Barriers and facilitators to accessing sexual health services for older LGBTQIA+ adults: a global scoping review and qualitative evidence synthesis.
Barriers and facilitators to accessing sexual health services for older LGBTQIA+ adults: a global scoping review and qualitative evidence synthesis.
复制标题
老年 LGBTQIA 成年人获得性健康服务的障碍和促进因素：全球范围审查和定性证据综合。
作者：
Conyers H
随着人口老龄化和社会环境变得更容易接受，认同女同性恋者、男同性恋者、双性恋者、变性人和其他性别和性别多样性身份的老年人(LGBTQIA+)的数量正在增加。这项研究使用全球证据综合来了解全球老年LGBTQIA+成年人获得性保健的感知障碍和促进者。我们采用范围综述和定性证据综合的方法。以LGBTQIA+人群、45岁成年人和性健康护理为关键词，检索EMBASE、PubMed和QicINFO。我们使用了Cochrane手册，并且注册了审查方案。使用PRISMA-SCR和少数群体压力模型对原始文本数据和次要文本数据进行编码并分组为主题。使用等级-CERQual方法评估审查结果的确定性。我们确定了19项研究，其中15项纳入了定性证据合成。所有研究都来自高收入国家。性保健服务的异质性和以男性为中心导致了老年LGBTQIA+成年人的被排斥感。来自医疗保健提供者的预期和实施的污名都导致LGBTQIA+老年人，特别是那些患有慢性病的成年人，逃避医疗服务(每项研究7项，确定性较低)。老年LGBTQIA+成年人有独特的性健康需求，可能觉得他们的年龄使他们能够获得适当的护理(四项研究，低确定性)。这篇综述强调了需要进行更多的研究和干预，以改善为LGBTQIA+老年人提供的性健康服务。减少性健康异质性的实用策略(例如中性性别标牌)可能会增加对基本的性健康服务的接受。
The number of older adults identifying as lesbian, gay, bisexual, transgender and other sexual and gender diverse identities (LGBTQIA+) is growing as populations age and social environments become more accepting. This study uses a global evidence synthesis to understand perceived barriers and facilitators to access to sexual healthcare globally for older LGBTQIA+ adults. We used a scoping review and qualitative evidence synthesis. Embase, PubMed and PsycInfo were searched with terms related to LGBTQIA+ populations, adults aged 45years, and sexual health care. We used the Cochrane Handbook and the review protocol was registered. Primary and secondary textual data were coded and grouped into themes using PRISMA-SCR and the Minority Stress Model. The certainty of review findings was assessed using the GRADE-CERQual approach. We identified 19 studies and 15 were included in the qualitative evidence synthesis. All studies were from high-income countries. Heterocentricity and male-centricity of sexual healthcare services contributed to feelings of exclusion for older LGBTQIA+ adults. Both anticipated and enacted stigma from healthcare providers resulted in older LGBTQIA+ adults, especially those with chronic conditions, avoiding health services (seven studies each, low certainty). Older LGBTQIA+ adults have unique sexual health needs and may feel their age empowers them to access appropriate care (four studies, low certainty). This review highlights the need for additional research and interventions to improve sexual health services for older LGBTQIA+ adults. Practical strategies to make sexual health less heterocentric (e.g. gender neutral signage) may increase uptake of essential sexual health services.