Factors Influencing Health Care Access Perceptions and Care-seeking Behaviors of Immigrant Latino Sexual Minority Men and Transgender Individuals: Baseline Findings from the HOLA Intervention Study

Background Black gay, bisexual, and other sexual minority men (BSMM) account for 39.1% of new HIV infections among men who have sex with men and 78.9% of newly diagnosed cases among Black men. Health care access, health care utilisation and disclosing sexuality to providers are important factors in HIV prevention and treatment. This study explored the associations among sexual orientation disclosure, health care access and health care utilisation among BSMM in the Deep South. Methods:Secondary analysis of existing data of a population-based study in Jackson, Mississippi, and Atlanta, Georgia, was conducted among 386 BSMM. Poisson regression models were used to estimate prevalence ratios (PR) between sexual orientation disclosure to healthcare providers, health care access and health care utilisation. Results:The mean (±s.d.) age of participants was 30.5 ± 11.2 years; 35.3% were previously diagnosed with HIV and 3.7% were newly diagnosed with HIV. Two-thirds (67.2%) self-identified as homosexual or gay; 70.6% reported being very open about their sexual orientation with their healthcare providers. After adjustment, BSMM who were not open about their sexual orientation had a lower prevalence of visiting a healthcare provider in the previous 12 months than those who were very open with their healthcare provider (PR 0.42; 95% confidence interval 0.18–0.97). Conclusion:Clinics, hospitals and other healthcare settings should promote affirming environments that support sexuality disclosure for BSMM.

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Structural Barriers to Pre-exposure Prophylaxis Use Among Young Sexual Minority Men: The P18 Cohort Study

Current HIV Research ◽

10.2174/1570162x16666180730144455 ◽

2018 ◽

Vol 16 (3) ◽

pp. 237-249 ◽

Cited By ~ 16

Author(s):

Jessica Jaiswal ◽

Marybec Griffin ◽

Stuart N. Singer ◽

Richard E. Greene ◽

Ingrid Lizette Zambrano Acosta ◽

...

Keyword(s):

Health Care ◽

Cohort Study ◽

Hiv Prevention ◽

Sexual Behaviors ◽

Sexual Minority ◽

Structural Level ◽

Sexual Minority Men ◽

Hiv Prevention Strategies ◽

Minority Men ◽

Exposure Prophylaxis

Background: Despite decreasing rates of HIV among many populations, HIV-related health disparities among gay, bisexual and other men who have sex with men persist, with disproportional percentages of new HIV diagnoses among racial and ethnic minority men. Despite increasing awareness of HIV pre-exposure prophylaxis (PrEP), PrEP use remains low. In addition to exploring individual-level factors for this slow uptake, structural drivers of PrEP use must also be identified in order to maximize the effectiveness of biomedical HIV prevention strategies. Method: Using cross-sectional data from an ongoing cohort study of young sexual minority men (N=492), we examine the extent to which structural-level barriers, including access to health care, medication logistics, counseling support, and stigma are related to PrEP use. Results: While almost all participants indicated awareness of PrEP, only 14% had ever used PrEP. PrEP use was associated with lower concerns about health care access, particularly paying for PrEP. Those with greater concerns talking with their provider about their sexual behaviors were less likely to use PrEP. Conclusion: Paying for PrEP and talking to one’s provider about sexual behaviors are concerns for young sexual minority men. In particular, stigma from healthcare providers poses a significant barrier to PrEP use in this population. Providers need not only to increase their own awareness of and advocacy for PrEP as an effective risk-management strategy for HIV prevention, but also must work to create open and non-judgmental spaces in which patients can discuss sexual behaviors without the fear of stigma.

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Co-occurring psychosocial problems predict HIV status and increased health care costs and utilization among sexual minority men

Journal of Behavioral Medicine ◽

10.1007/s10865-018-9913-z ◽

2018 ◽

Vol 41 (4) ◽

pp. 450-457 ◽

Cited By ~ 3

Author(s):

Conall O’Cleirigh ◽

David W. Pantalone ◽

Abigail W. Batchelder ◽

Mark L. Hatzenbuehler ◽

Samantha M. Marquez ◽

...

Keyword(s):

Health Care ◽

Health Care Costs ◽

Sexual Minority ◽

Psychosocial Problems ◽

Hiv Status ◽

Sexual Minority Men ◽

Minority Men ◽

Care Costs

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Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment

American Journal of Public Health ◽

10.2105/ajph.2011.300382 ◽

2012 ◽

Vol 102 (2) ◽

pp. 285-291 ◽

Cited By ~ 133

Author(s):

Mark L. Hatzenbuehler ◽

Conall O'Cleirigh ◽

Chris Grasso ◽

Kenneth Mayer ◽

Steven Safren ◽

...

Keyword(s):

Health Care ◽

Sexual Minority ◽

Natural Experiment ◽

Health Care Use ◽

Same Sex ◽

Same Sex Marriage ◽

Sexual Minority Men ◽

Marriage Laws ◽

Minority Men

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Nursing and Health Care Preferences Among Opioid and Stimulant Using Black Sexual Minority Men

Journal of the Association of Nurses in AIDS Care ◽

10.1097/jnc.0000000000000201 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Derek T. Dangerfield ◽

Jessica Cooper ◽

Omeid Heidari ◽

Sophia Allen ◽

Terrell J.A. Winder ◽

...

Keyword(s):

Health Care ◽

Sexual Minority ◽

Sexual Minority Men ◽

Minority Men ◽

Health Care Preferences

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Traveling for Care: Factors Influencing Health Care Access for Rural Dwellers

Public Health Nursing ◽

10.1111/j.1525-1446.1994.tb00393.x ◽

1994 ◽

Vol 11 (3) ◽

pp. 145-149 ◽

Cited By ~ 17

Author(s):

Sharon D. Horner ◽

Janet Ambrogne ◽

Martha A. Coleman ◽

Charlene Hanson ◽

Donna Hodnicki ◽

...

Keyword(s):

Health Care ◽

Health Care Access ◽

Care Access ◽

Factors Influencing ◽

Rural Dwellers

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Sexual Identity Differences in Health Care Access and Satisfaction: Findings from Nationally Representative Data

American Journal of Epidemiology ◽

10.1093/aje/kwab012 ◽

2021 ◽

Author(s):

Jessica N Fish ◽

Rodman E Turpin ◽

Natasha D Williams ◽

Bradley O Boekeloo

Keyword(s):

Health Care ◽

Sexual Identity ◽

Sexual Minority ◽

Health Care Access ◽

Sexual Minorities ◽

Care Utilization ◽

Care Needs ◽

Care Access ◽

Nationally Representative ◽

And Bisexual

Abstract Identification of barriers to adequate health care for sexual minority populations remains elusive as they are complex and variable across sexual orientation subgroups (e.g., gay, lesbian, bisexual). To address these complexities, we use a U.S. nationally representative sample of health care consumers to assess sexual identity differences in health care access and satisfaction. We conducted a secondary data analysis of 12 waves (2012-2018) of the biannual Consumer Survey of Health Care Access (n=30,548) to assess sexual identity differences in 6 health care access and 3 health care satisfaction indicators. Despite parity in health insurance coverage, sexual minorities – with some variation across sexual minority subgroups and sex – reported more chronic health conditions alongside restricted health care access and unmet health care needs. Gay/lesbian females had the lowest prevalence of health care utilization and higher prevalence rates of delaying needed health care and medical tests relative to heterosexual females. Gay/lesbian females and bisexual males were less likely than their heterosexual counterparts to be able to pay for needed health care services. Sexual minorities also reported less satisfactory experiences with medical providers. Examining barriers to health care among sexual minorities is critical to eliminating health disparities that disproportionately burden this population.

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The Impact of Binational Barriers to Medical Care on the Care-Seeking Practices of Mexican Immigrants

Qualitative Health Research ◽

10.1177/1049732321992041 ◽

2021 ◽

pp. 104973232199204

Author(s):

Rebecca M. Crocker

Keyword(s):

United States ◽

Health Care ◽

Medical Care ◽

Health Care Access ◽

Mexican Immigrants ◽

The United States ◽

Care Utilization ◽

Care Seeking ◽

Care Access ◽

The Impact

Barriers to health care access faced by Mexican immigrants in the United States have been well-documented, including lack of insurance, fear of deportation, and language barriers. However, little is known about this population’s care-seeking experiences before migration. In this article, I use a life-course approach to explore binational isolation from health care and the ways in which early-life experiences pattern Mexicans’ care-seeking practices in the United States. This ethnographic research project took place in Tucson, Arizona, between 2013 and 2014 and used semistructured interviews with service providers and first-generation Mexican immigrants. The majority of participants faced significant barriers to medical care in Mexico, which resulted in low rates of care utilization and heavy reliance on lay modalities. Immigrants faced an even broader array of barriers to care in the United States, and their lack of prior health care access further discouraged care utilization and compromised their medical care experiences after migration.

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