered at schools of public health across the nation.
Researchers mailed questionnaires to 184 department and division heads at 35 of the country's schools of public health. The questionnaire covered overall climate for lesbian, gay, bisexual and transgender faculty; faculty and student lesbian, gay, bisexual and transgender research; and planned lesbian, gay, bisexual and transgender health curricula. The majority of schools include sexual orientation in their non-discrimination policy. Of the 102 respondents, 41 percent reported having at least one faculty member who was conducting research on an issue related to lesbian, gay, bisexual or transgender health—yet the majority of the research was on HIV/AIDS. In addition, fewer than 10 percent of the departments had offered a course covering lesbian, gay, bisexual or transgender health topics in the previous two years.
The importance of offering such courses and providing research are highlighted by previous studies identifying that lesbian, gay, bisexual and transgender people are at increased risk for some health problems, such as substance use and being victims of violence. They also face "unique barriers to accessing and utilizing appropriate health services," the study's authors said. "Consequently, factors associated with sexual orientation and gender identity are increasingly recognized as important to consider in public health practice and research." In recognition of lesbian, gay, bisexual and transgender health disparities, official American Public Health Association policy urges educational institutions to support efforts to improve the health of this population.
[From: "Research, Curricula, and Resources Related to Lesbian, Gay, Bisexual, and Transgender Health in U.S. Schools of Public Health." Contact: Heather L. Corliss, PhD, MPH, Children's Hospital, Boston, Mass., firstname.lastname@example.org.]
Early condom use bodes well for adolescents' sexual health
Despite fears that early condom use encourages adolescents to be sexually promiscuous, a study found that those who use condoms the first time they have sexual intercourse are more likely to continue using condoms into young adulthood. These adolescents are also less likely than their peers to have contracted a sexually transmitted infection.
The study was based on a nationally representative sample of more than 4,000 sexually active adolescents, who were interviewed shortly after losing their virginity and then an average of 6.8 years later. The study found that those who used condoms at "sexual debut" were 36 percent more likely to report condom use for their most current sexual encounter and half as likely to test positive for chlamydia or gonorrhea when compared with those who did not use condoms at “sexual debut”. The lifetime number of sexual partners did not differ between those who had used condoms during their first sexual experience and those who had not.
The study's authors point out that, "Although abstinence-only messages are being promoted in some parts of the United States today, 62 percent of high school students report that they have had sexual intercourse by their senior year." This study’s findings suggest that those who use condoms during their early sexual experiences protect not only themselves, but their intimate partners as well.
[From: "Association Between Condom Use at Sexual Debut and Subsequent Sexual Trajectories: A Longitudinal Study Using Biomarkers" Contact: Taraneh Shafii, MD, MPH, University of Washington, Seattle, email@example.com.]
Survivors of childhood sexual abuse more likely to engage in risky behaviors
Gay and bisexual men who were victims of childhood sexual abuse are more likely to engage in sexual behaviors that put them at higher risk of contracting HIV.
A study of 862 randomly selected gay and bisexual men who were enrolled in a community festival found that almost one in seven had been victims of childhood sexual abuse. Those who reported regular childhood sexual abuse were at significantly greater risk for being HIV positive, were 7 times more likely to have ever exchanged sex for money and were 6.4 times more likely to be a current drug user than those who did not report abuse. However, the victims of childhood sexual abuse were not more likely to have a current sexually transmitted infection or to report practicing unprotected sex.
The study’s authors recommended further research to help determine how childhood sexual abuse contributes to sexual risk taking in gay and bisexual men and the types of interventions that may be most effective. “We also believe that data such as ours reflect the importance of [lesbian, gay, bisexual and transgender] voices in policy development and advocacy to address child sexual abuse,” the study’s authors said.
[From: “History of Childhood Sexual Abuse and HIV Risk Behaviors in Homosexual and Bisexual Men.” Contact: Seth L. Welles, Sc.D, Boston University, Boston, Mass., firstname.lastname@example.org.]
Racial/ethnic disparities persist in HIV’s impact on homosexual men
HIV continues to hit black and Hispanic men harder than their white counterparts.
A study of HIV diagnosis rates from 2001–2004 for gay and bisexual men found that among all age groups, rates were higher among black and Hispanic men than among white men, as was the proportion in which AIDS had developed within three years. In addition, black men who have sex with men (MSM) were significantly less likely to be alive 3 years after AIDS diagnosis (80.6 percent) than were Hispanic (85.2 percent) or white (84.5 percent) MSM. The study’s authors said the poorer outcomes for minority men might be tied to later diagnosis or lack of adequate access to treatment.
For all MSM, HIV diagnosis rates climbed the highest among younger age groups: 14 percent among those ages 13–19, 13 percent for those ages 20–24. The study’s authors said HIV intervention programs should “be tailored to the needs and behavioral context of black and Hispanic youth for effective prevention, and to address stigma, distrust and health literacy to improve access to HIV prevention and care.”
[From: “ Racial/Ethnic and Age Disparities in HIV Prevalence and Disease Progression Among Men Who Have Sex With Men in the United States.” Contact: H. Irene Hall, PhD, Centers for Disease Control and Prevention, Atlanta, Ga., email@example.com .]
Lesbians more likely to be overweight and obese
Compared to heterosexual women, lesbians are more than twice as likely to be overweight or obese.
Researchers compared population estimates of overweight and obesity across sexual orientation groups using data from the 2002 National Survey of Family Growth. The study sample of almost 6,000 women found that lesbians were more likely to be overweight and obese, putting themselves at higher risk for conditions such as diabetes and heart disease. The study’s authors said their findings point to “an urgent need for weight-reduction interventions that target the high-risk group of sexual-minority women.”
[From: “Overweight and Obesity in Sexual-Minority Women: Evidence From Population-Based Data.” Contact: Ulrike Boehmer, PhD, Department of Social and Behavioral Sciences, Boston University School of Public Health, Boston, Mass., firstname.lastname@example.org.]