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Haines HM, Fields EL, Alvarenga A, Yang Y, Shorrock F, Reed C, Armington G, Gaydos CA, Manabe YC, Arrington-Sanders R. Improving Access to Care Through Youth-Focused Virtual Sexual Health Navigation. J Adolesc Health 2024; 75:155-161. [PMID: 38597840 PMCID: PMC11180585 DOI: 10.1016/j.jadohealth.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 02/12/2024] [Accepted: 02/16/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE Gender and sexually diverse adolescents and young adults in Baltimore City, Maryland, are disproportionately impacted by HIV. The Virtual and Online Integrated Sexual Health Services for Youth program is a health navigation program which combines virtual sexual health service delivery and health navigation to link youth at risk for HIV acquisition to HIV testing/prevention and sexual healthcare services. METHODS Youth between 13 and 26 years old and residing in the Baltimore area were eligible to participate in the program. Demographic and engagement data from 238 youth (average age 21.4, SD = 2.5) who requested navigation were collected and recorded in a Health Insurance Portability and Accountability Act (HIPAA)-secure medical database and examined for associations between demographics, referral source, and the number of navigational services to which they were linked. Focused populations were defined as residents of high HIV prevalence zip codes who identify as sexual and gender diverse youth. RESULTS Receipt of navigational services was significantly associated with self-identifying as sexually diverse. A multivariate regression revealed a significant association between the count of navigational services a youth was linked to and recording one's sexual orientation, identifying as a cisgender male, and residing in a high HIV-prevalence zip code. DISCUSSION Virtual health navigation has the potential to engage priority populations, including sexual and gender diverse youth. By refining linkage and identification approaches to health navigation, future outreach attempts can be tailored to support vulnerable communities, with the potential to improve sexual healthcare access.
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Affiliation(s)
- Haley M Haines
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Errol L Fields
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Aubrey Alvarenga
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Yeng Yang
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Fiona Shorrock
- Johns Hopkins Hospital Children's Center, Baltimore, Maryland
| | - Christopher Reed
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Gretchen Armington
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Charlotte A Gaydos
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Yukari C Manabe
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Renata Arrington-Sanders
- Division of Adolescent and Young Adult Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland; Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, Maryland; Craig-Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Lee JJ, Wang L, Vo K, Gonzalez C, Orellana ER, Kerani RP, Katz DA, Sanchez TH, Graham SM. Characterizing the Communication Networks of Spanish- and English-Speaking Latinx Sexual Minority Men and Their Roles in Pre-Exposure Prophylaxis Uptake. JOURNAL OF HEALTH COMMUNICATION 2024:1-14. [PMID: 38872332 DOI: 10.1080/10810730.2024.2366498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
While pre-exposure prophylaxis (PrEP) has demonstrated efficacy in preventing HIV transmission, disparities in access persist in the United States, especially among Hispanic/Latinx sexual minority men (SMM). Language barriers and differences in how Latinx SMM obtain information may impact access to PrEP and HIV prevention. This study used data from the 2021 American Men's Internet Survey (AMIS) to examine differences in communication networks and PrEP use among Latinx SMM by primary language (Spanish vs. English). We examined the associations between Latinx SMM's individual- and meso-level communication networks and PrEP-related outcomes using modified Poisson regression with robust variances. Spanish-speaking Latinx SMM in the study were less likely to test for HIV, be aware of PrEP, and use daily PrEP, compared to English-speaking participants. Sexuality disclosure to a healthcare provider was positively associated with PrEP uptake among all participants and predicted STI testing over the past 12 months among English-speaking Latinx SMM. Findings highlight disparities in PrEP awareness and uptake among Latinx SMM, especially among those whose primary language is Spanish. Addressing these disparities through targeted interventions, including improved communication with healthcare providers, may help facilitate PrEP access and use in this population.
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Affiliation(s)
- Jane J Lee
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Liying Wang
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Katie Vo
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Carmen Gonzalez
- Department of Communication, University of Washington, Seattle, Washington, USA
| | - E Roberto Orellana
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Roxanne P Kerani
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - David A Katz
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Travis H Sanchez
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Susan M Graham
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
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3
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Karris MY, Lau M, Blumenthal J. Preventive and Sexual Health in LGBTQ+ Older Adults. Clin Geriatr Med 2024; 40:223-237. [PMID: 38521594 DOI: 10.1016/j.cger.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
Sexual health is an important but often overlooked health concern of LGBTQ + older adults. Multiple factors influence sexual health including intersecting identities; adverse life events; coping mechanisms; and psychological, social, and physical health domains. Thus, the use of a culturally competent and comprehensive person-centered approach to sexual health is warranted. In this review, we discuss approaches to engaging LGBTQ + older adults to ensure they are able to achieve their sexual health priorities and prevent new human immunodeficiency virus infections. We also discuss doxycycline postexposure prophylaxis to prevent other sexually transmitted infections and the impact of chemsex.
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Affiliation(s)
- Maile Young Karris
- Department of Medicine, University of California San Diego, San Diego, CA, USA.
| | - Megan Lau
- Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Jill Blumenthal
- Department of Medicine, University of California San Diego, San Diego, CA, USA
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Valli JL, Shearer K, Zachry AH, Weisser-Pike O, Boughter JD. A Missing Piece of Occupational Therapy Education: Attitudes About Sex. Occup Ther Health Care 2024:1-16. [PMID: 38557162 DOI: 10.1080/07380577.2024.2325069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/26/2024] [Indexed: 04/04/2024]
Abstract
Following a lecture on sexual health and function, occupational therapy students were surveyed regarding their past sex education and their comfort level with the topic of sex. Students indicated a lack of sexual education received from parents/guardians and a prevalence of fear-based education from formal or informal sources. Results reflected a significant increase in students' perceived comfort level with the topic following the lecture from a provider trained and certified in sexual health. As sexuality falls within the domain of occupational therapy, these results suggest a need for comprehensive sex education taught to students by qualified instructors.
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Affiliation(s)
- Jennifer L Valli
- Department of Urology, University of TN Health Science Center, Memphis, TN, USA
| | - Katie Shearer
- School of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Anne H Zachry
- Department of Occupational Therapy, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Orli Weisser-Pike
- Department of Occupational Therapy, University of Tennessee Health Science Center, Memphis, TN, USA
| | - John D Boughter
- Department of Anatomy & Neurobiology, University of Tennessee Health Science Center, Memphis, TN, USA
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5
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Saunders RK, Carr DC, Burdette AM. Health Care Stereotype Threat and Sexual and Gender Minority Well-Being. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024; 65:20-37. [PMID: 37905532 DOI: 10.1177/00221465231205549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Sexual and gender minorities (SGMs) have experienced progressive change over the last 50 years. However, this group still reports worse health and health care experiences. An innovative survey instrument that applies stereotype threat to the health care setting, health care stereotype threat (HCST), offers a new avenue to examine these disparities. We harmonized two national probability data sets of SGMs-Generations and TransPop-capturing 503 gay men, 297 lesbians, 467 bisexuals, and 221 trans people. Using these data, we, first, explored how HCST's association with self-rated health and psychological distress changed while considering more established constructs: discrimination and stigma. Second, we examined how HCST's association varied across SGM groups. Results suggest that HCST is a unique predictor net of the associations with discrimination and stigma. Furthermore, results highlight the more consequential associations for trans people on well-being compared to gay men. We discuss implications of these findings for future research and potential interventions.
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Affiliation(s)
- R Kyle Saunders
- Knowli Data Science, Tallahassee, FL, USA
- Florida State University, Tallahassee, FL, USA
| | - Dawn C Carr
- Florida State University, Tallahassee, FL, USA
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Hascher K, Jaiswal J, LoSchiavo C, Ezell J, Duffalo D, Greene RE, Cox A, Burton WM, Griffin M, John T, Grin B, Halkitis PN. Lack of Informed and Affirming Healthcare for Sexual Minority Men: A Call for Patient-Centered Care. J Gen Intern Med 2024:10.1007/s11606-024-08635-8. [PMID: 38308157 DOI: 10.1007/s11606-024-08635-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 01/16/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Sexual minority men (SMM) face severe health inequities alongside negative experiences that drive avoidance of medical care. Understanding how SMM experience healthcare is paramount to improving this population's health. Patient-centered care, which emphasizes mutual respect and collaboration between patients and providers, may alleviate the disparaging effects of the homophobia that SMM face in healthcare settings. OBJECTIVE To explore how SMM perceive their experiences with healthcare providers and how care can most effectively meet their needs. DESIGN Semi-structured qualitative interviews focused on healthcare experiences, pre-exposure prophylaxis (PrEP), and HIV-related beliefs were conducted between July and November 2018. PARTICIPANTS The study included a sample of 43 young adult SMM (ages 25-27), representing diverse socioeconomic, racial, and ethnic backgrounds, in New York City. APPROACH Researchers utilized a multiphase, systematic coding method to identify salient themes in the interview transcripts. KEY RESULTS Analyses revealed three main themes: (1) SMM perceived that their clinicians often lack adequate skills and knowledge required to provide care that considers participants' identities and behaviors; (2) SMM desired patient-centered care as a way to regain agency and actively participate in making decisions about their health; and (3) SMM felt that patient-centered care was more common with providers who were LGBTQ-affirming, including many who felt that this was especially true for LGBTQ-identified providers. CONCLUSIONS SMM expressed a clear and strong desire for patient-centered approaches to care, often informed by experiences with healthcare providers who were unable to adequately meet their needs. However, widespread adoption of patient-centered care will require improving education and training for clinicians, with a focus on LGBTQ-specific clinical care and cultural humility. Through centering patients' preferences and experiences in the construction of care, patient-centered care can reduce health inequities among SMM and empower healthcare utilization in a population burdened by historic and ongoing stigmatization.
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Affiliation(s)
- Kevin Hascher
- Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Jessica Jaiswal
- Department of Family and Community Medicine, University of Alabama, Birmingham School of Medicine, Birmingham, AL, 35294, USA.
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, 06510, USA.
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA.
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
| | - Caleb LoSchiavo
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
| | - Jerel Ezell
- Department of Community Health Sciences, UC Berkeley, Berkeley, CA, 94720, USA
- Center for Cultural Humility, UC Berkeley, Berkeley, CA, 94720, USA
| | - Danika Duffalo
- School of Medicine, Creighton University, Phoenix, AZ, USA
| | - Richard E Greene
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, 10001, USA
| | - Amanda Cox
- Culverhouse College of Business, University of Alabama, Tuscaloosa, AL, USA
| | - Wanda M Burton
- Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, 35401, USA
| | - Marybec Griffin
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
| | - Tejossy John
- Department of Family and Community Medicine, University of Alabama, Birmingham School of Medicine, Birmingham, AL, 35294, USA
| | - Benjamin Grin
- Department of Primary Care, Kansas City University College of Osteopathic Medicine, Kansas City, MO, 64106, USA
| | - Perry N Halkitis
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
- Department of Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ, 07102, USA
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Lin E, Sleboda P, Rimel BJ, Chen JT, Hernandez DV, Datta GD. Sexual orientation and gender identity inequities in cervical cancer screening by race and ethnicity. Cancer Causes Control 2024; 35:133-151. [PMID: 37599335 PMCID: PMC10764448 DOI: 10.1007/s10552-023-01771-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 07/30/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND In the United States, inequities in preventive health behaviors such as cervical cancer screening have been documented. Sexual orientation, gender identity, and race/ethnicity all individually contribute to such disparities. However, little work has investigated their joint impact on screening behavior. METHODS Using sampling weighted data from the 2016 and 2018 Behavioral Risk Factor Surveillance System, we assessed differences in two metrics via chi-square statistics: 1) lifetime uptake, and 2) up-to-date cervical cancer screening by sexual orientation and gender identity, within and across racial/ethnic classifications. RESULTS Within all races, individuals who identify as members of sexual and gender minority (SGM) communities reported higher rates of never being screened (except for Black transgender men) than straight or cisgender individuals (p < 0.0001). [*START* Across all races, the Asian/Pacific Islander transgender population (32.4%; weighted n (w.n.) = 1,313) had the lowest proportion of lifetime screening, followed by the Asian/Pacific Islander gay/lesbian (53.0%, w.n. = 21,771), Hispanic transgender (58.7%; w.n. = 24,780), Asian/Pacific Islander bisexual (61.8%, w.n. = 54,524), and Hispanic gay/lesbian (69.6%, w.n. = 125,781) populations. *END*] Straight or cisgender Non-Hispanic White (w.n. = 40,664,476) individuals had the highest proportion of lifetime screening (97.7% and 97.5%, respectively). However, among individuals who had been screened at least once in their lifetime, identifying as SGM was not associated with a decreased proportion of up-to-date screening within or between races. CONCLUSIONS Due to small sample sizes, especially among Asian/Pacific Islander and Hispanic populations, confidence intervals were wide. Heterogeneity in screening participation by SGM status within and across racial/ethnic groups were observed. IMPACT These screening disparities reveal the need to disaggregate data to account for intersecting identities and for studies with larger sample sizes to increase estimate reliability.
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Affiliation(s)
- Emmeline Lin
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, 90069, USA
| | - Patrycja Sleboda
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, 90069, USA
| | - Bobbie J Rimel
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, 90069, USA
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School Of Public Health, Boston, MA, 02115, USA
| | - Diana V Hernandez
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, 90069, USA
| | - Geetanjali D Datta
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, 90069, USA.
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.
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Lo IPY, Liu EH, Lai DWL, Yan E. Reflexive Planning for Later Life: Minority Stress and Aging Challenges among Midlife Chinese Lesbians and Gay Men. JOURNAL OF HOMOSEXUALITY 2023; 70:3470-3492. [PMID: 35849423 DOI: 10.1080/00918369.2022.2095242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examines how Chinese lesbians and gay men make sense of the prospect of growing old and plan for later life in Hong Kong, where same-sex relationships are yet to be legally recognized. Drawing on in-depth narrative interviews, the results show that lesbians and gay men in midlife reported a range of previous, current, and anticipated challenges associated with the stigma attached to homosexuality. These, in turn, shaped their ways of perceiving and planning for later life. Three forms of reflexivity in response to minority stress and the prospect of aging were identified: coping with fears of aging alone, striving for self-mastery, and planning ahead with feelings of wariness. Participants' concerns and plans around aging demonstrated differing degrees of reflexivity, through which they attempted to navigate family norms and structural constraints and find ways to accumulate resources for later life. Meanwhile, their heightened sense of uncertainty and insecurity showed that their perceptions and experiences of aging were influenced by minority stress and material, familial, and socio-political circumstances. This article builds a constructive dialogue between sexuality and aging studies by unraveling both the aging insecurity and capacities for reflexive planning among an oft-neglected group of sexual minority people in midlife.
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Affiliation(s)
- Iris Po Yee Lo
- Department of Applied Social Sciences, the Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Emma H Liu
- Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Daniel W L Lai
- Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Elsie Yan
- Department of Applied Social Sciences, the Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Lin E, Sleboda P, Rimel BJ, Datta GD. Inequities in colorectal and breast cancer screening: At the intersection of race/ethnicity, sexuality, and gender. SSM Popul Health 2023; 24:101540. [PMID: 37920304 PMCID: PMC10618777 DOI: 10.1016/j.ssmph.2023.101540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Abstract
Objective To investigate the joint impact of sexual orientation, gender identity, and race/ethnicity on colorectal and breast cancer screening disparities in the United States. Methods Utilizing sampling weighted data from the 2016 and 2018 Behavioral Risk Factor Surveillance System, we assessed differences in two metrics via chi-square statistics: 1) lifetime uptake, and 2) up-to-date colorectal and breast cancer screening by sexual orientation and gender identity, within and across racial/ethnic classifications. Results Within specific races/ethnicities, lifetime CRC screening was higher among gay/lesbian (within NH-White, Hispanic, and Asian/Pacific Islander) and bisexual individuals (Hispanic) compared to straight individuals, and lowest overall among transgender women and transgender nonconforming populations (p < 0.05). Asian transgender women had the lowest lifetime CRC screening (13.0%; w.n. = 1,428). Lifetime breast cancer screening was lowest among the Hispanic bisexual population (86.6%; w.n. = 26,940) and Hispanic transgender nonconforming population (71.8%; w.n. = 739); within all races, SGM individuals (except NH-White, Hispanic, and Black bisexual populations, and NH-White transgender men) had greater breast cancer screening adherence compared to straight individuals. Conclusions Due to small, unweighted sample sizes, results should be interpreted with caution. Heterogeneity in screening participation by SGM status within and across racial/ethnic groups were observed, revealing the need to disaggregate data to account for intersecting identities and for studies with larger sample sizes to increase estimate reliability.
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Affiliation(s)
- Emmeline Lin
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, 90069, USA
| | - Patrycja Sleboda
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, 90069, USA
| | - Bobbie J. Rimel
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, 90069, USA
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Geetanjali D. Datta
- Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, 90069, USA
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
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10
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Komlenac N, Langmann F, Hochleitner M. Explorative Questionnaire Study About Education with Regard to the Health of Sexual Minorities at an Austrian Medical University. JOURNAL OF HOMOSEXUALITY 2023; 70:2955-2977. [PMID: 35700380 DOI: 10.1080/00918369.2022.2085937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Physicians can play a critical role in helping lesbian, gay, and bisexual-identified (LGB) individuals face minority stress. The current questionnaire study among 305 medical students (62.6% women/37.4% men; Mage = 23.4, SD = 3.2) assessed whether medical students learn about LGB-specific concepts at an Austrian medical university. Students reported that their education contained little content about LGB-specific concepts. The majority of students did not hold negative attitudes toward homosexuality and they would like a larger range of courses concerning LGB-specific topics. The barrier most strongly associated with the intention to ask future patients about their sexual orientation was the belief that sexual orientation was irrelevant for clinical practice. Future education programs on LGB-specific topics may not need to focus on reducing negative attitudes toward sexual minorities, but should contain more facts on LGB individuals' specific healthcare needs and explain to students why a patient's sexual orientation is important to healthcare.
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Affiliation(s)
- Nikola Komlenac
- Gender Medicine Unit, Medical University of Innsbruck, Innsbruck, Austria
| | - Flora Langmann
- Gender Medicine Unit, Medical University of Innsbruck, Innsbruck, Austria
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11
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Ohtsuka MS, Shannon K, Krüsi A, Lee M, King D, Braschel M, Deering K. Prevalence and Correlates of HIV Disclosure Without Consent Among Women Living With HIV in Metro Vancouver, Canada. AIDS Patient Care STDS 2023; 37:351-360. [PMID: 37432310 PMCID: PMC10354302 DOI: 10.1089/apc.2023.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023] Open
Abstract
This study identified the prevalence and perpetrators of HIV disclosure without consent, and social-structural correlates, among women living with HIV (WLWH). Data were drawn from 7 years (September 14 to August 21) of a longitudinal community-based open cohort of cis and trans WLWH living and/or accessing care in Metro Vancouver, Canada. The study sample included 1871 observations among 299 participants. Overall, 160 (53.3%) women reported lifetime HIV disclosure without consent at baseline, and 115 (38.5%) reported HIV disclosure without consent in the previous 6 months during 7 years of follow-up. In a subanalysis (n = 98), the most common perpetrators of HIV disclosure without consent were friends, people in the community, family, health professionals, and neighbors. In multivariable logistic regression analysis with generalized estimating equations, recent (last 6 months) housing insecurity [adjusted odds ratio (AOR): 1.43, 95% confidence interval: (1.10-1.86)], minoritized sexual identities (LGBQ2S) [AOR: 1.84 (1.22-2.78)], recently being treated, monitored, or diagnosed with depression, anxiety, or post-traumatic stress disorder [AOR: 1.37 (0.98-1.92)], and experiencing physical symptoms related to HIV [AOR: 1.75 (1.25-2.44)] was positively associated with recent disclosure without consent. In a context where HIV nondisclosure before sex is criminalized unless viral load is low and a condom is used, it is concerning that a large proportion of women have experienced HIV disclosure without consent. Laws should focus on protecting rights of WLWH, promoting equity, guaranteeing sexual and reproductive rights, and ensuring access to essential services and privacy. Findings highlight the need for trauma-informed approaches among health and housing services that are responsive to intersections of violence and stigma, and include a focus on confidentiality, autonomy, and safe disclosure practices.
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Affiliation(s)
- Mika S. Ohtsuka
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Kate Shannon
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Andrea Krüsi
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Melanie Lee
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
| | - Desire King
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
| | | | - Kathleen Deering
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
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12
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Why do queer men experience negative body image? A narrative review and testable stigma model. Body Image 2023; 45:94-104. [PMID: 36867966 DOI: 10.1016/j.bodyim.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 03/05/2023]
Abstract
Queer men (i.e., men who are not heterosexual; sexual minority men) are disproportionately affected by negative body image - they experience greater body dissatisfaction are more likely to develop eating disorders than heterosexual men. While existing literature has examined individual-level predictors of negative body image for queer men, less is known about why queer men as a group are disproportionately affected by negative body image. By synthesising existing theoretical frameworks, research, policy, and media reporting, this narrative review moves towards an understanding of systemic-level negative body image for queer men. Through the lens of hegemonic masculinity, we explain how systemic experiences of stigma work to inform unattainable appearance standards for queer men, and how these standards then contribute to pervasive negative body image concerns among this community. Next, we describe how systemic stigma works to exacerbate negative health outcomes for queer men with body image concerns. Finally, we present a synthesized model of the processes outlined in this review, articulate testable predictions for future studies, and describe practical implications that could be widely employed to improve body image for queer men. Our review is the first to propose a comprehensive explanation of systemic negative body image for queer men.
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Scott SB, Gaska KA, Knopp K, Do QA, Yang JP. Sexual Minority Women and Discriminatory Health Care Experiences: An Intersectional Evaluation Across Race and Ethnicity. Womens Health Issues 2023; 33:160-166. [PMID: 36517367 DOI: 10.1016/j.whi.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 10/05/2022] [Accepted: 10/31/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Health care discrimination contributes to medical mistrust among marginalized communities. Sexual minority women of color (SM-WOC) are marginalized because of the intersection of their sexual orientation, gender, and race/ethnicity and regularly report poor health care experiences at the intersection of these identities. However, research has yet to quantify differences in the prevalence of reported health care discrimination across SM women of various racial/ethnic backgrounds. As such, this study compared the rates of discriminatory treatment during the most recent medical appointment between SM-WOC (Black, Hispanic, Asian American, Native American) and White SM women. METHODS We used nationally representative data from the Association of American Medical Colleges survey of health care services. Data were collected from 2010 to 2019 from N = 1,499 SM women (n = 458 SM-WOC). Binary logistic regressions compared frequencies of reported identity-based discrimination between each minoritized racial/ethnic group to White SM women. RESULTS Across the sample, 33% of SM-WOC reported discrimination during their last medical appointment compared with 19% of White SM women. Discriminatory treatment was more common among every minoritized racial/ethnic group of SM women compared with White SM women, with variability in frequency of specific forms of identity-based discrimination across minoritized racial/ethnic groups. CONCLUSIONS Although discriminatory treatment during the last medical appointment was common for all SM women, prevalence was higher for SM-WOC compared with White SM women. Findings have important implications for policy and practice to reduce health disparities, such as targeted interventions for SM-WOC and provider trainings in cultural humility, implicit bias, and common microaggressions.
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Affiliation(s)
- Shelby B Scott
- Department of Psychology, University of Texas at San Antonio, San Antonio, Texas.
| | - Karie A Gaska
- Department of Clinical Foundations, Ross University School of Medicine, Bridgetown, Barbados
| | - Kayla Knopp
- Research Service, VA San Diego Health Care System, San Diego, California
| | - Quyen A Do
- Department of Psychology, University of Texas at San Antonio, San Antonio, Texas
| | - Joyce P Yang
- Department of Psychology, University of San Francisco, San Francisco, California
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14
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Conyers H, Wu D, Kpokiri E, Zhang Q, Hinchliff S, Shakespeare T, Tucker J. Barriers and facilitators to accessing sexual health services for older LGBTQIA+ adults: a global scoping review and qualitative evidence synthesis. Sex Health 2023; 20:9-19. [PMID: 36653021 DOI: 10.1071/sh22144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/15/2022] [Indexed: 01/20/2023]
Abstract
The number of older adults identifying as lesbian, gay, bisexual, transgender and other sexual and gender diverse identities (LGBTQIA+) is growing as populations age and social environments become more accepting. This study uses a global evidence synthesis to understand perceived barriers and facilitators to access to sexual healthcare globally for older LGBTQIA+ adults. We used a scoping review and qualitative evidence synthesis. Embase, PubMed and PsycInfo were searched with terms related to LGBTQIA+ populations, adults aged 45years, and sexual health care. We used the Cochrane Handbook and the review protocol was registered. Primary and secondary textual data were coded and grouped into themes using PRISMA-SCR and the Minority Stress Model. The certainty of review findings was assessed using the GRADE-CERQual approach. We identified 19 studies and 15 were included in the qualitative evidence synthesis. All studies were from high-income countries. Heterocentricity and male-centricity of sexual healthcare services contributed to feelings of exclusion for older LGBTQIA+ adults. Both anticipated and enacted stigma from healthcare providers resulted in older LGBTQIA+ adults, especially those with chronic conditions, avoiding health services (seven studies each, low certainty). Older LGBTQIA+ adults have unique sexual health needs and may feel their age empowers them to access appropriate care (four studies, low certainty). This review highlights the need for additional research and interventions to improve sexual health services for older LGBTQIA+ adults. Practical strategies to make sexual health less heterocentric (e.g. gender neutral signage) may increase uptake of essential sexual health services.
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Affiliation(s)
- Hayley Conyers
- London School of Hygiene and Tropical Medicine, London, UK
| | - Dan Wu
- Department of Clinical Research at the London School of Hygiene and Tropical Medicine, London, UK
| | - Eneyi Kpokiri
- London School of Hygiene and Tropical Medicine, London, UK
| | - Qihang Zhang
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Tom Shakespeare
- Disability Research, International Centre for Evidence in Disability at the London School of Hygiene and Tropical Medicine, London, UK
| | - Joseph Tucker
- London School of Hygiene and Tropical Medicine, London, UK; and University of North Carolina, Chapel Hill, NC, USA
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15
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Bogen KW, Jones HR, Lorenz TK. Relational and Trait Factors Mediate the Associations between Women's Intoxication-Related Unwanted Sexual Experiences, Pleasure, and Desire. JOURNAL OF SEX RESEARCH 2022; 59:1175-1191. [PMID: 35262426 PMCID: PMC9458769 DOI: 10.1080/00224499.2022.2030661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Despite documented negative sexual health sequelae of unwanted sexual contact (USC), it is unclear why individuals who have experienced USC within the context of intoxication (intoxication-related USC) are at particular risk for poor sexual functioning. Intoxication-related USC may impact relational factors like relationship satisfaction, as trauma symptoms interfere with emotional closeness during sex. Additionally, although individual traits - such as sexual excitation and sensation seeking - affect the relationship between trauma and sexual functioning, it is unknown whether these factors differentially impact those who have experienced intoxication-related USC. Finally, because presence of a partner may evoke trauma-related symptoms during partnered (dyadic) sexual activity, mediators may differ across solitary versus dyadic sexual pleasure and desire. We tested relational and individual trait mediators of the association between intoxication-related USC and solitary and dyadic sexual pleasure and desire in a sample of heterosexual and sexual minority women. Trait factors consistently mediated the association between intoxication-related USC and both dyadic and solitary desire and pleasure, while relational factors such as emotional closeness were inconsistently related to sexual wellbeing. If replicated, these findings would suggest that trait factors may be useful targets for clinical sexual wellness interventions among sexuality-diverse women who have experienced intoxication-related USC.
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Affiliation(s)
- Katherine W. Bogen
- University of Nebraska – Lincoln, Department of Psychology; 238 Burnett Hall, Lincoln, NE 68588
- University of Nebraska – Lincoln, Center for Brain, Biology, and Behavior; C89 East Stadium, Lincoln, NE 68588
| | - Harper R. Jones
- University of Nebraska – Lincoln, Department of Psychology; 238 Burnett Hall, Lincoln, NE 68588
- University of Nebraska – Lincoln, Center for Brain, Biology, and Behavior; C89 East Stadium, Lincoln, NE 68588
| | - Tierney K. Lorenz
- University of Nebraska – Lincoln, Department of Psychology; 238 Burnett Hall, Lincoln, NE 68588
- University of Nebraska – Lincoln, Center for Brain, Biology, and Behavior; C89 East Stadium, Lincoln, NE 68588
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16
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Intersectional Stigma and Sexual Health Among Sexual and Gender Minority Women. CURRENT SEXUAL HEALTH REPORTS 2022. [DOI: 10.1007/s11930-022-00338-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Burdick S, Nicholus S. A Pilot Study of Latinx Lesbian, Gay, and Bisexual Adolescent Patients' Goal Prioritizations in Patient-Provider Sexual Orientation and Health Disclosures. HEALTH COMMUNICATION 2022; 37:1215-1228. [PMID: 34334073 DOI: 10.1080/10410236.2021.1957213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This pilot study provides a theoretically-driven explanation of the dilemmas young Latinx LGB patients may experience surrounding disclosure of personal sexual orientation and sexual health information to a health care provider (HCP). The research team conducted face-to-face semi-structured interviews with LGB Latinx individuals (N= 29) ages 18-22 about their experiences, concerns, and preferences regarding divulging this type of information to an HCP. Interviews were thematically analyzed to identify (a) participants' instrumental, identity, and relational goals during the potential and real disclosures and (b) patterns of how the participants prioritized their goals. Thematic analysis revealed four distinct goal prioritization patterns detailed in this study. Participants' goals were shaped by (a) cultural upbringing, (b) beliefs about human sexuality, (c) perception of data leakage risk, (d) individual personality, (e) medical situation, and (f) the geographic location of clinic.
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Affiliation(s)
- Suzanne Burdick
- Department of Communication Studies, University of Texas at Austin
| | - Sarah Nicholus
- Women's, Gender, and Sexuality Studies, University of Texas at Austin
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18
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Tabaac AR, Sutter ME, Haneuse S, Agénor M, Bryn Austin S, Guss CE, Charlton BM. The interaction of sexual orientation and provider-patient communication on sexual and reproductive health in a sample of U.S. women of diverse sexual orientations. PATIENT EDUCATION AND COUNSELING 2022; 105:466-473. [PMID: 34023174 PMCID: PMC8594287 DOI: 10.1016/j.pec.2021.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 05/11/2023]
Abstract
OBJECTIVE Our goal was to examine associations among provider-patient communication, past-year contraceptive use and lifetime sexually transmitted infection. METHODS Data were analyzed cross-sectionally from 22,554 women in the Growing Up Today Study and Nurses' Health Study 3 between the follow-up period of 1996-2020. We used multivariable Poisson regression models adjusted for race/ethnicity, age in years, study cohort, and region of residence to obtain risk ratio (RR) associations and 95% confidence intervals (CI). RESULTS Provider-patient communication was associated with higher likelihood of using all methods of past-year contraceptive use (RRs ranging from 1.11 to 1.63) and lifetime STI diagnosis (RRs ranging from 1.18 to 1.96). Completely heterosexual women with no same-sex partners (referent) were 13% more likely than lesbians and 4% less likely than other groups to report a provider ever discussed their SRH. Significant interactions emerged between sexual minority status and provider-patient communication. Sexual minority women whose providers discussed their SRH were less likely to report contraceptive non-use in the past year (p < .0001). CONCLUSION Provider-patient communication may benefit sexual minority women's contraceptive practices and engagement with STI testing. PRACTICE IMPLICATIONS Differences in provider-patient SRH discussion by sexual orientation indicate lesbian women are not receiving the same attention in clinical encounters.
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Affiliation(s)
- Ariella R Tabaac
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Center for Gender Surgery, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Megan E Sutter
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA; Department of Obstetrics and Gynecology, NYU Grossman School of Medicine, New York, NY, USA.
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Madina Agénor
- Department of Community Health, Tufts University, Medford, MA, USA; Department of Obstetrics/Gynecology, Tufts University School of Medicine, Boston, MA, USA.
| | - S Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
| | - Carly E Guss
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Brittany M Charlton
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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LGBTQ+ Psychosocial Concerns in Nursing and Midwifery Education Programmes: Qualitative Findings from a Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111366. [PMID: 34769885 PMCID: PMC8582806 DOI: 10.3390/ijerph182111366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 12/30/2022]
Abstract
LGBTQ+ people experience significant physical and psychosocial health issues and concerns, and encounter barriers when accessing healthcare services. We conducted a mixed-methods research study across all Schools of Nursing and Midwifery in the United Kingdom and Ireland using a survey and qualitative interviews. This was to identify the current content within nursing and midwifery pre-registration programmes in relation to LGBTQ+ health and to identity best practice and education innovation within these programmes. The survey was completed by 29 academics, with 12 selected to participate in a follow-up in-depth qualitative interview. Analysis of the data from the survey and interviews identified five themes: there is variable programme content; academics are developing their own programmes with no clear consistency; LGBTQ+ health is being linked to equality and diversity; there are barriers to education provision; and these is some evidence of best practice examples. The findings of the study support the need to develop and implement a curriculum for LGBTQ+ health in nursing and midwifery pre-registration programmes with learning aims and outcomes. Academics need support and tools to prepare and deliver LGBTQ+ health content to nurses and midwives as they ultimately have the potential to improve the experiences of LGBTQ+ people when accessing healthcare.
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20
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[The European MSM Internet Survey as a basis for prevention work in Germany for men who have sex with men]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:1430-1439. [PMID: 34643744 PMCID: PMC8550191 DOI: 10.1007/s00103-021-03429-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 09/08/2021] [Indexed: 11/23/2022]
Abstract
Hintergrund Sexuelle Minderheiten sind in hohem Maße anfällig für sexuell übertragbare Infektionen (STI), psychische Probleme wie Depressionen und Suizidalität sowie für gesundheitliche und soziale Probleme, die mit Substanzkonsum assoziiert sind. Ziel der Arbeit Wir beschreiben ausgewählte Ergebnisse aus dem Europäischen MSM Internet Survey (EMIS) 2017, eine der größten Onlinebefragungen von Männern, die Sex mit Männern haben (MSM), und diskutieren deren Implikationen für die Prävention in Deutschland. Material und Methoden Das übergeordnete Ziel von EMIS-2017 war es, Daten für die Planung von HIV- und STI-Präventions- und -Behandlungsprogrammen zu erheben. Die Zielpopulation waren in Europa lebende MSM. Der Fragebogen enthielt Fragen zu Demografie, Morbiditäten, Verhalten, Bedarfen und Interventionen. Die deutschen Teilnehmer wurden von 10/2017 bis 01/2018 vor allem über 2 große Onlinedatingplattformen rekrutiert. Ergebnisse und Diskussion EMIS-2017 zeigt, dass MSM stark von psychischen Belastungen und STI betroffen sind. Jüngere MSM leiden verstärkt unter depressiven Störungen und Suizidalität, während bei älteren MSM der Konsum von Alkohol und anderen psychoaktiven Substanzen bedeutsam ist. MSM sind von STI stärker betroffen als Heterosexuelle. Viele STI verursachen keine oder nur untypische Beschwerden, daher wird ein Screening auf der Basis einer Risikoeinschätzung favorisiert. Für einen Teil der STI gibt es bislang keine medizinischen und/oder Public-Health-Erkenntnisse, die für eine Behandlung asymptomatischer Infektionen sprechen. EMIS-2017 identifizierte Bedarfe nach Untergruppen in Bezug auf Wissenslücken zu HIV-Post- und HIV-Präexpositionsprophylaxe (PEP, PrEP), Erreichbarkeit durch Informations- und Präventionsangebote sowie unzureichende Nutzung dieser Angebote. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00103-021-03429-3) enthalten.
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21
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Cipollina R, Sanchez DT. Identity cues influence sexual minorities' anticipated treatment and disclosure intentions in healthcare settings: Exploring a multiple pathway model. J Health Psychol 2021; 27:1569-1582. [PMID: 33678046 DOI: 10.1177/1359105321995984] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The present work experimentally examines how identity cues that signal minority inclusion contribute to sexual minorities' (SM) healthcare visit expectations. We find that minority representation cues reduced SM's (N = 188) expectations of a healthcare provider's bias and increased perceived provider cultural competency which was, in turn, associated with lower anticipated identity-based devaluation and greater sexual orientation disclosure comfort. Providers' diversity-valuing statements had mixed effects highlighting the importance of more concrete indicators of inclusion in this context. This work suggests that a lack of identity safety cues in healthcare settings may contribute to disparate health outcomes for sexual minority populations.
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22
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Burgess C, Batchelder A. Improving Clinical Research to Inform Advocacy Initiatives with Underserved Individuals. THE BEHAVIOR THERAPIST 2020; 43:235-241. [PMID: 35002016 PMCID: PMC8734961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
| | - Abigail Batchelder
- Harvard Medical School
- Massachusetts General Hospital
- The Fenway Institute, Fenway Health
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