Healthcare access and sexual health literacy among LGBTQ+ people: A cross-sectional study in health zone 6, Thailand

Background Health inequities among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) populations remain a public health concern regarding healthcare access and sexual health literacy. This study examined sexual health literacy and factors associated with healthcare access among LGBTQ+ people in Thailand’s Health Zone 6. Methods A cross-sectional study was conducted among 451 LGBTQ+ people aged 18 years or older using multistage sampling. Data were collected using a structured questionnaire on demographic characteristics, sexual health behaviors, sexual health literacy, and healthcare access. Data were analyzed using descriptive statistics, univariable logistic regression, and multivariable logistic regression. Results Most participants were gay (30.6%), lived in rural areas (60.5%), and had monthly incomes of 15,001–30,000 Baht (56.3%). Sexual health literacy was at a good level (mean = 135.94 ± 24.99). Most participants reported adequate healthcare access (82.7%), while stigma and discrimination were the most common barriers to care (42.5%). In the adjusted model, living in Chonburi (AOR = 2.41, 95% CI: 1.22–4.76) or Samut Prakan (AOR = 3.12, 95% CI: 1.51–6.42), urban residence (AOR = 2.14, 95% CI: 1.29–3.56), gay identity (AOR = 3.84, 95% CI: 2.01–7.32), monthly income >30,000 Baht (AOR = 3.71, 95% CI: 1.27–10.55), self-payment for healthcare (AOR = 2.08, 95% CI: 1.11–4.00), and high sexual health literacy (AOR = 4.82, 95% CI: 1.96–11.87) were associated with greater healthcare access. Conclusions Healthcare access among LGBTQ+ populations is influenced by socioeconomic, geographic, and literacy-related factors. Strengthening LGBTQ+-affirming healthcare services and sexual health literacy programs may help reduce healthcare inequities in Thailand.