​LGBT的性健康

 LGBT sexual health

——原载《医学》杂志2022年2月24日（线上发表）——

<Medicine>, Available online February 24, 2022

【摘要】越来越多的证据表明，女同性恋、男同性恋、双性恋和变性者 (LGBT) 在心理健康以及物质和酒精使用领域的综合健康不平等导致了更差的性健康。这是一个多元化的人群，不仅个人行为因素，而且更广泛的政治、法律、经济、制度和社会文化因素也是健康不平等的重要驱动因素。女同性恋者对细菌性阴道病的易感性增加，而与顺性别的异性恋者相比，跨性别女性、男同性恋和双性恋男性更容易感染性传播感染和HIV。沟通中的非评判态度和文化能力对于临床评估至关重要。必须考虑根据性史进行非生殖器临床检查和取样。有特定的疫苗接种考虑因素，那些感染HIV 风险较高的人需要信息和获得生物医学预防干预措施的机会。在性健康咨询期间对心理健康、物质和酒精使用的常规评估为寻求超越感染或生育控制，以改善整体健康和福祉的干预措施创造了机会。

【关键词】双性恋、男同性恋、艾滋病毒、同性恋、女同性恋、男男性行为者(MSM)、MRCP、性和性别少数群体、性健康、性传播感染、综合性不平等、跨性别

[Abstract] There is a growing body of evidence that the syndemic health inequalities in the areas of mental health and substance and alcohol use in lesbian, gay, bisexual and transsexual (LGBT) people contribute to poorer sexual health. This is a diverse population where not only individual behavioural factors, but the wider political, legal, economic, institutional and sociocultural factors are also important drivers of health inequalities. Lesbian women have increased susceptibility to bacterial vaginosis, while trans women and gay and bisexual men have greater vulnerability to sexually transmitted infections and HIV compared to cis-gendered heterosexuals. A non-judgemental attitude and cultural competency in communication are essential for clinical assessments. Consideration must be given to non-genital clinical examination and sampling according to sexual history. There are specific vaccination considerations and those at higher risk of HIV infection require information and access to biomedical prevention interventions. Routine assessments of mental health, substance and alcohol use during sexual health consultations create opportunities for interventions that seek to go beyond infection or fertility control to improve overall health and well-being.

[Key words] Bisexual, gay men, HIV, homosexuality, lesbian, men who have sex with men (MSM), MRCP, sexual and gender minorities, sexual health, sexually transmitted infections, syndemic inequalities, transgender

论文原文：Aseel Hegazi, Mark Pakianathan (2022). LGBT sexual health. Medicine, Available online February 24, 2022.

https://doi.org/10.1016/j.mpmed.2022.01.008

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