Within the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community, people of color (POC) disproportionately experience intimate partner violence (IPV). While shared decision-making (SDM)—a model of patient-provider communication—about IPV could benefit LGBTQ POC, its unique challenges merit consideration. This study identifies key factors affecting SDM between LGBTQ POC and healthcare providers surrounding IPV. LGBTQ POC participants ( n = 217) in Chicago and San Francisco completed surveys about demographic information, healthcare utilization, and IPV history. Individual interviews and focus groups were then conducted with a Chicago-based subset of participants ( n = 46) who identified as LGBTQ IPV survivors of color. Descriptive analyses were conducted of survey responses while focus group and interview transcripts were analyzed and thematically coded. Although 71% of survey participants experienced IPV, only 35% were asked about IPV in healthcare interactions within the previous year. Focus group and interview participants endorsed encounter-, patient-, and provider-centered factors affecting SDM around IPV. When IPV was discussed, patient-provider trust was essential while concordance of identities could either encourage or discourage IPV disclosure. Patients were hesitant to disclose IPV if they had never discussed their LGBTQ identity with their provider or thought providers would ignore their preferences for addressing IPV. Deterrents to SDM included providers denying the prevalence of IPV among LGBTQ individuals or lacking resources to support LGBTQ IPV survivors of color. This study highlights the identity-driven barriers that LGBTQ POC face in discussing IPV with providers. Utilizing SDM to discuss IPV with LGBTQ POC can better address the diverse health needs of this community. However, its success requires that providers acknowledge the diversity of experiences among this population, promote LGBTQ-inclusive practices, and identify resources welcome to LGBTQ POC.

中文翻译：

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影响医疗保健提供者与女同性恋、男同性恋、双性恋、跨性别者和有色人种酷儿之间关于亲密伴侣暴力的共同决策的因素

在女同性恋、男同性恋、双性恋、跨性别者和酷儿 (LGBTQ) 群体中，有色人种 (POC) 遭受亲密伴侣暴力 (IPV) 的比例尤其高。虽然有关 IPV 的共享决策 (SDM)（患者与提供者沟通的一种模式）可能有利于 LGBTQ POC，但其独特的挑战值得考虑。本研究确定了影响 LGBTQ POC 和 IPV 医疗保健提供者之间 SDM 的关键因素。芝加哥和旧金山的 LGBTQ POC 参与者（n = 217）完成了有关人口信息、医疗保健利用率和 IPV 历史的调查。然后对芝加哥的一部分参与者 (n = 46) 进行了个人访谈和焦点小组讨论，这些参与者被认定为 LGBTQ IPV 有色人种幸存者。对调查回复进行描述性分析，同时对焦点小组和访谈记录进行分析和主题编码。尽管 71% 的调查参与者经历过 IPV，但只有 35% 的人在上一年的医疗保健互动中被问及 IPV。焦点小组和访谈参与者认可影响 IPV 周围 SDM 的以遭遇、患者和提供者为中心的因素。在讨论 IPV 时，患者与提供者之间的信任至关重要，而身份一致性可能会鼓励或阻止 IPV 披露。如果患者从未与医疗服务提供者讨论过自己的 LGBTQ 身份，或者认为医疗服务提供者会忽视他们对 IPV 的偏好，那么他们就会犹豫是否披露 IPV。 SDM 的障碍包括提供者否认 LGBTQ 人群中 IPV 的流行，或缺乏支持有色人种 LGBTQ IPV 幸存者的资源。这项研究强调了 LGBTQ POC 在与提供商讨论 IPV 时面临的身份驱动障碍。利用SDM与LGBTQ POC讨论IPV可以更好地满足该社区多样化的健康需求。然而，它的成功要求提供者承认该人群经历的多样性，促进 LGBTQ 包容性做法，并确定欢迎 LGBTQ POC 的资源。