Social Marginalization and Health Service Utilization among MSM and Transgender Women in San Salvador, El Salvador

Katherine Andrinopoulos, Tulane University
Flor de Maria Hernandez, TEPHINET
Maria Elena Guardado, TEPHINET

A cross sectional study using respondent driven sampling among men who have sex with men (n=506) and transgender women (n=164) was conducted in San Salvador (N=670, total sample) to better understand health service utilization (HSU) among this population. Participants reported physical and verbal abuse (21.6%), sexual assault (20.8%), contemplation of suicide (26.6%), illicit substance use (15.3%), and binge drinking (60.5%). Only 52.9% had disclosed their sexual orientation to family, and only 7.7% to a healthcare provider. Multivariate analysis indicate a positive association between HSU and disclosure of sexual orientation to family (aOR 2.84), a healthcare provider (aOR 3.53), and access to a healthcare provider supportive sexual minorities (aOR 3.30). HSU was negatively associated with higher levels of discrimination from a health provider (aOR 0.42). Social marginalization of sexual minorities should be addressed within the health system and wider community to increase HSU.