A Comparative Analysis of Lifetime Medical Conditions and Infectious Diseases by Sexual Identity, Attraction, and Concordance: Results from a National U.S. Survey
Main Article Content
Abstract
BACKGROUND. There have been relatively few studies of potential disparities in the prevalence/risk for health conditions or infectious diseases other than HIV/AIDs and other sexually transmitted infections (STIs) among sexual minority men (e.g., men who self-identify as gay or bisexual or who have sex with other men). The recent addition of sexual orientation questions to the National Survey on Drug Use and Health (NSDUH) and other general population surveys now allows for health-related research using national surveys that identify participant sexual orientation.
OBJECTIVES. We sought to: compare the prevalences/odds of having ten medical conditions/infectious diseases for sexual majority and sexual minority men and assess for differences associated with sexual identity, sexual attraction, and the degree of concordance between identity and attraction.
METHOD. Data from 18,718 adult (18 and over) male participants in the 2015 NSDUH survey were analyzed using bivariate and multivariable logistic regression models to assess for differences in the prevalence/adjusted odds of seven medical conditions (asthma, heart condition, hypertension, diabetes, chronic bronchitis or chronic obstructive pulmonary disease, kidney disease, cancer of any kind) and three infectious diseases (hepatitis B or C; STIs, and HIV/AIDS). Multivariable models adjusted for demographics, substance abuse/dependence, and mental illness.
RESULTS. Except for HIV/AIDS, there were no significant associations between sexual identity and any medical condition in the multivariable models nor were there any significant associations with sexual attraction or concordance.
CONCLUSION. The findings diverge from prior studies that used non-national samples and which found modest health differences for gay and bisexual men for some conditions other than HIV or STIs. The divergent findings highlight the importance of having nationally representative data for health research related to sexual minorities.
OBJECTIVES. We sought to: compare the prevalences/odds of having ten medical conditions/infectious diseases for sexual majority and sexual minority men and assess for differences associated with sexual identity, sexual attraction, and the degree of concordance between identity and attraction.
METHOD. Data from 18,718 adult (18 and over) male participants in the 2015 NSDUH survey were analyzed using bivariate and multivariable logistic regression models to assess for differences in the prevalence/adjusted odds of seven medical conditions (asthma, heart condition, hypertension, diabetes, chronic bronchitis or chronic obstructive pulmonary disease, kidney disease, cancer of any kind) and three infectious diseases (hepatitis B or C; STIs, and HIV/AIDS). Multivariable models adjusted for demographics, substance abuse/dependence, and mental illness.
RESULTS. Except for HIV/AIDS, there were no significant associations between sexual identity and any medical condition in the multivariable models nor were there any significant associations with sexual attraction or concordance.
CONCLUSION. The findings diverge from prior studies that used non-national samples and which found modest health differences for gay and bisexual men for some conditions other than HIV or STIs. The divergent findings highlight the importance of having nationally representative data for health research related to sexual minorities.
Article Details
How to Cite
SWARTZ, James; HORN, Kelly.
A Comparative Analysis of Lifetime Medical Conditions and Infectious Diseases by Sexual Identity, Attraction, and Concordance: Results from a National U.S. Survey.
Medical Research Archives, [S.l.], v. 5, n. 8, aug. 2017.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/1452>. Date accessed: 15 nov. 2024.
Keywords
health conditions, infectious diseases, sexual minority, gay men, bisexual men, gay men’s health
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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18. Conron KJ, Mimiaga MJ, Landers SJ. A Population-based study of sexual orientation identity and gender differences in adult health. Am J Public Health. 2010;100(10):1953-60.
19. [Author]. The relative odds of lifetime health conditions and infectious diseases among men who have sex with men compared with a matched general population sample. Am J Mens Health. 2015;9(2):150-62.
20. Medley G, Lipari RN, Bose J, Cribb DS, Kroutil LA, McHenry G. Sexual orientation and estimates of adult substance use and mental health: Results from the 2015 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration; (2016, October).
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25. Center for Behavioral Health Statistics and Quality. 2015 National Survey on Drug Use and Health public use file. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2016.
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28. StataCorp. Stata 14.2 for Mac. College Station, TX: StataCorp; 2017.
29. Tjur T. Coefficients of determination in logistic regression models—A new proposal: The coefficient of discrimination. The American Statistician. 2009;63(4):366-72.
30. Swartz JA. The relative odds of lifetime health conditions and infectious diseases among men who have sex with men compared with a matched general population sample. American Journal of Men’s Health. 2015;9(2):150-62.
31. Kalichman SC, Pellowski J, Turner C. Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention. Sex Transm Infect. 2011;87:183-90.
32. Safren SA, Blashill AJ, O'Cleirigh CM. Promoting the sexual health of MSM in the context of comorbid mental health problems. AIDS Behav. 2011;15:S30-S4.
33. Hatzenbuehler ML, Slopen N, McLaughlin KA. Stressful life events, sexual orientation, and cardiometabolic risk among young adults in the United States. Health Psychol. 2014;33(10):1185-94.
34. Slopen N, Koenen KC, Kubzansky LD. Cumulative adversity in childhood and emergent risk factors for long-term health. J Pediatr. 2014;164(3):631-8 e1-2.
35. Chapman Institute. How valid is self-reported health data? Seatle, WA: Chapman Institute; 2012, May.
2. Cochran SD, Ackerman D, Mays VM, Ross MW. Prevalence of non-medical drug use and dependence among homosexually active men and women in the US population. Addiction. 2004;99(8):989-98.
3. Stall R, Mills TC, Williamson J, Hart T, Greenwood G, Paul J, et al. Association of co-occurring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. Am J Public Health. 2003;93(6):939-42.
4. Gee R. Primary care health issues among men who have sex with men. J Am Acad Nurse Pract. 2006;18(4):144-53.
5. Safren SA, Reisner SL, Herrick A, Mimiaga MJ, Stall R. Mental Health and HIV Risk in Men Who Have Sex With Men. Journal of Acquired Immune Deficiency Syndrome. 2010;55(Supplement 2):S74-S7.
6. Wolitski RJ, Fenton KA. Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States. AIDS Behav. 2011;15(1):9-17.
7. Lert F, Sitta R, Bouhnik AD, Dray-Spira R, Spire B. HIV-positive men who have sex with men: biography, diversity in lifestyles, common experience of living with HIV. ANRS-EN12 VESPA Study, 2003. AIDS Care. 2010;22(1):71-80.
8. Akhtar-Khaleel WZ, Cook RL, Shoptaw S, Surkan P, Stall R, Beyth RJ, et al. Trends and Predictors of Cigarette Smoking Among HIV Seropositive and Seronegative Men: The Multicenter Aids Cohort Study. AIDS Behav. 2016;20(3):622-32.
9. Sander PM, Cole SR, Stall RD, Jacobson LP, Eron JJ, Napravnik S, et al. Joint effects of alcohol consumption and high-risk sexual behavior on HIV seroconversion among men who have sex with men. AIDS. 2013;27(5):815-23.
10. van de Laar TJ, Richel O. Emerging viral STIs among HIV-positive men who have sex with men: the era of hepatitis C virus and human papillomavirus. Sex Transm Infect. 2016.
11. Bourne A, Weatherburn P. Substance use among men who have sex with men: patterns, motivations, impacts and intervention development need. Sex Transm Infect. 2017.
12. Snyder JE. Trend analysis of medical publications about LGBT persons: 1950-2007. J Homosex. 2011;58(2):164-88.
13. Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. . Washington, DC: The National Academics Press; 2011.
14. Makadon HJ, Mayer KH, Garofalo R. Optimizing primary care for men who have sex with men. J Am Med Assoc. 2006;296(19):2362-5.
15. Patterson JG, Jabson JM, Bowen DJ. Measuring sexual and gender minority populations in health surveillance. LGBT Health. 2017;4(2):82-105.
16. Centers for Disease Control. HIV Surveillance Report, 2015. November 2016.
17. Wolff M, Wells B, Ventura-DiPersia C, Renson A, Grov C. Measuring sexual orientation: A review and critique of U.S. data collection efforts and Implications for health policy. J Sex Res. 2017;54(4-5):507-31.
18. Conron KJ, Mimiaga MJ, Landers SJ. A Population-based study of sexual orientation identity and gender differences in adult health. Am J Public Health. 2010;100(10):1953-60.
19. [Author]. The relative odds of lifetime health conditions and infectious diseases among men who have sex with men compared with a matched general population sample. Am J Mens Health. 2015;9(2):150-62.
20. Medley G, Lipari RN, Bose J, Cribb DS, Kroutil LA, McHenry G. Sexual orientation and estimates of adult substance use and mental health: Results from the 2015 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration; (2016, October).
21. Ward BW, Dahlhamer JM, Galinsky AM, Joestl S, S. Sexual orientation and health among U.S. adults: National Health Interview Survey, 2013. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; (2014, July).
22. Gonzales G, Henning-Smith C. Health disparities by sexual orientation: Results and implications from the Behavioral Risk Factor Surveillance System. J Community Health. 2017;epub.
23. Gonzales G, Przedworski J, Henning-Smith C. Comparison of health and health risk factors between lesbian, gay, and bisexual adults and heterosexual adults in the United States: Results from the National Health Interview Survey. JAMA Intern Med. 2016;176(9):1344-51.
24. van Anders SM. Beyond sexual orientation: Integrating gender/sex and diverse sexualities via sexual configurations theory. Arch Sex Behav. 2015;44(5):1177-213.
25. Center for Behavioral Health Statistics and Quality. 2015 National Survey on Drug Use and Health public use file. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2016.
26. American Psychiatric Association, editor. Diagnostic and Statistical Manual of Mental Disorders, Text-Revision. Washington, DC: American Psychiatric Association 2002.
27. Shiffman S, Waters A, Hickcox M. The nicotine dependence syndrome scale: a multidimensional measure of nicotine dependence. Nicotine Tob Res. 2004;6(2):327-48.
28. StataCorp. Stata 14.2 for Mac. College Station, TX: StataCorp; 2017.
29. Tjur T. Coefficients of determination in logistic regression models—A new proposal: The coefficient of discrimination. The American Statistician. 2009;63(4):366-72.
30. Swartz JA. The relative odds of lifetime health conditions and infectious diseases among men who have sex with men compared with a matched general population sample. American Journal of Men’s Health. 2015;9(2):150-62.
31. Kalichman SC, Pellowski J, Turner C. Prevalence of sexually transmitted co-infections in people living with HIV/AIDS: systematic review with implications for using HIV treatments for prevention. Sex Transm Infect. 2011;87:183-90.
32. Safren SA, Blashill AJ, O'Cleirigh CM. Promoting the sexual health of MSM in the context of comorbid mental health problems. AIDS Behav. 2011;15:S30-S4.
33. Hatzenbuehler ML, Slopen N, McLaughlin KA. Stressful life events, sexual orientation, and cardiometabolic risk among young adults in the United States. Health Psychol. 2014;33(10):1185-94.
34. Slopen N, Koenen KC, Kubzansky LD. Cumulative adversity in childhood and emergent risk factors for long-term health. J Pediatr. 2014;164(3):631-8 e1-2.
35. Chapman Institute. How valid is self-reported health data? Seatle, WA: Chapman Institute; 2012, May.