Article Text
Abstract
Objective Little is known about barriers to healthcare access for two-spirit, gay, bisexual and queer (2SGBQ+) men in Manitoba.
Design Data were drawn from a community-based, cross-sectional survey designed to examine health and healthcare access among 2SGBQ+ men.
Setting Community-based cross-sectional study in Manitoba, Canada.
Participants Community-based sample of 368 2SGBQ+ men.
Outcomes Logistic regression analyses assessed the relationship between sociodemographics, healthcare discrimination, perceived healthcare providers’ 2SGBQ+ competence/knowledge and two indicators of healthcare access (analytic outcome variables): (1) having a regular healthcare provider and (2) having had a healthcare visit in the past 12 months.
Results In multivariate analyses, living in Brandon (adjusted OR (AOR)=0.08, 95% CI 0.03 to 0.22), small cities (AOR=0.20, 95% CI 0.04 to 0.98) and smaller towns (AOR=0.26, 95% CI 0.08 o 0.81) in Manitoba (compared with living in Winnipeg), as well as having a healthcare provider with poor (AOR=0.19, 95% CI 0.04 to 0.90) or very poor competence/knowledge (AOR=0.03, 95% CI 0.03 to 0.25) of 2SGBQ+ men’s issues (compared with very good competence) was associated with lower odds of having a regular healthcare provider. Living in Brandon (AOR=0.05, 95% CI 0.02 to 0.17) and smaller towns (AOR=0.25, 95% CI 0.67 to 0.90) in Manitoba (compared with living in Winnipeg) was associated with lower odds of having a healthcare visit in the past 12 months, while identifying as a gay man compared with bisexual (AOR=12.57, 95% CI 1.88 to 83.97) was associated with higher odds of having a healthcare visit in the past 12 months.
Conclusions These findings underscore the importance of reducing the gap between the healthcare access of rural and urban 2SGBQ+ men, improving healthcare providers’ cultural competence and addressing their lack of knowledge of 2SGBQ+ men’s issues.
- health services administration & management
- health policy
- organisation of health services
- public health
Data availability statement
Data are available on reasonable request.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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- health services administration & management
- health policy
- organisation of health services
- public health
Data availability statement
Data are available on reasonable request.
Footnotes
Twitter @mikejamespayne, @NJLachowsky, @DrDavidJBrennan
Contributors RS was responsible for the overall design of the study. All authors participated in discussions about the data source and planning of the analyses, and critically revised successive versions of the paper. RS drafted the first version of the manuscript. RS, JS, AM, SA, SM and CC were involved in the initial data analysis. RL, MP, LR, LL, GR, PM, BM, NJL, DJB and UNS provided input into the data analysis and interpretation. All coauthors were involved in the drafting various components of the manuscript. The study was conceptualised and developed while working closely with our community partners from the health and social sector and our community advisory committee. RS is responsible for the overall content as the guarantor.
Funding This work was supported by the Canadian Institutes of Health Research Catalyst Grant (#162929), the Manitoba Medical Service Foundation operating grant (#8-2019-12) and the Winnipeg Foundation operating grant (#321813).
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.