Do homosexual persons use health care services more frequently than heterosexual persons:findings from a Dutch population survey

Use of health care services has been suggested to be lower among homo- or bisexual persons than among heterosexual persons, due to a lack of trust in the health care system. However, population-based studies on differences in health care utilization according to sexual orientation are scarce. The purpose of the current study was to explore differences in health care utilization and confidence in health care between heterosexual, bisexual and homosexual persons. A survey of a random sample of patients of Dutch general practices (n=9684) gathered data on socio-demographic variables, sexual orientation, health status, confidence in health care and health care utilization. Differences in health care utilization between homo- or bisexual persons and heterosexual persons were analyzed with logistic regression analysis, in which we statistically adjusted for socio-demographics and health status. Reported health was lower among homosexual men and women as compared to heterosexual persons. There were no sexual orientation-related differences in confidence in health care. Controlling for health status, it appeared that gay men more frequently used mental and somatic health care than heterosexual men, and that lesbian or bisexual women more frequently used mental health care than heterosexual women. We found a higher rate of health care use among homosexual and bisexual persons as compared to heterosexual persons, that could only be partly explained by differences in health status. To gain a better understanding of our findings, data on the predisposition to use health services among homosexual and bisexual men and women is needed. (aut.ref.

HIV Risk Among Men Who Have Sex With Men, Women Who Have Sex With Women, Lesbian, Gay, Bisexual and Transgender Populations in South Africa: A Mini-Review

BACKGROUND: The HIV epidemic in South Africa is characterized mainly by heterosexual transmission. Recently, the importance of targeting key populations and marginalized groups, including men who have sex with men (MSM) and transgender people, has been added to the national agenda. OBJECTIVES: This mini-review explores the current state of empirical research on HIV risk and MSM, women who have sex with women (WSW), lesbian, gay, bisexual and transgender (LGBT) populations in South Africa in order to assess the current state of research and identify gaps in the literature. METHOD: Peer-reviewed empirical social and behavioral articles on HIV prevalence and risk focusing on MSM, WSW, and LGBT populations published since 2006 were included in this mini-review. RESULTS: In total 35 articles were included: 30 on MSM, gay, and/or bisexual male-identified populations, three on WSW, lesbian, and/or bisexual female-identified populations, two on LGB youth, and none on transgender populations. CONCLUSION: Despite South Africa being the country with the largest number of people living with HIV in the world, there is a limited amount of research in South Africa on HIV and non-normative gender identities and sexualities, especially WSW, lesbian, and/or bisexual female-identified populations, transgender populations, and LGB youth. Research with MSM, WSW, and LGBT populations should be prioritized in South Africa in order to appropriately inform HIV prevention strategies that meet the specific needs of these marginalized groups