Many LGBT individuals believe HIV, AIDS are priority concern over other chronic diseases that affect LGBT communities

June 11, 2020

Health concerns for people in LGBT communities can vary vastly from the concerns faced by cisgender and heterosexual people. The attention drawn to these disparities has been a driving force in the advocacy for change, such as efforts to address HIV and AIDS, suicide and hate crimes. A study recently released by researchers at the UNC Gillings School of Global Public Health has reported that a quarter of participants in a national phone survey believe HIV and AIDS are the most serious health concerns LGBT communities are currently facing.

The results, published in February 2020 by Health Promotion Practice, will be included in an upcoming collection of the journal’s articles that will be free to download between June 13-30 in celebration of Pride Month.

Dr. Marcella Boynton

Dr. Marcella Boynton

Jeff Gilbert

Jeff Gilbert

The study was conducted in 2017 by Marcella Boynton, PhD, adjunct assistant professor of health behavior and assistant professor in the UNC School of Medicine; Jeffrey Gilbert, MPH, 2019 Master of Public Health alumnus in health behavior and partnership manager at MLPB; Bonnie Shook-Sa, DrPH, a postdoctoral research associate in biostatistics; and Joseph Lee, PhD, 2008 Master of Public Health alumnus in maternal and child health, 2015 doctoral alumnus in health behavior and associate professor at East Carolina University.

Dr. Bonnie Shook-Sa

Dr. Bonnie Shook-Sa

Dr. Joseph Lee

Dr. Joseph Lee

The study was designed to explore how LGBT communities viewed their health risks. Boynton explained, “As tobacco use and cancer prevention researchers, we wanted to understand how LGBT adults perceive the health risks facing their communities. Currently, about 1 in 5 LGBT adults smoke, compared to 1 in 7 cisgender and heterosexual adults. This means that tobacco-related diseases such as cancer, pulmonary disease and cardiovascular issues are greatly impacting LGBT communities.”

Participants, who were self-identified members of LGBT communities, were asked what they believed was the most serious health problem facing LGBT people today. They were also asked to rate the seriousness of alcohol abuse, hate crimes, HIV/AIDS, smoking and suicide.

The study found that respondents rated health concerns that are more immediate — HIV/AIDS, sexual risk and suicide — as more serious, compared to health issues that might develop later in life, like chronic disease due to smoking or alcohol use. More than 25% of those surveyed identified HIV/AIDS as the most serious health problem, and more than 17% of respondents similarly identified sexually transmitted infections as most serious. Respondents also frequently cited a lack of access to quality health care as a problem.

“Addressing inequities in HIV/AIDS for sexual and gender minority (SGM) men and gender minority women remains an important area of work, given, for example, the striking inequities in HIV prevalence by race and gender identity among SGM populations,” the team stated in the study. “HIV/AIDS has historically been viewed as a core issue of SGM health; however, improvements in care (e.g., antiretroviral therapy) are resulting in chronic diseases replacing HIV/AIDS as leading causes of death for people living with HIV/AIDS.”

In the context of public health, the study’s findings raise concerns that the LGBT public’s focus on HIV/AIDS, while important, may hinder efforts to address other prominent health care issues within LGBT communities. Diseases such as cancer, cardiovascular disease and other chronic conditions that can be caused by smoking or harmful substance use also pose a significant health risk and contribute to mortality rates among LGBT people. It is important for public health leaders to advocate for media campaigns, public health policies and health programs addressing a broader range of health issues within LGBT communities, especially as related to chronic disease.

“Everyone deserves a fair chance at a healthy life, and we all have a responsibility to work for healthier communities. These results can help LGBT leaders build support for changes that promote health,” said Lee.

The research reported in this publication was supported by grant number P50CA180907 from the National Cancer Institute and the U.S. Food and Drug Administration’s Center for Tobacco Products (Kurt Ribisl, PhD, principal investigator).


Contact the UNC Gillings School of Global Public Health communications team at sphcomm@unc.edu.

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