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Rosen AD, Javanbakht M, Shoptaw SJ, Seamans MJ, Gorbach PM. Associations of Sleep Deficiency With Sexual Risk Behaviors and HIV Treatment Outcomes Among Men Who Have Sex With Men Living With or at High Risk of Acquiring HIV. J Acquir Immune Defic Syndr 2024; 96:326-333. [PMID: 38916426 PMCID: PMC11207189 DOI: 10.1097/qai.0000000000003444] [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: 06/28/2023] [Accepted: 04/11/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Associations of sleep deficiency and methamphetamine use with sexual health and HIV treatment outcomes are poorly understood. SETTING A longitudinal cohort of men who have sex with men at risk for or living with HIV (the mSTUDY) was analyzed. This analysis included 1445 study visits among 382 participants. Data were collected from June 2018 to February 2022. METHODS Semiannual study visits included self-interviews for sleep deficiency, sexual behaviors, substance use, and HIV treatment. Sleep deficiency was measured using the Pittsburgh Sleep Quality Index. Participants provided specimens for HIV viral load and sexually transmitted infection (STI) testing (chlamydia, gonorrhea, syphilis). Associations between sleep deficiency and STI/HIV outcomes were estimated using multiple logistic regression. RESULTS Across visits, the prevalence of sleep deficiency was 56%, with 33% reporting methamphetamine use and 55% living with HIV. Sleep deficiency was associated with reporting at least 1 new anal sex partner (aOR = 1.62, 95% CI: 1.21 to 2.15), exchange sex (aOR = 2.71, 95% CI: 1.15 to 6.39), sex party attendance (aOR = 2.60, 95% CI: 1.68 to 4.04), and missing HIV medications (aOR = 1.91, 95% CI: 1.16 to 3.14). The association between sleep deficiency and exchange sex differed for participants who did and did not report the use of methamphetamine (P = 0.09). CONCLUSION Sleep deficiency was associated with sexual health and HIV treatment behaviors after accounting for methamphetamine use. Sleep health should be considered in STI/HIV prevention, particularly for those who use methamphetamine.
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Affiliation(s)
- Allison D. Rosen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Steven J. Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Marissa J. Seamans
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Pamina M. Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Huber BD, Kim B, Chaix B, Regan SD, Duncan DT. Objective and Subjective Neighborhood Crime Associated with Poor Sleep among Young Sexual Minority Men: a GPS Study. J Urban Health 2022; 99:1115-1126. [PMID: 35931941 PMCID: PMC9727059 DOI: 10.1007/s11524-022-00674-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 01/14/2023]
Abstract
Sleep disparities in sexual minority male (SMM) populations have received relatively little attention but they may be critical to explaining other health disparities seen among SMM, via neural or hormonal pathways. Recent research suggests that crime may be a psychosocial stressor that contributes to sleep disparities but that finding has been based on subjective measures of crime. We conducted the P18 Neighborhood Study of 250 SMM in New York City, including 211 with adequate GPS tracking data. We used the GPS tracking data to define daily path area activity spaces and tested the associations of violent crime in those activity spaces and in the subject's residential neighborhood, perceived neighborhood safety, and witnessing crime with a subjective measure of sleep. Using quasi-Poisson regression, adjusted for individual and neighborhood socio-demographics, we found that SMM who witnessed more types of crime experienced significantly more nights of poor sleep over the course of a month (RR: 1.16, 95%CI: 1.05-1.27, p-value: < 0.01). We did not find any associations between violent crime rates in either the activity area or residential area and sleep. Our findings support the conclusion that personal exposure to crime is associated with sleep problems and provide further evidence for the pathway between stress and sleep. The lack of association between neighborhood crime levels and sleep suggests that there must be personal experience with crime and ambient presence is insufficient to produce an effect.
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Affiliation(s)
- Benjamin D Huber
- Department of Epidemiology, Columbia Spatial Epidemiology Lab, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA.
| | - Byoungjun Kim
- Department of Epidemiology, Columbia Spatial Epidemiology Lab, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA
- Department of Population Health, New York University Grossman School of Medicine, 550 1st Ave, New York, NY, 10016, USA
| | - Basile Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique IPLESP, Nemesis team, F75012, Paris, France
| | - Seann D Regan
- Department of Epidemiology, Columbia Spatial Epidemiology Lab, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA
| | - Dustin T Duncan
- Department of Epidemiology, Columbia Spatial Epidemiology Lab, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY, 10032, USA
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Duncan DT, Park SH, Chen YT, Mountcastle H, Pagkas-Bather J, Timmins L, Kim B, Hanson H, Koli K, Durrell M, Makarem N, Eavou R, Bharadwaj K, Schneider JA. Sleep characteristics among black cisgender sexual minority men and black transgender women during the COVID-19 pandemic: The role of multi-level COVID-19-related stressors. Sleep Health 2022; 8:440-450. [PMID: 36075791 PMCID: PMC9444827 DOI: 10.1016/j.sleh.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/10/2022] [Accepted: 06/10/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To determine the association between individual, network, and structural COVID-19-related stressors and changes in sleep duration and quality among Black cisgender sexual minority men (SMM) and Black transgender women during the COVID-19 peak infectivity rate in Chicago. METHODS From April 20, 2020 to July 31, 2020, we conducted the N2 COVID Study in Chicago (n = 226). The survey included questions regarding multi-level COVID-19-related stressors (eg, food unavailability, partner violence, housing instability, concern about neighborhood COVID-19), sleep duration, and sleep quality. RESULTS About 19.5% of our sample reported a shorter duration of sleep during the initial peak COVID-19 infectivity, while 41.2% reported more sleep and 38.9% reported about the same. Compared to the prepandemic period, 16.8% reported that their sleep quality worsened in the COVID-19 pandemic, while 27.9% reported their sleep quality had improved and 55.3% reported it was about the same. In multivariable models, we found that ≥1 day of physical stress reaction, worrying about being infected with COVID-19, traveling during COVID-19 being a financial burden, not having enough medication, knowing someone who was diagnosed with COVID-19, partner violence and housing instability were associated with poor sleep health in the COVID-19 pandemic (adjusted risk ratio: 1.82-3.90, p < .05). CONCLUSIONS These data suggest that COVID-19-related stressors impacted poor sleep duration and quality during the pandemic among this cohort. Multi-level interventions to reduce COVID-19-related stressors (eg, meditation, intimate partner violence prevention and housing programs) may be useful for improving sleep health among Black cisgender sexual minority men and Black transgender women.
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Affiliation(s)
- Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.
| | - Su Hyun Park
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Yen-Tyng Chen
- Department of Public Health, William Paterson University of New Jersey, Wayne, New Jersey, USA; Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA; Department of Medicine, University of Chicago, Chicago, Illinois, USA; Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, New Jersey, USA
| | - Hayden Mountcastle
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Jade Pagkas-Bather
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA; Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Liadh Timmins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Byoungjun Kim
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Hillary Hanson
- Survey Lab, University of Chicago, Chicago, Illinois, USA
| | - Kangkana Koli
- Survey Lab, University of Chicago, Chicago, Illinois, USA
| | - Mainza Durrell
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA; Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Nour Makarem
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Rebecca Eavou
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
| | - Kevalyn Bharadwaj
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA; Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA; Department of Medicine, University of Chicago, Chicago, Illinois, USA; Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA; Crown School of Social Work, University of Chicago, Chicago, Illinois, USA
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4
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Al-Ajlouni YA, Park SH, Alawa J, Dodin B, Shamaileh G, Makarem N, Keyes KM, Duncan DT. Staying Physically Active Is Associated with Better Mental Health and Sleep Health Outcomes during the Initial Period of COVID-19 Induced Nation-Wide Lockdown in Jordan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020776. [PMID: 35055598 PMCID: PMC8776168 DOI: 10.3390/ijerph19020776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/22/2021] [Accepted: 01/09/2022] [Indexed: 02/04/2023]
Abstract
Jordan, a Middle Eastern country, initially responded to an outbreak of COVID-19 cases within its own borders by imposing a 7-week strict lockdown and closure of international and domestic travel. Such measures drastically influenced lifestyle behaviors of the population. This study aimed to investigate the prevalence of physical activity, and its association with mental and sleep health outcomes among Jordanians during a period of COVID-19 induced lockdown. Validated questionnaires were administered using a web-based platform to evaluate moderate-to-vigorous physical activity (MVPA), anxiety and depressive symptoms, sleep health, and sociodemographic characteristics. A modified Poisson regression model with robust error variance was used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs). Compared to participants who met the guidelines, those who did not had significantly higher prevalence of moderate or severe anxiety symptoms than that of minimal or mild anxiety symptoms and increased depressive symptoms. Insufficient MVPA was associated with higher prevalence of poor sleep quality, short sleep duration (<7 h) and sleep problems. Overall, sufficient MVPA was associated with better mental and sleep health during the COVID-19 induced nation-wide lockdown in Jordan. While further research is necessary, promoting physical activity during the lockdown could potentially improve mental and sleep health outcomes among the population.
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Affiliation(s)
- Yazan A. Al-Ajlouni
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (S.H.P.); (N.M.); (K.M.K.); (D.T.D.)
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA
- Correspondence: ; Tel.: +1-(914)-484-1014
| | - Su Hyun Park
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (S.H.P.); (N.M.); (K.M.K.); (D.T.D.)
| | - Jude Alawa
- School of Medicine, Stanford University, Stanford, CA 94305, USA;
| | - Ban Dodin
- School of Medicine and Public Health, University of Wisconsin, Madison, WI 53705, USA;
| | - Ghaith Shamaileh
- Department of Cell and Molecular Biology, Tulane University School of Science and Engineering, New Orleans, LA 70118, USA;
| | - Nour Makarem
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (S.H.P.); (N.M.); (K.M.K.); (D.T.D.)
| | - Katherine M. Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (S.H.P.); (N.M.); (K.M.K.); (D.T.D.)
| | - Dustin T. Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, USA; (S.H.P.); (N.M.); (K.M.K.); (D.T.D.)
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Chan KKS, Fung WTW. Differential Impact of Experienced and Anticipated Discrimination on Sleep and Health Among Sexual Minorities. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3053-3063. [PMID: 34617190 DOI: 10.1007/s10508-021-01981-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 02/16/2021] [Accepted: 03/06/2021] [Indexed: 06/13/2023]
Abstract
For many lesbian, gay, and bisexual (LGB) individuals, stigma may represent a psychosocial stressor that can disrupt sleep and impair health. The present study tested a stigma model of sleep health to examine whether experienced and anticipated discrimination, as well as associated primal threat, would affect sleep quality and, in turn, physical and mental health among LGB individuals. A total of 401 LGB individuals (201 women and 200 men; mean age = 27.48 years) from Hong Kong, China, provided cross-sectional questionnaire data on experienced and anticipated discrimination, primal threat, sleep disturbance, and self-rated physical and mental health. Path analyses showed that experienced and anticipated discrimination were associated with higher primal threat, which was, in turn, associated with greater sleep disturbance and then poorer physical and mental health. Bootstrap analyses further revealed that experienced and anticipated discrimination had significant indirect effects on sleep disturbance via primal threat and on physical and mental health via primal threat and sleep disturbance. In addition, multi-group analyses demonstrated that the mediation model held across women and men and across lesbian/gay and bisexual individuals. Theoretically, our findings highlighted the importance of considering the differential effects of experienced and anticipated discrimination, as well as the contributive role of primal threat, on the sleep quality and health status of LGB individuals. Practically, our findings pointed to the necessity of developing community-based stigma reduction programs and individual-oriented stigma coping interventions in order to facilitate LGB individuals to reduce discrimination-related primal threat and thereby improve sleep and health.
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Affiliation(s)
- Kevin Ka Shing Chan
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong.
- Centre for Psychosocial Health, The Education University of Hong Kong, Tai Po, Hong Kong.
| | - Winnie Tsz Wa Fung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
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6
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Yip T, Feng Y, Fowle J, Fisher CB. Sleep disparities during the COVID-19 pandemic: An investigation of AIAN, Asian, Black, Latinx, and White young adults. Sleep Health 2021; 7:459-467. [PMID: 34284964 DOI: 10.1016/j.sleh.2021.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 03/11/2021] [Accepted: 05/12/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study investigates race-related disparities in sleep duration and quality among diverse young adults during the coronavirus 2019 (COVID-19) pandemic. DESIGN & SETTING Online cross-sectional study of young adults in the United States in April 2020. PARTICIPANTS About 547 American Indian/Alaskan Native (AIAN), Asian, Black, Latinx, and White young adults ages 18-25 years. MEASUREMENTS Participants completed measures of sleep duration and quality, coronavirus victimization distress, depression, age, sex/gender, employment status, essential worker status, student status, residential region, socioeconomic status, concerns about contracting coronavirus and CDC health risks. RESULTS Black young adults reported the largest disparity in sleep duration and quality. For sleep duration, AIAN, Asian, White, and Latinx young adults reported approximately one additional hour of sleep compared to Black respondents. Mediation analyses suggest that disparities in sleep duration between Asian and Black young adults may be explained by the higher likelihood of Black respondents being essential workers. For sleep quality, Latinx, White, AIAN, and Asian young adults reported higher levels than Black respondents. Including coronavirus victimization distress as an intervening pathway decreased the effect for Asian and White respondents on sleep quality, suggesting that coronavirus victimization distress partially explains Black and Asian, as well as Black and White differences in sleep quality. CONCLUSIONS Black young adults reported the shortest sleep duration and lowest levels of sleep quality relative to AIAN, Asian, Latinx and White peers. Interpersonal experiences of coronavirus victimization and structural inequities may partially explain disparities during the COVID-19 pandemic.
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Affiliation(s)
- Tiffany Yip
- Department of Psychology, Fordham University, Bronx, New York, USA.
| | - Ye Feng
- Department of Psychology, Fordham University, Bronx, New York, USA
| | - Jillianne Fowle
- Department of Psychology, Fordham University, Bronx, New York, USA
| | - Celia B Fisher
- Department of Psychology, Fordham University, Bronx, New York, USA
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7
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Al-Ajlouni YA, Park SH, Alawa J, Shamaileh G, Bawab A, El-Sadr WM, Duncan DT. Anxiety and depressive symptoms are associated with poor sleep health during a period of COVID-19-induced nationwide lockdown: a cross-sectional analysis of adults in Jordan. BMJ Open 2020; 10:e041995. [PMID: 33371040 PMCID: PMC7757395 DOI: 10.1136/bmjopen-2020-041995] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Jordan, a Middle Eastern country, declared a state of national emergency due to COVID-19 and a strict nationwide lockdown on 17 March 2020, banning all travel and movement around the country, potentially impacting mental health. This study sought to investigate the association between mental health (eg, anxiety and depressive symptoms) and sleep health among a sample of Jordanians living through a state of COVID-19-induced nationwide lockdown. METHODS Using Facebook, participants (n=1240) in Jordan in March 2020 were recruited and direct to a web-based survey measuring anxiety (items from General Anxiety Disorder 7-item (GAD-7) scale instrument), depressive symptoms (items from Center for Epidemiologic Studies Depression Scale), sleep health (items from the Pittsburgh Sleep Quality Index) and sociodemographic. A modified Poisson regression model with robust error variance. Adjusted prevalence ratios (aPRs) and 95% CIs were estimated to examine how anxiety and depressive symptoms may affect different dimensions of sleep health: (1) poor sleep quality, (2) short sleep duration, (3) encountering sleep problems. RESULTS The majority of participants reported having experienced mild (33.8%), moderate (12.9%) or severe (6.3%) levels of anxiety during lockdown, and nearly half of respondents reported depressive symptoms during lockdown. Similarly, over 60% of participants reported having experienced at least one sleep problem in the last week, and nearly half reported having had short sleep duration. Importantly, anxiety was associated with poor sleep health outcomes. For example, corresponding to the dose-response relationship between anxiety and sleep health outcomes, those reporting severe anxiety were the most likely to experience poor sleep quality (aPR =8.95; 95% CI=6.12 to 13.08), short sleep duration (aPR =2.23; 95% CI=1.91 to 2.61) and at least one problem sleep problem (aPR=1.73; 95% CI=1.54 to 1.95). Moreover, depressive symptoms were also associated with poor sleep health outcomes. As compared with scoring in the first quartile, scoring fourth quartile was associated with poor sleep quality (aPR=11.82; 95% CI=6.64 to 21.04), short sleep duration (aPR=1.87; 95% CI=1.58 to 2.22), and experiencing at least one sleep problem (aPR=1.90; 95% CI=1.66 to 2.18). CONCLUSIONS Increased levels of anxiety and depressive symptoms can negatively influence sleep health among a sample of Jordanian adults living in a state of COVID-19-induced nationwide lockdown.
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Affiliation(s)
- Yazan A Al-Ajlouni
- Department of Primary Care and Public Health, Cambridge University, Cambridge, UK
| | - Su Hyun Park
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, New York, USA
| | - Jude Alawa
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Ghaith Shamaileh
- Department of Cell and Molecular Biology, Tulane University School of Science and Engineering, New Orleans, Louisiana, USA
| | - Aziz Bawab
- Presbyterian Hospital, New York City, New York, USA
| | - Wafaa M El-Sadr
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, New York, USA
- ICAP at Columbia University, New York City, New York, USA
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York City, New York, USA
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8
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Butler ES, McGlinchey E, Juster R. Sexual and gender minority sleep: A narrative review and suggestions for future research. J Sleep Res 2019; 29:e12928. [DOI: 10.1111/jsr.12928] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Eliana S. Butler
- School of Psychology Fairleigh Dickinson University Teaneck NJ USA
| | - Eleanor McGlinchey
- School of Psychology Fairleigh Dickinson University Teaneck NJ USA
- Division of Child and Adolescent Psychiatry Columbia University Medical Center/New York State Psychiatric Institute New York NY USA
| | - Robert‐Paul Juster
- Department of Psychiatry and Addiction University of Montreal Montreal QC Canada
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9
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Patterson CJ, Potter EC. Sexual orientation and sleep difficulties: a review of research. Sleep Health 2019; 5:227-235. [PMID: 30975620 DOI: 10.1016/j.sleh.2019.02.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 02/06/2019] [Accepted: 02/18/2019] [Indexed: 12/11/2022]
Abstract
Is sexual orientation associated with sleep difficulties? In this article, we review empirical evidence that addresses this question. Stress is associated with sleep difficulties such as insomnia and, because members of sexual minorities experience greater stress, on average, than do others, lesbian, gay, and bisexual (LGB) individuals can be expected to report more sleep difficulties than their heterosexual peers. We reviewed 17 studies published since 1990, with data gathered from more than 600,000 individuals; some included data on both quantity and quality of sleep. In nine of 12 relevant studies, at least some sexual minority individuals reported shorter sleep duration than did heterosexual individuals, on average. In nine of 10 relevant studies, sexual minority individuals reported lower quality sleep, on average. Few data were available about other aspects of sleep as a function of sexual orientation. No investigators found LGB people to have fewer sleep difficulties than did heterosexual individuals. We conclude that, although research in this area is new and still limited in some respects, sleep difficulties are more common among LGB than heterosexual people. Our conclusion suggests the possibility that sleep difficulties may underlie known health disparities among members of sexual minorities. Further research is needed to evaluate differences in sleep difficulties among members of sexual minorities, and to explore treatment options for LGB individuals suffering from sleep difficulties.
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Callander D, Park SH, Al-Ajlouni YA, Schneider JA, Khan MR, Safren SA, Duncan DT. Condomless Group Sex Is Associated With HIV Pre-Exposure Prophylaxis Knowledge and Interest Uptake: A Cross-Sectional Study of Gay and Bisexual Men in Paris, France. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2019; 31:127-135. [PMID: 30917015 PMCID: PMC6557130 DOI: 10.1521/aeap.2019.31.2.127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
As a prevention strategy, HIV pre-exposure prophylaxis (PrEP) may benefit men who participate in group sex, but little is known about PrEP among this group internationally and virtually nothing is known of the European context. This study used an online survey of gay men living in Paris, France to assess associations between group sex and awareness of, use and interest in PrEP in its once-daily, episodic, injectable, and microbicidal forms. Men reporting recent (within 3 months) condomless group sex were much more likely to report once-daily PrEP use than men with no group sex experience (41.5% vs 7.7%, p < .001). Uptake was similarly low among men who had group sex with condoms (8.0%) and those with less-recent experience (6.43%). Overall, willingness to use PrEP-including its non-daily forms-was high among men reporting group sex, suggesting opportunities for outreach and implementation.
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Affiliation(s)
- Denton Callander
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, New York
| | - Su Hyun Park
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, New York
| | - Yazan A Al-Ajlouni
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, New York
| | - John A Schneider
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, New York
- Chicago Center for HIV Elimination, University of Chicago School of Medicine, Chicago, Illinois
| | - Maria R Khan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, New York
| | - Steven A Safren
- Department of Psychology, University of Miami, Miami, Florida
| | - Dustin T Duncan
- Spatial Epidemiology Lab, Department of Population Health, New York University School of Medicine, New York, New York
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