Continued disparities in lesbian, gay, and bisexual research funding at NIH.

Since its inception, the National Institutes of Health (NIH) has possibly spent more dollars on research to cure and treat homosexuality and “gender identity disorder” than to understand and address the concerns of lesbian, gay, and bisexual (LGB) individuals. Previous articles, including the one by Coulter et al.1 from earlier this year, have documented this lack of attention on the real and pressing concerns of these communities extending beyond HIV/AIDS. Our analysis of NIH’s fiscal year 2012 funding portfolio supports the findings of previous publications summarizing the bleak state of funding for LGB health research, providing more detailed information regarding the trends of funding at the institute and center level, for different activity codes, dollar amounts allocated, and study section or review panel. Of the 78 827 funded projects described in RePORTER at the time of study, only 26 were non-HIV LGB health related; seven were newly funded and 19 were continuing projects. Non-HIV LGB projects represented less than 0.05% of each of the total projects within the 13 activity codes represented (Table 1). The state of research grants is particularly disheartening; only 10 of the 27 221 R01s awarded in fiscal year 2012 represented non-HIV LGB research. TABLE 1— Actual and Financial Representation of Non-HIV Lesbian, Gay, and Bisexual (LGB) Projects as Part of Fiscal Year 2012 Overall National Institutes of Health (NIH) Funding Portfolio Listed by Activity Code Of the 27 institutes and centers at NIH, 20 awarded funding to zero non-HIV LGB projects and none devoted more than 0.05% of its funding toward these topics. The National Institute of Child Health and Human Development administered funding to the greatest number of projects (11, 0.31% of its portfolio) while the National Institute on Alcohol Abuse and Alcoholism awarded the greatest percentage of non-HIV LGB projects at 0.49% (six projects). The National Institute on Aging, the National Institute on Deafness and Other Communication Disorders, and the National Institute on Minority Health and Health Disparities each administered funding to only one project. In eliminating HIV-related studies from our analysis, we hoped to see a more equitable distribution of health topics funded than discovered by Coulter et al.1 NIH lists 237 distinct Research, Condition, and Disease Categorization categories, 43 of which were represented (Table A, available as a supplement to this article at http://www.apha.org). While there is a somewhat wide range of topics covered, it is not deep. Twenty-seven of these spending categories are represented by only one or two studies. Many of the categories related to topics highlighted by the Institute of Medicine report2 as priorities for research, such as cancer, adolescent sexual activity, sexually transmitted infections or herpes, and interventions related to homicide and substance abuse among sexual minority groups are not receiving funding outside of the context of HIV/AIDS. Our findings suggest that individual LGB health projects may not be underfunded, as the proportion of funding resembles the proportion of projects per activity code. However, well-funded, single projects on a sampling of topics fail to reveal the full picture of LGB health. The historical funding trends have contributed to the de facto definition of LGB health research as HIV research. Current voids of relevant research within institutes and centers, disease categories, and activity codes, now uncovered, are opportunities to contribute to a broader definition of health and addressing the other pressing health concerns of this population.