Table 1.
Summary of publications that addressed accessibility to health and health care services
| Publication/country | Database | Population | Obtaining results | Key findings |
|---|---|---|---|---|
| Qualitative Study | ||||
| Melo, Perilo, Braz and Pedrosa. [1] Brazil | SciELO | 52 managers in Health and 43 LGBT activists | Analysis of government documentary sources and application of semi-structured interviews. | There are difficulties in implementation of health actions with respect to homosexuals, which implies the search for services only in situations of emergency care, considered the gateway system by LGBT group |
| Barbosa and Facchini [2] Brazil | SciELO | 30 homosexual women | Ethnographic observation and application of semi-structured interviews. | Due to be instances of discrimination against homosexuals in health services, LGBT members seek health care generally in situations of greater illness. |
| Araújo, Saraiva, Galvão and Albuquerque. [3] Brazil |
SciELO | One homosexual woman | Experience report through a case study with application of semi-structured interview. | There is weakness in interpersonal relationships between women and health professionals, because of homosexual orientation, with communication difficulties and disattention to issues linked to the experience of sexuality. |
| Gutiérrez [4] Mexico | LILACS | 92 homosexuals (49 men and 43 women) | Application of semi-structured interviews. | Homosexual women have needs for sexual and reproductive health that cannot be contemplated because of discriminatory and prejudicial barriers related to sexual orientation on the part of health services. |
| Seaver, Freund, Wright, Tija and Frayne. [8] USA | PubMed | 22 homosexual women | Accomplishment of focus groups with Application of semi-structured interviews. | Healthcare professionals should adopt behaviors inviting the LGBT population, assuring them the information that should take into account all aspects of health and not only aspects related to sexuality. |
| Boyce, Barrington, Bolanõs, Arandi and Paz-Bailey [9] Guatemala | Cochrane | 8 transsexuals, 16 homo/ bisexual men and 5 heterosexual men | Application of semi-structured interviews. | Gay and bisexual men suffer from difficulties of access to health services due to homosexual orientation as well as experience breach of confidentiality and discrimination in services by professionals. |
| Quantitative Study | ||||
| Buchmueller and Carpenter [5] United States | PubMed | 5,265 homosexuals and 802,659 heterosexuals | Application of structured interviews and accomplishment of logistic regression. | There are differences in attendance between homosexual and heterosexual women with regard to access to insurance and health services; the first present more difficulties, because of prejudice and discrimination based on sexual orientation. |
| Heck, Randall and Gorin. [6] United States | PubMed | 614 homosexuals and 93,418 heterosexuals | Application of structured interviews and accomplishment of logistic regression. | Important differences were found in access to health care, especially for gay women, because of heteronormative attitudes of the services. |
| Kerker, Mostashari and Thorpe. [10] USA | PubMed | 19,349 between homosexuals and heterosexuals | Population-based cross-sectional surveys and application of structured interviews. | Homosexual women have more difficulty accessing health services due to discriminatory attitudes in services, which implies difficulty of being up-to-date with their routine exams, such as the Pap smear and mammogram. |
| Hiestand, Horne and Levit. [11] USA | PubMed | 516 women among lesbians and bisexuals | Snowball sampling technique and application of online structured questionnaire. | Lesbians and bisexual women have more health risks than heterosexual, particularly diseases affecting the genitals, because they have limited access to services as a result of prejudice and discrimination on grounds of sexual orientation present in the attitudes of the area professionals. |
| Steele, Tinmouth and Lu [12] England | PubMed | 489 homosexual women | Self-administered survey with application of structured questionnaires. | Disclosure of sexual orientation in health care reflects the difficulty of access and use of health services, which implies not seeking care early and increased susceptibility to health disorders. |
| Hoffman, Freeman and Swann. [15] USA | PubMed | 733 young homosexuals | Application of online structured questionnaire and accomplishment of focus groups. | The young LGBT population reveals the need for health professionals to provide health care not only in reducing sexual risk (by associating, culturally, sexual diseases to the homosexual population), but also in promoting health in family disputes. |
| Goldsen, Kim, Barkan, Muraco and Ellis. [14] USA | PubMed | 96,992 participants (homosexual, bisexual and heterosexual) over 50 years | Application of online structured questionnaire. | The LGBT population over 50 years experiences major challenges to reveal their sexual orientation in health services. This, coupled with the stigma of aging, it raises the barriers to care services, resulting in the onset of diseases on a larger scale. |
| Herrick, Stall, Chmiel, Guadamuz, Penniman, Shoptwan, Ostrow and Plankey. [13] USA | PubMed | 6,972 gay men | Prospective study with recruitment and application of structured interviews. | The internalized homophobia by the homosexual hinders the search for health services, bringing him a set of health problems, among them those of mental order. |
Source: SciELO, Lilacs, PubMed, and Cochrane
Legend: LGBT - Lesbians, Gays, Bisexuals and Transgenders