Finding the answer to this question is the challenge that a research group at IDIAPJGol has set for itself. The question arises from studies conducted in North America that suggest that LGTBIQA+ people have higher rates of hypertension, diabetes, or dyslipidemia than heterosexual or cisgender individuals. According to these studies, the LGTBIQA+ population visits medical consultations less frequently due to fear of stigmatization or discrimination, which worsens their cardiovascular health. For example, it has been observed that the use of statins —medication to lower cholesterol— is almost half in the LGTBIQA+ population.
In our context, there is no data on the cardiovascular health of LGTBIQA+ people, as research on this group is still very limited and mostly focused on sexually transmitted diseases. For this reason, IDIAPJGol is launching the IRIS project, which aims to clarify the cardiovascular health of LGTBIQA+ people living in Catalonia.
The IRIS project has been funded by the Instituto de Salud Carlos III of the Ministry of Science and Innovation, under the title: “Lifestyle, risk factors, and cardiovascular disease in sexual and gender minorities: population-based study using primary care electronic records (IRIS Project).” The project is led by Dr. María García-Gil and Dr. Anna Ponjoan, both from the Vascular Health Research Group of Girona at IDIAPJGol. The goal is to compare the prevalence and incidence of lifestyle factors, risk factors, and cardiovascular diseases between the general population and the LGTBIQA+ population; medication use and healthcare resource utilization will also be compared between the two populations. To make this possible, the project will apply a method never before used in Europe to study LGTBIQA+ health: large clinical databases.
“In Catalonia we have one of the most powerful clinical databases in Europe: SIDIAP. It collects millions of records generated daily in primary care consultations and manages them so they can be used in scientific research in an anonymous and secure manner. SIDIAP has existed for 12 years, is internationally recognized, and with the platform we have already conducted many studies and publications. But until now it had never been used to study the LGTBIQA+ population, which is why the IRIS project is such a challenge,” explains Dr. María Gil-García, who knows this database well as she was its general coordinator. She adds: “We need about 800 LGTBIQA+ people to provide access to their anonymized clinical data through SIDIAP. Data confidentiality is guaranteed since SIDIAP depends on the Department of Health and the project has Ethics Committee certification. Therefore, we encourage all LGTBIQA+ people to participate in the study; without you, we cannot end the invisibility of this group in the medical field.”
A fundamental pillar of the IRIS project is the LGTBIQA+ perspective, reflected in the involvement of people from the community in various phases of the project. The study design was carried out with the participation of people who identify with the community, some of whom are linked to the PRISMA association, which works to promote the LGTBIQA+ perspective in the field of science.
Participation in the study will be online, requiring only a few clicks on a mobile device. On one hand, participants can give consent with a single click to share their anonymized clinical data with the IRIS project. On the other hand, also via mobile, they can send a link to three friends to invite them to participate in the study. In this way, the aim is to reach around 800 LGTBIQA+ participants, constituting the first European e-cohort to study cardiovascular health.
The interpretation of results will be conducted with the research team and a group of LGTBIQA+ people who will jointly construct the clinical message based on the data obtained in the project. Dissemination of these results will also involve associations from the community, so that LGTBIQA+ people can learn about the cardiovascular health status of this population. We believe this knowledge is crucial both for the empowerment of these individuals and to make the community visible in the medical sphere.
“The IRIS project is a unique opportunity to generate the first e-cohort of LGTBIQA+ people in Spain and Europe. This creates a new scenario for LGTBIQA+ health research, as this platform will substantially contribute to ending the invisibility of this group in the scientific field,” explains Dr. Anna Ponjoan.
