title: Health status, health service use, and satisfaction according to sexual identity of young Australian women.
abstract: OBJECTIVE
  we sought to compare physical and mental health status, health service use, and satisfaction among young Australian women of varying sexual identity; and to explore associations of all of these variables with satisfaction with their general practitioner (GP).
  
  
  METHODS
  data are from the youngest cohort of women in the Australian Longitudinal Study on Women's Health surveyed in 2003. The sample included women aged 25 to 30 who identified as exclusively heterosexual (n = 8,083; 91.3%), mainly heterosexual (n = 568; 6.4%), bisexual (n = 100; 1.1%), or lesbian (n = 99; 1.1%). Univariate analyses compared self-reported mental health, physical health, access to GP services, and satisfaction across the four sexual identity groups. Linear regression, controlling for education, income, and residence, was used to identify factors associated with GP satisfaction.
  
  
  RESULTS
  sexual minority women (lesbian, bisexual, and mainly heterosexual) were significantly more likely than were heterosexual women to report poorer mental health and to have more frequently used health services; depression was strongly associated with mental health services use. Bisexual and mainly heterosexual women were most likely to report poorer general health, abnormal Pap tests, sexually transmissible infections, urinary tract infections, hepatitis B or C virus infection, and asthma. Lesbians were most likely to have never had a Pap test or be underscreened. All sexual minority women had lower continuity of GP care and lower satisfaction with that care than heterosexual women.
  
  
  CONCLUSIONS
  underlying social determinants of physical and mental health disparities experienced by sexual minority women require exploration, including the possible effects of discrimination and marginalization on higher levels of risk taking. Lower continuity of care and lower satisfaction with GP services also need further investigation.
authors.affiliation: Department of General Practice, University of Melbourne, Victoria, Australia. r.mcnair@unimelb.edu.au
authors.forename: Ruth
authors.initials: R
authors.lastname: McNair
authors.forename: Laura A
authors.initials: LA
authors.lastname: Szalacha
authors.forename: Tonda L
authors.initials: TL
authors.lastname: Hughes
mesh_terms: D000328:Adult; D001315:Australia; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D003863:Depression / Q000209:etiology; D005260:Female; D058005:General Practitioners; D006304:Health Status; D054625:Healthcare Disparities; D006801:Humans; D008137:Longitudinal Studies; D008603:Mental Health; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data*; D010549:Personal Satisfaction; D019529:Sexuality; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult