title: Evidence of Syndemics and Sexuality-Related Discrimination Among Young Sexual-Minority Women.
abstract: OBJECTIVE
  Syndemics, or the co-occurrence and interaction of health problems, have been examined extensively among young men who have sex with men, but their existence remain unexamined, to our knowledge, among sexual-minority (i.e., lesbian, gay, and bisexual) women. Thus, we investigated if syndemics were present among young sexual-minority women, and if sexual-orientation discrimination was an independent variable of syndemic production.
  
  
  METHODS
  A total of 467 sexual-minority women between the ages of 18 and 24 completed a cross-sectional online survey regarding their substance use, mental health, sexual behaviors, height, weight, and experiences of discrimination. We used structural equation modeling to investigate the presence of syndemics and their relationship to sexual-orientation discrimination.
  
  
  RESULTS
  Heavy episodic drinking, marijuana use, ecstasy use, hallucinogen use, depressive symptoms, multiple sexual partners, and history of sexually transmitted infections (STIs) comprised syndemics in this population (chi-square=24.989, P=.201; comparative fit index [CFI]=0.946; root mean square error of approximation [RMSEA]=0.023). Sexual-orientation discrimination is significantly and positively associated with the latent syndemic variable (unstandardized coefficient=0.095, P<.05), and this model fit the data well (chi-square=33.558, P=.059; CFI=0.914; RMSEA=0.029). The reverse causal model showed syndemics is not an independent variable of sexual-orientation discrimination (unstandardized coefficient=0.602, P>.05).
  
  
  CONCLUSIONS
  Syndemics appear to be present and associated with sexual-orientation discrimination among young sexual-minority women. Interventions aimed at reducing discrimination or increasing healthy coping may help reduce substance use, depressive symptoms, and sexual risk behaviors in this population.
authors.affiliation: 1 Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania.
authors.forename: Robert W S
authors.initials: RW
authors.lastname: Coulter
authors.affiliation: 1 Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Kinsky
authors.affiliation: 1 Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Herrick
authors.affiliation: 1 Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh , Pittsburgh, Pennsylvania.
authors.forename: Ron D
authors.initials: RD
authors.lastname: Stall
authors.affiliation: 2 Center for Sexuality & Health Disparities, School of Public Health, University of Michigan , Ann Arbor, Michigan.
authors.forename: José A
authors.initials: JA
authors.lastname: Bauermeister
mesh_terms: D000293:Adolescent; D001727:Bisexuality / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D018452:Homosexuality, Female / Q000523:psychology*; D006801:Humans; D008603:Mental Health; D011287:Prejudice / Q000523:psychology; D012111:Residence Characteristics; D012725:Sexual Behavior / Q000523:psychology*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
keywords: depressive symptoms; discrimination; sexual-minority women; sexually transmitted infections; substance use