{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T23:02:52Z","timestamp":1782255772200,"version":"3.54.5"},"reference-count":71,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002879","name":"canadian hiv trials network, canadian institutes of health research","doi-asserted-by":"publisher","award":["CTN-333"],"award-info":[{"award-number":["CTN-333"]}],"id":[{"id":"10.13039\/501100002879","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH123349"],"award-info":[{"award-number":["R01MH123349"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CBR-151184"],"award-info":[{"award-number":["CBR-151184"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FDN-143349"],"award-info":[{"award-number":["FDN-143349"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MOP-133617"],"award-info":[{"award-number":["MOP-133617"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT-169119"],"award-info":[{"award-number":["PJT-169119"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Data were drawn from a longitudinal community\u2013based cohort of women living with HIV (Sexual Health and HIV\/AIDS Women\u2019s Longitudinal Needs Assessment).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study sample included 1460 observations on 315 participants over 4.5\u2009years (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\u2009=\u20091.39 (0.94\u20132.05); sexual and\/or gender minority adjusted odds ratio\u2009=\u20091.48 (1.00\u20132.18)) and being unable to access health services (sexual minority adjusted odds ratio\u2009=\u20091.89 (1.20\u20132.97); sexual and\/or gender minority adjusted odds ratio\u2009=\u20091.91 (1.23\u20132.98)). 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\u2009=\u20091.38; 95% CI\u2009=\u20090.76\u20132.52) and being unable to access health services (gender minority adjusted odds ratio\u2009=\u20091.72; 95% CI\u2009=\u20090.89\u20133.31) possibly due to low sample size among women with gender minority identities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057231205677","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T05:31:55Z","timestamp":1700803915000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["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"],"prefix":"10.1177","volume":"19","author":[{"given":"H","family":"Perrin","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Shannon","sequence":"additional","affiliation":[{"name":"Centre for Gender & Sexual Health Equity (CGSHE), The University of British Columbia, Vancouver, BC, Canada"},{"name":"Division of Social Medicine, Department of Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AJ","family":"Lowik","sequence":"additional","affiliation":[{"name":"Centre for Gender & Sexual Health Equity (CGSHE), The University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Rich","sequence":"additional","affiliation":[{"name":"Centre for Gender & Sexual Health Equity (CGSHE), The University of British Columbia, Vancouver, BC, Canada"},{"name":"Department of Social Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Baral","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Braschel","sequence":"additional","affiliation":[{"name":"Centre for Gender & Sexual Health Equity (CGSHE), The University of British Columbia, Vancouver, BC, Canada"},{"name":"Division of Social Medicine, Department of Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6265-3013","authenticated-orcid":false,"given":"K","family":"Deering","sequence":"additional","affiliation":[{"name":"Centre for Gender & Sexual Health Equity (CGSHE), The University of British Columbia, Vancouver, BC, Canada"},{"name":"Division of Social Medicine, Department of Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,11,24]]},"reference":[{"key":"bibr1-17455057231205677","unstructured":"British Columbia Centre for Excellence in HIV\/AIDS. HIV monitoring quarterly report for British Columbia: first quarter 2019. Vancouver, 2019, http:\/\/stophivaids.ca\/qmr\/2019-Q1\/#\/bc"},{"key":"bibr2-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-03084-w"},{"key":"bibr3-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1097\/JNC.0000000000000234"},{"key":"bibr4-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2020.1717418"},{"key":"bibr5-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001775"},{"key":"bibr6-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2017.1338658"},{"key":"bibr7-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/0966369X.2015.1073701"},{"key":"bibr8-17455057231205677","unstructured":"Ogden J, Nyblade L. Common at its core: HIV-related stigma across contexts, 2005, https:\/\/www.icrw.org\/wp-content\/uploads\/2016\/10\/Common-at-its-Core-HIV-Related-Stigma-Across-Contexts.pdf"},{"key":"bibr9-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1016\/j.jana.2016.07.003"},{"key":"bibr10-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2006.103"},{"key":"bibr11-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2006.0202"},{"key":"bibr12-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-007-9220-4"},{"key":"bibr13-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2017.29.4.364"},{"key":"bibr14-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix998"},{"key":"bibr15-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1781-y"},{"key":"bibr16-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003125"},{"key":"bibr17-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1093\/hsw\/30.1.19"},{"key":"bibr18-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001124"},{"key":"bibr19-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.03.016"},{"key":"bibr20-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1177\/0020731419885093"},{"key":"bibr21-17455057231205677","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2015.01511"},{"key":"bibr22-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/10538720802235179"},{"key":"bibr23-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/07448481.2013.787619"},{"key":"bibr24-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2014.0118"},{"key":"bibr25-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/00918369.2019.1694337"},{"key":"bibr26-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70315-8"},{"key":"bibr27-17455057231205677","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2018.304727"},{"key":"bibr28-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/00918369.2011.614903"},{"key":"bibr29-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1007\/978-94-007-6324-1"},{"key":"bibr30-17455057231205677","first-page":"139","volume":"1989","author":"Crenshaw K.","year":"1989","journal-title":"U Chi Legal F"},{"key":"bibr31-17455057231205677","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.300750"},{"key":"bibr32-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2021.100798"},{"key":"bibr33-17455057231205677","first-page":"134","volume-title":"Transgender: a reference handbook","author":"Pruden H.","year":"2019"},{"key":"bibr34-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/00918369.2019.1591789"},{"key":"bibr35-17455057231205677","first-page":"252","volume-title":"Handbook of psychology and sexual orientation","author":"Meyer IH","year":"2013"},{"key":"bibr36-17455057231205677","volume-title":"Ecological models of health behavior: health behavior and health education: theory, research, and practice","author":"Sallis J","year":"2008","edition":"4"},{"key":"bibr37-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-017-1818-2"},{"key":"bibr38-17455057231205677","volume-title":"Minority stress and lesbian women","author":"Brooks V.","year":"1981"},{"key":"bibr39-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1089\/lgbt.2019.0223"},{"key":"bibr40-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116813"},{"key":"bibr41-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2014.03.022"},{"key":"bibr42-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2019.03.018"},{"key":"bibr43-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1177\/0361684316654282"},{"key":"bibr44-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1007\/s11199-008-9400-z"},{"key":"bibr45-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2017.12.018"},{"key":"bibr46-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2015.1057757"},{"key":"bibr47-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1071\/SH19011"},{"key":"bibr48-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2020.1728212"},{"key":"bibr49-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2018.1499862"},{"issue":"17392","key":"bibr50-17455057231205677","volume":"15","author":"Logie CH","year":"2012","journal-title":"J Int AIDS Soc"},{"key":"bibr51-17455057231205677","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2007.127811"},{"key":"bibr52-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/10538720.2010.538009"},{"key":"bibr53-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1016\/j.jana.2009.06.002"},{"key":"bibr54-17455057231205677","unstructured":"Lambda Legal. When health care isn\u2019t caring: Lambda Legal\u2019s survey of discrimination against LGBT people and people with HIV, 2010, https:\/\/legacy.lambdalegal.org\/sites\/default\/files\/publications\/downloads\/whcic-report_when-health-care-isnt-caring.pdf"},{"key":"bibr55-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/15538605.2017.1273164"},{"key":"bibr56-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-021-02991-3"},{"key":"bibr57-17455057231205677","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.300796"},{"key":"bibr58-17455057231205677","unstructured":"James SE, Herman JL, Rankin S, et al. The report of the 2015 U.S. transgender survey. National Center for Transgender Equality, Washington, DC, 2016."},{"key":"bibr59-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1007\/s11930-018-0185-y"},{"key":"bibr60-17455057231205677","doi-asserted-by":"publisher","DOI":"10.15766\/mep_2374-8265.10551"},{"key":"bibr61-17455057231205677","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20200102"},{"key":"bibr62-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000656"},{"key":"bibr63-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1080\/00918369.2011.614902"},{"issue":"5","key":"bibr64-17455057231205677","volume":"37","author":"Jenner SC","year":"2020","journal-title":"J Interpers Violence"},{"key":"bibr65-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60833-3"},{"key":"bibr66-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1179\/1753807614Y.0000000045"},{"key":"bibr67-17455057231205677","unstructured":"Jaffray B. Intimate partner violence: experiences of sexual minority women in Canada, 2018. Canadian Centre for Justice and Community Safety Statistics, 26 April 2021, https:\/\/www150.statcan.gc.ca\/n1\/pub\/85-002-x\/2021001\/article\/00005-eng.htm"},{"key":"bibr68-17455057231205677","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.18.6.20285"},{"key":"bibr69-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-014-2832-y"},{"key":"bibr70-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2015.03.008"},{"key":"bibr71-17455057231205677","doi-asserted-by":"publisher","DOI":"10.1016\/j.psym.2014.10.006"}],"container-title":["Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057231205677","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17455057231205677","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057231205677","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:26:31Z","timestamp":1777710391000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17455057231205677"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":71,"alternative-id":["10.1177\/17455057231205677"],"URL":"https:\/\/doi.org\/10.1177\/17455057231205677","relation":{},"ISSN":["1745-5057","1745-5065"],"issn-type":[{"value":"1745-5057","type":"print"},{"value":"1745-5065","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]},"article-number":"17455057231205677"}}