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Psychiatric Risk in Unstably Housed Sexual Minority Women: Relationship between Sexual and Racial Minority Status and Human Immunodeficiency Virus and Psychiatric Diagnoses.
Womens Health Issues. 2017 May - Jun; 27(3):294-301.WH

Abstract

BACKGROUND

Stress associated with minority statuses has been linked to mental health disorders. However, research conducted exclusively among impoverished women, a population known to be at risk for poor health owing to overlapping risks, is sparse. We sought to determine if homeless and unstably housed sexual minority (i.e., nonheterosexual) women were at greater psychiatric risk than their heterosexual counterparts. We also sought to determine if racial/ethnic minority and human immunodeficiency virus status contributed to psychiatric risks.

METHODS

Homeless/unstably housed women living in San Francisco between 2008 and 2010 were followed biannually over 3 years. Generalized estimating equation analysis identified significant correlates of any substance use, mood, or anxiety disorder, as well as the total number of psychiatric disorders.

RESULTS

Among 300 women, 24% reported nonheterosexual identity at the first study visit. Consistent with minority stress theory, lesbian and bisexual identity were associated with higher levels of mental health comorbidity, and bisexual identity was related to greater rates of substance use disorders and mood disorders. Unique to this study, we found that identity assessed 1 or 2 years prior does not predict current substance disorders, but current identity does. In addition, women who were infected with the human immunodeficiency virus also had higher rates of mental health comorbidity and substance use disorders. Contrary to psychosocial stress theory, racial/ethnic minority status was associated with reduced odds of substance use disorder in this population. Recent homelessness was related to greater risk of anxiety disorder.

CONCLUSIONS

Best research and health care practices should include the assessment of sexual orientation and housing status when addressing risks for mental health and substance disorders among low-income women.

Authors+Show Affiliations

Community Health Systems, School of Nursing, University of California, San Francisco, San Francisco, California. Electronic address: Annesa.flentje@ucsf.edu.Department of Psychiatry, School of Medicine, University of California, San Francisco, San Francisco, California.Department of Liberal Arts, Saint Louis College of Pharmacy, St. Louis, Missouri.Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28108194

Citation

Flentje, Annesa, et al. "Psychiatric Risk in Unstably Housed Sexual Minority Women: Relationship Between Sexual and Racial Minority Status and Human Immunodeficiency Virus and Psychiatric Diagnoses." Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, vol. 27, no. 3, 2017, pp. 294-301.
Flentje A, Shumway M, Wong LH, et al. Psychiatric Risk in Unstably Housed Sexual Minority Women: Relationship between Sexual and Racial Minority Status and Human Immunodeficiency Virus and Psychiatric Diagnoses. Womens Health Issues. 2017;27(3):294-301.
Flentje, A., Shumway, M., Wong, L. H., & Riley, E. D. (2017). Psychiatric Risk in Unstably Housed Sexual Minority Women: Relationship between Sexual and Racial Minority Status and Human Immunodeficiency Virus and Psychiatric Diagnoses. Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, 27(3), 294-301. https://doi.org/10.1016/j.whi.2016.12.005
Flentje A, et al. Psychiatric Risk in Unstably Housed Sexual Minority Women: Relationship Between Sexual and Racial Minority Status and Human Immunodeficiency Virus and Psychiatric Diagnoses. Womens Health Issues. 2017 May - Jun;27(3):294-301. PubMed PMID: 28108194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychiatric Risk in Unstably Housed Sexual Minority Women: Relationship between Sexual and Racial Minority Status and Human Immunodeficiency Virus and Psychiatric Diagnoses. AU - Flentje,Annesa, AU - Shumway,Martha, AU - Wong,Lauren H, AU - Riley,Elise D, Y1 - 2017/01/17/ PY - 2016/04/11/received PY - 2016/12/07/revised PY - 2016/12/09/accepted PY - 2017/1/22/pubmed PY - 2018/1/5/medline PY - 2017/1/22/entrez SP - 294 EP - 301 JF - Women's health issues : official publication of the Jacobs Institute of Women's Health JO - Womens Health Issues VL - 27 IS - 3 N2 - BACKGROUND: Stress associated with minority statuses has been linked to mental health disorders. However, research conducted exclusively among impoverished women, a population known to be at risk for poor health owing to overlapping risks, is sparse. We sought to determine if homeless and unstably housed sexual minority (i.e., nonheterosexual) women were at greater psychiatric risk than their heterosexual counterparts. We also sought to determine if racial/ethnic minority and human immunodeficiency virus status contributed to psychiatric risks. METHODS: Homeless/unstably housed women living in San Francisco between 2008 and 2010 were followed biannually over 3 years. Generalized estimating equation analysis identified significant correlates of any substance use, mood, or anxiety disorder, as well as the total number of psychiatric disorders. RESULTS: Among 300 women, 24% reported nonheterosexual identity at the first study visit. Consistent with minority stress theory, lesbian and bisexual identity were associated with higher levels of mental health comorbidity, and bisexual identity was related to greater rates of substance use disorders and mood disorders. Unique to this study, we found that identity assessed 1 or 2 years prior does not predict current substance disorders, but current identity does. In addition, women who were infected with the human immunodeficiency virus also had higher rates of mental health comorbidity and substance use disorders. Contrary to psychosocial stress theory, racial/ethnic minority status was associated with reduced odds of substance use disorder in this population. Recent homelessness was related to greater risk of anxiety disorder. CONCLUSIONS: Best research and health care practices should include the assessment of sexual orientation and housing status when addressing risks for mental health and substance disorders among low-income women. SN - 1878-4321 UR - https://www.unboundmedicine.com/medline/citation/28108194/Psychiatric_Risk_in_Unstably_Housed_Sexual_Minority_Women:_Relationship_between_Sexual_and_Racial_Minority_Status_and_Human_Immunodeficiency_Virus_and_Psychiatric_Diagnoses_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1049-3867(16)30393-0 DB - PRIME DP - Unbound Medicine ER -