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Krause KD, D'Avanzo PA, Karr AG, Rhem C, Halkitis PN. Vaccination uptake in LGBTQ adults in two US states: Findings from the QVax study. Vaccine 2024; 42:126320. [PMID: 39277945 DOI: 10.1016/j.vaccine.2024.126320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 08/30/2024] [Accepted: 09/03/2024] [Indexed: 09/17/2024]
Abstract
OBJECTIVES Lesbian, gay, bisexual, transgender, queer and other (LGBTQ+) individuals face numerous health disparities, including higher rates of chronic diseases and sexually transmitted infections, partly due to marginalization, discrimination, and a healthcare system often unprepared to meet their specific needs. Despite the importance of vaccination in preventing these health issues, vaccination patterns in LGBTQ+ populations remain under-researched, with limited data available due to the absence of sexual orientation and gender identity information on most healthcare forms. As such, we sought to understand vaccine uptake among LGBTQ+ individuals living in New Jersey and New York for 7 primary adult vaccines. METHODS Participants were 768 LGBTQ+ adults living in New Jersey and New York, US. We recruited this convenience sample through community centers and events, social media, and listservs of local professional organizations. The online survey examined uptake for 7 adult vaccines. RESULTS Of the 7 adult vaccines, human papilloma virus (HPV) had the lowest proportion of participants who were fully/partially vaccinated (54.4 %), followed by hepatitis A (59.8 %), hepatitis B (63.0 %), meningitis B (63.7 %), seasonal influenza during the COVID-19 pandemic (70.2 %), seasonal influenza before the COVID-19 pandemic (70.3 %), and nearly all participants (99.2 %) received at least one dose of the COVID-19 vaccine. For Shingles virus, among participants age 50+, 63.8 % were fully/partially vaccinated. In adjusted models, age was the strongest predictor of vaccination uptake in HPV, hepatitis A, hepatitis B, meningitis B, and seasonal influenza before and during the COVID-19 pandemic. Younger participants were more likely to be vaccinated for 4 of the 6 vaccines, excluding Shingles (<0.001), whereas older adults were more likely to be vaccinated for seasonal influenza before and during the COVID-19 pandemic (<0.010). CONCLUSIONS This study highlights the differences in uptake across different vaccines. It also draws attention to differences within LGBTQ+ populations which is important to consider when ensuring more equitable vaccine access.
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Affiliation(s)
- Kristen D Krause
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health (CHIBPS), Rutgers University, Newark, NJ, USA; Department of Urban-Global Health, School of Public Health, Rutgers University, Newark, NJ, USA.
| | - Paul A D'Avanzo
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health (CHIBPS), Rutgers University, Newark, NJ, USA; HIV Center for Clinical and Behavioral Studies, Columbia University and the New York State Psychiatric Institute, New York, NY, USA
| | - Anita G Karr
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health (CHIBPS), Rutgers University, Newark, NJ, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Coree Rhem
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health (CHIBPS), Rutgers University, Newark, NJ, USA; Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Perry N Halkitis
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health (CHIBPS), Rutgers University, Newark, NJ, USA; Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
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Hascher K, Jaiswal J, LoSchiavo C, Ezell J, Duffalo D, Greene RE, Cox A, Burton WM, Griffin M, John T, Grin B, Halkitis PN. Lack of Informed and Affirming Healthcare for Sexual Minority Men: A Call for Patient-Centered Care. J Gen Intern Med 2024; 39:2023-2032. [PMID: 38308157 PMCID: PMC11306825 DOI: 10.1007/s11606-024-08635-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 01/16/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Sexual minority men (SMM) face severe health inequities alongside negative experiences that drive avoidance of medical care. Understanding how SMM experience healthcare is paramount to improving this population's health. Patient-centered care, which emphasizes mutual respect and collaboration between patients and providers, may alleviate the disparaging effects of the homophobia that SMM face in healthcare settings. OBJECTIVE To explore how SMM perceive their experiences with healthcare providers and how care can most effectively meet their needs. DESIGN Semi-structured qualitative interviews focused on healthcare experiences, pre-exposure prophylaxis (PrEP), and HIV-related beliefs were conducted between July and November 2018. PARTICIPANTS The study included a sample of 43 young adult SMM (ages 25-27), representing diverse socioeconomic, racial, and ethnic backgrounds, in New York City. APPROACH Researchers utilized a multiphase, systematic coding method to identify salient themes in the interview transcripts. KEY RESULTS Analyses revealed three main themes: (1) SMM perceived that their clinicians often lack adequate skills and knowledge required to provide care that considers participants' identities and behaviors; (2) SMM desired patient-centered care as a way to regain agency and actively participate in making decisions about their health; and (3) SMM felt that patient-centered care was more common with providers who were LGBTQ-affirming, including many who felt that this was especially true for LGBTQ-identified providers. CONCLUSIONS SMM expressed a clear and strong desire for patient-centered approaches to care, often informed by experiences with healthcare providers who were unable to adequately meet their needs. However, widespread adoption of patient-centered care will require improving education and training for clinicians, with a focus on LGBTQ-specific clinical care and cultural humility. Through centering patients' preferences and experiences in the construction of care, patient-centered care can reduce health inequities among SMM and empower healthcare utilization in a population burdened by historic and ongoing stigmatization.
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Affiliation(s)
- Kevin Hascher
- Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA
| | - Jessica Jaiswal
- Department of Family and Community Medicine, University of Alabama, Birmingham School of Medicine, Birmingham, AL, 35294, USA.
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, 06510, USA.
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA.
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
| | - Caleb LoSchiavo
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
| | - Jerel Ezell
- Department of Community Health Sciences, UC Berkeley, Berkeley, CA, 94720, USA
- Center for Cultural Humility, UC Berkeley, Berkeley, CA, 94720, USA
| | - Danika Duffalo
- School of Medicine, Creighton University, Phoenix, AZ, USA
| | - Richard E Greene
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, 10001, USA
| | - Amanda Cox
- Culverhouse College of Business, University of Alabama, Tuscaloosa, AL, USA
| | - Wanda M Burton
- Capstone College of Nursing, University of Alabama, Tuscaloosa, AL, 35401, USA
| | - Marybec Griffin
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
| | - Tejossy John
- Department of Family and Community Medicine, University of Alabama, Birmingham School of Medicine, Birmingham, AL, 35294, USA
| | - Benjamin Grin
- Department of Primary Care, Kansas City University College of Osteopathic Medicine, Kansas City, MO, 64106, USA
| | - Perry N Halkitis
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, 07102, USA
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, 08854, USA
- Department of Urban-Global Public Health, Rutgers School of Public Health, Newark, NJ, 07102, USA
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Marshall D, McRee AL, Gower AL, Reiter PL. Views about vaccines and how views changed during the COVID-19 pandemic among a national sample of young gay, bisexual, and other men who have sex with men. Hum Vaccin Immunother 2023; 19:2281717. [PMID: 37965729 PMCID: PMC10653772 DOI: 10.1080/21645515.2023.2281717] [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: 09/11/2023] [Accepted: 11/04/2023] [Indexed: 11/16/2023] Open
Abstract
We examined perceptions of vaccines and changes during the coronavirus disease 2019 (COVID-19) pandemic. From 2019 to 2021, a national sample of young gay, bisexual, and other men who have sex with men completed an open-ended survey item about vaccine perceptions. Analyses identified themes and polarity (negative, neutral, or positive) within responses and determined temporal changes across phases of the pandemic ("pre-pandemic," "pandemic," "initial vaccine availability," or "widespread vaccine availability"). Themes included health benefits of vaccines (53.9%), fear of shots (23.7%), COVID-19 (10.3%), vaccines being safe (5.6%), and vaccine hesitancy/misinformation (5.5%). Temporal changes existed for multiple themes (p < .05). Overall, 53.0% of responses were positive, 31.2% were negative, and 15.8% were neutral. Compared to the pre-pandemic phase, polarity was less positive for the widespread vaccine availability phase (odds ratio = 0.64, 95% confidence interval: 0.42-0.96). The findings provide insight into how vaccine perceptions change in concert with a public health emergency.
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Affiliation(s)
- Daniel Marshall
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Annie-Laurie McRee
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
- Center for Scientific Review, National Institutes of Health, Bethesda, MD, USA
| | - Amy L. Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Paul L. Reiter
- Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
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Mwaniki SW, Kaberia PM, Mugo PM, Palanee-Phillips T. "We must help them despite who they are…": healthcare providers' attitudes and perspectives on care for young gay, bisexual and other men who have sex with men in Nairobi, Kenya. BMC Health Serv Res 2023; 23:1055. [PMID: 37789339 PMCID: PMC10546658 DOI: 10.1186/s12913-023-10026-4] [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: 12/24/2022] [Accepted: 09/12/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Compared to young heterosexual men, young gay, bisexual and other men who have sex with men (YMSM) face a disproportionate burden of sexual health conditions. This disparity is occasioned by factors such as criminalization and stigmatization of same-sex practices, YMSM's limited access to non-judgmental and non-discriminatory health services, and challenges associated with healthcare delivery. We explored the attitudes and perspectives of tertiary academic institution-based healthcare providers (HCPs) toward provision of services to YMSM in Nairobi, Kenya. METHODS In September 2021, six in-person focus group discussions (FGDs) were held with 36 HCPs drawn from six public tertiary academic institutions within the Nairobi metropolis. HCPs were drawn from six cadres: front office staff, nurses, clinicians, counsellors, laboratory technologists, and pharmaceutical technologists. Discussions were conducted in English, transcribed verbatim and analyzed thematically using NVivo version 12. RESULTS Analysis showed that despite expressing disapproval of same-sex practices, HCPs recognized their professional duty to provide care to YMSM, voiced challenges they experienced when providing care to YMSM, and suggested possible strategies for improving care for YMSM. Disapproval of same-sex practices mainly stemmed from HCPs' personal values, societal norms and religious beliefs, though some HCPs identified religious principles such as the golden rule of "treating others as one would want to be treated" as motivation to providing care to YMSM. HCPs did not perceive criminalization of same-sex practices as a barrier to providing care to YMSM. Healthcare delivery challenges included inadequate knowledge and skills, a desire to "convert" YMSM's perceived deviant homosexual to the normative heterosexual orientation, secondary stigma from other HCPs, and healthcare settings that did not support YMSM to disclose same-sex practices. Suggestions for improving care comprised sensitization and training of HCPs, encouraging more HCP-YMSM interaction, providing YMSM-friendly and inclusive services, and advocacy for YMSM services. CONCLUSION There is need for interventions to improve HCPs' knowledge of YMSM's health needs, build skills to respond to these needs, and foster affirming attitudes toward same-sex practices. By so doing, YMSM can hopefully be able to access services that meet their needs, and are non-discriminatory, non-stigmatizing and non-judgmental.
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Affiliation(s)
- Samuel Waweru Mwaniki
- School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- Department of Health Services, Administration and Campus Support Services, University of Nairobi, Nairobi, Kenya.
| | - Peter Mwenda Kaberia
- Department of Mathematics, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Peter Mwangi Mugo
- Kenya Medical Research Institute - Wellcome Trust Research Programme, Nairobi, Kenya
| | - Thesla Palanee-Phillips
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Hascher K, Jaiswal J, Lorenzo J, LoSchiavo C, Burton W, Cox A, Dunlap K, Grin B, Griffin M, Halkitis PN. 'Why aren't you on PrEP? You're a gay man': reification of HIV 'risk' influences perception and behaviour of young sexual minority men and medical providers. CULTURE, HEALTH & SEXUALITY 2023; 25:63-77. [PMID: 34965849 PMCID: PMC9243195 DOI: 10.1080/13691058.2021.2018501] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/10/2021] [Indexed: 05/06/2023]
Abstract
Public health models and medical interventions have often failed to consider the impact of reductionist HIV 'risk' discourse on how sexual minority men interpret, enact and embody biomedical knowledge in the context of sexual encounters. The aim of this study was to use an anthropological lens to examine sexual minority men's perception of HIV risk and experience within the medical system in order to examine the influence of risk discourse on their health, behaviour and social norms. In-depth interviews (n = 43) were conducted with a racially, ethnically and socioeconomically diverse sample of young sexual minority men and explored HIV-related beliefs and experiences, as well as their interactions with healthcare providers. Findings suggest that the stigmatisation of behaviours associated with HIV appears to be shaped by three key forces: healthcare provider perceptions of sexual minority men as inherently 'risky', community slut-shaming, and perceptions of risk related to anal sex positioning. Stigmatising notions of risk appear to be embodied through sexual health practices and identities vis-à-vis preferred anal sex positions and appear to influence condom use and PrEP initiation.
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Affiliation(s)
- Kevin Hascher
- Department of Biology and Anthropology, University of Alabama, Tuscaloosa, AL, USA
| | - Jessica Jaiswal
- Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, USA
| | - Julianna Lorenzo
- Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
| | - Caleb LoSchiavo
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, USA
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Wanda Burton
- Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
| | - Amanda Cox
- Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
| | - Kandyce Dunlap
- Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
| | - Benjamin Grin
- Department of Primary Care, Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA
| | - Marybec Griffin
- School of Public Health, Rutgers University, Piscataway, NJ, USA
- Department of Health Behavior, Society and Policy, Rutgers University, Piscataway, NJ, USA
| | - Perry N. Halkitis
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, NJ, USA
- School of Public Health, Rutgers University, Piscataway, NJ, USA
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Krause KD, Brennan-Ing M, Halkitis PN. Assessing the Factor Structure and Psychometric Properties of the HIV-Related Resilience Screener: The GOLD Studies. AIDS Behav 2022; 27:1703-1715. [PMID: 36369501 DOI: 10.1007/s10461-022-03902-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/15/2022]
Abstract
People who are 50 and older constitute the majority of those living with HIV/AIDS (PLWHA) in the US. Aging PLWHA face myriad biopsychosocial health challenges related to HIV/AIDS and the aging process. Resilience may act as a buffer to the negative impact of these challenges however measuring it among PLWHA has been inconsistent, so the HIV-Related Resilience Screener (HIV-RRS) was developed. Data for the present study are drawn from 250 sociodemographically diverse HIV-positive gay men ages 50-69 in NYC. Tests of reliability and validity were conducted, and an Exploratory Factor Analysis indicated a three-factor model was the most parsimonious solution. Items were examined for their underlying relationships and labeled: adaptive coping, optimism, and effective coping. The total HIV-RRS yielded a Cronbach's α of 0.84. Convergent and face validity were established using psychosocial and physical outcomes. The HIV-RRS is a psychometrically sound instrument to assess resilience among older HIV-positive gay men.
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Harkness A, Bainter SA, Mendez NA, Hernandez Altamirano D, O'Cleirigh C, Mimiaga MJ, Mayer KH, Safren SA. Factors associated with barriers to engagement in HIV-prevention care among sexual minority men. J Behav Med 2021; 44:784-793. [PMID: 33993442 PMCID: PMC8981556 DOI: 10.1007/s10865-021-00230-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/24/2021] [Indexed: 10/21/2022]
Abstract
Engagement with HIV-prevention services varies among sexual minority men (SMM). 183 HIV-negative SMM completed a baseline assessment including sociodemographic, psychosocial, identity and stigma, and sexuality measures, as well as HIV-prevention behaviors: (1) date of most recent HIV test, (2) whether they discussed HIV or (3) sexual behavior with their provider, and (4) disclosure to provider about engaging in condomless anal sex (CAS). Factor analysis of these four items yielded an HIV-prevention engagement factor score. Stochastic search variable selection (SSVS) followed by multiple linear regression identified variables associated with HIV-prevention engagement. SSVS identified three variables for inclusion in a multiple linear regression model. Not disclosing sexual orientation to one's provider (p < 0.001), discomfort discussing sex with provider (p < 0.001) and lower education (p = 0.007) were associated with less HIV-prevention engagement. Findings suggest the importance of training providers in culturally competent care to mitigate observed barriers.
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Affiliation(s)
- Audrey Harkness
- Clinical Research Building, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA.
| | - Sierra A Bainter
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA
| | - Noelle A Mendez
- Clinical Research Building, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
| | | | | | | | - Kenneth H Mayer
- Harvard School of Public Health, Boston, USA
- The Fenway Institute, Boston, MA, USA
| | - Steven A Safren
- Clinical Research Building, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA
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Khan MR, Kapadia F, Geller A, Mazumdar M, Scheidell JD, Krause KD, Martino RJ, Cleland CM, Dyer TV, Ompad DC, Halkitis PN. Racial and ethnic disparities in "stop-and-frisk" experience among young sexual minority men in New York City. PLoS One 2021; 16:e0256201. [PMID: 34437565 PMCID: PMC8389488 DOI: 10.1371/journal.pone.0256201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 08/02/2021] [Indexed: 11/19/2022] Open
Abstract
Although racial/ethnic disparities in police contact are well documented, less is known about other dimensions of inequity in policing. Sexual minority groups may face disproportionate police contact. We used data from the P18 Cohort Study (Version 2), a study conducted to measure determinants of inequity in STI/HIV risk among young sexual minority men (YSMM) in New York City, to measure across-time trends, racial/ethnic disparities, and correlates of self-reported stop-and-frisk experience over the cohort follow-up (2014-2019). Over the study period, 43% reported stop-and-frisk with higher levels reported among Black (47%) and Hispanic/Latinx (45%) than White (38%) participants. Stop-and-frisk levels declined over follow-up for each racial/ethnic group. The per capita rates among P18 participants calculated based on self-reported stop-and-frisk were much higher than rates calculated based on New York City Police Department official counts. We stratified respondents' ZIP codes of residence into tertiles of per capita stop rates and observed pronounced disparities in Black versus White stop-and-frisk rates, particularly in neighborhoods with low or moderate levels of stop-and-frisk activity. YSMM facing the greatest economic vulnerability and mental disorder symptoms were most likely to report stop-and-frisk. Among White respondents levels of past year stop-and-frisk were markedly higher among those who reported past 30 day marijuana use (41%) versus those reporting no use (17%) while among Black and Hispanic/Latinx respondents stop-and-frisk levels were comparable among those reporting marijuana use (38%) versus those reporting no use (31%). These findings suggest inequity in policing is observed not only among racial/ethnic but also sexual minority groups and that racial/ethnic YSMM, who are at the intersection of multiple minority statuses, face disproportionate risk. Because the most socially vulnerable experience disproportionate stop-and-frisk risk, we need to reach YSMM with community resources to promote health and wellbeing as an alternative to targeting this group with stressful and stigmatizing police exposure.
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Affiliation(s)
- Maria R. Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, United States of America
- Center for Drug Use and HIV Research, New York University, New York, New York, United States of America
| | - Farzana Kapadia
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, United States of America
- Department of Epidemiology, New York University, New York, New York, United States of America
| | - Amanda Geller
- Department of Criminology, Law and Society, University of California - Irvine, Irvine, California, United States of America
| | - Medha Mazumdar
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Joy D. Scheidell
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, United States of America
- Center for Drug Use and HIV Research, New York University, New York, New York, United States of America
| | - Kristen D. Krause
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers University, Piscataway, New Jersey, United States of America
| | - Richard J. Martino
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers University, Piscataway, New Jersey, United States of America
| | - Charles M. Cleland
- Department of Population Health, New York University Grossman School of Medicine, New York, New York, United States of America
- Center for Drug Use and HIV Research, New York University, New York, New York, United States of America
| | - Typhanye V. Dyer
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, United States of America
| | - Danielle C. Ompad
- Center for Drug Use and HIV Research, New York University, New York, New York, United States of America
- Department of Epidemiology, New York University, New York, New York, United States of America
| | - Perry N. Halkitis
- Center for Health, Identity, Behavior & Prevention Studies, Rutgers University, Piscataway, New Jersey, United States of America
- Departments of Biostatistics and Epidemiology and Urban-Global Health, Rutgers University, Piscataway, New Jersey, United States of America
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Martino RJ, Krause KD, Griffin M, LoSchiavo C, Comer-Carruthers C, Karr AG, Bullock AF, Halkitis PN. A Nationwide Survey of COVID-19 Testing in LGBTQ+ Populations in the United States. Public Health Rep 2021; 136:493-507. [PMID: 34034566 PMCID: PMC8203041 DOI: 10.1177/00333549211018190] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Lesbian, gay, bisexual, transgender, or queer and questioning (LGBTQ+) people and populations face myriad health disparities that are likely to be evident during the COVID-19 pandemic. The objectives of our study were to describe patterns of COVID-19 testing among LGBTQ+ people and to differentiate rates of COVID-19 testing and test results by sociodemographic characteristics. METHODS Participants residing in the United States and US territories (N = 1090) aged ≥18 completed an internet-based survey from May through July 2020 that assessed COVID-19 testing and test results and sociodemographic characteristics, including sexual orientation and gender identity (SOGI). We analyzed data on receipt and results of polymerase chain reaction (PCR) and antibody testing for SARS-CoV-2 and symptoms of COVID-19 in relation to sociodemographic characteristics. RESULTS Of the 1090 participants, 182 (16.7%) received a PCR test; of these, 16 (8.8%) had a positive test result. Of the 124 (11.4%) who received an antibody test, 45 (36.3%) had antibodies. Rates of PCR testing were higher among participants who were non-US-born (25.4%) versus US-born (16.3%) and employed full-time or part-time (18.5%) versus unemployed (10.8%). Antibody testing rates were higher among gay cisgender men (17.2%) versus other SOGI groups, non-US-born (25.4%) versus US-born participants, employed (12.6%) versus unemployed participants, and participants residing in the Northeast (20.0%) versus other regions. Among SOGI groups with sufficient cell sizes (n > 10), positive PCR results were highest among cisgender gay men (16.1%). CONCLUSIONS The differential patterns of testing and positivity, particularly among gay men in our sample, confirm the need to create COVID-19 public health messaging and programming that attend to the LGBTQ+ population.
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Affiliation(s)
- Richard J. Martino
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health, Rutgers University, Newark, NJ, USA
| | - Kristen D. Krause
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health, Rutgers University, Newark, NJ, USA
- Department of Health Behavior, Society, and Policy, School of Public Health, Rutgers University, Newark, NJ, USA
| | - Marybec Griffin
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health, Rutgers University, Newark, NJ, USA
| | - Caleb LoSchiavo
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health, Rutgers University, Newark, NJ, USA
- Department of Health Behavior, Society, and Policy, School of Public Health, Rutgers University, Newark, NJ, USA
| | - Camilla Comer-Carruthers
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health, Rutgers University, Newark, NJ, USA
| | - Anita G. Karr
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health, Rutgers University, Newark, NJ, USA
| | - Allie F. Bullock
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health, Rutgers University, Newark, NJ, USA
| | - Perry N. Halkitis
- Center for Health, Identity, Behavior, and Prevention Studies, School of Public Health, Rutgers University, Newark, NJ, USA
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA
- Department of Urban–Global Health, School of Public Health, Rutgers University, Newark, NJ, USA
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Misinformation, Gendered Perceptions, and Low Healthcare Provider Communication Around HPV and the HPV Vaccine Among Young Sexual Minority Men in New York City: The P18 Cohort Study. J Community Health 2021; 45:702-711. [PMID: 32016677 DOI: 10.1007/s10900-019-00784-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection among adults in the United States, and can cause several types of cancer. This is of particular concern for sexual minority men, as their increased risk of HIV acquisition increases risk for HPV and HPV-associated cancers, particularly when coupled with low rates of HPV vaccination. As part of a larger study of the syndemic of HIV, substance use, and mental health among young sexual minority men in New York City, we sought to explore what sexual minority men know about HPV and the HPV vaccine, along with their experiences have been communicating about the virus and vaccine. We interviewed 38 young sexual minority men with diverse sociodemographic characteristics and identified three main themes: low knowledge about HPV infection and vaccination, highly gendered misconceptions about HPV only affecting women, and lack of communication from healthcare providers about HPV. The prevalence of incorrect HPV knowledge, coupled with inadequate education and vaccination in healthcare settings, indicates a missed opportunity for HPV prevention in a high-risk and high-need population.
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