Access to and quality of care for sexual and gender minority women living with HIV in Metro Vancouver, Canada: results from a longitudinal cohort study

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dc.contributor.authorPerrin, H.
dc.contributor.authorShannon, K.
dc.contributor.authorLowk, A.J.
dc.contributor.authorRich, A.
dc.contributor.authorBaral, S.
dc.contributor.authorBraschel, M.
dc.contributor.authorDeering, K.
dc.date.accessioned2025-02-25T23:29:50Z
dc.date.available2025-02-25T23:29:50Z
dc.date.issued2023
dc.descriptionOpen access article. Creative Commons Attribution-NonCommercial 4.0 International license (CC BY-NC 4.0) applies
dc.description.abstractBackground: While scarce, literature suggests that women at the intersection of HIV status and gender and/or sexual minority identities experience heightened social and health disparities within health care systems. Objectives: This study examines the association between sexual and/or gender minority identities and: (1) experiences of poor treatment by health professionals and (2) being unable to access health services among a cohort of women living with HIV in Metro Vancouver, Canada. Design: Data were drawn from a longitudinal community–based cohort of women living with HIV (Sexual Health and HIV/AIDS Women’s Longitudinal Needs Assessment). Methods: We examined associations between sexual and/or gender minority identities and the two outcomes. We drew on explanatory variables to measure sexual minority and gender minority identities independently and a combined variable measuring sexual and/or gender minority identities. The associations between each of these three variables and each outcome were analysed using bivariate and multivariable logistic regression models with generalized estimating equations for repeated measures over time. Adjusted odds ratios and 95% confidence intervals are reported. Results: The study sample included 1460 observations on 315 participants over 4.5 years (September 2014 to February 2019). Overall, 125 (39.7%) reported poor treatment by health professionals and 102 (32.4%) reported being unable to access health care services when needed at least once over the study period. A total of 110 (34.9%) of participants reported sexual and/or gender minority identities, 106 (33.7%) reporting sexual minority identities, with 29 (9.2%) reporting gender minority identities. In multivariable analysis, adjusting for confounders, sexual minority identities, and combined sexual and/or gender minority identities were significantly associated with increased odds of experiencing poor treatment by health professionals (sexual minority adjusted odds ratio = 1.39 (0.94–2.05); sexual and/or gender minority adjusted odds ratio = 1.48 (1.00–2.18)) and being unable to access health services (sexual minority adjusted odds ratio = 1.89 (1.20–2.97); sexual and/or gender minority adjusted odds ratio = 1.91 (1.23–2.98)). In multivariable analysis, gender minority identities were not significantly associated with increased odds of experiencing poor treatment by health professionals (gender minority adjusted odds ratio = 1.38; 95% CI = 0.76–2.52) and being unable to access health services (gender minority adjusted odds ratio = 1.72; 95% CI = 0.89–3.31) possibly due to low sample size among women with gender minority identities. Conclusion: Our findings suggest the need for access to inclusive, affirming, trauma-informed health care services tailored specifically for and by women living with HIV with sexual and/or gender minority identities.
dc.description.peer-reviewYes
dc.identifier.citationPerrin, H., Shannon, K., Lowik, A., Rich, A., Baral, S., Braschel, M., & Deering, K. (2023). Access to and quality of care for sexual and gender minority women living with HIV in Metro Vancouver, Canada: Results from a longitudinal cohort study, 19, https://doi.org/10.1177/17455057231205677
dc.identifier.urihttps://hdl.handle.net/10133/6992
dc.language.isoen
dc.publisherSage
dc.publisher.departmentDepartment of Sociology
dc.publisher.facultyArts and Science
dc.publisher.institutionUniversity of Toronto
dc.publisher.institutionUniversity of British Columbia
dc.publisher.institutionUniversity of North Carolina at Chapel Hill
dc.publisher.institutionJohns Hopkins Bloomberg Schol of Public Health
dc.publisher.institutionUniversity of Lethbridge
dc.publisher.urlhttps://doi.org/10.1177/17455057231205677
dc.subjectGender identity
dc.subjectGender minority women
dc.subjectHealth care services access
dc.subjectSexual minority women
dc.subjectSexual orientation
dc.subjectWomen living with HIV
dc.subject.lcshHIV-positive women--Medical care--Canada
dc.titleAccess to and quality of care for sexual and gender minority women living with HIV in Metro Vancouver, Canada: results from a longitudinal cohort study
dc.typeArticle
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