1
|
Liu X, Zhai M, Li J, Liu D, Yuan L, Wang H, Yu B, Yan H. Longitudinal effects of sexual minority stigma on depressive symptoms among young men who have sex with men: Distinguish between and within person effects. J Adolesc 2024. [PMID: 38769773 DOI: 10.1002/jad.12338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 04/17/2024] [Accepted: 05/02/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Young men who have sex with men (YMSM) may experience high levels of sexual minority stigma (SMS) and depressive symptoms (DS) over the world and in China. However, there is a lack of studies investigating the longitudinal effects of SMS on DS of YMSM, especially focusing on YMSM and separating the between-person and within-person effects. This study aimed to fill the said gaps. METHODS Study data were derived from a prospective cohort of 349 YMSM from central China (Wuhan, Changsha, Nanchang), the baseline survey was started in 2017 with one follow-up visit every year. SMS and DS were measured three times using valid and reliable instruments. The cross-lagged panel model (CLPM) and the random intercept CLPM (RI-CLPM) were used to examine the between-person and within-person concurrent and lagged effects, respectively. RESULTS Findings of CLPM revealed bidirectional associations between SMS and DS over time. RI-CLPM suggested that at the between-person level, SMS was significantly associated with DS, echoing the results of CLPM. However, this reciprocal relationship has not been found at the within-person level. CONCLUSION The associations between SMS and DS among YMSM at the population level is more significant than that at the individual level. We suggest that interventions should be against the adverse effects of cultural marginalization and systemic change the social concepts to reduce the amount of SMS in society.
Collapse
Affiliation(s)
- Xin Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Mengxi Zhai
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Jiayu Li
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Dan Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Liang Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Huihao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Bin Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Hong Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| |
Collapse
|
2
|
Wong CS, Chidgey A, Lee KL, Mo PKH, Wong T, Banerjee S, Ho V, Leow Y, Gowindah R, Yew YJ, Fung R, Lau A. Empowering people living with HIV (PLHIV): unveiling care gaps and identifying opportunities for improving care for PLHIV in Singapore and Hong Kong. J Int AIDS Soc 2024; 27:e26250. [PMID: 38726655 PMCID: PMC11082721 DOI: 10.1002/jia2.26250] [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: 05/29/2023] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION This study explored the behaviours of people living with HIV in Singapore and Hong Kong in terms of achieving and maintaining their physical and psychological wellbeing in relation to HIV, to identify the challenges and support needed in HIV care. METHODS This qualitative study involved 90-minute interviews among Singapore and Hong Kong people living with HIV aged ≥18 years to explore health-related quality of life perceptions and gaps in patient empowerment in HIV care during February-May 2022. The COM-B (C: Capability; O: Opportunity; M: Motivation; B: Behaviour) framework was used during data analysis to identify behaviour facilitators and barriers for people living with HIV to achieve and maintain their wellbeing. Detailed accounts of respondents' experience of living with and managing HIV, that is what worked well, unmet needs and perceived significance of wellbeing indicators, were analysed qualitatively via a combination of inductive content and deductive frameworks. RESULTS A total of 30 and 28 respondents were recruited from Singapore (SG) and Hong Kong (HK), respectively. Most respondents were aged 20-49 years (SG: 83.3%; HK: 64.3%), males (SG: 96.7%; HK: 92.9%), men who have sex with men (SG: 93.3%; HK: 71.4%), had university or higher education (SG: 73.3%; HK: 50.0%) and were fully employed (SG: 73.3%; HK: 57.1%). In both Singapore and Hong Kong, physical health was considered a key focus of overall wellbeing, albeit attention to long-term health associated with cardiovascular and renal health was less salient. The impact of symptoms, side effects of treatment, mood and sleep were among the top wellbeing indicators of importance. Respondents felt that insufficient information was provided by physicians, citing consultation time and resource constraints impeding further expression of concerns to their physicians during consultation. Respondents prioritized functional wellness and delegated psychosocial health to supportive care professionals, patient groups, families and/or friends. CONCLUSIONS There is a need in Singapore and Hong Kong to empower people living with HIV to establish better communications with their physicians and be more involved in their treatment journey and equally prioritize their psychosocial wellbeing.
Collapse
Affiliation(s)
- Chen Seong Wong
- National Centre for Infectious DiseasesSingaporeSingapore
- Department of Infectious DiseasesTan Tock Seng HospitalSingaporeSingapore
- Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | | | | | - Phoenix K. H. Mo
- Centre for Health Behaviours ResearchThe School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong SARHong Kong SAR
- Hong Kong Coalition of AIDS Service OrganisationsHong Kong SARHong Kong SAR
| | - Timothy Wong
- Hong Kong AIDS FoundationHong Kong SARHong Kong SAR
| | | | | | | | | | | | - Ricky Fung
- Gilead SciencesHong Kong SARHong Kong SAR
| | - Agnes Lau
- Gilead SciencesHong Kong SARHong Kong SAR
| |
Collapse
|
3
|
Zhang R, Qiao S, Aggarwal A, Yuan G, Muttau N, Sharma A, Lwatula C, Ngosa L, Kabwe M, Manasyan A, Menon A, Ostermann J, Weissman S, Li X, Harper GW. Impact of enacted stigma on mental health, substance use, and HIV-related behaviors among sexual minority men in Zambia. Arch Psychiatr Nurs 2024; 48:51-58. [PMID: 38453282 DOI: 10.1016/j.apnu.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/08/2023] [Accepted: 01/03/2024] [Indexed: 03/09/2024]
Abstract
Sexual minority men (SMM) in Zambia face significant challenges including stigma, discrimination, and mental health issues, which further impact their HIV-related risk behaviors. This study aimed to investigate the associations between enacted stigma, substance abuse, HIV-related behaviors, and mental health (i.e., depression, anxiety, and post-traumatic stress disorder [PTSD] symptoms) among SMM in Zambia. SMM aged 18-35 years who reported having multiple and/or concurrent sexual partners or low and/or inconsistent condom use in the past three months were recruited from four districts in Zambia between February and November 2021. Participants completed an anonymous interviewer-administered survey. Key variables of interest were compared between participants with higher vs. lower levels of enacted stigma. Independent samples t-tests were used for continuous variables, and chi-squared tests were used for categorical variables. A total of 197 eligible SMM participated in the study (mean age = 24.41 years). Participants with a higher level of enacted stigma showed a higher level of anxiety symptoms (χ2 = 12.91, p ≤ .001), PTSD symptoms (χ2 = 7.13, p < .01), tobacco use (χ2 = 10.47, p < .01), cannabis use (χ2 = 5.90, p < .05), and a higher number of sexual partners (t = 1.99, p < .05) in the past three months. Stigma reduction interventions may help mitigate substance abuse, HIV-related behaviors, and adverse mental health outcomes among SMM in Zambia. Health care providers, especially psychiatric-mental health nurses, can incorporate strategies for recognizing and addressing stigma into their practice through training and integrate multiple resources to create an inclusive and non-judgmental environment for SMM to improve their well-being.
Collapse
Affiliation(s)
- Ran Zhang
- University of South Carolina, Columbia, South Carolina, USA
| | - Shan Qiao
- University of South Carolina, Columbia, South Carolina, USA.
| | | | - Guangzhe Yuan
- University of South Carolina, Columbia, South Carolina, USA
| | - Nobutu Muttau
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Anjali Sharma
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | | | - Levy Ngosa
- Dignitate Zambia Limited, Lusaka, Zambia
| | | | - Albert Manasyan
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Jan Ostermann
- University of South Carolina, Columbia, South Carolina, USA
| | | | - Xiaoming Li
- University of South Carolina, Columbia, South Carolina, USA
| | | |
Collapse
|
4
|
Nouri E, Moradi Y, Moradi G. The global prevalence of suicidal ideation and suicide attempts among men who have sex with men: a systematic review and meta-analysis. Eur J Med Res 2023; 28:361. [PMID: 37735701 PMCID: PMC10514985 DOI: 10.1186/s40001-023-01338-6] [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] [Received: 10/04/2022] [Accepted: 09/02/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND This study aimed to determine the global prevalence of suicidal ideation and attempts among men who have sex with men (MSM) as a systematic review, and meta-analysis. METHODS For this meta-analysis, a search in four international databases (PubMed, Scopus, Web of Science, and EMBASE) was designed, and performed. In the next step, the information extraction checklist was prepared based on the study authors' opinions, and the quality of the articles was evaluated using the Newcastle-Ottawa scale (NOS) checklist. Data meta-analysis was performed using STATA16 software with a significance level below 0.05. RESULTS The results showed the prevalence of suicidal ideation, and suicide attempts among MSM was 21% (95% CI 17%-26%), and 12% (95% CI 8%-17%), respectively. The results of the subgroup analysis showed that the prevalence of suicidal ideation in the population of MSM living with Human immunodeficiency virus (HIV) was 40% (95% CI 35%-45%), and the prevalence of suicide attempts among MSM with HIV was 10% (95% CI 1%-27%). The prevalence of suicidal ideation in European MSM, and the prevalence of suicide attempts among American MSM were higher than other MSM in other geographical areas. CONCLUSION Considering that the prevalence of suicidal ideation and attempts among these people is many times higher than that among men in the general population, developing programs for the prevention of mental disorders with special attention to suicide is necessary for these people. Screening programs are also recommended for early diagnosis and prevention of suicide among these people.
Collapse
Affiliation(s)
- Elham Nouri
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Ghobad Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| |
Collapse
|
5
|
Zhai M, Yu B, Li J, Liu X, Yuan L, Liu D, Wang H, Yan H. Relationship between adverse childhood experiences, depression and suicidal behaviors in adulthood among young men who have sex with men: A prospective cohort study. J Psychiatr Res 2023; 161:455-460. [PMID: 37059030 DOI: 10.1016/j.jpsychires.2023.03.038] [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: 11/12/2022] [Revised: 03/11/2023] [Accepted: 03/27/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Suicidal behaviors have been a crucial public health issue among young men who have sex with men (YMSM). Adverse childhood experiences (ACEs) and depression are important predictors of suicidal behaviors. Few studies have examined the underlying mechanisms. This study aims to examine the mediation mechanism from ACEs to depression and further to suicidal ideation based on a prospective cohort study of YMSM. METHOD Study data were derived from 499 YMSM recruited from three cities (Wuhan, Changsha and Nanchang) of China from September in 2017 to January in 2018. ACEs (abuse, neglect and household challenges), depressive symptoms and suicidal behaviors (suicidal ideation, suicidal plan and suicidal attempt) were measured at the baseline, the first wave and second wave follow-up survey, respectively. Mediation modeling analysis was used for data analysis only for suicidal ideation due to the low frequency of suicidal plan and attempt. RESULTS An estimated 17.86% of YMSM reported suicidal ideation, 2.27% ever made a suicidal plan and 0.65% of YMSM had a suicidal attempt in the past six months. The effect of ACEs on suicidal ideation was fully mediated through depressive symptoms (indirect effect [95%CI] = 0.011 [0.004,0.022]). Among the three subconstructs of ACEs, childhood abuse and neglect could increase the risk of suicidal ideation in adulthood by increasing depressive symptoms (indirect effect = 0.020 [0.007,0.042] for childhood abuse, and 0.043 [0.018,0.083] for neglect), but not for household challenges (indirect effect = 0.003 [-0.011,0.018]). CONCLUSIONS ACEs could affect suicidal ideation through depression, particularly for childhood abuse and neglect. Preventive strategies may focus on the treatment of depression and psychological counseling, especially for YMSM who ever experienced negative experiences in childhood.
Collapse
Affiliation(s)
- Mengxi Zhai
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Bin Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China; Population and Health Research Center, Wuhan University, Wuhan, Hubei Province, China
| | - Jiayu Li
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Xin Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Liang Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Dan Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Huihao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Hong Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China.
| |
Collapse
|
6
|
Parra LA, Spahr CM, Goldbach JT, Bray BC, Kipke MD, Slavich GM. Greater lifetime stressor exposure is associated with poorer mental health among sexual minority people of color. J Clin Psychol 2023; 79:1130-1155. [PMID: 36459589 PMCID: PMC10010942 DOI: 10.1002/jclp.23463] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/25/2022] [Accepted: 11/04/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Research has shown that sexual minority people of color experience pervasive and sometimes severe life stressors that increase their risk of experiencing mental health problems, and that can contribute to lifelong health disparities. However, no studies in this population have investigated stressor exposure occurring over the entire lifespan. Moreover, it remains unknown whether these stressor-health effects differ based on the timing or types of stressors experienced. PURPOSE The purpose of this study is to examine how cumulative lifetime stressor exposure is associated with mental health among Black, Latinx, and biracial Black-Latinx sexual minority persons. METHOD Participants were 285 ethnic/racial minority young adults (Mage = 25.18 years old, SD = 1.94, age range = 19-29 years), who completed the Stress and Adversity Inventory for Adults to assess for retrospective reports of lifetime stressor count and severity. The Brief Symptom Inventory was used to assess participants' symptoms of anxiety, depression, and somatization, which were the main outcomes. Most participants identified as cisgender male (94.7%) and gay (74.2%), with the remaining participants identifying as transgender or genderqueer/nonbinary for gender and bisexual/pansexual, queer, or another sexual orientation. RESULTS Multiple regression analyses indicated that experiencing more-and more severe-stressors across the lifespan was related to greater anxiety, depressive, and somatization symptoms. These effects were robust while controlling for race/ethnicity, sexual orientation, education, and employment status, and they differed based on stressor exposure timing, type, primary life domain, and core social-psychological characteristic. CONCLUSION Greater cumulative lifetime stressor exposure is related to poorer mental health among sexual minority people of color. Screening for lifetime stressors may thus help identify at-risk persons and provide an opportunity to intervene to help mitigate or prevent mental health disparities in multiply stigmatized adults.
Collapse
Affiliation(s)
- Luis A. Parra
- School of Nursing, University of Michigan, Ann Arbor, MI USA
| | - Chandler M. Spahr
- Department of Psychology, University of California, Riverside, CA, USA
| | | | - Bethany C. Bray
- Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, USA
| | - Michele D. Kipke
- Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Departments of Pediatrics and Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| |
Collapse
|
7
|
O'Byrne P, McCready L, Tigert J, Musten A, Orser L. First-time testers in the GetaKit study: conceptualizing new paths to care for gbMSM. Health Promot Int 2023; 38:7143325. [PMID: 37099678 PMCID: PMC10132581 DOI: 10.1093/heapro/daad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
When analyzing the data for Ontario, Canada, HIV rates continue to be highest among gay, bisexual and other men who have sex with men (gbMSM). Since HIV diagnosis is a key component of HIV care, self-testing has provided options for allowing this population to access care, resulting in a significant number of first-time testers. Between 1 April 2021 and 31 January 2022, 882 gbMSM participants ordered an HIV self-test through GetaKit. Of these, 270 participants reported that they had never undergone HIV testing previously. Our data showed that first-time testers were generally younger, members of BIPOC (Black, Indigenous and people of color) communities and they reported more invalid test results than those who had tested previously. This suggests that HIV self-testing may be a more successful and appealing component of the HIV prevention armamentarium for this population, but one that is not without its shortcomings as an entry to care.
Collapse
Affiliation(s)
| | - Lance McCready
- Leadership, Higher & Adult Education, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Jason Tigert
- Leadership, Higher & Adult Education, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | | | - Lauren Orser
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
8
|
Wongsomboon V, Sietins E, Webster GD. Predictors of Face and Body Visibility in Online Dating Applications Among Young Men Who Have Sex with Men. JOURNAL OF HOMOSEXUALITY 2022; 69:2305-2325. [PMID: 34110271 DOI: 10.1080/00918369.2021.1938469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this study, we explored the factors relating to face and body visibility in young men who have sex with men (YMSM) from online dating applications. Research on visual self-presentation in online dating applications, especially in YMSM, remains scarce. The sample consisted of 339 young men (ages 18-24 years) who had casual sex with one or more male partners from online dating applications. Participants completed an online survey asking how visible their face and body were on their profile pictures. For body visibility, participants rated the visibility of their upper and lower body separately. We also computed difference scores between face and body visibility to measure face visibility in relation to body visibility (e.g., showing more-visible face compared to body). Predictors included self-rated attractiveness, fear of being identified on the applications, and motives for application use. Participant age and duration of application use were statistically controlled in all analyses. Results showed that higher perceived attractiveness related to higher upper- and lower-body visibility on profile pictures. Greater fear of being identified related to lower face visibility and less-visible face relative to upper- and lower-body visibility. Having a relationship motive was associated with higher face visibility. Older age and longer duration of application use were associated with more-visible face relative to lower body. The findings contribute to the literature on visual self-presentation in online dating applications in young and vulnerable sexual minorities.
Collapse
Affiliation(s)
- Val Wongsomboon
- Department of Psychology, University of Florida, Gainesville, Florida, USA
| | - Emils Sietins
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Gregory D Webster
- Department of Psychology, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
9
|
Bonett S, Bauermeister J, Meanley S. Social identity support, descriptive norms, and economic instability in PrEP engagement for emerging adult MSM in the United States. AIDS Care 2022; 34:1452-1460. [PMID: 35765164 PMCID: PMC10071877 DOI: 10.1080/09540121.2022.2075821] [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: 02/16/2021] [Accepted: 05/03/2022] [Indexed: 10/17/2022]
Abstract
Rates of pre-exposure prophylaxis (PrEP) uptake for HIV prevention continue to increase rapidly among men who have sex with men (MSM) in the United States (U.S.); however, these increases have been slower among young MSM. Emerging adulthood (ages 18-25) is a time of transitions and social development, resulting in increased vulnerability to HIV. Analyzing data from a cross-sectional survey of emerging adult MSM (ages 18-25 years; n = 281) in the Mid-Atlantic urban metropolitan region of the U.S., we examined how social identity support, descriptive PrEP norms, and economic instability were related to PrEP engagement. In structural equation models, PrEP norms were directly associated with PrEP engagement (β = 0.29, 95% CI = [0.12,0.46]) and social identity support was indirectly associated with PrEP engagement through its association with descriptive PrEP norms (β = 0.18, 95% CI = [0.09,0.28]). Economic instability was not significantly associated with PrEP engagement, although a negative trend was present (β = -0.19, 95% CI = [-0.39,0.02]). Our results suggest that an integrative socioecological model is appropriate for the study of PrEP engagement among emerging adult MSM. Efforts to increase PrEP engagement should support community capacity building, amplify positive descriptive PrEP norms, and address unmet economic needs.
Collapse
Affiliation(s)
- Stephen Bonett
- School of Nursing, University of Pennsylvania, Philadelphia PA, USA
| | | | - Steven Meanley
- School of Nursing, University of Pennsylvania, Philadelphia PA, USA
| |
Collapse
|
10
|
Nouri E, Moradi Y, Moradi G. What is the global prevalence of depression among men who have sex with men? A systematic review and meta-analysis. Ann Gen Psychiatry 2022; 21:38. [PMID: 36096814 PMCID: PMC9465955 DOI: 10.1186/s12991-022-00414-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 09/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression due to stigma resulting from their sexual identity, isolation, social exclusion, and insufficient access to care and counseling services has become a health problem among men who have sex with men (MSM). OBJECTIVES This study aimed to determine the global prevalence of depression among MSM as a systematic review and meta-analysis. METHODS This study was a systematic review and meta-analysis performed in five steps of search strategy, screening and selecting articles, data extraction, evaluation of the risk of bias, and meta-analysis. In this study, the determined keywords were searched in the databases of PubMed, Scopus, Embase, and Web of Science from January 1913 to July 2021 to find the initial articles, from which data were extracted according to the set checklist in the data extraction stage. Finally, the studies were included in the present meta-analysis according to the inclusion and exclusion criteria, to be evaluated using the Newcastle Ottawa scale checklist. I Square and Q Cochrane were also used to assess the degree of heterogeneity. The analyses were performed using the random-effects model in STATA 16. RESULTS The results showed the quality score of the majority of cross-sectional studies included in the meta-analysis (62 studies) was equal to six or seven (moderate), and five ones had a high-quality score. After combining these studies, the pooled prevalence of depression among MSM in the world was 35% (95% CI 31%-39%, I square; 98.95%, P-value < 0.001). Population subgroup analysis showed the pooled prevalence of depression among MSM living with HIV was 47% (95% CI 39%-55%, I square; 95.76%, P-value < 0.001). Continent subgroup analysis showed the highest pooled prevalence of depression among Asian MSM at 37% (95% CI 31%-43%, I square; 99.07%, P-value < 0.001). Also, in the subgroup analysis of the sampling method, the pooled prevalence in the studies which used the respondent-driven sampling method was equal to 34% (95% CI 25%-43%, I square; 99.32%, P-value < 0.001). Sensitivity analysis revealed the pooled prevalence of depression in studies included in the meta-analysis was near or around the pooled estimate. CONCLUSION The pooled prevalence of depression among MSM was almost three times higher than the general male population. Therefore, particular and therapeutic interventions such as screening, and harm reduction programs for mental disorders, especially depression, are suggested to be considered in service packages.
Collapse
Affiliation(s)
- Elham Nouri
- Social Determinant of the Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Social Determinant of the Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ghobad Moradi
- Social Determinant of the Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran. .,Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| |
Collapse
|
11
|
Association between enacted stigma, internalized stigma, resilience, and depressive symptoms among young men who have sex with men in China: a moderated mediation model analysis. Ann Epidemiol 2021; 56:1-8. [DOI: 10.1016/j.annepidem.2021.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 11/08/2020] [Accepted: 01/02/2021] [Indexed: 12/13/2022]
|
12
|
Crosby RA, Kubicek K, Kipke MD. Is the experience of hunger associated with risk of engaging in condomless anal sex among minority young men who have sex with men? Int J STD AIDS 2020; 31:447-453. [PMID: 32208817 PMCID: PMC8437430 DOI: 10.1177/0956462420911562] [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: 11/16/2022]
Abstract
Although emerging evidence suggests that hunger may be a risk factor for engaging in risk behaviors that lead to HIV acquisition, this has rarely been explored for young minority men who have sex with men (YMSM). This study explored a range of sexual risk behaviors for associations with a measure of hunger, assessed among 448 YMSM residing in Los Angeles, CA. Forty-five percent experienced hunger (past 12 months). Hunger was significantly associated with engaging in any condomless anal receptive sex (CARS) (adjusted odds ratio 1.74; 95% confidence interval 1.01–3.01; P .049). Further, hunger was also significantly associated with a greater percentage of CARS (Beta .12; t 2.18; P .03). Parallel effects were not observed relative to condomless anal insertive sex. Findings suggest that the experience of hunger among young minority MSM is generally not associated with a milieu of sexual risk. One important exception is that hunger may lead to having CARS. This suggests a potential ‘trade off’ for receptive partners experiencing hunger and partially supports the idea that at hunger may predispose minority YMSM to partner demands not to use condoms.
Collapse
Affiliation(s)
- Richard A Crosby
- Kinsey Institute for Research on Sex, Gender, and Reproduction, Indiana University, Bloomington, IN, USA
- College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Katrina Kubicek
- Community, Health Outcomes and Intervention Research Program, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Michele D Kipke
- Community, Health Outcomes and Intervention Research Program, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
13
|
Henry RS, Perrin PB, Sawyer A, Pugh M. Health Conditions, Access to Care, Mental Health, and Wellness Behaviors in Lesbian, Gay, Bisexual, and Transgender Adults. Int J Chronic Dis 2020; 2020:9094047. [PMID: 32206669 PMCID: PMC7079213 DOI: 10.1155/2020/9094047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 02/13/2020] [Accepted: 02/21/2020] [Indexed: 01/07/2023] Open
Abstract
This study examined relationships among wellness behaviors, physical health conditions, mental health, health insurance, and access to care among a sample of 317 lesbian, gay, bisexual, and transgender (LGBT) adults. Participants completed a web-administered survey from May 2013 to April 2014. Of the sample, 41.6% of the participants reported having one or more health conditions. Most participants (92.1%) reported access to a health care facility and current health insurance coverage (84.9%), though 24.9% of those with health insurance reported being incapable of paying the copayments. Physical health conditions, age, and self-esteem explained 24% of the variance in engagement in wellness behaviors; older age, a greater number of health conditions, higher self-esteem, possession of health insurance, and ability to access to care were associated with increased wellness behaviors. Providing affordable insurance coverage, improving access to care, and properly treating mental health in LGBT individuals could improve wellness behaviors.
Collapse
Affiliation(s)
- Richard S. Henry
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Paul B. Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ashlee Sawyer
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Mickeal Pugh
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
14
|
Kubicek K, Beyer WJ, Wong CF, Kipke MD. Engaging Young Men in the HIV Prevention and Care Continua: Experiences From Young Men of Color Who Have Sex With Men. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2019; 31:325-343. [PMID: 31361519 DOI: 10.1521/aeap.2019.31.4.325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sexual minority individuals experience barriers to receiving equitable health care. Research also indicates that young men who have sex with men (YMSM), particularly young men of color, have limited engagement in the HIV care continuum and there are significant disparities across the continuum. This study aims to uncover how providers can engage YMSM of color in all forms of care, including primary care and HIV prevention through an HIV prevention continuum. This qualitative study reports data from the Healthy Young Men's Cohort Study; a total of 49 YMSM participated in the eight focus groups. This study provides a description of YMSM's overall health concerns, experiences with health care, and under what circumstances YMSM seek care. We then present a model describing the salient characteristics of a HIV prevention continuum for YMSM of color and provide clear areas for education, intervention, and policy change to support better overall health for YMSM of color.
Collapse
Affiliation(s)
| | | | | | - Michele D Kipke
- Community, Health Outcomes, and Intervention Research Program, Children's Hospital Los Angeles
| |
Collapse
|
15
|
Kubicek K. Setting an Agenda to Address Intimate Partner Violence Among Young Men Who Have Sex With Men: A Conceptual Model and Review. TRAUMA, VIOLENCE & ABUSE 2018; 19:473-487. [PMID: 27756778 DOI: 10.1177/1524838016673599] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Research investigating intimate partner violence (IPV) among sexual minorities is limited. The research that does exist has found that rates of IPV are similar to or higher than the rates found for heterosexual women, the most commonly studied population in this area. This limited research has resulted in a dearth of prevention/intervention programs targeted for these populations. While some may argue that existing IPV programs can be used for these populations, this review presents an argument for more targeted work with sexual minority populations, using young men who have sex with men (YMSM) as an example. Drawing on the framework of intersectionality, this article argues that the intersectionality of age, sexual identity, and gender combines to create a spectrum of unique factors that require specific attention. This framework allows for the identification of known correlates for IPV as well as factors that may be unique to YMSM or other sexual minority populations. The article presents a conceptual model that suggests new areas of research as well as a foundation for the topics and issues that should be addressed in an intervention.
Collapse
Affiliation(s)
- Katrina Kubicek
- 1 Community, Health Outcomes and Intervention Research Program, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
16
|
Morgan A, Saunders B, Dodge B, Harper G, Arrington Sanders R. Exploring the Sexual Development Experiences of Black Bisexual Male Adolescents Over Time. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1839-1851. [PMID: 29299791 PMCID: PMC6123617 DOI: 10.1007/s10508-017-1084-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 09/08/2017] [Accepted: 09/16/2017] [Indexed: 06/07/2023]
Abstract
Scant research has sought to explore the development of dimensions of sexual orientation among Black bisexual male adolescents (BBMA). Understanding how sexual attractions, behaviors, and identities evolve among BBMA over time is crucial to understanding the most appropriate support strategies to provide during this developmental period. We sought to understand and describe the sexual orientation development experiences in a sample of BBMA over the course of 1 year. We further sought to understand the sociocontextual factors that may play a role during this development process. Fifteen BBMA, aged 15-19 years, were interviewed about sexual debut experiences (baseline) and were re-interviewed three times over a 1-year period about sexual attractions, behaviors, and identity at each follow-up point. A three-person team used inductive open coding to analyze each participant's data set. The mean Kinsey scale score for the sample was 2.93 (SD = 1.2) most closely translating to "heterosexual/gay-equally." A case study analysis was used to identify themes related to sexual attractions, behavior, and identity over time, within and across participants. Among the sample of young men, two unique groups were identified based on self-reported sexual identity and experiences of same- and other-sex sexual attractions and behaviors over time. The first group consisted of seven young men who consistently described their sexual identity as bisexual from baseline to the final follow-up. These young men also described similar experiences related to same- and other-sex sexual and romantic attractions and more consistently described same- and other-sex sexual behaviors. The second group consisted of eight young men that described changing sexual identity and same- and other-sex sexual romantic attractions over time. Participants described sociocontextual factors such as religion, masculinity, and homophobia played during their development. Findings from this study underscore the complexity of sexual orientation development and sociocultural factors and expectations that may influence sexual identity and behavior among BBMA.
Collapse
Affiliation(s)
- Anthony Morgan
- Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, 200 North Wolfe Street, 2063, Baltimore, MD, 21287, USA.
| | - Brianna Saunders
- Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, 200 North Wolfe Street, 2063, Baltimore, MD, 21287, USA
| | - Brian Dodge
- Indiana University School of Public Health, Bloomington, IN, USA
| | - Gary Harper
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Renata Arrington Sanders
- Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine, 200 North Wolfe Street, 2063, Baltimore, MD, 21287, USA
| |
Collapse
|
17
|
Griffin M, Krause KD, Kapadia F, Halkitis PN. A Qualitative Investigation of Healthcare Engagement Among Young Adult Gay Men in New York City: A P18 Cohort Substudy. LGBT Health 2018; 5:368-374. [PMID: 30048197 PMCID: PMC6916523 DOI: 10.1089/lgbt.2017.0015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE We used in-depth interviews with a cohort of young adult gay men (YAGM) to provide a more detailed understanding of their current healthcare engagement, including experiences with the healthcare system, provider knowledge of healthcare needs, and desired provider characteristics. METHODS Qualitative interviews were conducted with a sample of 40 YAGM in New York City. The interview guide examined healthcare engagement across key developmental stages: childhood (birth-12), adolescence (13-18), young adulthood (19-22), and the present (23-26). All transcripts were coded using a consensual qualitative research approach to identify crosscutting topics. The interviews were conducted between September and October 2015. RESULTS The following topics were identified: experiences with the healthcare system, provider knowledge of healthcare needs, and desired provider characteristics. Common barriers to healthcare access were financial concerns, lack of insurance, and dissatisfaction with the care provided. Reasons for dissatisfaction with care were based on perceptions of providers' anti-gay attitudes, judgment of same-sex sexual behavior, and lack of provider knowledge about YAGM's health needs. This often led men in this study to seek sexual healthcare from providers other than their primary care provider. When asked about desired provider characteristics, participants noted that basic demographics were of less importance than skills-based characteristics such as rapport, comfort discussing sexual health issues, and knowledge of YAGM's health. CONCLUSION YAGM have unique challenges to engaging in healthcare, including provider stigma and lack of provider knowledge of YAGM's health needs, which are not faced by other young adult populations. The results from this study highlight the need for more extensive and standardized training in medical school and as part of continuing medical education for healthcare providers.
Collapse
Affiliation(s)
- Marybec Griffin
- College of Global Public Health, New York University, New York, New York
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Newark, New Jersey
| | - Kristen D. Krause
- College of Global Public Health, New York University, New York, New York
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Newark, New Jersey
| | - Farzana Kapadia
- College of Global Public Health, New York University, New York, New York
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Newark, New Jersey
- Department of Population Health, Langone Medical Center, New York University, New York, New York
| | - Perry N. Halkitis
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Newark, New Jersey
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey
- Department of Urban-Global Public Health, Rutgers School of Public Health, Rutgers University, Newark, New Jersey
| |
Collapse
|
18
|
Luong CT, Rew L, Banner M. Suicidality in Young Men Who Have Sex with Men: A Systematic Review of the Literature. Issues Ment Health Nurs 2018; 39:37-45. [PMID: 29286830 DOI: 10.1080/01612840.2017.1390020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This systematic literature review addresses risk and protective factors associated with suicidal ideation and attempts in young men who have sex with men (YMSM). The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, PsychArticles, and PsychInfo yielded 14 articles. Risk factors included (1) not being enrolled in school, (2) earlier sexual debut, (3) substance use/abuse, (4) homelessness, (5) bullying and victimization, (6) fear of community violence, (7) and parental abuse. Protective factors included (1) positive sexual minority LGBT stereotypes, (2) family acceptance, (3) school and peer support, (4) high self-esteem, and (5) adaptive coping mechanisms.
Collapse
Affiliation(s)
- Casey T Luong
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
| | - Lynn Rew
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
| | - Matthew Banner
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
| |
Collapse
|
19
|
Freese TE, Padwa H, Oeser BT, Rutkowski BA, Schulte MT. Real-World Strategies to Engage and Retain Racial-Ethnic Minority Young Men Who Have Sex with Men in HIV Prevention Services. AIDS Patient Care STDS 2017; 31:275-281. [PMID: 28530444 DOI: 10.1089/apc.2016.0310] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Racial/ethnic minority young men who have sex with men (YMSM)-particularly African Americans and Hispanics/Latinos-are at particularly high risk for HIV infection. Devising strategies to improve engagement and retention in HIV prevention services among minority YMSM is critical if the United States is going to achieve the National HIV/AIDS Strategy goal of reducing HIV health-related disparities. This article presents findings from a national summit on racial/ethnic YMSM services convened by the Substance Abuse and Mental Health Services Administration-funded Center of Excellence on Racial and Ethnic Minority Young Men Who Have Sex with Men and Other Lesbian, Gay, Bisexual, and Transgender Populations (YMSM + LGBT CoE) in September 2015. The summit included (1) subgroup discussions focused on issues related to treatment access, outreach/engagement/retention, continuing care/recovery support, and health literacy for minority YMSM; and (2) a ranking process, where the NIATx Nominal Group Technique was used to identify the strategies and approaches that summit participants believed to be most promising for engaging and retaining minority YMSM in HIV prevention services. Analyses of results from summit activities highlight four key cross-cutting strategies-utilizing peers, providing holistic care, making services fun, and utilizing technology-as critical for engaging minority YMSM in HIV prevention care. Examples of programs that utilize these strategies and implications of these findings for policy and practice are discussed.
Collapse
Affiliation(s)
- Thomas E. Freese
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
| | - Howard Padwa
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
| | - Brandy T. Oeser
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
| | - Beth A. Rutkowski
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
| | - Marya T. Schulte
- Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
| |
Collapse
|
20
|
Taquette SR, Rodrigues ADO, Bortolotti LR. HIV infection in male adolescents: a qualitative study. CIENCIA & SAUDE COLETIVA 2017; 20:2193-200. [PMID: 26132259 DOI: 10.1590/1413-81232015207.18102014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 11/15/2014] [Indexed: 11/22/2022] Open
Abstract
`The gradual reduction in the incidence of AIDS among men who have sex with men has not occurred in the youngest age group; on the contrary, it is growing. This paper examines the vulnerabilities of adolescent males at risk of HIV infection. This is a qualitative study conducted through interviews with HIV positive young men undergoing treatment, whose diagnosis was made during adolescence. The interviews were recorded and transcribed in full. They were analyzed by intensive reading, classified by issues, and interpreted from a hermeneutic-dialectic perspective in dialogue with the literature. We interviewed 16 young men whose diagnosis occurred between the ages of 11 and 19 and for all of them the method of HIV transmission was sexual; 12 of the men were homosexual and 4 were heterosexual. It was evident that vulnerable situations included disbelief in the possibility of contamination, subjection to sex, homophobia and commercial sexual exploitation. This study demonstrates the importance of the formulation of public policies on sexual and reproductive health, which include adolescents and young men. These policies should embody the perspective of masculinity in all its widest aspects, as well as actions in favor of sexual diversity.
Collapse
Affiliation(s)
- Stella Regina Taquette
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil,
| | | | - Livia Rocha Bortolotti
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil,
| |
Collapse
|
21
|
Coleman TA, Bauer GR, Pugh D, Aykroyd G, Powell L, Newman R. Sexual Orientation Disclosure in Primary Care Settings by Gay, Bisexual, and Other Men Who Have Sex with Men in a Canadian City. LGBT Health 2016; 4:42-54. [PMID: 27996376 DOI: 10.1089/lgbt.2016.0004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Sexual orientation affects individuals' health histories and is fundamental to providers' understanding of patients as a whole. Gay, bisexual, and other men who have sex with men (GB-MSM) are vulnerable to certain health conditions, including HIV. The aim of this exploratory analysis was to examine factors associated with sexual orientation disclosure and communication with providers about GB-MSM health issues and to discuss implications. METHODS We conducted a cross-sectional internet survey of GB-MSM (n = 202) in London-Middlesex, Ontario, Canada; analyses were limited to those with a regular primary care provider (n = 173). Blockwise regression models explored demographic, psychosocial, and healthcare-related factors associated with sexual orientation disclosure and physician-patient communication about GB-MSM-related health. RESULTS Just over seventy-one percent (71.1%) of participants reported that their primary care provider (PCP) knew their sexual orientation, and 44.5% had talked to them about GB-MSM health. Overt negative comments or being refused care based on sexual orientation occurred infrequently, although 26.6% reported their provider had assumed they were heterosexual. Being married to or living common-law with another man, more frequent experiences of homosexual prejudice, and higher quality assessment of provider's communication skills were associated with the PCP knowing respondents' sexual orientation. Greater internalized homonegativity was associated with not talking to a PCP about GB-MSM-related health issues. More frequent experiences of homosexual prejudice, higher assessment of provider communication, and having prior negative experiences with a PCP were significantly associated with talking to a PCP about GB-MSM health. CONCLUSION The majority of our sample disclosed their sexual orientation; however, not all patients voluntarily disclose. Medical training and education in Canada, where specific rights protections exist for sexual orientation minority populations, should emphasize awareness of essential patient health information. Training should include information about GB-MSM health and building a foundation on how to speak with GB-MSM patients nonjudgmentally.
Collapse
Affiliation(s)
- Todd A Coleman
- 1 Department of Psychology, Ryerson University , Toronto, Canada .,2 Department of Epidemiology and Biostatistics, University of Western Ontario , London, Canada
| | - Greta R Bauer
- 2 Department of Epidemiology and Biostatistics, University of Western Ontario , London, Canada
| | - Daniel Pugh
- 3 Gay Men's Sexual Health Alliance , Toronto, Canada
| | - Gloria Aykroyd
- 4 St. Joseph's Infectious Diseases Care Program , London, Canada
| | | | - Rob Newman
- 6 Regional HIV/AIDS Connection , London, Canada
| |
Collapse
|
22
|
Krause KD, Kapadia F, Ompad DC, D'Avanzo PA, Duncan DT, Halkitis PN. Early Life Psychosocial Stressors and Housing Instability among Young Sexual Minority Men: the P18 Cohort Study. J Urban Health 2016; 93:511-25. [PMID: 27169631 PMCID: PMC4899333 DOI: 10.1007/s11524-016-0049-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Homelessness and housing instability is a significant public health problem among young sexual minority men. While there is a growing body of literature on correlates of homelessness among sexual minority men, there is a lack of literature parsing the different facets of housing instability. The present study examines factors associated with both living and sleeping in unstable housing among n = 600 sexual minority men (ages 18-19). Multivariate models were constructed to examine the extent to which sociodemographic, interpersonal, and behavioral factors as well as adverse childhood experiences explain housing instability. Overall, 13 % of participants reported sleeping in unstable housing and 18 % had lived in unstable housing at some point in the 6 months preceding the assessment. The odds of currently sleeping in unstable housing were greater among those who experienced more frequent lack of basic needs (food, proper hygiene, clothing) during their childhoods. More frequent experiences of childhood physical abuse and a history of arrest were associated with currently living in unstable housing. Current enrollment in school was a protective factor with both living and sleeping in unstable housing. These findings indicate that being unstably housed can be rooted in early life experiences and suggest a point of intervention that may prevent unstable housing among sexual minority men.
Collapse
Affiliation(s)
- Kristen D Krause
- Center for Health, Identity, Behavior, and Prevention Studies, New York University, 726 Broadway, Suite 525, New York, NY, 10003, USA.,College of Global Public Health, New York University, 41 E. 11th St., New York, NY, 10003, USA
| | - Farzana Kapadia
- Center for Health, Identity, Behavior, and Prevention Studies, New York University, 726 Broadway, Suite 525, New York, NY, 10003, USA.,College of Global Public Health, New York University, 41 E. 11th St., New York, NY, 10003, USA.,Center for Drug Use and HIV Research, New York University, 433 First Ave. 7th Floor, New York, NY, 10010, USA
| | - Danielle C Ompad
- Center for Health, Identity, Behavior, and Prevention Studies, New York University, 726 Broadway, Suite 525, New York, NY, 10003, USA.,College of Global Public Health, New York University, 41 E. 11th St., New York, NY, 10003, USA.,Center for Drug Use and HIV Research, New York University, 433 First Ave. 7th Floor, New York, NY, 10010, USA
| | - Paul A D'Avanzo
- Center for Health, Identity, Behavior, and Prevention Studies, New York University, 726 Broadway, Suite 525, New York, NY, 10003, USA
| | - Dustin T Duncan
- Center for Health, Identity, Behavior, and Prevention Studies, New York University, 726 Broadway, Suite 525, New York, NY, 10003, USA.,College of Global Public Health, New York University, 41 E. 11th St., New York, NY, 10003, USA.,Center for Drug Use and HIV Research, New York University, 433 First Ave. 7th Floor, New York, NY, 10010, USA.,Department of Population Health, Langone School of Medicine, New York University, 227 E. 30th St., New York, NY, 10016, USA
| | - Perry N Halkitis
- Center for Health, Identity, Behavior, and Prevention Studies, New York University, 726 Broadway, Suite 525, New York, NY, 10003, USA. .,College of Global Public Health, New York University, 41 E. 11th St., New York, NY, 10003, USA. .,Center for Drug Use and HIV Research, New York University, 433 First Ave. 7th Floor, New York, NY, 10010, USA. .,Department of Population Health, Langone School of Medicine, New York University, 227 E. 30th St., New York, NY, 10016, USA. .,Department of Applied Psychology, Steinhardt School of Culture, Education and Human Development, New York University, 246 Greene St. 8th Floor, New York, NY, 10003, USA.
| |
Collapse
|
23
|
Ikuta N, Koike Y, Aoyagi N, Matsuzaka A, Fuse-Nagase Y, Kogawa K, Takizawa T. Prevalence of lesbian, gay, bisexual, and transgender among Japanese university students: a single institution survey. Int J Adolesc Med Health 2016; 29:/j/ijamh.ahead-of-print/ijamh-2015-0113/ijamh-2015-0113.xml. [PMID: 27060732 DOI: 10.1515/ijamh-2015-0113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/13/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To elucidate the prevalence of lesbian, gay, bisexual, and transgender (LGBT) among Japanese youth, we conducted a survey research that targeted university students. MATERIALS AND METHODS Participants were first-year students (n=1597) at Ibaraki University, Japan (Phase 1 study) or second- to fourth-year students (n=944) at the university who were randomly preferred in the survey (Phase 2 study). Surveys measured gender identity and sexual orientation, partly using the gender identity scale (GIS). RESULTS The prevalence of LGBT youth among university students were 2.7%, 0.5%, 5.3%, and 0.8% (Phase 1 study) or 1.4% (Phase 2 study), respectively. The GIS scores of the transgender group were significantly lower than those of the female, male, and LGB groups (p<0.01). DISCUSSION This is the first to clarify the prevalence of LGBT among youth in Japan. It has been suggested that such individuals in Japan, as in other countries, are at risk for physical and mental health concerns, thereby necessitating social and medical intervention. Further investigation in these areas will be needed.
Collapse
|
24
|
Holloway IW. Substance use homophily among geosocial networking application using gay, bisexual, and other men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2015. [PMID: 26216146 PMCID: PMC4574511 DOI: 10.1007/s10508-015-0581-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Geosocial networking applications (GSN apps) represent important virtual contexts in which gay, bisexual, and other men who have sex with men (MSM) seek affiliation. These apps allow users to create and view public profiles, send photos, and text messages, and connect with other users based on shared interests and geographic proximity. The present study examined substance use homophily among a sample of 295 MSM recruited via a popular GSN app. Comparisons of social network members met via GSN app versus elsewhere and associations between both individual and network characteristics and recent binge drinking, marijuana use, and illicit substance use were explored using bivariate tests of association and multivariate logistic regression analyses. High rates of recent binge drinking (59 %), marijuana use (37 %), and illicit substance use (27 %) were observed among participants. GSN app use greater than 1 year and showing naked chest or abs in a profile picture were positively associated with recent illicit substance use. In multivariate analyses, the strongest predictors of binge drinking (AOR 3.81; 95 % CI 1.86-7.80), marijuana use (AOR 4.12; 95 % CI 2.22-7.64), and illicit substance use (AOR 6.45; 95 % CI 3.26-12.79) were the presence of a social network member who also engaged in these behaviors. Social network interventions that target binge drinking, marijuana use, and illicit substance use may be delivered via GSN apps to reduce the prevalence of substance use and related risks among MSM in these virtual contexts.
Collapse
Affiliation(s)
- Ian W Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, 3250 Public Affairs Building, Box 951656, Los Angeles, CA, 90095-1656, USA,
| |
Collapse
|
25
|
Kubicek K, McNeeley M, Collins S. Young Men Who Have Sex With Men’s Experiences With Intimate Partner Violence. JOURNAL OF ADOLESCENT RESEARCH 2015. [DOI: 10.1177/0743558415584011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Research estimating the prevalence of intimate partner violence (IPV) among men who have sex with men (MSM) and other sexual minority populations is limited. However, existing research indicates rates similar to heterosexual women. This mixed-methods study was designed to inform intervention development and provides a description of the types of IPV experienced by young MSM (YMSM) within their dating and intimate relationships. Data collected include 101 surveys with YMSM aged 18 to 25 and 26 semi-structured qualitative interviews. YMSM experienced high levels of psychological aggression, physical assault, and sexual coercion both as victims and perpetrators. The study also found that there were high rates of mutual perpetration, young men reporting being both victim and perpetrator of partner violence. Qualitative data provide context and descriptions of these incidents to provide more information about the circumstances and perceptions of these incidents. The findings indicate that interventions should be multifaceted and include schools, communities, and families to address anger management, conflict resolution, and communication skills within young men’s relationships.
Collapse
|
26
|
HIV status disclosure, depressive symptoms, and sexual risk behavior among HIV-positive young men who have sex with men. J Behav Med 2015; 38:507-17. [PMID: 25773478 DOI: 10.1007/s10865-015-9624-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 02/14/2015] [Indexed: 11/27/2022]
Abstract
The rate of HIV infection among young men who have sex with men (YMSM) is increasing in the United States, and targeted research is needed to inform interventions aimed at reducing HIV transmission in this population. This study aims to understand the association between HIV status disclosure and sexual risk behavior among HIV-positive YMSM. A particular focus is given to depressive symptoms and their potential role in explaining the association between HIV disclosure and sexual risk behavior. In a sample of 991 YMSM receiving care at 20 clinics across the United States, Univariate and multivariate analyses were conducted to explore these associations. Approximately one-half (52.4 %) of participants reported disclosing to their current sexual/romantic partner. Disclosure to family members was negatively associated with sexual risk behavior. Also, depressive symptoms were positively associated with sexual risk behavior. We discuss the implications of our findings for future research and intervention.
Collapse
|
27
|
Holloway IW, Rice E, Kipke MD. Venue-based network analysis to inform HIV prevention efforts among young gay, bisexual, and other men who have sex with men. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2015; 15:419-27. [PMID: 24464324 DOI: 10.1007/s11121-014-0462-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In the USA, human immunodeficiency virus (HIV) incidence rates continue to increase among young gay, bisexual, and other men have sexual intercourse with men. Young men who have sex with men (YMSM) indicate interest in HIV prevention programming that is implemented in the social venues that they frequent when they want to socialize with other men. We sought to understand YMSM venues as a networked space to provide insights into venue-based HIV prevention intervention delivery. The present study used survey data reported by 526 YMSM (ages 18-24) in 2005 to conduct a venue-based social network analysis. The latter sought to determine if the structure and composition of the networks in Los Angeles could be used to facilitate the delivery of HIV prevention messages to YMSM. Degree of person sharing between venues was used to demonstrate interconnectivity between venues classified as low risk (e.g., coffee shops) and high risk (e.g., bars and clubs) by a Community Advisory Board. Sixty-five percent of the 110 venues nominated were bars and clubs. Nearly all YMSM were connected by a single venue and over 87 % were connected by the six most central venues. A handful of highly connected low-risk venues was central to the venue network and connected to popular high-risk venues. Venue-based network analysis can inform tailored HIV prevention messaging for YMSM. Targeted delivery of prevention messaging at low-risk centralized venues may lead to widespread diffusion among venue-attending YMSM.
Collapse
Affiliation(s)
- Ian W Holloway
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, 3250 Public Affairs Building, Box 951656, Los Angeles, CA, 90095-1656, USA,
| | | | | |
Collapse
|
28
|
Salem BE, Nyamathi Anp A, Reback C, Shoptaw S, Zhang S, Nudelman O. Unmet physical and mental healthcare needs among stimulant-using gay and bisexual homeless men. Issues Ment Health Nurs 2015; 36:685-92. [PMID: 26440871 PMCID: PMC4801108 DOI: 10.3109/01612840.2015.1021938] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to gain a greater understanding of predictors of the unmet physical and mental healthcare needs of homeless, stimulant-using, gay and bisexual (G/B) men. This study correlated baseline self-reported unmet physical and mental healthcare needs among stimulant-using homeless G/B men (n = 422, 18-46 years of age). A structured questionnaire was administered at baseline and data were collected from October 2009 to January 2013. The study was approved by the University of California Human Subjects' Protection committee and the Friends Research Institute Human Research Protection Committee. Logistic regression revealed that those who self-reported ever being married, being in fair or poor health and in moderate-to-very severe pain, were more likely to experience unmet needs for physical health care. In terms of unmet mental health needs, those who self-reported moderate-to-very severe pain and/or those reporting having sex while high, were more likely to report unmet needs for mental health care. In contrast, those reporting receiving social support from others were less likely to have an unmet mental healthcare need. Research implications are discussed as they relate to access to healthcare needs among this vulnerable population.
Collapse
Affiliation(s)
| | | | - Cathy Reback
- b Friends Research Institute; University of California; Integrated Substance Abuse Programs and Semel Institute for Neuroscience and Human Behavior , Los Angeles , California , USA
| | - Steven Shoptaw
- c University of California , Los Angeles , California , USA
| | - Sheldon Zhang
- d San Diego State University , Los Angeles , California , USA
| | - Olga Nudelman
- a UCLA School of Nursing , Los Angeles , California , USA
| |
Collapse
|
29
|
Herrick A, Stall R, Egan J, Schrager S, Kipke M. Pathways towards risk: syndemic conditions mediate the effect of adversity on HIV risk behaviors among young men who have sex with men (YMSM). J Urban Health 2014; 91:969-82. [PMID: 25146488 PMCID: PMC4199441 DOI: 10.1007/s11524-014-9896-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Research shows that young men who have sex with men (YMSM) engage in higher rates of health risk behaviors and experience higher rates of negative health outcomes than their peers. The purpose of this study is to determine if the effects of adversity on HIV risk are mediated by syndemics (co-occurring health problems). Participants were 470 ethnically diverse YMSM ages 18 to 24 recruited between 2005 and 2006 and surveyed every 6 months for 24 months. Regression analyses examined the impact of adversity on syndemics (emotional distress, substance use, and problematic alcohol use) and the effects of both adversity and syndemics on HIV risk behaviors over time. Gay-related discrimination and victimization-among other adversity variables-were significantly associated with syndemics and condomless sex (CS). Syndemics mediated the effects of adversity on CS in all models. Adverse events impact HIV risk taking among YMSM through syndemics. These findings suggest that prevention programs aimed at reducing adversity may reduce both the synergistic effect of multiple psychosocial health problems and HIV risk taking.
Collapse
Affiliation(s)
- Amy Herrick
- Graduate school of Public Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA, USA,
| | | | | | | | | |
Collapse
|
30
|
Glick SN, Golden MR. Early male partnership patterns, social support, and sexual risk behavior among young men who have sex with men. AIDS Behav 2014; 18:1466-75. [PMID: 24356869 DOI: 10.1007/s10461-013-0678-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Few data exist on the early sexual behavior patterns of contemporary young men who have sex with men (YMSM), the social context of these patterns, and which of these factors influence risk for HIV and other sexually transmitted infections (STI). We enrolled 94 YMSM (age 16-30) into a 1-year cohort study with serial online retrospective surveys and HIV/STI testing. The first three partnerships of YMSM were characterized by relatively high rates of unprotected anal sex and a rapidly expanding sexual repertoire, but also increasing rates of HIV status disclosure. During follow-up, 17 % of YMSM reported any nonconcordant unprotected anal intercourse (NCUAI) and 15 % were newly diagnosed with HIV/STI. Sex education in high school and current maternal support were protective against HIV/STI, while isolation from family and friends was associated with recent NCUAI. Social support-including from parents, peers, and school-based sex education-may help mitigate HIV/STI risk in this population.
Collapse
Affiliation(s)
- Sara Nelson Glick
- Department of Epidemiology and Biostatistics, The George Washington University, 2100-W Pennsylvania Ave NW, 8th Floor, Washington, DC, 20037, USA,
| | | |
Collapse
|
31
|
Winetrobe H, Rice E, Bauermeister J, Petering R, Holloway IW. Associations of unprotected anal intercourse with Grindr-met partners among Grindr-using young men who have sex with men in Los Angeles. AIDS Care 2014; 26:1303-8. [DOI: 10.1080/09540121.2014.911811] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
32
|
Matarazzo BB, Barnes SM, Pease JL, Russell LM, Hanson JE, Soberay KA, Gutierrez PM. Suicide risk among lesbian, gay, bisexual, and transgender military personnel and veterans: what does the literature tell us? Suicide Life Threat Behav 2014; 44:200-17. [PMID: 24494604 DOI: 10.1111/sltb.12073] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 08/27/2013] [Indexed: 11/28/2022]
Abstract
Research suggests that both the military and veteran and the lesbian, gay, bisexual, and transgender (LGBT) populations may be at increased risk for suicide. A literature review was conducted to identify research related to suicide risk in the LGBT military and veteran populations. Despite the paucity of research directly addressing this issue, themes are discussed evident in the literature on LGBT identity and suicide risk as well as LGBT military service members and veterans. Factors such as social support and victimization appear to be particularly relevant. Suggestions are made with respect to future research that is needed on this very important and timely topic.
Collapse
Affiliation(s)
- Bridget B Matarazzo
- Veterans Integrated Service Network (VISN) 19 Mental Illness, Research, Education and Clinical Center (MIRECC), Denver, CO, USA; Department of Psychiatry, School of Medicine, University of Colorado, Denver, CO, USA
| | | | | | | | | | | | | |
Collapse
|
33
|
Kapadia F, Halkitis P, Barton S, Siconolfi D, Figueroa RP. Associations between social support network characteristics and receipt of emotional and material support among a sample of male sexual minority youth. JOURNAL OF GAY & LESBIAN SOCIAL SERVICES 2014; 26:279-302. [PMID: 25214756 PMCID: PMC4157518 DOI: 10.1080/10538720.2014.924458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Few studies have examined how social support network characteristics are related to perceived receipt of social support among male sexual minority youth. Using egocentric network data collected from a study of male sexual minority youth (n=592), multivariable logistic regression analyses examined distinct associations between individual and social network characteristics with receipt of (1) emotional and (2) material support. In multivariable models, frequent communication and having friends in one's network yielded a two-fold increase in the likelihood of receiving emotional support whereas frequent communication was associated with an almost three-fold higher likelihood of perceived material support. Finally, greater internalized homophobia and personal experiences of gay-related stigma were inversely associated with perceived receipt of emotional and material support, respectively. Understanding the evolving social context and social interactions of this new generation of male sexual minority youth is warranted in order to understand the broader, contextual factors associated with their overall health and well-being.
Collapse
Affiliation(s)
- Farzana Kapadia
- Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of, Culture, Education & Human Development, New York University, NY
| | - Perry Halkitis
- Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of, Culture, Education & Human Development, New York University, NY
| | - Staci Barton
- Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of, Culture, Education & Human Development, New York University
| | - Daniel Siconolfi
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public, Health, Baltimore, Maryland
| | - Rafael Perez Figueroa
- Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of, Culture, Education & Human Development, New York University
| |
Collapse
|
34
|
Burns MN, Montague E, Mohr DC. Initial design of culturally informed behavioral intervention technologies: developing an mHealth intervention for young sexual minority men with generalized anxiety disorder and major depression. J Med Internet Res 2013; 15:e271. [PMID: 24311444 PMCID: PMC3869054 DOI: 10.2196/jmir.2826] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Revised: 09/09/2013] [Accepted: 09/11/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To our knowledge, there is no well-articulated process for the design of culturally informed behavioral intervention technologies. OBJECTIVE This paper describes the early stages of such a process, illustrated by the methodology for the ongoing development of a behavioral intervention technology targeting generalized anxiety disorder and major depression among young sexual minority men. METHODS We integrated instructional design for Internet behavioral intervention technologies with greater detail on information sources that can identify user needs in understudied populations, as well as advances in the understanding of technology-specific behavioral intervention technology dimensions that may need to be culturally tailored. RESULTS General psychological theory describing how to effect change in the clinical target is first integrated with theory describing potentially malleable factors that help explain the clinical problem within the population. Additional information sources are then used to (1) evaluate the theory, (2) identify population-specific factors that may affect users' ability to relate to and benefit from the behavioral intervention technology, and (3) establish specific skills, attitudes, knowledge, etc, required to change malleable factors posited in the theory. User needs result from synthesis of this information. Product requirements are then generated through application of the user needs to specific behavioral intervention technology dimensions (eg, technology platform). We provide examples of considerations relevant to each stage of this process and how they were applied. CONCLUSIONS This process can guide the initial design of other culturally informed behavioral intervention technologies. This first attempt to create a systematic design process can spur development of guidelines for design of behavioral intervention technologies aimed to reduce health disparities.
Collapse
Affiliation(s)
- Michelle Nicole Burns
- Department of Preventive Medicine, Center for Behavioral Intervention Technologies (CBITs), Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
| | | | | |
Collapse
|
35
|
Deputy NP, Boehmer U. Weight status and sexual orientation: differences by age and within racial and ethnic subgroups. Am J Public Health 2013; 104:103-9. [PMID: 24228650 DOI: 10.2105/ajph.2013.301391] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES We determined differences in weight at age 18 years and at current age and weight change by sexual orientation within different racial/ethnic populations, stratifying by gender. METHODS We used 2001-2007 data from the California Health Interview Survey, resulting in an unweighted sample of 120,274 individuals aged 18 to 74 years. Using regression models, we examined overweight status and change in weight by sexual orientation, stratifying by race/ethnicity and gender. RESULTS Compared with heterosexual women of the same race/ethnicity, White and African American lesbians and bisexuals had increased likelihood of being overweight at age 18 years and maintaining overweight status during adulthood. Sexual minority status was unrelated to weight among Latinas and inconsistently linked to weight among Asian women compared with heterosexual women of the same race/ethnicity. Sexual minority status was protective against unhealthy weight among White, African American, Asian, and Latino men compared with heterosexual counterparts of the same race/ethnicity. This protective effect was seen after age 18 years except among African American bisexual men. CONCLUSIONS Our findings indicate a need for age- and culture-sensitive interventions that reduce weight or prevent weight gain in sexual minority women and men.
Collapse
Affiliation(s)
- Nicholas P Deputy
- Nicholas P. Deputy and Ulrike Boehmer are with the Department of Community Health Sciences, Boston University School of Public Health, Boston, MA
| | | |
Collapse
|
36
|
Abstract
The American Academy of Pediatrics issued its last statement on homosexuality and adolescents in 2004. Although most lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth are quite resilient and emerge from adolescence as healthy adults, the effects of homophobia and heterosexism can contribute to health disparities in mental health with higher rates of depression and suicidal ideation, higher rates of substance abuse, and more sexually transmitted and HIV infections. Pediatricians should have offices that are teen-friendly and welcoming to sexual minority youth. Obtaining a comprehensive, confidential, developmentally appropriate adolescent psychosocial history allows for the discovery of strengths and assets as well as risks. Referrals for mental health or substance abuse may be warranted. Sexually active LGBTQ youth should have sexually transmitted infection/HIV testing according to recommendations of the Sexually Transmitted Diseases Treatment Guidelines of the Centers for Disease Control and Prevention based on sexual behaviors. With appropriate assistance and care, sexual minority youth should live healthy, productive lives while transitioning through adolescence and young adulthood.
Collapse
|
37
|
Abstract
The American Academy of Pediatrics issued its last statement on homosexuality and adolescents in 2004. This technical report reflects the rapidly expanding medical and psychosocial literature about sexual minority youth. Pediatricians should be aware that some youth in their care may have concerns or questions about their sexual orientation or that of siblings, friends, parents, relatives, or others and should provide factual, current, nonjudgmental information in a confidential manner. Although most lesbian, gay, bisexual, transgender, and questioning(LGBTQ) youth are quite resilient and emerge from adolescence as healthy adults, the effects of homophobia and heterosexism can contribute to increased mental health issues for sexual minority youth. LGBTQ and MSM/WSW (men having sex with men and women having sex with women) adolescents, in comparison with heterosexual adolescents,have higher rates of depression and suicidal ideation, high errates of substance abuse, and more risky sexual behaviors. Obtaining a comprehensive, confidential, developmentally appropriate adolescent psychosocial history allows for the discovery of strengths and assets as well as risks. Pediatricians should have offices that are teen-friendly and welcoming to sexual minority youth. This includes having supportive, engaging office staff members who ensure that there are no barriers to care. For transgender youth, pediatricians should provide the opportunity to acknowledge and affirm their feelings of gender dysphoria and desires to transition to the opposite gender. Referral of transgender youth to a qualified mental health professional is critical to assist with the dysphoria, to educate them,and to assess their readiness for transition. With appropriate assistance and care, sexual minority youth should live healthy, productive lives while transitioning through adolescence and young adulthood.
Collapse
|
38
|
Wong CF, Schrager SM, Chou CP, Weiss G, Kipke MD. Changes in developmental contexts as predictors of transitions in HIV-risk behaviors among young men who have sex with men (YMSM). AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2013; 51:439-450. [PMID: 23254866 DOI: 10.1007/s10464-012-9562-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Emerging adulthood is a transitional time often marked by instability in many areas of life, including residential status, work, school, and romantic relationships. The purpose of this study is to examine transitions in HIV-risk related behaviors among a cohort of ethnically-diverse young men who have sex with men (YMSM) and to reveal how changes in developmental contexts during emerging adulthood might be associated with these behavioral changes. Hidden Markov models were used to examine movement across different stages of behavioral risk-taking over time. Semi-annual surveys were administered across 2 years; analyses included those with at least three of the five waves of data. Results indicated substantial movement at the individual-level transitions. Additionally, high variability in sexual risk, alcohol misuse, and illicit drug-risk behaviors was predicted by age, ethnicity, and correlates of emerging adulthood, such as residential status, work, post-secondary school enrollment, and primary-relationship status. Findings provide evidence of great change in risky behaviors among YMSM during this pivotal time, particularly among those who actively experiment in varying levels of risk-taking. In order to prevent experimental behaviors from evolving into more serious risk, interventions must consider ways to assist YMSM to adjust to life changes brought on by emerging adulthood.
Collapse
Affiliation(s)
- Carolyn F Wong
- Community, Health Outcomes, and Intervention Research Program, The Saban Research Institute, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS#30, Los Angeles, CA 90027, USA.
| | | | | | | | | |
Collapse
|
39
|
Traube DE, Schrager SM, Holloway IW, Weiss G, Kipke MD. Environmental risk, social cognition, and drug use among young men who have sex with men: longitudinal effects of minority status on health processes and outcomes. Drug Alcohol Depend 2013; 127:1-7. [PMID: 22749680 PMCID: PMC3480562 DOI: 10.1016/j.drugalcdep.2012.06.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 05/04/2012] [Accepted: 06/01/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Young men who have sex with men (YMSM) continue to be at elevated risk for substance use; however, models explaining this phenomenon have often focused on a limited array of explanatory constructs. This study examined the longitudinal relationship of contextual risk factors, social cognitive processes, mental health, and health protective behavior to identify key mechanisms of illicit drug use of YMSM as they aged through emerging adulthood. METHODS Our sample included an ethnically diverse cohort of 487 YMSM recruited through venue based probability sampling in Los Angeles. We used latent growth curve modeling to understand relationships between environmental risk factors, changing individual and social process variables, health protective behavior, psychological distress, and illicit drug use outcomes among YMSM. RESULTS Age, ethnicity, violence and discrimination, depression, and previous histories of illicit drug use were key elements of risk for future illicit drug use among YMSM. During this theoretically distinct time period, health as a value, self-efficacy, and social support are vital social cognitive processes for promoting self-change among YMSM, and YMSM have independent growth within each process. Health as a value, self-efficacy, and social support were dynamic social cognitive processes, which served as key mechanisms by which risk factors were converted into health promotion strategies or psychological distress, and ultimately illicit drug use. CONCLUSIONS The efficacy of prevention interventions aimed at reducing illicit drug use among YMSM can be enhanced by addressing social cognitive processes for this underserved portion of the male population.
Collapse
Affiliation(s)
- Dorian E Traube
- School of Social Work, University of Southern California, Los Angeles, CA 90089-041, United States.
| | | | | | | | | |
Collapse
|
40
|
Storholm ED, Siconolfi DE, Halkitis PN, Moeller RW, Eddy JA, Bare MG. Sociodemographic Factors Contribute to Mental Health Disparities and Access to Services Among Young Men Who Have Sex with Men in New York City. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2013; 17:10.1080/19359705.2012.763080. [PMID: 24224066 PMCID: PMC3819040 DOI: 10.1080/19359705.2012.763080] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Young men who have sex with men (YMSM) may be at increased risk for mental health problems including depression, post-traumatic stress (PTSD), and suicidality. The overriding goal of the current investigation was to examine mental health and mental health services in a diverse sample of YMSM. We analyzed cross-sectional data from a cohort study of 598 YMSM, including sociodemographics, mental health, and mental health care. We then tested for bivariate associations, and used multivariable modeling to predict depression, PTSD, suicidality and mental health care utilization. Lower socioeconomic status, unstable housing, and school non-enrollment predicted depression and PTSD scores, while unstable housing and school non-enrollment predicted recent suicide attempt(s). These recent suicide attempt(s) also predicted current utilization of counseling or treatment, any history of psychiatric hospitalization, and any history of psychiatric diagnosis. Black and API men were less likely to have ever accessed mental health counseling or treatment. There were significant class-based differences with regard to mental health outcomes, but not mental health services. Further, recent crises (i.e., suicide attempt, hospitalization) were strong predictors of accessing mental health services. Improving the mental health of YMSM requires addressing the underlying structural factors that influence mental health outcomes and service access.
Collapse
Affiliation(s)
- Erik David Storholm
- Center for Health, Identity, Behavior & Prevention Studies (CHIBPS), Steinhardt School of Culture, Education & Human Development, New York University
| | | | | | | | | | | |
Collapse
|
41
|
Kubicek K, Beyer W, Weiss G, Kipke MD. Photovoice as a tool to adapt an HIV prevention intervention for African American young men who have sex with men. Health Promot Pract 2012; 13:535-43. [PMID: 21460254 PMCID: PMC3134174 DOI: 10.1177/1524839910387131] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. HIV rates for African American young men who have sex with men (AAYMSM) have reached as much as 14.7%, compared with 2.5% and 3.5% among Caucasian and Latino YMSM. However, there remains a lack of HIV prevention interventions for this population. This study describes the use of Photovoice in the adaptation process of an evidence-based intervention (Adult Identity Mentoring) to make it developmentally and culturally appropriate for AAYMSM. Method. A total of 36 AAYMSM (aged 18-24 years) participated in weekly working group sessions to conduct a community-, youth-, and data-driven adaptation process. Photovoice was used as a technique to facilitate guided discussions on topics that were identified for the new curriculum. Results. Through Photovoice discussions, we identified a new focus for the adapted intervention, Young Men's Adult Identity Mentoring (YM-AIM): development and maintenance of healthy intimate relationships. This new focus and the resulting curriculum are rooted in the voices and perceptions of the target population. Conclusions. Including youth was integral to the adaptation process and the use of techniques such as Photovoice helped ensure that the resulting adaptation was relevant to the target population.
Collapse
Affiliation(s)
- Katrina Kubicek
- Community, Health Outcomes, and Intervention Research Program, Saban Research Institute, Childrens Hospital Los Angeles
| | - William Beyer
- Community, Health Outcomes, and Intervention Research Program, Saban Research Institute, Childrens Hospital Los Angeles
| | - George Weiss
- Community, Health Outcomes, and Intervention Research Program, Saban Research Institute, Childrens Hospital Los Angeles
| | - Michele D. Kipke
- Community, Health Outcomes, and Intervention Research Program, Saban Research Institute, Childrens Hospital Los Angeles
- Department of Pediatrics, Keck School of Medicine, University of Southern California
| |
Collapse
|
42
|
Beidas RS, Birkett M, Newcomb ME, Mustanski B. Do psychiatric disorders moderate the relationship between psychological distress and sexual risk-taking behaviors in young men who have sex with men? A longitudinal perspective. AIDS Patient Care STDS 2012; 26:366-74. [PMID: 22680282 DOI: 10.1089/apc.2011.0418] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Young men who have sex with men (YMSM) account for two-thirds of new HIV infections in young people in the United States. Identifying between-person and within-person correlates of sexual risk-taking provides critical information for developing behavioral prevention efforts for this group. Possible predictors of sexual-risk behavior in YMSM include major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and variation in psychological distress over time. To date, research has been equivocal with regard to the relationship between psychiatric disorders, psychological distress, and sexual risk behaviors. Participants included 119 16-20-year-old YMSM. Ethnicity/race of the participants included: black/African-American (46.2%), white (19.3%), Latino/Hispanic (12.6%), multiracial (11.8%), Asian/Pacific Islander (2.5%), and other (5.9%). Sexual risk outcomes included total number of male partners and unprotected anal sex acts across four waves of data collection (24 months). The study found that the between-person correlates, including ethnicity and age, predicted total male partners. Between-person correlates, including ethnicity, MDD, and a moderating effect of PTSD on psychological distress emerged as determinants of unprotected anal sex acts.
Collapse
Affiliation(s)
- Rinad S. Beidas
- Department of Psychiatry, University of Pensylvania, Philadelphia, Pennsylvania
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Michelle Birkett
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| | - Michael E. Newcomb
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
| |
Collapse
|
43
|
Holloway IW, Traube DE, Rice E, Schrager SM, Palinkas LA, Richardson J, Kipke MD. Community and Individual Factors Associated with Cigarette Smoking Among Young Men Who Have Sex With Men. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2012; 22:199-205. [PMID: 22661879 PMCID: PMC3362198 DOI: 10.1111/j.1532-7795.2011.00774.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Young men who have sex with men (YMSM) have higher rates of cigarette smoking than their heterosexual counterparts, yet few studies have examined factors associated with cigarette smoking among YMSM. The present study sought to understand how different types of gay community connection (i.e., gay community identification and involvement, gay bar/club attendance) were associated with smoking among YMSM recruited through venue-based sampling in Los Angeles, California (N = 526). Structural equation modeling was used to isolate direct and indirect effects of gay community connection on smoking through cognitive and psychological mediators (i.e., psychological distress, health values, internalized homophobia). Findings indicate YMSM cigarette smoking prevention and intervention must be tailored to address the direct and indirect influences of the gay community.
Collapse
Affiliation(s)
| | | | - Eric Rice
- School of Social Work, University of Southern California
| | | | | | - Jean Richardson
- Department of Preventive Medicine, University of Southern California
| | - Michele D. Kipke
- Department of Preventive Medicine, University of Southern California
- Saban Research Institute, Children’s Hospital Los Angeles
| |
Collapse
|
44
|
Jenkins WD, Wold B. Use of the Internet for the surveillance and prevention of sexually transmitted diseases. Microbes Infect 2011; 14:427-37. [PMID: 22207184 DOI: 10.1016/j.micinf.2011.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 12/08/2011] [Accepted: 12/08/2011] [Indexed: 10/14/2022]
Abstract
The Internet is a relatively new tool in the surveillance and prevention of sexually transmitted infections, and this review examines its global use in this regard. Much use has been made in the form of information collection and dissemination; targeted population engagement through chat rooms, partner notification and other mechanisms; and the provision of testing services and other products. Internet users may need education concerning reputable websites, and public health practitioners need proficiency in the use of social media and marketing.
Collapse
Affiliation(s)
- Wiley D Jenkins
- Southern Illinois University School of Medicine, Department of Family and Community Medicine, Springfield, IL 62791-9671, USA.
| | | |
Collapse
|
45
|
Kubicek K, Carpineto J, McDavitt B, Weiss G, Kipke MD. Use and perceptions of the internet for sexual information and partners: a study of young men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2011; 40:803-16. [PMID: 20809373 PMCID: PMC3000442 DOI: 10.1007/s10508-010-9666-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 01/15/2010] [Accepted: 06/20/2010] [Indexed: 05/09/2023]
Abstract
The Internet has opened many doors with its accessibility to information, entertainment and web-based communities. For young men who have sex with men (YMSM), the Internet can provide access to information on relevant sexual behavior and health information, stories from other men about relationship issues, and a venue for locating potential sexual and dating partners. Understanding YMSM's motivations for going online for information, advice or sexual relationships, is important as the Internet becomes increasingly used not only as a space to find sexual partners, but also as a venue for HIV and STI interventions. Having an understanding of the risks associated with searching for partners online, and how and why YMSM use the Internet for a variety of purposes, can inform the development of more effective Internet-based risk reduction programs. This article presents qualitative and quantitative data from the Healthy Young Men's Study, a longitudinal study of an ethnically diverse cohort of 526 YMSM. Qualitative interviews (N = 24) described not only the prevalence of using the Internet for finding sexual partners and the possible benefits and risks associated with that practice, but also the processes and perceptions of using this mechanism. Our data indicate that YMSM used the Internet to find information related to sex and sexuality, seek friendships, sexual partners as well as "hook-ups" or casual sex. Findings were presented in relation to how YMSM researchers and interventionists can identify how to most effectively reach YMSM through online methods.
Collapse
Affiliation(s)
- Katrina Kubicek
- Community, Health Outcomes, and Intervention Research Program, The Saban Research Institute, Childrens Hospital Los Angeles, Los Angeles, CA 90028, USA.
| | | | | | | | | |
Collapse
|
46
|
Rothman EF, Exner D, Baughman AL. The prevalence of sexual assault against people who identify as gay, lesbian, or bisexual in the United States: a systematic review. TRAUMA, VIOLENCE & ABUSE 2011; 12:55-66. [PMID: 21247983 PMCID: PMC3118668 DOI: 10.1177/1524838010390707] [Citation(s) in RCA: 261] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This article systematically reviews 75 studies that examine the prevalence of sexual assault victimization among gay or bisexual (GB) men, and lesbian or bisexual (LB) women, in the United States. All studies were published between 1989 and 2009 and report the results of quantitative research. The authors reviewed the reported prevalence of lifetime sexual assault victimization (LSA), and where available, childhood sexual assault (CSA), adult sexual assault (ASA), intimate partner sexual assault (IPSA), and hate crime-related sexual assault (HC). The studies were grouped into those that used a probability or census sampling technique (n=25) and those that used a non-probability or ''community-based'' sampling technique (n=50). A total of 139,635 gay, lesbian, and bisexual (GLB) respondents participated in the underlying studies reviewed. Prevalence estimates of LSA ranged from 15.6-85.0% for LB women and 11.8-54.0% for GB men. Considering the median estimates derived from the collective set of studies reviewed, LB women were more likely to report CSA, ASA, LSA, and IPSA than GB men, whereas GB men were more likely to report HC than LB women. Across all studies, the highest estimates reported were for LSA of LB women (85.0%), CSA of LB women (76.0%), and CSA of GB men (59.2%). With some exceptions, studies using non-probability samples reported higher sexual assault prevalence rates than did population-based or census sample studies. The challenges of assessing sexual assault victimization with GLB populations are discussed, as well as the implications for practice, policy, and future research.
Collapse
Affiliation(s)
- Emily F Rothman
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, USA.
| | | | | |
Collapse
|
47
|
Feldman MB. A critical literature review to identify possible causes of higher rates of HIV infection among young black and Latino men who have sex with men. J Natl Med Assoc 2011; 102:1206-21. [PMID: 21287902 DOI: 10.1016/s0027-9684(15)30776-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Black and Latino young men who have sex with men (YMSM) are disproportionately impacted by HIV infection; however, the reason for this disparity is unclear. To identify possible causes of the higher rates of HIV infection in this population, data from studies of HIV infection and risk-related behaviors among black and Latino YMSM were used to evaluate a series of hypotheses adapted from Millett et al's literature review that might explain the disparity. High rates of HIV infection might be attributable to unrecognized HIV infection, social/sexual networks, and a history of childhood sexual abuse; however, they were not attributable to risk-related behaviors. More research is needed to understand the risk factors for HIV infection and how to address them in HIV prevention interventions.
Collapse
|
48
|
Schrager SM, Wong CF, Weiss G, Kipke MD. Human immunodeficiency virus testing and risk behaviors among young men who have sex with men in Los Angeles County. Am J Health Promot 2011; 25:244-7. [PMID: 21361809 PMCID: PMC3164870 DOI: 10.4278/ajhp.090203-arb-43] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study investigated human immunodeficiency virus (HIV) testing and risk behaviors in a longitudinal sample of young men who have sex with men (YMSM). DESIGN Data came from the Healthy Young Men's study, comprising five waves of nonexperimental survey data collection every 6 months between February 2005 and January 2008. SETTING Participants were recruited from public venues in Los Angeles County in which YMSM spend time. SUBJECTS A total of 526 participants (24% African-American, 37% white, 39% Latino; mean age, 20.14 years; range, 18?24 years) were enrolled. Retention was 93%. MEASURES Testing recency was assessed with a four-point ordinal scale. HIV risk behaviors were operationalized as binary measures of unprotected anal intercourse with multiple partners or partners with unknown or discordant serostatus, club drug use, and illicit drug use over the prior 3 months. ANALYSIS Correlations, Cochran's Q tests, and repeated-measures analysis of variance (ANOVA) were performed in SPSS. Analyses included all data available at each wave. RESULTS No significant correlations emerged between testing recency and sex risk at any wave. Repeated-measures ANOVA showed significant positive, linear change in HIV testing recency over time, but no significant changes emerged for sex risk or drug use. CONCLUSION Although participation in testing increased, there was no corresponding change in HIV risk behavior. Initiatives may need to target risk behavior separately and specifically to reduce these behaviors among YMSM.
Collapse
Affiliation(s)
- Sheree M Schrager
- Community, Health Outcomes, and Intervention Research, Saban Research Institute, Childrens Hospital Los Angeles, California 90028, USA.
| | | | | | | |
Collapse
|
49
|
Feldman MB, Meyer IH. Comorbidity and age of onset of eating disorders in gay men, lesbians, and bisexuals. Psychiatry Res 2010; 180:126-31. [PMID: 20483473 PMCID: PMC3726047 DOI: 10.1016/j.psychres.2009.10.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Revised: 10/19/2009] [Accepted: 10/20/2009] [Indexed: 11/19/2022]
Abstract
This study examines the prevalence of psychiatric disorders among lesbian, gay, and bisexual (LGB) men with eating disorders. A total of 388 white, black, and Latino LGB men and women were sampled from community venues. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnoses of anorexia, bulimia, and binge eating disorder were assessed using the World Health Organization's Composite International Diagnostic Interview. Gay and bisexual men with eating disorders were more likely to have an anxiety or substance abuse disorder than gay and bisexual men without eating disorders, whereas lesbian and bisexual women with eating disorders were more likely to have a mood disorder than lesbian and bisexual women without an eating disorder. For individuals diagnosed with an eating and anxiety or major depressive disorder, the onset of the psychiatric disorder was more likely to precede the onset of the eating disorder. Researchers should study potential explanations of the relationship between eating and psychiatric disorders among LGB men and women.
Collapse
|
50
|
Deputy NP, Boehmer U. Determinants of body weight among men of different sexual orientation. Prev Med 2010; 51:129-31. [PMID: 20510272 DOI: 10.1016/j.ypmed.2010.05.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 05/17/2010] [Accepted: 05/19/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate eating habits and exercise behaviors as mediators in the relationship between sexual orientation and BMI in men. We hypothesized that sexual minority men (SMM) that is, men who identify as either homosexual or bisexual, have a lower BMI due to healthier eating habits and increased physical activity compared to heterosexual men. METHOD We used weighted data from the 2005 California Health Interview Survey to produce population-based estimates of the California male population. Numerous measures of eating and exercise habits, including daily servings of fruits and vegetables, and participation in varying levels of physical activity, were used in multiple regression models to test for mediation. RESULTS We found that SMM had significantly lower prevalence of overweight and obesity compared to straight men. Mediation was not confirmed, rather eating habits and exercise habits had an independent effect on BMI. CONCLUSIONS Because sexual orientation has an independent effect on BMI that is not mediated by eating or exercise behaviors, other factors explain the differences in BMI status between sexual minority and straight men.
Collapse
Affiliation(s)
- Nicholas P Deputy
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, USA
| | | |
Collapse
|