Risk and protective health behaviors among sexual minority females in Mumbai, Indi

Purpose: To understand the health risk and protective factors, with a focus on social support, of sexual minority females (SMF) in India. Introduction: SMF in India are marginalized and stigmatized. This likely affects their health, but we have scarce scientific literature on the health of SMF in India.;Methods: Using community-based participatory research principles, this project is a partnership with The Humsafar Trust. This is India's oldest and largest LGBT-advocacy organization. In a multi-method approach we used an online survey (N=49) and photo-elicitation interviews (N=18) to understand the health risk and protective factors of SMF in Mumbai. In photo-elicitation interviews, interview discussion is prompted by participants' photographs.;Results: There was a low prevalence of reproductive health services (including breast and cervical cancer screenings and STI testing). Survey participants reported a higher perceived need of mental health care services compared to physical health, and low awareness of mental health providers. Participants identified body image as a concern, with some describing pressure from their parents. Participants were involved with caregiving of their parents, sometimes to the detriment of their own health. PEI participants described negative experiences with mental health care, such as forced medication or conversion therapies. Substance use, especially alcohol and tobacco, was common and was linked to social support rituals. Social support included varying levels of mediated communication depending on level of intimacy. Participants constructed communities of support that included family members (most often mothers), friends (both sexual minority and heterosexual friends), as well as casual acquaintances (such as service workers at roadside stalls or bars).;Conclusion: Further research is needed to examine the prevalence of substance use and health care utilization with other populations of SMF. Social support systems may be strengthened through community dialogues on sexual identity acceptance and providing training on how to support healthy behaviors.