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Abstract(s)
Introdução: O número limitado de profissionais de saúde culturalmente competentes
e treinados nas necessidades específicas da população lésbica, gay, bissexual,
transgénero e outros (LGBT+) constitui uma barreira à prestação de cuidados
adequados. Existem disparidades em saúde nesta população, estando estas presentes
também em idades mais avançadas. Comparativamente aos homens heterossexuais, os
homens gays e bissexuais (GB) mais velhos apresentam níveis mais elevados de
depressão, incapacidade física e uma saúde geral mais pobre, procuram menos cuidados
médicos e estão mais vulneráveis a isolamento social.
Objetivos: Descrever a saúde física e mental percecionada de uma amostra de homens
gays e bissexuais (GB) mais velhos, avaliar as suas condições de saúde e descrever as suas
experiências e acesso aos cuidados de saúde. Comparar diferenças nos resultados em
função da: orientação sexual, situação relacional, estatuto socioeconómico, nível de
escolaridade e infeção pelo Vírus da Imunodeficiência Humana (VIH).
Materiais e métodos: Estudo quantitativo e transversal. Aplicou-se um questionário
online, construído com base em escalas pré-existentes que foram sujeitas a um processo
de tradução e adaptação, e que esteve disponível para preenchimento voluntário entre os
meses de outubro e dezembro de 2019. Os critérios de inclusão dos participantes foram:
autoidentificarem-se como homens gays e bissexuais, terem 50 ou mais anos, saberem
ler português e terem acesso à internet. A análise estatística dos dados foi realizada com
recurso ao software Statistical Package for the Social Sciences® (SPSS), tendo-se
procedido a uma análise descritiva e inferencial dos resultados, com recurso aos testes
de Mann-Whitney, Kruskal-Wallis e qui-quadrado.
Resultados: 85.1% dos participantes autoidentificou-se como gay e 14.9% como
bissexual, sendo a média de idades de 58.8. O estatuto socioeconómico mais baixo
relacionou-se com uma perceção mais negativa da saúde física e mental. Os participantes
que se autoidentificaram como gays e os que não tinham parceiro/a avaliaram a sua
saúde mental de forma menos positiva. Mais de metade dos participantes disse já ter
contraído alguma infeção sexualmente transmissível (IST) e maior percentagem de
participantes com estatuto socioeconómico baixo reportou diagnóstico de doença
mental. 26.4% dos participantes não comunica abertamente a sua orientação sexual aos
profissionais de saúde, com os participantes bissexuais em desvantagem. Os
participantes VIH (Vírus da Imunodeficiência Humana) positivos avaliaram as suas experiências com os serviços e profissionais de saúde de forma significativamente mais
positiva. As experiências de discriminação explícita foram pouco frequentes. 25.7% dos
participantes sentiu que os profissionais não responderam às suas necessidades
específicas e um maior nível de educação relacionou-se com uma maior procura de
serviços direcionados para a população LGBT+ (lésbica, gay, bissexual, transgénero e
outros).
Conclusões: Vários determinantes de saúde, além da orientação sexual, interagem
entre si em múltiplos níveis na obtenção de resultados em saúde e nas experiências
percecionadas. Estratégias a serem implementadas com o objetivo de melhorar a saúde
e o acesso aos cuidados desta população passam pela educação e formação contínua dos
profissionais.
Introduction: The limited number of culturally competent healthcare providers trained in the specific needs of the lesbian, gay, bisexual, transgender and other population (LGBT+) constitutes a barrier to the provision of adequate care. There are health disparities in this population, which are also present at older ages. Compared to heterosexual men, older gay and bisexual (GB) men have higher levels of depression, physical disability, poorer general health, seek less medical care and are more vulnerable to social isolation. Objectives: To describe the perceived physical and mental health of a sample of older gay and bisexual men, to assess their health conditions and describe their health experiences and access to care. Compare differences in results according to sexual orientation, relationship status, socioeconomic status, education level and human immunodeficiency virus (HIV) infection. Materials and methods: Quantitative and cross-sectional study. An online questionnaire was applied, built on the basis of existing scales that were translated and adapted, which was available for voluntary completion between the months of October and December 2019. The inclusion criteria of the participants were: self-identification as gay and bisexual men, aged 50 or over, able to read portuguese and have access to the internet. Statistical analysis of the data was performed using the Statistical Package for the Social Sciences® (SPSS) software, with a descriptive and inferential analysis of the results, using the Mann-Whitney, Kruskal-Wallis and chi-square tests. Results: 85.1% of the participants identified themselves as gay and 14.9% as bisexual, with a mean age of 58.8. Lower socioeconomic status was related to a more negative perception of physical and mental health. Participants who self-identified as gay and those who had no partner rated their mental health less positively. More than half of the participants said they had previously contracted a sexually transmitted infection (STI) and a higher percentage of participants with low socioeconomic status reported a diagnosis of mental illness. 26.4% of participants do not disclose their sexual orientation to health professionals, with bisexual participants at a disadvantage. HIV (Human Immunodeficiency Virus) positive participants evaluated their experiences with services and health professionals in a significantly more positive way. Experiences of explicit discrimination were infrequent. 25.7% of the participants felt that the healthcare providers did not respond to their specific needs and a higher level of education was related to a greater demand for services specifically aimed at the LGBT+ (lesbian, gay, bisexual, transgender and other) population. Conclusions: Various health determinants, in addition to sexual orientation, interact with each other on multiple levels in achieving health outcomes and perceived experiences. Strategies to be implemented in order to improve health and access to care for this population include education and continuous training of healthcare providers.
Introduction: The limited number of culturally competent healthcare providers trained in the specific needs of the lesbian, gay, bisexual, transgender and other population (LGBT+) constitutes a barrier to the provision of adequate care. There are health disparities in this population, which are also present at older ages. Compared to heterosexual men, older gay and bisexual (GB) men have higher levels of depression, physical disability, poorer general health, seek less medical care and are more vulnerable to social isolation. Objectives: To describe the perceived physical and mental health of a sample of older gay and bisexual men, to assess their health conditions and describe their health experiences and access to care. Compare differences in results according to sexual orientation, relationship status, socioeconomic status, education level and human immunodeficiency virus (HIV) infection. Materials and methods: Quantitative and cross-sectional study. An online questionnaire was applied, built on the basis of existing scales that were translated and adapted, which was available for voluntary completion between the months of October and December 2019. The inclusion criteria of the participants were: self-identification as gay and bisexual men, aged 50 or over, able to read portuguese and have access to the internet. Statistical analysis of the data was performed using the Statistical Package for the Social Sciences® (SPSS) software, with a descriptive and inferential analysis of the results, using the Mann-Whitney, Kruskal-Wallis and chi-square tests. Results: 85.1% of the participants identified themselves as gay and 14.9% as bisexual, with a mean age of 58.8. Lower socioeconomic status was related to a more negative perception of physical and mental health. Participants who self-identified as gay and those who had no partner rated their mental health less positively. More than half of the participants said they had previously contracted a sexually transmitted infection (STI) and a higher percentage of participants with low socioeconomic status reported a diagnosis of mental illness. 26.4% of participants do not disclose their sexual orientation to health professionals, with bisexual participants at a disadvantage. HIV (Human Immunodeficiency Virus) positive participants evaluated their experiences with services and health professionals in a significantly more positive way. Experiences of explicit discrimination were infrequent. 25.7% of the participants felt that the healthcare providers did not respond to their specific needs and a higher level of education was related to a greater demand for services specifically aimed at the LGBT+ (lesbian, gay, bisexual, transgender and other) population. Conclusions: Various health determinants, in addition to sexual orientation, interact with each other on multiple levels in achieving health outcomes and perceived experiences. Strategies to be implemented in order to improve health and access to care for this population include education and continuous training of healthcare providers.
Description
Keywords
Cuidados de Saúde Experiências de Saúde Homens Gays e Bissexuais Mais Velhos Lgbt+ Saúde Percecionada