JMIR Publications

ABSTRACT

Background:

Hispanic/Latino sexual and gender minorities (SGM) are the fastest growing ethnic group of SGM in the U.S. Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among Hispanics/Latinos. SGM inequities in cardiovascular disease (CVD) risk have been identified as early as young adulthood; and minority stress has been identified as a potential mediator. Yet, small numbers of ethnic/racial minority participants in SGM studies have precluded examination of the intersections of sexual orientation, gender identity, and race/ethnicity.

Objective:

Minority Stress Models conceptualize relationships between minority stressors and health outcomes. In this study, we will (1) examine the influence of sexual orientation and gender identity on CVD risk among all Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants at visit 3 (V3, 2021-2024; N = ~9300); (2) model pathways from sexual orientation and gender identity to CVD risk through stigma, discrimination, and stress among a 1:2 matched sub-cohort of SGM and non-SGM participants at V3 (N~1680); and (3) examine the influence of resilience factors on SOGI and CVD risk relationships among sub-cohort participants at V3 (N~1680).

Methods:

This study will leverage existing data from the parent HCHS/SOL study while collecting new data on sexual orientation, gender identity, stigma, discrimination, stress, coping, social support, and CVD risk. Data analysis will follow the SGM Minority Stress Model in which excess stigma against SGM populations leads to minority stress that increases CVD risk. In this model, coping and social support serve as resilience factors that can mitigate the impact of minority stress on CVD risk. Cross-sectional and longitudinal regression models as well as structural equation models will be used to test these relationships. This project builds on existing data collected since 2008 in HCHS/SOL and collects new data for novel analyses.

Results:

This study was funded by the National Heart Lung and Blood Institute in March 2020. Recruitment is scheduled to begin in the first quarter of 2021 and continue through 2024.

Conclusions:

Understanding the influence of stigma-induced stress on CVD risk among Hispanic/Latino SGM has significant implications for the development of culturally-specific CVD risk reduction strategies. Study findings will be used to build on identified Hispanic/Latino cultural strengths to inform adaptation and testing of family and community acceptance interventions.