Social
Healthcare avoidance and sexual orientation identity among college students in China: a cross-sectional survey Stephen W. Pan* Stephen Pan Cheng Yu Katelyn Sileo Sudais Imtiaz Etienne Jaime
Background: Due partly to stigma (anticipated, internalized, enacted, structural), healthcare avoidance behaviors may be more prevalent among sexual minorities. However, research on sexual orientation and healthcare avoidance in China remains limited. In response, we examined the extent to which sexual orientation identity is associated with healthcare avoidance among college students in mainland China.
Methods: In 2020, 806 first-year college students >18 years old in East China completed a baseline online survey. Sexual orientation identity was self-reported as heterosexual, gay, bisexual, and other/unsure. Non-heterosexual categories were coded as “sexual minority.” Healthcare avoidance was defined as refraining from seeing a doctor in the past 12 months, despite an illness or injury. Multiple logistic regression was used to assess associations between sexual orientation identity and healthcare avoidance. Males and females were analyzed separately. Standardized predicted probabilities were calculated controlling for socio-demographics, health insurance, and medical history.
Results: Prevalence of healthcare avoidance among males was 22.5% and 29.6% among females. Prevalence of sexual minority identity was 10.8% among males and 20.05% among females. The odds of reporting healthcare avoidance were 2.17 times significantly greater for sexual minority males than heterosexual males (95% CI: 1.10 – 4.27). Among females, no significant association was observed between healthcare avoidance and sexual orientation identity.
Conclusion: Uptake of healthcare services may be suboptimal for sexual minority male college students in China. Further studies are needed to elucidate generalizability of these findings, mechanisms of association, and explore potential interventions to mitigate healthcare avoidance among sexual minority male college students in China.
