LGBT sexual health

There is a growing body of evidence that the syndemic health inequalities in the areas of mental health and substance and alcohol use in lesbian, gay, bisexual and transsexual (LGBT) people can drive greater inequalities in sexual health. This is a diverse population where additional individual behavioural factors and wider structural socioeconomic and legal factors also play a part. Lesbian women have increased susceptibility to bacterial vaginosis, while trans women and gay and bisexual men have greater vulnerability to sexually transmitted infections and human immunodeficiency virus compared with cis-gendered heterosexuals. Consideration must be given to non-genital clinical examination and sampling according to sexual history. Cultural competence and holistic clinical assessments, which include assessments of mental health, substance and alcohol use, can enable opportunities for interventions to prevent transmission of infection and improved well-being.