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White M, Ferlatte O, Joy P, Mann L. Exploring Food Security and Mental Health Among Street-Involved Canadian 2S/LGBTQI+ Youth: A Review of the Literature. CAN J DIET PRACT RES 2024:1-6. [PMID: 38848459 DOI: 10.3148/cjdpr-2024-011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
The purpose of this literature review is to evaluate the extant research addressing food insecurity and mental health among street-involved 2S/LGBTQI+ youth in Canada. Searches were undertaken in academic databases, Google, and Google Scholar for relevant research articles, reports, and grey literature. Our team found nil research specifically addressing food insecurity and the mental health of street-involved 2S/LGBTQI+ youth in Canada. Given that, contextual and contributory factors affecting the mental health and food security of this population are discussed. The available research demonstrates a significant misalignment between the existing support mechanisms and the requirements of this specific population. This underscores the urgent necessity for the establishment of structurally competent, safe, and easily accessible resources. Moreover, there is a clear imperative for additional research endeavors aimed at addressing knowledge deficiencies. These efforts are crucial in empowering dietitians to facilitate enhanced interdisciplinary collaboration, thereby fostering the creation of sustainable, accessible, and appropriate food systems tailored to the needs of this vulnerable demographic.
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Affiliation(s)
- Megan White
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Olivier Ferlatte
- École de Santé Publique de l'Université de Montréal, Montreal, QC
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC
| | - Phillip Joy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Linda Mann
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
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2
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Lanni S, Stone M, Berger AF, Wilson RLH, Wilens TE, Philpotts LL, Burke CW. Design, Recruitment, and Implementation of Research Interventions Among Youth Experiencing Homelessness: A Systematic Review. Community Ment Health J 2024; 60:722-742. [PMID: 38332393 PMCID: PMC11017793 DOI: 10.1007/s10597-023-01224-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/23/2023] [Indexed: 02/10/2024]
Abstract
Transitional age youth experiencing homelessness (TAY-EH) represent an underserved and understudied population. While an increasing number of empirical interventions have sought to address the high burden of psychopathology in this population, findings remain mixed regarding intervention effectiveness. In this systematic review of behavioral health interventions for TAY-EH, we sought to examine the structural framework in which these interventions take place and how these structures include or exclude certain populations of youth. We also examined implementation practices to identify how interventions involving youth and community stakeholders effectively engage these populations. Based on PRISMA guidelines, searches of Medline, PsycInfo, Embase, Cochrane Central, Web of Science, and ClinicalTrials.gov databases were conducted, including English language literature published before October 2022. Eligible studies reported on interventions for adolescent or young adult populations ages 13-25 years experiencing homelessness. The initial search yielded 3850 citations; 353 underwent full text review and 48 met inclusion criteria, of which there were 33 unique studies. Studies revealed a need for greater geographic distribution of empirically based interventions, as well as interventions targeting TAY-EH in rural settings. Studies varied greatly regarding their operationalizations of homelessness and their method of intervention implementation, but generally indicated a need for increased direct-street outreach in participant recruitment and improved incorporation of youth feedback into intervention design. To our knowledge, this is the first systematic review to examine the representation of various groups of TAY-EH in the literature on substance use and mental health interventions. Further intervention research engaging youth from various geographic locations and youth experiencing different forms of homelessness is needed to better address the behavioral health needs of a variety of TAY-EH.
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Affiliation(s)
- Sylvia Lanni
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Mira Stone
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA
| | - Amy F Berger
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA
| | - Ronan L H Wilson
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA
| | - Timothy E Wilens
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA
| | - Lisa L Philpotts
- Treadwell Library, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Colin W Burke
- Department of Psychiatry, Massachusetts General Hospital, Warren Building, Room 628, 55 Fruit Street, Boston, MA, 02114, USA
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3
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Servais J, Vanhoutte B, Aguirre-Sánchez-Beato S, Aujoulat I, Kraus C, T'Sjoen G, Tricas-Sauras S, Godin I. Integrating perspectives of transgender and gender-diverse youth, family members, and professionals to support their health and wellbeing - a mixed-method study protocol. Arch Public Health 2024; 82:40. [PMID: 38500212 PMCID: PMC10949725 DOI: 10.1186/s13690-024-01270-z] [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: 12/17/2023] [Accepted: 03/11/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The current literature highlights a strong link between the poor health outcomes of transgender and gender diverse (TGD) individuals and their negative experiences in various areas of life. Most of these publications rely on adults' memories, lacking a focus on the current experiences and needs of young transgender and gender-diverse individuals. Furthermore, previous studies on support for these young people often solely consider the perspectives of TGD adults or professionals and rarely involve parents' viewpoints. METHODS This study will use a mixed sequential method with a participatory approach. Firstly, the qualitative phase will explore the difficulties and needs of TGD (15-20 years old) and of the families and professionals who support them. Results from this part will be used to develop the questionnaire for the quantitative phase, with the help of a community board. Secondly, based on participatory epidemiological research, the quantitative phase will use an intersectional perspective to measure the impact of individual and structural factors on the quality of life and well-being of transgender and gender-diverse young people. Finally, a co-creation phase will be undertaken to formulate recommendations based on the results of the first two phases. DISCUSSION This research aims at better understanding the influence of gender identity on the quality of life and health of TGD young people and their families and to identify protective and risk factors that affect their vulnerabilities. ETHICS AND DISSEMINATION This study has been approved by the Ethics Committee of the Erasme Faculty Hospital (CCB B4062023000140). As this research is participatory and part of a PhD dissertation, we aim to disseminate the results through our partners' networks and structures locally, and internationally through conferences and peer-reviewed journals.
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Affiliation(s)
- Julie Servais
- School of Public Health, Université Libre de Bruxelles, CP 596, Route de Lennik, 808, Brussels, 1070, Belgium.
| | - Bram Vanhoutte
- School of Public Health, Université Libre de Bruxelles, CP 596, Route de Lennik, 808, Brussels, 1070, Belgium
| | - Sara Aguirre-Sánchez-Beato
- Faculty of Psychology and Education, Université Libre de Bruxelles, CP 122, Avenue F.D. Roosevelt, 50, Brussels, 1050, Belgium
| | - Isabelle Aujoulat
- Health and Society Research Institute - UCLouvain, Clos Chapelle-Aux-Champs 30/B1.30.15, Woluwe-Saint-Lambert, 1200, Belgium
| | - Cynthia Kraus
- Faculty of Social and Political Sciences - UNIL, CH-1015, Lausanne, Switzerland
| | - Guy T'Sjoen
- Faculty of Medicine and Health Sciences, Ghent University Hospital, C. Heymanslaan 10, Ghent, 9000, Belgium
| | - Sandra Tricas-Sauras
- School of Public Health, Université Libre de Bruxelles, CP 596, Route de Lennik, 808, Brussels, 1070, Belgium
| | - Isabelle Godin
- School of Public Health, Université Libre de Bruxelles, CP 596, Route de Lennik, 808, Brussels, 1070, Belgium
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4
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Will J, Walsh K, Chyten-Brennan J. A comparison of chronic conditions between transgender and cisgender individuals with recent incarceration and in the community in a United States county. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2023; 25:187-198. [PMID: 38681500 PMCID: PMC11044716 DOI: 10.1080/26895269.2023.2280175] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Background: Transgender individuals are known to be at a higher risk for certain chronic conditions compared to cisgender individuals. Similarly, research also shows justice-involved individuals have a higher risk of chronic conditions compared to non-justice-involved individuals. Aim: This study aims to investigate the differences in chronic disease diagnoses between transgender and cisgender individuals who either utilized healthcare services provided by a US county health system or who were incarcerated in the same county's jail. Method: We leveraged electronic health record data from a United States county health system, including data from the local jail, to evaluate the difference in diagnosis of certain chronic conditions among transgender and cisgender individuals. We also compared individuals who experienced incarceration and those who did not. Results: We found transgender individuals experiencing recent incarceration were more likely to be diagnosed with substance use disorder, HIV/AIDS, and Hepatitis C than cisgender individuals. Transgender individuals not experiencing recent incarceration were more likely to be diagnosed with HIV/AIDS, seizure disorder, major depressive disorder, and bipolar disorder than cisgender individuals. Conclusion: These results highlight how transgender individuals may be disproportionately impacted by certain diseases within and outside carceral settings.
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Affiliation(s)
- John Will
- Custody Health Services, Santa Clara Valley Medical Center, San Jose, California, USA
- New York University Langone Health, New York, New York, USA
| | - Kristin Walsh
- Custody Health Services, Santa Clara Valley Medical Center, San Jose, California, USA
| | - Jules Chyten-Brennan
- Custody Health Services, Santa Clara Valley Medical Center, San Jose, California, USA
- Thundermist Health Center, Woonsocket, Rhode Island, USA
- Department of Family Medicine, Brown University, Providence, Rhode Island, USA
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5
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Robinson IS, Carswell JM, Boskey E, Agarwal CA, Brassard P, Bélanger M, Zhao LC, Bluebond-Langner R. Gender-Affirming Surgery in Adolescents and Young Adults: A Review of Ethical and Surgical Considerations. Plast Reconstr Surg 2023; 152:737e-750e. [PMID: 36827481 DOI: 10.1097/prs.0000000000010325] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND The number of transgender adolescents seeking gender-affirming surgery (GAS) in increasing. Surgical care of the adolescent transgender patient is associated with several unique technical, legal, and ethical factors. The authors present a review of the current literature on gender-affirming surgery for individuals under the age of legal majority and propose directions for future research. METHODS A scoping review of recent literature was performed to assess evidence on gender-affirming surgery in individuals under the age of legal majority. Articles were included that examined either ethical or technical factors unique to pediatric GAS. Study characteristics and conclusions were analyzed in conjunction with expert opinion. RESULTS Twelve articles were identified that met inclusion criteria. Ten of these articles discussed ethical challenges in adolescent GAS, seven discussed legal challenges, and five discussed technical challenges. Ethical discussions focused on the principles of beneficence, nonmaleficence, and autonomy. Legal discussions centered on informed consent and insurance coverage. Technical discussions focused on the effects of puberty blockade on natal tissue. CONCLUSIONS Surgical care of the adolescent transgender patient involves important ethical, legal, and technical considerations that must be addressed by the clinical team. As the population of individuals seeking GAS after puberty blockade increases, future research is needed describing functional and psychosocial outcomes in these individuals.
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Affiliation(s)
| | | | - Elizabeth Boskey
- Department of Plastic and Oral Surgery, Boston Children's Hospital
| | | | - Pierre Brassard
- Chirurgie Plastique et Esthétique, Centre Métropolitain de Chirurgie
| | - Maud Bélanger
- Chirurgie Plastique et Esthétique, Centre Métropolitain de Chirurgie
| | - Lee C Zhao
- Department of Urology, New York University Langone Health
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6
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Balma B, Vasilakos L, Osman I, Elgonda A, Gewirtz O'Brien JR. COVID-19 vaccine attitudes among youth experiencing homelessness: a qualitative analysis with opportunities for action. BMC Public Health 2023; 23:1672. [PMID: 37648987 PMCID: PMC10469469 DOI: 10.1186/s12889-023-16413-0] [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: 04/18/2023] [Accepted: 07/28/2023] [Indexed: 09/01/2023] Open
Abstract
Youth experiencing homelessness (YEH) are uniquely vulnerable to COVID-19 infection, yet are often excluded from response planning during the COVID-19 pandemic and other public health crises. As part of a larger community- and youth-engaged project through a national network of Prevention Research Centers, our qualitative study sought to describe youth perspectives that influence COVID-19 vaccine confidence and uptake, and identify youth-driven strategies to guide public health efforts to improve vaccine confidence and access. We conducted focus groups with youth experiencing homelessness (n = 20) and semi-structured interviews with staff members (n = 10) at youth-serving agencies to solicit youth perspectives about COVID-19 vaccination. Focus groups and interviews were recorded, transcribed, and analyzed using thematic qualitative analysis. In partnership with youth and cross-sector partners, we distilled eight salient themes that influenced COVID-19 vaccine uptake and confidence among YEH: 1. historical harms and mistrust of systems, 2. access to reliable health information, 3. prioritization of basic needs, 4. personal health influence, 5. barriers to healthcare, 6. fear and uncertainty of the vaccines, 7. sense of bodily autonomy, and 8. community influence. We also identified three youth-driven opportunities to increase COVID-19 vaccination among this population: emphasizing autonomy, leveraging trusted sources of information, and improving vaccine access.Our study elucidates perspectives of YEH on COVID-19 vaccination, and identifies several opportunities to improve youth vaccine confidence and access. It also underscores the importance of centering youth voice in response planning during current and future public health crises.
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Affiliation(s)
- Brandon Balma
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA.
| | - Lauren Vasilakos
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
| | - Ingie Osman
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
| | - Asha Elgonda
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
| | - Janna R Gewirtz O'Brien
- Department of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
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Maragh-Bass AC, Stoner MCD, Castellanos-Usigli A, Agarwal H, Katz AWK, Patani H, Sukhija-Cohen A, Campbell L, Arreola S, Saberi P. New preexposure prophylaxis options need updated counseling approaches: reframing 'risk' in HIV prevention counseling for young sexual and gender minorities of color. AIDS 2023; 37:1361-1366. [PMID: 37070546 DOI: 10.1097/qad.0000000000003563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Affiliation(s)
- Allysha C Maragh-Bass
- Behavioral, Epidemiological, Clinical Sciences Division, FHI 360
- Duke Global Health Institute, Duke University, Durham, North Carolina
- Center for AIDS Prevention Studies, University of California
| | | | - Antón Castellanos-Usigli
- ACU Innovations & Consulting, New York, New York
- TH Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Harsh Agarwal
- Behavioral, Epidemiological, Clinical Sciences Division, FHI 360
| | | | | | | | | | | | - Parya Saberi
- Center for AIDS Prevention Studies, University of California
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8
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Tubertini E, Carbone A, Santinello M. Staff Members' Experience of Italian Shelters for LGBTQIA+ Homeless and Runaway People: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6214. [PMID: 37444062 PMCID: PMC10341461 DOI: 10.3390/ijerph20136214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Some LGBTQIA+ people, after coming out, experience marginalization and homelessness due to rejection and discrimination from their family and community. The increase in support requests led to the creation of LGBTQIA+ temporary shelter homes worldwide. This study aims to explore the functioning and effectiveness of shelters, analyzing the experiences of staff members in Italy. METHODS Focus groups were held with a total of 15 staff members (age range: 32-53) working in three shelters for LGBTQIA+ people. Data were analyzed qualitatively through the grounded theory methodology. RESULTS Data coding showed five final core categories: (1) user characteristics; (2) staff characteristics; (3) community relations; (4) activities carried out by services; (5) criteria for intervention assessment and staff satisfaction. Results revealed some criticalities in the effectiveness of these services, particularly the difficulty in achieving autonomy for users, a weakness attributable to the non-exhaustive training of staff members and the funding discontinuity. CONCLUSION To improve the efficacy of shelters, this study emphasizes the necessity to (a) carry out an analysis of the vulnerability of the local LGBTQIA+ community, (b) establish a stable network with local services (NHS system), and (c) implement staff members' psychological training.
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Affiliation(s)
- Elena Tubertini
- Department of Developmental Psychology and Socialisation, University of Padua, 35131 Padova, Italy; (E.T.); (M.S.)
| | - Agostino Carbone
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Department of Health Policy–The London School of Economics and Political Sciences, CPEC–Care Policy and Evaluation Center, St Clement’s Ln, London WC2A 2HD, UK
| | - Massimo Santinello
- Department of Developmental Psychology and Socialisation, University of Padua, 35131 Padova, Italy; (E.T.); (M.S.)
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Ware OD, Austin AE, Srivastava A, Dawes HC, Baruah D, Hall WJ. Characteristics of Outpatient and Residential Substance Use Disorder Treatment Facilities with a Tailored LGBT Program. Subst Abuse 2023; 17:11782218231181274. [PMID: 37342586 PMCID: PMC10278416 DOI: 10.1177/11782218231181274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/23/2023] [Indexed: 06/23/2023]
Abstract
Lesbian, gay, bisexual, and transgender (LGBT) individuals have a high prevalence of substance use disorders (SUDs) and experience unique barriers to treatment. Little is known about the characteristics of SUD treatment facilities providing LGBT-tailored programs at the outpatient and residential levels of care. The purpose of this study is to examine the availability of LGBT-tailored programs in outpatient and residential SUD treatment facilities. Using the National Survey of Substance Abuse Treatment Services 2020, we conducted logistic regression to examine facility characteristics, including ownership, pay assistance, region, outreach, and telehealth services, associated with having an LGBT-tailored program among SUD treatment facilities. Outpatient facilities that were for-profit, had pay assistance, had community outreach services, and provided telemedicine/telehealth were more likely to have an LGBT-tailored program. Those that were government-owned, in the Midwest, and that accepted Medicaid were less likely to have an LGBT-tailored program. Residential facilities that were in the West, for-profit, and had community outreach services were more likely to have an LGBT-tailored program. This study offers a national examination of the availability of LGBT-tailored programs in SUD treatment facilities. Differences in availability based on ownership, region, pay assistance, and outreach highlight potential gaps in treatment availability.
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Affiliation(s)
- Orrin D. Ware
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC, USA
| | - Anna E. Austin
- University of North Carolina at Chapel Hill Gillings School of Public Health, Chapel Hill, NC, USA
| | - Ankur Srivastava
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC, USA
| | - Hayden C. Dawes
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC, USA
| | - Dicky Baruah
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC, USA
| | - William J. Hall
- University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC, USA
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10
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Mitsdarffer ML, McColl R, Nescott E, Bianchetta J, Layland EK, Tóth T. LGBTQ+ Youth Homelessness in Delaware:: Building a Case for Targeted Surveillance and Assessment of LGBTQ+ Youth Needs and Experiences. Dela J Public Health 2023; 9:80-86. [PMID: 37622145 PMCID: PMC10445598 DOI: 10.32481/djph.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
Objective In this article, we examine the issue of LGBTQ+ youth homelessness in Delaware, summarize current services available and prior research work that has been done, examining the number, needs, and experiences of unaccompanied unhoused LGBTQ+ youth. Methods We provide a literature review detailing risks associated with LGBTQ+ youth homelessness, resources available, and prior studies and surveys examining this population. Results LGBTQ+ youth experiencing homelessness are particularly vulnerable to physical and mental health challenges, abuse, and violence. The unique needs of this population necessitate specialized resources, yet there are a limited number of such resources available in Delaware and a dearth of information on youth homelessness in general, including LGBTQ+ youth. For example, administrative barriers exist for unaccompanied queer youth seeking shelter services, such as need for legal identification or being grouped in shelter populations based on sex assigned at birth rather than gender identity. Exposure to unsafe environments is a general problem for queer youth. This can make public spaces feel unsafe and increase risk of physical or mental harm, mistreatment, or abuse when seeking shelter outside of agency services and resources. In order to accurately identify and appropriately serve this population, additional research is necessary. Conclusions Evidence building is a critical first step in creating an effective study to examine the issue of LGBTQ+ youth homelessness in Delaware. With the evidence acquired in our literature review our next step to establish an informed methodology is to hold service provider and LGBTQ+ lived experience focus groups. Through a qualitative approach we aim to learn how to appropriately utilize the quantitative tools identified in our analysis and to assess what questions are missing to advance the needs of this population.
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Affiliation(s)
- Mary Louise Mitsdarffer
- Assistant Professor, Center for Community Research & Service, Joseph R. Biden, Jr. School of Public Policy and Administration, University of Delaware
| | - Rebecca McColl
- Associate Policy Scientist, Center for Community Research & Service, Joseph R. Biden, Jr. School of Public Policy and Administration, University of Delaware
| | - Erin Nescott
- Associate Policy Scientist, Center for Community Research & Service, Joseph R. Biden, Jr. School of Public Policy and Administration, University of Delaware
| | | | - Eric K Layland
- Assistant Professor, Department of Human Development and Family Sciences, University of Delaware
| | - Tibor Tóth
- Assistant Professor, Joseph R. Biden, Jr. School of Public Policy and Administration, University of Delaware
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11
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Schultz TR, Zoucha R, Sekula K, Abrams BAD. Emergency care for youth who experience suicidality and identify as LGBTQ. Public Health Nurs 2023; 40:243-249. [PMID: 36519928 DOI: 10.1111/phn.13162] [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: 08/17/2022] [Revised: 11/01/2022] [Accepted: 11/27/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of youth who identify as LGBTQ+ and sought emergency care for suicidality as adolescents. METHODS Hermeneutics phenomenology is the research method used in this study. Youth who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents were recruited; fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described their gender identity as male, female, non-binary, transgender female, and their sexual orientation as: female, demisexual, bisexual, gay, homosexual, lesbian, queer, asexual, and transgender. RESULTS This study establishes that youth who identify as LGBTQ+ seeking emergency care for suicidality value: coping and control, acceptance from others and self, communicating with me about me, and moving beyond danger and distress. Lack of psychological safety-from the emic perspective-emerged as a critical finding. CONCLUSION This research has strong implications for public health, policy, and research. Future research must seek to understand ways in which psychological safety is assessed in healthcare if we are to more deeply understand and effectively address the impact on health equity.
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Affiliation(s)
- Theresa Ryan Schultz
- Children's National Hospital, Director of Nursing, Emergency Medicine and Trauma Center, Washington, DC
| | - Rick Zoucha
- School of Nursing, Duquesne University, Pittsburgh, Pennsylvania
| | - Kathleen Sekula
- School of Nursing, Duquesne University, Pittsburgh, Pennsylvania
| | - Bishop Allyson D Abrams
- Pastor of Empowerment Liberation Cathedral, President of Empowerment Justice Center, Bowie, Maryland
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12
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Kaltiala R, Heino E, Marttunen M, Fröjd S. Family Characteristics, Transgender Identity and Emotional Symptoms in Adolescence: A Population Survey Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2948. [PMID: 36833645 PMCID: PMC9963798 DOI: 10.3390/ijerph20042948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Sociodemographic and psychosocial family factors have profound implications for adolescent development, identity formation and mental health during the adolescent years. We explored the associations of sociodemographic and psychosocial family factors with transgender identity in adolescence and the role of these factors in the associations between gender identity and emotional disorders. Data from a large adolescent population survey from Finland were analysed using logistic regression models. Reporting transgender identity was associated with mother's low level of education, accumulating family life events, lack of family cohesion, perceived lack of family economic resources and female sex. A lack of family cohesion further differentiated between adolescents reporting identifying with the opposite sex and those reporting non-binary/other gender identification. The associations between transgender identity, depression and anxiety were attenuated but did not level out when family factors were controlled for. Transgender identity in adolescence is associated with socioeconomic and psychosocial family factors that are known correlates of negative outcomes in mental health and psychosocial well-being. However, transgender identification is also associated with emotional disorders independent of these family factors.
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Affiliation(s)
- Riittakerttu Kaltiala
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
- Department of Adolescent Psychiatry, Tampere University Hospital, 33520 Tampere, Finland
- Vanha Vaasa Hospital, 65380 Vaasa, Finland
| | - Elias Heino
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | - Mauri Marttunen
- Adolescent Psychiatry, Helsinki University Hospital, University of Helsinki, 00260 Helsinki, Finland
| | - Sari Fröjd
- Department of Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland
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13
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Moore H, De Pedro K. Lesbian, Gay, and Bisexual Students Experiencing Homelessness and Substance Use in the School Context: A Statewide Study. THE JOURNAL OF SCHOOL HEALTH 2023; 93:107-114. [PMID: 36661077 PMCID: PMC10087241 DOI: 10.1111/josh.13246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE This study explored differences between lesbian, gay, and bisexual (LGB)-housed and homeless students regarding substance use patterns on and off school grounds and the unique contribution of homelessness to substance use in school. METHODS Data were from the 2013-2015 California Healthy Kids Survey, a statewide survey of school protective factors and risk behaviors. A representative sample of 9th- and 11th-grade students (N = 20,337) was used. Comparisons between housed (n = 19,456) and homeless (doubled up: n = 715; acute homeless: n = 166) LGB students were conducted. We used chi-square tests to compare rates of lifetime, past-30-day, and in-school substance use and conducted multivariate logistic regression models for each substance use variables. RESULTS Chi-square test results indicated significant differences in rates of substance use among students experiencing homelessness (both categories) and housed LGB students. Lesbian, gay, and bisexual students experiencing homelessness were more likely to report substance use off and on school grounds. Results from logistic regression analyses indicated that LGB students who experience homelessness were significantly more likely to report recent and in-school substance use. For example, students experiencing acute homelessness were about 3 times as likely to report heavy episodic drinking (adjusted odds ratio [AOR] = 3.13; 95% confidence interval [CI] = 2.13, 4.26) and more than 5 times as likely to smoke marijuana in school (AOR = 5.38; 95% CI = 3.46, 8.36), compared to housed LGB students. CONCLUSIONS LGB students who experience homelessness are at higher risk than housed LGB students of substance use on and off school grounds. Findings highlight the need to provide support in the school context for this subpopulation.
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Affiliation(s)
- Hadass Moore
- The Paul Baerwald School of Social Work and Social WelfareHebrew University of JerusalemJerusalemIsrael
| | - Kris De Pedro
- Attallah College of Educational StudiesChapman UniversityOrangeCA
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Deal C, Doshi RD, Gonzales G. Gender Minority Youth Experiencing Homelessness and Corresponding Health Disparities. J Adolesc Health 2023; 72:763-769. [PMID: 36646565 DOI: 10.1016/j.jadohealth.2022.11.229] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 11/06/2022] [Accepted: 11/21/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE Pediatricians and youth service providers frequently interface with vulnerable populations, including gender minority youth (e.g., transgender, nonbinary, gender questioning, and other gender diverse individuals) and youth experiencing homelessness. The purposes of this study are to estimate the prevalence of homelessness and types of homelessness experienced among gender minority youth and their corresponding health outcomes. METHODS Data for this study came from gender minority (n = 3,194) and cisgender (n = 93,337) high school students who answered questions on transgender status and homelessness status in the 2017 and 2019 Youth Risk Behavior Survey (YRBS). We compared the prevalence of homelessness between gender minority and cisgender youth and assessed where youth experiencing homelessness had slept in the prior month: shelters, nonparental homes, streets, hotel, or other locations. Finally, logistic regression models and marginal effects (ME) were used to examine health outcomes at the intersection of gender minority status and homelessness. RESULTS 22% of gender minority youth reported homelessness during the prior month. Cisgender youth were significantly less likely to report being homeless (3%). Transgender youth experiencing homelessness were significantly more likely to live on the streets than cisgender youth experiencing homelessness (ME = 0.20; 95% CI = 0.10-0.30; p < .001). Gender minority youth experiencing homelessness reported elevated health-risk behaviors in excess of nonhomeless gender minority youth and cisgender youth experiencing homelessness. DISCUSSION Public health campaigns, housing interventions, and youth service providers should consider and create tailored programs to secure housing and to promote the health of gender minority youth experiencing homelessness.
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Affiliation(s)
- Cameron Deal
- Program for Public Policy Studies, Vanderbilt University, Nashville, Tennessee
| | - Riya D Doshi
- Department of Medicine, Health & Society, Vanderbilt University, Nashville, Tennessee
| | - Gilbert Gonzales
- Department of Medicine, Health & Society, Department of Health Policy, Program for Public Policy Studies, Vanderbilt University, Nashville, Tennessee.
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Hill C, Hsu H, Holguin M, Morton M, Winetrobe H, Rice E. An examination of housing interventions among youth experiencing homelessness: an investigation into racial/ethnic and sexual minority status. J Public Health (Oxf) 2022; 44:834-843. [PMID: 34355749 DOI: 10.1093/pubmed/fdab295] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 04/28/2021] [Accepted: 07/02/2021] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES The purpose of this study is to explore main and interaction effects of minority and multiple minority statuses on exits from homelessness and the stability of homelessness exits overtime. METHODS This study utilized the Homeless Management Information System administrative data of 10 922 youth experiencing homelessness collected from a convenience sample of 16 geographically diverse communities across the USA between 2015-17. Using multinomial logistic regression analyses and logistic regression, main effects and interaction effects of racial/ethnic minority identity and sexual/gender minority identity were examined on various homelessness exits (n = 9957) and housing sustainability (n = 5836). RESULTS Black youth, relative to White youth, were disproportionately exiting homelessness through incarceration (P < 0.001). Black and Latinx youth were less likely to successfully self-resolve their homelessness (both P < 0.05). Black heterosexual and Black and Latinx non-heterosexual youth were most frequently lost to the homeless system (all P < 0.01). Black youth, relative to White youth, were approximately half as likely to remain stably housed after returning to family (P < 0.01). CONCLUSIONS With respect to housing exits and exit stability, Black and Latinx heterosexual youth are consistently at a disadvantage. Homelessness/housing systems and programs need to conduct a deeper investigation into how they implement and develop equitable outreach and engagement practices.
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Affiliation(s)
- C Hill
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - H Hsu
- School of Social Work, University of Missouri, Columbia, MO 65211, USA
| | - M Holguin
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
| | - M Morton
- University of Chicago, Chicago, IL 60637
| | - H Winetrobe
- Center for Artificial Intelligence in Society Operations Coordinator, Suzanne Dworak Peck School of Social Work, University of Southern California, ,Los Angeles, CA 90089, USA
| | - E Rice
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA 90089, USA
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Flatley CA, Hatchimonji DR, Treglia D, Cutuli JJ. Adolescent homelessness: Evaluating victimization risk based on LGBT identity and sleeping location. J Adolesc 2022; 94:1108-1117. [PMID: 36031745 DOI: 10.1002/jad.12087] [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: 11/15/2021] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Teen homelessness confers risk for victimization experiences, and teens that identify as lesbian, gay, bisexual, or transgender (LGBT) are at an even greater risk of experiencing victimization and homelessness. METHODS Using the 2019 Youth Risk Behavior Surveillance System, we evaluated the association of experiencing homelessness with physical and sexual victimization and we examined whether LGBT identification moderated this relationship. We also evaluated if the odds of experiencing sexual and physical victimization differed depending on the reported sleeping location. RESULTS Students who reported homelessness had increased odds of having experienced physical and sexual victimization. LGBT identity was related to increased risk for physical and sexual victimization; however, LGBT identity did not moderate the relationship between homelessness and victimization. Considering nighttime sleeping arrangement, students who reported having no usual place to stay had the highest odds of experiencing sexual or physical victimization, followed by car, park, campground, hotels/motels, emergency housing, and doubled-up with family or friends. Notably, all homeless sleeping locations were associated with increased odds of experiencing victimization relative to sleeping at a parent or guardian's home. CONCLUSIONS Our findings confirm links between teen homelessness and sexual and physical victimization, as well as increased risk for victimization experienced by LGBT youth. Special considerations should be made when developing and implementing interventions for teens experiencing homelessness and teens who identify as LGBT.
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Affiliation(s)
- Claire A Flatley
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, Delaware, USA
| | - Danielle R Hatchimonji
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, Delaware, USA
| | - Dan Treglia
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - J J Cutuli
- Center for Healthcare Delivery Science, Nemours Children's Health, Wilmington, Delaware, USA
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Anderson RE, Kuhn SK, Vitale AM, Ciampaglia AM, Silver KE. The Prevalence of Sexual Violence Perpetration in Sexual Minority Men: A Secondary Analysis of Systematic Review Data. EUROPES JOURNAL OF PSYCHOLOGY 2022; 18:437-449. [PMID: 36605089 PMCID: PMC9780731 DOI: 10.5964/ejop.6127] [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: 02/10/2021] [Accepted: 09/07/2021] [Indexed: 12/02/2022]
Abstract
Prior literature illustrates that sexual minority people (e.g., bisexual, gay, queer) are at increased vulnerability for sexual violence victimization compared to heterosexual peers, including while in college. However, the study of sexual violence perpetration in sexual minority populations, much less specifically sexual minority college men, has been neglected. This article reviews the literature and presents a secondary data analysis of a systematic review on college men's sexual perpetration rates and associated methodology. We also conducted analyses to summarize available literature regarding publishing dates, authors, and data inclusivity. METHODS We downloaded the dataset and associated materials from Mendeley.com's data archive. RESULTS To our surprise, we could not analyze sexual perpetration prevalence rates in sexual minority men using the systematic review data due to absence of reported data across all 77 independent samples including over 5,500 male participants. We found no significant relationship between inclusion of sexual minority men and the use of measurement strategies specialized to assess sexual minority needs. We did find a positive relationship between recency of publication and the inclusion of sexual minority men, r(76) = .24, p = .03, and that most authors/co-authors were women (72%). CONCLUSIONS Preventing perpetration is central to ending sexual violence; therefore, future research should include sexual minority people and use appropriate methodology in the investigation of sexual perpetration characteristics and patterns.
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Affiliation(s)
- RaeAnn E. Anderson
- Department of Psychology, University of North Dakota, Grand Forks, ND, USA
| | - Sara K. Kuhn
- Department of Psychology, University of North Dakota, Grand Forks, ND, USA
| | - Amanda M. Vitale
- James J. Peters Veterans Affairs Medical Center, New York, NY, USA,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alyssa M. Ciampaglia
- Neuro-Oncology Department, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kristin E. Silver
- Department of Neurology, Duke University, Durham, NC, USA,Durham Veterans Affairs Medical Center, Durham, NC, USA
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Bizarria FPDA, Figueredo IB, Cavalcante SDN, Silva EJDD, Barbosa FLS. [Public Health Policies for Youth - Bibliometric Study and Research Agenda based on the Web of Science]. CIENCIA & SAUDE COLETIVA 2022; 27:3975-3985. [PMID: 36134803 DOI: 10.1590/1413-812320222710.04812022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/10/2022] [Indexed: 11/21/2022] Open
Abstract
The scope of this research outlines the field of study on public health policies for youth supported by bibliometric maps, from the perspective of identifying research gaps. VOSviewer software was used based on the exploratory-descriptive profile, with data located in October 2021, using the key words "public", "youth", "health" with the connecting "and", which resulted in 172 articles. The following groupings were located: co-authorship by country; co-authorship by key words; co-quote by article; co-quote by reference cited; bibliographic coupling; co-quote of authors. The results reveal an interdisciplinary field, represented by studies in the areas of education, social work, law, and social sciences, with a significant recurrence of the themes of mental health, violence, and obesity, as well as discussions on substance use and abuse, such as cigarette smoking for example. Debates about the social configuration, defined by the idea of community, as well as its prevalence and prevention are present in the scope of these studies. Finally, eight research agenda topics are derived from the discussion about the growing movement towards health promotion as a public policy, while socio-economic and cultural aspects are presented with greater emphasis, in the quest to understand the impacts of this scenario for youth.
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Affiliation(s)
- Fabiana Pinto de Almeida Bizarria
- Programa de Pós-Graduação em Gestão Pública, Universidade Federal do Piauí (UFPI). Campus Universitário Ministro Petrônio Portella, Bairro Ininga. 64049-550 Teresina PI Brasil.
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Liu M, Wadhera RK. Mental Health and Substance Use Among US Homeless Adolescents-Reply. JAMA 2022; 328:890. [PMID: 36066522 DOI: 10.1001/jama.2022.11625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Michael Liu
- Harvard Medical School, Boston, Massachusetts
| | - Rishi K Wadhera
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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20
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Ventriglio A, Mirandola M, Galeazzi GM, Amaddeo F, Pinna F, Converti M, Fiorillo A. Mental health for LGBTQI people: a policies' review. Int Rev Psychiatry 2022; 34:200-214. [PMID: 36151824 DOI: 10.1080/09540261.2022.2052266] [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] [Indexed: 10/18/2022]
Abstract
The mental health of lesbian, gay, bisexual, transgender, queer, intersexual (LGBTQI) individuals is significantly influenced by many factors such as difficulties in coming-out, poor acceptance, isolation and discrimination as well as minority-related stress. LGBTQI individuals, in fact, show a significant higher risk of mental health conditions, substance- use disorders and suicide. In addition, mental health services access may be difficult for personal and social barriers as well as a lack of adequate and specific mental health support. This review aims to assess and describe international policies, guidelines, position statements and recommendations regarding the promotion and protection of mental health rights for LGBTQI people. The search has been focussed on peer-reviewed papers, Governmental and Mental Health Association- Guidelines and Position Statements, Health Agencies - Guidelines and Position Statements (with a specific focus on mental health), LGBTQI Alliances and Foundations Publishing (with a specific focus on mental health). In addition, relevant international initiatives, and projects in the field of LGBTQI mental health will be described.
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Affiliation(s)
- Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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21
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McNair RP, Parkinson S, Dempsey D, Andrews C. Lesbian, gay and bisexual homelessness in Australia: Risk and resilience factors to consider in policy and practice. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e687-e694. [PMID: 34038599 DOI: 10.1111/hsc.13439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 03/11/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
Lesbian, gay and bisexual (LGB) people are more likely than heterosexual people to experience homelessness. The study aimed to compare risk and resilience factors commonly associated with homelessness according to sexual identity to inform more LGB-inclusive and targeted policy and service provision in this area. The study involved analysis of data from two Australian surveys: the General Social Survey 2014 (n = 17,401) and the Journeys Home study (n = 1,659). Chi-squared analyses of the survey data compared LGB with heterosexual respondents. Bisexual respondents had a significantly earlier average age of first homelessness, and were more likely to have repeated episodes of homelessness than lesbian, gay or heterosexual respondents. Risk factors that were higher among bisexual people included family violence, conflict and rejection and substance use issues. LGB respondents were twice as likely to have experienced discrimination as heterosexual respondents, more likely to have experienced violence and have mental health problems. Conversely, resilience factors for LGB respondents included being more likely to access friends for support in times of crisis, and to be involved in civic or political groups. We suggest that LGB people at risk of homelessness need effective responses based on their risk and resilience factors, including targeted peer support and mainstream services that affirm and acknowledge their diverse sexual identities. Australian policies should encourage improved LGB data collection and specific service responses. Primary prevention approaches include educating families of origin about LGB identities and assertive outreach to prevent housing loss.
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Affiliation(s)
- Ruth P McNair
- Department of General Practice, The University of Melbourne, Carlton, VIC, Australia
| | | | - Deborah Dempsey
- Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Cal Andrews
- The University of Melbourne, Carlton, VIC, Australia
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22
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Abstract
Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are 120% more likely to be homeless than cisgender and heterosexual youth, yet current federal policies are insufficient and exclude LGBTQ youth. Youth homeless shelters are inadequately equipped to serve LGBTQ homeless youth due to poor funding, a focus on heterosexual or cisgender clients in their programs, and a lack of LGBTQ-friendly policies. Given the pervasiveness of this issue, public health and social policy interventions must be considered. In this perspective, the LGBTQ homeless youth epidemic is introduced and described, past policies are analyzed, and policy recommendations are made.
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Affiliation(s)
- Cameron K Ormiston
- Global Health Department, University of California, San Diego, La Jolla, California, USA
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23
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Siconolfi D, Storholm ED, Vincent W, Pollack L, Rebchook GM, Huebner DM, Peterson JL, Kegeles SM. Prevalence and Correlates of Sexual Violence Experienced by Young Adult Black Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3621-3636. [PMID: 34725750 PMCID: PMC9473496 DOI: 10.1007/s10508-021-02011-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 03/27/2021] [Accepted: 04/09/2021] [Indexed: 05/06/2023]
Abstract
Men who have sex with men (MSM) experience high prevalence of sexual violence (SV), and SV has well-documented effects on health. Research gaps are especially evident for young Black MSM (YBMSM), who experience significant HIV disparities and syndemics, including multiple forms of violence victimization. We examined lifetime prevalence of SV (having been forced or frightened into sexual activity) in a cross-sectional sample of YBMSM (N = 1732), and tested associations of demographic, psychosocial, and structural factors using multivariable regression. YBMSM were recruited between 2013 and 2015 using modified venue-based time-location sampling (e.g., at bars and clubs) in Dallas and Houston, Texas. Approximately 17% of YBMSM experienced any SV in their lifetimes. SV was associated with high school non-completion (OR 1.78; 95% CI 1.15-2.77), lower psychological resilience (OR 0.84; 95% CI 0.71-0.98), lifetime history of homelessness (OR 5.52; 95% CI 3.80-8.02), recent financial hardship (OR 2.16; 95% CI 1.48-3.14), and recent transactional sex (OR 3.87; 95% CI 2.43-6.15). We also examined differences by age of SV onset (childhood versus adulthood). YBMSM with adolescent/emerging adult-onset SV may have been more ambivalent in reporting lifetime SV experience, compared to men with childhood-onset SV, and correlates differed by age of onset. Childhood-onset SV was associated with high school non-completion, lower levels of psychological resilience, history of homelessness, recent financial hardship, and recent transactional sex. Adolescent/emerging adult-onset SV was associated with greater depressive symptoms, history of homelessness, and recent financial hardship. There is a need for multi-level approaches to SV prevention and treatment, including services and supports that are culturally-relevant and responsive to the needs of YBMSM.
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Affiliation(s)
| | - Erik D Storholm
- RAND, Santa Monica, CA, USA
- Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
| | - Wilson Vincent
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Lance Pollack
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Gregory M Rebchook
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - David M Huebner
- Department of Prevention and Community Health, George Washington University, Washington, DC, USA
| | - John L Peterson
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Susan M Kegeles
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Brewster KL, Tillman KH, Holway GV. Timing of First Sexual Experience with a Same-Sex Partner: A Life Course Approach. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:3587-3599. [PMID: 34697690 DOI: 10.1007/s10508-021-02043-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 06/13/2023]
Abstract
Theories of sexual identity development recognize the initiation of sexual experience with same-sex partners (SESSP) to be a significant event in the coming-out process, yet the research literature lacks a population-based description of its timing and variation across population subgroups. Using data from the 2011-2017 National Survey of Family Growth and guided by the life course paradigm, we explored the timing and correlates of first SESSP among individuals (1425 women; 545 men) who identified as lesbian (n = 307), gay (n = 285), or bisexual (n = 1378) (LGB). Descriptive findings revealed that the median age at first SESSP was about 19 years for lesbian women and gay men and one to two years later for bisexual women and men. Notably, initiation of SESSP occurred over a wide age range, particularly among bisexual men. Multivariable results indicated that the probability of first SESSP did not vary by demographic characteristics or family background among men. Among women, nativity status, family stability, and independent living were associated with probability of first SESSP. Coital experience predicted timing among both women and men. Tests for statistical interactions suggested that age at first SESSP was contingent on mother's education (women), sexual identity (men), family stability (men), and birth cohort (women and men). Our findings highlight the complicated nature of LGB sexual experiences, and we end with a call for greater effort to ensure that LGB individuals are represented in national surveys designed to provide data on sexual and reproductive health.
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Affiliation(s)
- Karin L Brewster
- Department of Sociology and Center for Demography and Population Health, Florida State University, 601 Bellamy Bldg, 113 Collegiate Loop, Tallahassee, FL, 32306-2240, USA.
| | - Kathryn Harker Tillman
- Department of Sociology and Center for Demography and Population Health, Florida State University, 601 Bellamy Bldg, 113 Collegiate Loop, Tallahassee, FL, 32306-2240, USA
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Hirschtritt ME, Folk JB, Marshall BDL, Li Y, Tolou-Shams M. Cannabis Use Among Court-Involved Minority Sexual Orientation and Gender Identity Adolescents. THE JOURNAL OF THE AMERICAN ACADEMY OF PSYCHIATRY AND THE LAW 2021; 49:350-360. [PMID: 34001670 PMCID: PMC8429183 DOI: 10.29158/jaapl.200104-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We examined the effects of family functioning and beliefs regarding peers' cannabis use among minority (n = 112) and non-minority (n = 275) sexual orientation and gender identity (SOGI), first-time court-involved adolescents. We examined longitudinally the effects of baseline general family functioning and peer cannabis use beliefs on self-reported cannabis use and cannabis-related consequences after 12 months. At baseline, 39.2 percent of adolescents reported using cannabis. Minority SOGI adolescents reported worse family functioning (p = .017) and higher peer cannabis use beliefs (p = .047). Higher peer cannabis use beliefs at baseline predicted recent cannabis use at the 12-month assessment for both minority and non-minority SOGI adolescents. Better family functioning predicted a lower likelihood of recent cannabis use at 12 months for non-minority SOGI adolescents, but not for minority SOGI adolescents. Baseline peer cannabis use beliefs and family functioning predicted cannabis-related consequences for both cohorts at 12 months when accounting for intermediate (i.e., four-month and eight-month) data. Among all first-time court-involved adolescents, those who believed greater cannabis use among their peers reported more subsequent cannabis use themselves. Conversely, higher general family functioning may be less of a protective factor for minority SOGI adolescents. These results suggest the utility of feedback interventions to modify peer norm beliefs among first-time court-involved adolescents.
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Affiliation(s)
- Matthew E Hirschtritt
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA.
| | - Johanna B Folk
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Brandon D L Marshall
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Yu Li
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | - Marina Tolou-Shams
- Dr. Hirschtritt is Clinical Professor, Dr. Folk is Assistant Professor, and Dr. Tolou-Shams is Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA. Dr. Marshall is Associate Professor and Dr. Li is Biostatistician, Department of Epidemiology, Brown University School of Public Health, Providence, RI. Dr. Tolou-Shams is Director, Division of Infant, Child, and Adolescent Psychiatry, Zuckerberg San Francisco General Hospital, San Francisco, CA
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Craig SL, Eaton AD, Kirkland A, Egag E, Pascoe R, King K, Krishnan S. Towards an integrative self: a digital photo elicitation study of resilience among key marginalized populations of sexual and gender minority youth. Int J Qual Stud Health Well-being 2021; 16:1961572. [PMID: 34375157 PMCID: PMC8366624 DOI: 10.1080/17482631.2021.1961572] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Purpose: Sexual and gender minority youth (SGMY) experience unique challenges related to identity and disclosure, and cope in vibrant ways. Qualitative research has not yet fulsomely explored the risk, resilience, and identity intersections that impact vulnerable SGMY wellbeing. Methods: This digital photo-elicitation study (QueerView) recruited thirty SGMY (aged 14–29) from priority populations that had one or more of the following experiences: trans and gender diverse, homelessness, child welfare, and immigration. From submission of fifteen photos representing resilience and a semi-structured interview via web conferencing, constructivist grounded theory was utilized for multimodal analysis of photos, interview video, and interview transcript. Triangulation, an audit trail, and member checking were employed to support trustworthiness. Results: A visual model emerged showing how participants work towards an integrative self, with themes of reflecting and knowing, discrimination and intersectional challenges, connecting, performing, curating, coping, (re)defining and (re)creating, growing and being. Sub-themes of the impact of family dynamic and values, mental health and trauma, and the cathartic benefit from advocacy and leadership offered insight. Participant images were captured in a digital gallery. Conclusions: QueerView animates the complex lives of multiply marginalized SGMY and their intersectional strengths and challenges while demonstrating the utility of a digital multimodal approach.
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Affiliation(s)
- Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Andrew D Eaton
- Faculty of Social Work, University of Regina - Saskatoon Campus, Regina, Canada
| | - Alexa Kirkland
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Egag Egag
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Rachael Pascoe
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Kourteney King
- Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Sreedevi Krishnan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Educating Nursing Students About Delivering Culturally Sensitive Care to Lesbian, Gay, Bisexual, Transgender, Questioning/Queer, Intersex, Plus Patients: The Impact of an Advocacy Program on Knowledge and Attitudes. Nurs Educ Perspect 2021; 42:E15-E19. [PMID: 33935246 DOI: 10.1097/01.nep.0000000000000819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM This study evaluated the effects of a program designed to help students provide culturally competent care for lesbian, gay, bisexual, transgender, questioning/queer, intersex, plus (LGBTQI+) patients. BACKGROUND The LGBTQI+ community faces disparities linked to stigma and discrimination. The Advocacy™ Program was developed to supplement the curriculum in schools of nursing. METHOD Nursing students from six schools of nursing (n = 1,398) received advocacy training. Students were administered the Genderism and Transphobia Scale, the Homonegativity Scale, and additional knowledge questions before and after training. RESULTS The findings were positive, indicating an increase in student attitude scores, vocabulary and disparity knowledge, and knowledge regarding care for an LGBTQI+ client (p < .05). CONCLUSION By building a culture of inclusion through recognition of diverse patients in the curriculum, nursing schools can develop a culture of connection that strengthens patient-provider relationships and improves mental and physical health.
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Lund EM, Burgess CM. Sexual and Gender Minority Health Care Disparities: Barriers to Care and Strategies to Bridge the Gap. Prim Care 2021; 48:179-189. [PMID: 33985698 DOI: 10.1016/j.pop.2021.02.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Gender and sexual minority individuals face considerable physical and mental health disparities, health risk factors, and barriers to care. These disparities are rooted in systemic and interpersonal prejudice, discrimination, and violence toward lesbian, gay, bisexual, transgender, queer, and other (LGBTQ+) individuals and communities that place LGBTQ+ individuals at increased risk for negative social determinants of health. While also advocating for systemic change, individual providers and clinics have an ethical duty to promote an openly affirming, culturally competent health care environment that can help to address these disparities on an individual patient level.
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Affiliation(s)
- Emily M Lund
- Department of Educational Studies in Psychology, Research Methodology, and Counseling, University of Alabama, PO Box 870231, Tuscaloosa, AL 35487, USA.
| | - Claire M Burgess
- VA Boston Healthcare System, Harvard Medical School, 940 Belmont Street, Brockton, MA 02310, USA
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Kaligis F, Ismail RI, Wiguna T, Prasetyo S, Indriatmi W, Gunardi H, Pandia V, Magdalena CC. Mental Health Problems and Needs among Transitional-Age Youth in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084046. [PMID: 33921344 PMCID: PMC8070090 DOI: 10.3390/ijerph18084046] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022]
Abstract
“Transitional-age youth” describes those whose ages range from 16–24 years old. In this phase, the youth face new challenges and new experiences which may increase the risk for having mental health problems, yet not very many seek help from mental health professionals. In Indonesia, no data are available about mental health problems and the needs of transitional-age youth. This study explores common mental health problems experienced during this stage and assesses how they cope with problems and their expectations from health services. This was a cross-sectional study involving 393 Indonesians aged 16–24 years in May 2020. More than 90% of students had financial and academic difficulties and felt lonely. The most prevalent mental health problem among students was anxiety (95.4%). Most of the students, ranging from 90% to 96.4%, had positive coping strategies. However, around 50% of respondents reported self-harming and having suicidal thoughts. The results of subcategories analysis between ages and faculties were similar. Their most important expectations from mental health services included confidentiality (99.2%) and being welcoming and friendly (99.2%). In conclusion, this study highlighted the most common problems transitional-age youth experience in Indonesia. While some of them already knew how to deal with their problems, not all the participants had good coping mechanisms. Their healthcare expectations were also explored, thereby providing a useful background to revise and amend the current conditions.
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Affiliation(s)
- Fransiska Kaligis
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (R.I.I.); (T.W.); (C.C.M.)
- Correspondence:
| | - Raden Irawati Ismail
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (R.I.I.); (T.W.); (C.C.M.)
| | - Tjhin Wiguna
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (R.I.I.); (T.W.); (C.C.M.)
| | - Sabarinah Prasetyo
- Faculty of Public Health, Universitas Indonesia, Depok 16424, West Java, Indonesia;
| | - Wresti Indriatmi
- Doctoral Program of Medical Science, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia;
- Department of Dermatovenereology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Hartono Gunardi
- Department of Child Health, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia;
| | - Veranita Pandia
- Department of Psychiatry, Faculty of Medicine, Universitas Padjajaran, Bandung 40115, West Java, Indonesia;
| | - Clarissa Cita Magdalena
- Department of Psychiatry, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia; (R.I.I.); (T.W.); (C.C.M.)
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Vincent W, Lin J, Veloso D, Miller D, McFarland W. Homelessness, HIV testing, and the reach of public health efforts for people who inject drugs, San Francisco, California. Drug Alcohol Depend 2021; 221:108560. [PMID: 33607498 PMCID: PMC8494070 DOI: 10.1016/j.drugalcdep.2021.108560] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 12/20/2020] [Accepted: 01/02/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND There is a dearth of literature that explicitly examines associations between housing and HIV testing among people who inject drugs (PWID). Thus, the present study investigated the links between housing status and HIV testing for PWID. METHODS Respondent-driven sampling recruited 382 HIV-negative PWID, who completed structured interviews in San Francisco. Logistic regression determined whether housing statuses in the past 12 months ([1] owned/rented, [2] single-room occupancy hotels [SROs], [3] living with friends/family/partners, [4] shelters, [5] outdoors) were associated with getting HIV tested in the past 12 months while adjusting for sociodemographics and receptive sharing of injection paraphernalia in the past 12 months. RESULTS PWID who lived in SROs had greater odds of being tested for HIV than PWID who did not live in SROs (aOR = 1.95, CI.95: 1.06-3.60) while adjusting for covariates. Although bivariable analyses indicated that receptively sharing syringes was more common for PWID who lived with others (χ2[3] = 7.94, p = 0.047) or lived outdoors (χ2[3] = 9.50, p = 0.023) than those who did not, respectively, PWID who lived with others (aOR = 1.72, CI.95 = 0.95-3.14) or lived outdoors (aOR = 1.37, CI.95 = 0.74-2.53) did not show greater odds of HIV testing in multivariable analyses. CONCLUSIONS PWID who lived in SROs had greater odds of HIV testing than PWID who did not live in SROs. Although PWID who lived with others or outdoors showed greater HIV risk, they did not show greater odds of HIV testing. Public health efforts may be reaching PWID in SROs, but more work is needed to reach PWID who live with other people or outdoors.
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Affiliation(s)
- Wilson Vincent
- Department of Psychology, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, United States.
| | - Jess Lin
- Department of Psychology, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, United States
| | - Danielle Veloso
- Department of Psychology, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, United States
| | - Desmond Miller
- Department of Psychology, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, United States
| | - Willi McFarland
- Department of Psychology, Weiss Hall, 1701 N. 13th Street, Philadelphia, PA, 19122, United States
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Comparing substance use and mental health among sexual and gender minority and heterosexual cisgender youth experiencing homelessness. PLoS One 2021; 16:e0248077. [PMID: 33705446 PMCID: PMC7951876 DOI: 10.1371/journal.pone.0248077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/18/2021] [Indexed: 11/20/2022] Open
Abstract
Youth homelessness has been demonstrated to disproportionately affect sexual and gender minority (SGM) youth compared to heterosexual cisgender peers. In this context, we aimed to compare health risks between service-seeking SGM and heterosexual cisgender youth experiencing homelessness, including harmful risks stemming from substance use and severity of symptoms of mental health disorders. We recruited 100 racially diverse, unstably housed participants aged 18-24 who access services at an urban non-profit organization in San Francisco, CA. Data analysis included 56 SGM participants who identified as gay, lesbian, bisexual, pansexual, unsure, transgender, and nongender, and 44 heterosexual cisgender participants. In contrast to previous studies reporting significantly higher frequency of substance use and more severe symptoms of depression, generalized anxiety, and post-traumatic stress disorder among SGM youth compared to heterosexual cisgender peers, many of these health disparities were not observed in our diverse study population of service-seeking youth. Furthermore, with the exception of methamphetamine, SGM participants did not exhibit greater harmful risks resulting from substance use, such as health, social, financial, and legal complications. We discuss the reduced burden of health disparities between SGM and heterosexual cisgender youth in our service-seeking study population within the context of gender- and sexuality-affirming programming offered at the partnering community organization. We conclude that longitudinal data on these tailored community-level interventions are needed to further explore the reduced burden of health disparities observed among service-seeking SGM youth experiencing homelessness in San Francisco in order to continue supporting pathways out of homelessness for youth of all sexual and gender identities nationwide.
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Abdel-Samad M, Calzo JP, Felner JK, Urada L, Verbyla ME, Madanat H, Adams BE, Alves T, Appleyard B, Chanin J, Flanigan S, Foad H, Ginsberg M, Higgins M, Ko E, Maher K, Mladenov N, Peattie P, Welsh M, Sleet D. Conceptualizing an Interdisciplinary Collective Impact Approach to Examine and Intervene in the Chronic Cycle of Homelessness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042020. [PMID: 33669672 PMCID: PMC7921968 DOI: 10.3390/ijerph18042020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/04/2021] [Accepted: 02/09/2021] [Indexed: 11/16/2022]
Abstract
Homelessness is a persistent problem in the United States in general and in Southern California especially. While progress has been made in reducing the number of people experiencing homelessness in the United States from 2007 (647,000) to 2019 (567,000), it remains an entrenched problem. The purpose of this paper is to outline a novel, interdisciplinary academic-practice partnership model to address homelessness. Where singular disciplinary approaches may fall short in substantially reducing homelessness at the community and population level, our model draws from a collective impact model which coordinates discipline-specific approaches through mutually reinforcing activities and shared metrics of progress and impact to foster synergy and sustainability of efforts. This paper describes the necessary capacity-building at the institution and community level for the model, the complementary strengths and contributions of each stakeholder discipline in the proposed model, and future goals for implementation to address homelessness in the Southern California region.
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Affiliation(s)
- Mounah Abdel-Samad
- School of Public Affairs, San Diego State University (SDSU), San Diego, CA 92182, USA; (B.A.); (J.C.); (S.F.); (M.W.)
- Correspondence:
| | - Jerel P. Calzo
- School of Public Health, SDSU, San Diego, CA 92182, USA; (J.P.C.); (J.K.F.); (H.M.)
| | - Jennifer K. Felner
- School of Public Health, SDSU, San Diego, CA 92182, USA; (J.P.C.); (J.K.F.); (H.M.)
| | - Lianne Urada
- School of Social Work, SDSU, San Diego, CA 92182, USA; (L.U.); (E.K.)
| | - Matthew E. Verbyla
- Department of Civil, Construction, and Environmental Engineering, SDSU, San Diego, CA 92182, USA; (M.E.V.); (T.A.); (N.M.)
| | - Hala Madanat
- School of Public Health, SDSU, San Diego, CA 92182, USA; (J.P.C.); (J.K.F.); (H.M.)
| | - Brian E. Adams
- Department of Political Science, SDSU, San Diego, CA 92182, USA; (B.E.A.); (K.M.)
| | - Thais Alves
- Department of Civil, Construction, and Environmental Engineering, SDSU, San Diego, CA 92182, USA; (M.E.V.); (T.A.); (N.M.)
| | - Bruce Appleyard
- School of Public Affairs, San Diego State University (SDSU), San Diego, CA 92182, USA; (B.A.); (J.C.); (S.F.); (M.W.)
| | - Joshua Chanin
- School of Public Affairs, San Diego State University (SDSU), San Diego, CA 92182, USA; (B.A.); (J.C.); (S.F.); (M.W.)
| | - Shawn Flanigan
- School of Public Affairs, San Diego State University (SDSU), San Diego, CA 92182, USA; (B.A.); (J.C.); (S.F.); (M.W.)
| | - Hisham Foad
- Department of Economics, SDSU, San Diego, CA 92182, USA;
| | - Maya Ginsberg
- School of Music and Dance, SDSU, San Diego, CA 92182, USA;
| | | | - Eunjeong Ko
- School of Social Work, SDSU, San Diego, CA 92182, USA; (L.U.); (E.K.)
| | - Kristen Maher
- Department of Political Science, SDSU, San Diego, CA 92182, USA; (B.E.A.); (K.M.)
| | - Natalie Mladenov
- Department of Civil, Construction, and Environmental Engineering, SDSU, San Diego, CA 92182, USA; (M.E.V.); (T.A.); (N.M.)
| | - Peggy Peattie
- School of Journalism and Media Studies, SDSU, San Diego, CA 92182, USA;
| | - Megan Welsh
- School of Public Affairs, San Diego State University (SDSU), San Diego, CA 92182, USA; (B.A.); (J.C.); (S.F.); (M.W.)
| | - David Sleet
- School of Public Health, SDSU, San Diego, CA 92182, USA; (J.P.C.); (J.K.F.); (H.M.)
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Tankersley AP, Grafsky EL, Dike J, Jones RT. Risk and Resilience Factors for Mental Health among Transgender and Gender Nonconforming (TGNC) Youth: A Systematic Review. Clin Child Fam Psychol Rev 2021; 24:183-206. [PMID: 33594611 DOI: 10.1007/s10567-021-00344-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2021] [Indexed: 11/24/2022]
Abstract
In recent years, there has been a proliferation of research regarding transgender and gender nonconforming (TGNC) people. The stigma and legal discriminations that this population faces have obvious and documented repercussions for mental health. In 2015, the American Psychological Association (APA) published Guidelines for Psychological Practice with TGNC People. The APA noted that due to the nuances of working with TGNC youth and the dearth of related literature, the guidelines focus primarily on TGNC adults. To date, there has not been a systematic review of risk and resilience factors for mental health among TGNC children, adolescents, and young adults under the age of 25. Forty-four peer-reviewed articles met inclusion criteria for this systematic review, and were evaluated for their methodological rigor and their findings. Common risk factors for negative mental health variables included physical and verbal abuse, exposure to discrimination, social isolation, poor peer relations, low self-esteem, weight dissatisfaction, and age. Across studies, older children and adolescents tended to report higher rates of psychological distress. Resilience-promoting factors for mental health were also documented, including parent connectedness, social support, school safety and belonging, and the ability to use one's chosen name. By synthesizing the existing literature using a resilience-focused and minority stress framework, the present review provides clinicians and researchers with a coherent evidence-base to better equip them to promote psychological adaptation and wellbeing among TGNC youth.
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The Prevalence and Correlates of Labor and Sex Trafficking in a Community Sample of Youth Experiencing Homelessness in Metro-Atlanta. SOCIAL SCIENCES 2021. [DOI: 10.3390/socsci10020032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Research suggests that runaway and homeless youth (RHY) in the United States are vulnerable to sex and labor trafficking. In this paper, we report and analyze estimates of sex and labor trafficking collected as part of the Atlanta Youth Count 2018, a community-based field survey of RHY between the ages of 14 and 25 in the metro-Atlanta area. A total of 564 participants were recruited and completed a survey that included questions about their backgrounds as well as the Human Trafficking Screening Tool (HTST). We found that 39.9% experienced some form of trafficking while homeless. While 15.6% of the youth reported commercial sexual exploitation while homeless, coerced labor (29.3%) or fraud (25.2%) were even more common experiences. Women, transgender, and gender nonconforming youth, as well young people who had prior system involvement and those who had been homeless for more than a year were the most likely to report having been trafficked. The significance of these findings for research and policy on RHY and trafficking are discussed.
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Litam SDA, Hipolito‐Delgado CP. When Being “Essential” Illuminates Disparities: Counseling Clients Affected by COVID‐19. JOURNAL OF COUNSELING AND DEVELOPMENT 2020. [DOI: 10.1002/jcad.12349] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Greenfield B, Alessi EJ, Manning D, Dato C, Dank M. Learning to endure: A qualitative examination of the protective factors of homeless transgender and gender expansive youth engaged in survival sex. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2020; 22:316-329. [PMID: 34240074 PMCID: PMC8118232 DOI: 10.1080/26895269.2020.1838387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Background: Transgender and gender expansive (TGE) youth face a number of adversities that are associated with deleterious consequences, including mental health problems, substance misuse, suicide, and homelessness. However, there is evidence that TGE youth still demonstrate resilience under extraordinary conditions. Aims: Therefore, this study examined how TGE youth who are homeless and engaging in survival sex describe and understand the protective factors present in their lives. Methods: In-depth qualitative interviews were conducted with 57 TGE youth living in a large U.S. city. Participants were 17-26 years old (M = 19.88, SD = 1.55), and identified as transgender woman (53%), transgender man (16%), and other (32%; gender-queer, gender-fluid, androgynous, or non-binary). Youth identified as Black (40%), multiracial (35%), Latinx (16%), White (5%), and as another race (3%). Researchers conducted a secondary analysis of qualitative data using thematic analysis. Results: We identified three themes to capture youth's understanding of their protective factors: relying on oneself and others to avoid violence, accessing gender-affirming health and mental health care, and proactively maintaining sexual health. Participants described strategies for mitigating risk of harm while attempting to meet their basic needs. Additionally, they discussed the importance of having gender-affirming health and mental health services. Participants also expressed keen awareness of their sexual health risks and making calculated, often proactive decisions about their sexual health. Conclusion: The protective factors described by TGE youth reflect the unique ways in which hyper-marginalized youth must navigate their own survival and well-being, and align with literature suggesting resilience is not mutually exclusive from risk. By focusing on TGE youth, this research privileges the experiences of individuals historically underrepresented in research and encourages future research to incorporate these perspectives into policies and programs.
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Affiliation(s)
- Brett Greenfield
- Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Edward J. Alessi
- Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Dean Manning
- Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Caroline Dato
- Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Meredith Dank
- John Jay College of Criminal Justice, City University of New York, New York, New York, USA
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37
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Suen YT, Chan R, Wong EMY. Effects of general and sexual minority-specific COVID-19-related stressors on the mental health of lesbian, gay, and bisexual people in Hong Kong. Psychiatry Res 2020; 292:113365. [PMID: 32862107 PMCID: PMC7397990 DOI: 10.1016/j.psychres.2020.113365] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/27/2020] [Accepted: 08/02/2020] [Indexed: 02/07/2023]
Abstract
The impact of COVID-19 on mental health has begun to be widely recognized, but there is an absence of studies on how the mental health of lesbian, gay, and bisexual (LGB) people have been affected by the COVID-19 pandemic. A total of 857 LGB people in Hong Kong participated in a community-based survey study. Over one-fourth of them met the criteria for probable clinical depression (31.5%) and generalized anxiety disorder (27.9%). Besides general stressors, we identified sexual minority-specific stressors during the pandemic. 4.2% of the participants indicated that they had frequently experienced family conflict related to sexual orientation. One-third responded that they had largely reduced connection to the lesbian, gay, bisexual, and transgender plus (LGBT+) community (34.7%). The results showed that sexual minority-specific COVID-19-related stressors explained significant variance in depressive and anxiety symptoms, above and beyond the contribution of general COVID-19-related stressors. Since LGB people are particularly vulnerable to poor mental health during the COVID-19 pandemic, LGB people-targeting organizations need to understand more about family, space, and privacy concerns in order to provide better support, and LGB safe spaces and shelters may be needed as a policy response.
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Affiliation(s)
- Yiu Tung Suen
- Gender Studies Programme, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Randolph C. H. Chan
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, Hong Kong,Corresponding author
| | - Eliz Miu Yin Wong
- Department of Social Policy, London School of Economics and Political Science, London, United Kingdom
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Fauer AJ, Manges K, Stroumsa D, Sinko L, Adynski GI, Aronowitz SV, Choi KR. Catalyzing a Nursing Response to Healthcare Discrimination Against Transgender and Nonbinary Individuals. J Nurs Scholarsh 2020; 52:599-604. [DOI: 10.1111/jnu.12597] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Alex J. Fauer
- Postdoctoral Fellow National Clinician Scholars Program UCLA Los Angeles CA USA
| | - Kirstin Manges
- Postdoctoral Fellow National Clinician Scholars Program University of Pennsylvania Philadelphia PA USA
| | - Daphna Stroumsa
- Clinical Lecturer Department of Obstetrics and Gynecology and Institute for Healthcare Policy and Innovation University of Michigan Ann Arbor MI USA
| | - Laura Sinko
- Postdoctoral Fellow National Clinician Scholars Program University of Pennsylvania Philadelphia PA USA
| | - Gillian I. Adynski
- Postdoctoral Fellow National Clinician Scholars Program Duke University Durham NC USA
| | - Shoshana V. Aronowitz
- Postdoctoral Fellow National Clinician Scholars Program University of Pennsylvania Philadelphia PA USA
| | - Kristen R. Choi
- Assistant Professor School of Nursing UCLA, Los Angeles, CA and Adjunct Investigator, Department of Research & Evaluation Kaiser Permanente Southern California Pasadena CA USA
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Siconolfi D, Tucker JS, Shadel WG, Seelam R, Golinelli D. Health, Homelessness Severity, and Substance Use among Sexual Minority Youth Experiencing Homelessness: A Comparison of Bisexual Versus Gay and Lesbian Youth. JOURNAL OF SEX RESEARCH 2020; 57:933-942. [PMID: 31809204 PMCID: PMC7274857 DOI: 10.1080/00224499.2019.1695723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Lesbian, gay, bisexual, and questioning (LGBQ) youth are overrepresented among youth experiencing homelessness (YEH), and health disparities among LGBQ youth are well-documented. LGBQ youth are typically aggregated as a single sexual minority group; however, research suggests that bisexual youth may have greater mental health, substance use, and physical health risks relative to their gay and lesbian peers. In a probability sample of LGBQ YEH in Los Angeles County (n = 183), we examined subgroup differences in homelessness severity, depression, physical health, and substance use, focusing on differences between bisexual and gay/lesbian youth due to the small subsample of questioning youth. Indicators of homelessness severity were standalone outcomes, and also were integrated as control variables with gender, age, race/ethnicity, and education in multivariable models. Bisexual youth were more likely to have become unaccompanied homeless persons as minors (OR = 4.35, 95% CI 1.85-10.23), and to have not recently utilized emergency shelters or transitional housing at least once in the past month (OR = 6.41; 95% CI 2.41-17.03). Bisexual youth were more likely to have probable depression (OR = 4.06, 95% CI 1.41-11.68). Among sexual minority YEH, bisexual youth may be at elevated risk for depression, in addition to more severe homelessness.
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Affiliation(s)
| | - Joan S Tucker
- RAND Social and Economic Well-Being, RAND Corporation
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Gerke DR, Step MM, Rünger D, Fletcher JB, Brooks RA, Davis N, Kisler KA, Reback CJ. Associations Between Social Support and Social Media Use Among Young Adult Cisgender MSM and Transgender Women Living With HIV. Health Promot Pract 2020; 21:705-715. [PMID: 32757834 DOI: 10.1177/1524839920936248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Social media platforms offer the opportunity to develop online social networks. Use of these platforms has been particularly attractive to younger sexual and gender minority individuals as well as those living with HIV. This cross-sectional study examined the perceived level of social support and associations with social media use among youth and young adult cisgender men who have sex with men (MSM) and transgender (trans) women living with HIV and examined these associations by gender identity. The study drew from baseline data collected from 612 cisgender MSM and 162 trans women enrolling in one of 10 demonstration sites that were part of a Health Resources and Services Administration Special Projects of National Significance initiative. The individual projects were designed to evaluate the potential for social media/mobile technology-based interventions to improve retention in care and HIV health outcomes. The data used in this study came from baseline surveys completed when participants enrolled in a site between October 2016 and May 2018. Results demonstrated that a significantly greater proportion of MSM than trans women participants reported the use of social media platforms (e.g., Facebook: MSM = 86%, trans women = 62%; Instagram: MSM = 65%, trans women = 35%). Furthermore, increased social media use improved perceptions of social support only among MSM participants (direct adjusted OR = 1.49) and not trans women participants (gender identity interaction term adjusted OR = 0.64). These results revealed that MSM participants perceived greater social benefit from the use of social media platforms than trans women, which could be a result of generalized online transphobia experienced by trans women. More nuanced data on various social media platforms, that is, anonymous versus profile-based, and group differences, are needed to better understand how social media platforms can be best utilized to optimize health care outcomes among sexual and gender minority youth and young adults living with HIV.
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Affiliation(s)
| | | | - Dennis Rünger
- University of California, Los Angeles, Los Angeles, CA, USA
| | | | | | | | | | - Cathy J Reback
- University of California, Los Angeles, Los Angeles, CA, USA.,Friends Research Institute, Los Angeles, CA, USA
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Jadwin-Cakmak L, Bauermeister JA, Cutler JM, Loveluck J, Sirdenis TK, Fessler KB, Popoff EE, Benton A, Pomerantz NF, Atkins SLG, Springer T, Harper GW. The Health Access Initiative: A Training and Technical Assistance Program to Improve Health Care for Sexual and Gender Minority Youth. J Adolesc Health 2020; 67:115-122. [PMID: 32268999 PMCID: PMC7739871 DOI: 10.1016/j.jadohealth.2020.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/17/2019] [Accepted: 01/03/2020] [Indexed: 01/23/2023]
Abstract
PURPOSE This article describes the Health Access Initiative (HAI), an intervention to improve the general and sexual health care experiences of sexual and gender minority youth (SGMY) by providing training and technical assistance to providers and staff. The training consisted of an online and in-person training, followed by site-specific technical assistance. We present the findings of a pilot evaluation of the program with 10 diverse clinics in Michigan. METHODS This program was developed using community-based participatory research principles. Based on a framework of cultural humility, program activities are guided by the Situated Information-Motivation-Behavioral Skills Model. The mixed method program evaluation used training feedback surveys assessing program feasibility, acceptability, and effectiveness; pre/post surveys assessing knowledge, attitudes, and practices toward SGMY; and in-depth interviews with site liaisons assessing technical assistance and structural change. RESULTS The HAI is a highly feasible and acceptable intervention for providers and staff at a variety of health care sites serving adolescents and emerging adults. The results from 10 clinics that participated in the HAI indicate strong intervention efficacy, with significant and meaningful improvements seen in the knowledge of, attitudes toward, and practices with SGMY reported by providers and staff at 6-month follow-up compared with baseline, as well as in qualitative interviews with site liaisons. CONCLUSIONS The HAI is a promising intervention to improve the quality of primary and sexual health care provided to SGMY. Expanded implementation with continued evaluation is recommended. The HAI may also be adapted to address specific health needs of SGMY beyond sexual health.
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Affiliation(s)
- Laura Jadwin-Cakmak
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan.
| | | | - Jacob M. Cutler
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
| | | | - Triana Kazaleh Sirdenis
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Kathryn B. Fessler
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Elliot E. Popoff
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
| | | | - Naomi F. Pomerantz
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
| | | | | | - Gary W. Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
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Tordoff DM, Haley SG, Shook A, Kantor A, Crouch JM, Ahrens K. “Talk about Bodies”: Recommendations for Using Transgender-Inclusive Language in Sex Education Curricula. SEX ROLES 2020. [DOI: 10.1007/s11199-020-01160-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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DiGuiseppi GT, Davis JP, Leightley D, Rice E. Predictors of Adolescents' First Episode of Homelessness Following Substance Use Treatment. J Adolesc Health 2020; 66:408-415. [PMID: 32057607 DOI: 10.1016/j.jadohealth.2019.11.312] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/10/2019] [Accepted: 11/23/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE A growing body of research has identified correlates (i.e., predictors) of youth homelessness. However, such risk and protective factors have not been identified for youth receiving substance use treatment. Using characteristics collected at treatment intake, the present study sought to identify predictors of youths' first episode of homelessness during the 12 months after substance use treatment entry. METHODS Data come from a longitudinal study of adolescents (n = 17,911; aged 12-17 years) receiving substance use treatment throughout the U.S. Participants completed surveys at intake and at 3, 6, and 12 months later. Logistic regression and Lasso machine learning regression were used to predict participants' first episode of homelessness in the 12 months after treatment intake. RESULTS After excluding adolescents reporting previous experiences of homelessness, 5.0% of adolescents reported their first episode of homelessness over the 12 months after treatment intake. The results from logistic and lasso models were generally consistent. Final models revealed that adolescents who were older, male, reported more victimization experiences, mental health problems, family problems, deviant peer relationships, and substance use problems (more treatment episodes and illicit drug dependence) were more likely to report experiencing homelessness. Hispanic/Latino adolescents were less likely to experience homelessness, compared with white adolescents. CONCLUSIONS The results point to the important risk and protective factors that can be assessed at treatment entry to identify adolescents at greater risk of experiencing their first episode of homelessness.
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Affiliation(s)
- Graham T DiGuiseppi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California.
| | - Jordan P Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Daniel Leightley
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Eric Rice
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
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Gewirtz O'Brien JR, Edinburgh LD, Barnes AJ, McRee AL. Mental Health Outcomes Among Homeless, Runaway, and Stably Housed Youth. Pediatrics 2020; 145:peds.2019-2674. [PMID: 32152134 DOI: 10.1542/peds.2019-2674] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Runaway youth and homeless youth are at risk for adverse mental health outcomes. These 2 populations are frequently pooled together in both research and interventions yet may have unique health needs. We sought to assess differences in mental health outcomes among these populations. METHODS We conducted a secondary data analysis of ninth- and 11th-graders in the 2016 minnesota Student Survey (n = 68 785). We categorized youth into 4 subgroups based on housing status in the previous year: (1) unaccompanied homeless youth (0.5%), (2) runaway youth (4%), (3) youth who had both run away and been homeless (0.6%), and (4) stably housed youth (95%). We performed multivariable logistic regression to compare 4 mental health outcomes (self-injury, suicidal ideation, suicide attempts, and depressive symptoms) across groups, controlling for demographics and abuse history. RESULTS Unstably housed youth had poorer mental health outcomes when compared with their stably housed peers (P < .05). For example, 11% of homeless youth, 20% of runaways, and 33% of youth who had experienced both had attempted suicide in the previous year compared with 2% of stably housed youth (adjusted odds ratios 2.4, 4.9, and 7.1, respectively). Other outcomes showed a similar pattern. CONCLUSIONS Our findings suggest that runaway and homeless youth represent unique populations with high levels of mental health needs who would benefit from targeted clinical and community interventions. Pediatric clinicians represent one potential point of screening and intervention.
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Affiliation(s)
| | - Laurel D Edinburgh
- Midwest Children's Resource Center, Children's Hospitals and Clinics of Minnesota, St Paul, Minnesota
| | - Andrew J Barnes
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; and
| | - Annie-Laurie McRee
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; and
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Barger BT, Obedin-Maliver J, Capriotti MR, Lunn MR, Flentje A. Characterization of substance use among underrepresented sexual and gender minority participants in The Population Research in Identity and Disparities for Equality (PRIDE) Study. Subst Abus 2020; 42:104-115. [PMID: 32032500 DOI: 10.1080/08897077.2019.1702610] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Profiles of substance use among less commonly described subgroups of sexual and gender minority (SGM) people (e.g., queer, genderqueer) remain largely unknown. Objective(s): To identify substance use differences among less commonly described SGM identity-based subgroups. Methods: The PRIDE Study is a national, online, longitudinal cohort study of self-identified SGM adults living in the U.S. Between 2015-2017, an iPhone application was used to administer three cross-sectional health questionnaires to participants, one of which included questions about binge alcohol, marijuana, and other drug use (substance use). This study was a secondary data analysis of participant responses to substance use survey items. Logistic regression and generalized linear modeling assessed relationships between sexual orientation or gender and use of or reported problems with substances within the past year. Results: Among the 1790 participants included in this study, 51.0% reported binge alcohol use, 39.8% reported marijuana use, and 19.7% reported other drug use (65.9% endorsed use of one or more of these) within the past year. Over 30% indicated substance use had been a problem in their life. Asexual individuals had lower odds of reporting past year binge alcohol and marijuana use (aOR: 0.27, 95% CI: 0.12-0.61; aOR: 0.38, 95% CI: 0.15-0.96, respectively), and queer participants had higher odds of reporting past year marijuana use (aOR: 2.52, 95% CI: 1.58-4.03) compared to lesbian participants. Gender nonbinary participants had lower odds of reporting past year binge alcohol use (aOR: 0.48, 95% CI: 0.32-0.71) and transmasculine participants had higher odds of reporting past year marijuana use (aOR: 2.18, 95% CI: 1.10-4.31) compared to cisgender women. Conclusions: Substance use heterogeneity exists between SGM groups. Comprehensive assessment of sexual orientation and gender may improve understanding of substance use and increase equity within support and treatment services for SGM populations. Highlights We examined substance use among less represented sexual and gender minority groups. Alcohol and other drug use were examined by both sexual orientation and gender identity. Analyses included identities such as queer, pansexual, genderqueer and nonbinary. Alcohol use differed across asexual, genderqueer and gender nonbinary groups. Marijuana use differed across queer, asexual and transmasculine groups.
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Affiliation(s)
- Branden T Barger
- Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco, California, USA.,The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA
| | - Juno Obedin-Maliver
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA.,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Matthew R Capriotti
- Department of Psychology, San Jose State University, San Jose, California, USA.,Division of Nephrology, Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, California, USA
| | - Mitchell R Lunn
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA.,Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Annesa Flentje
- The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Stanford, California, USA.,Department of Community Health Systems, University of California, San Francisco, School of Nursing, San Francisco, California, USA.,Alliance Health Project, Department of Psychiatry, University of California, San Francisco, School of Medicine, San Francisco, California, USA
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Gambon TB, Gewirtz O'Brien JR. Runaway Youth: Caring for the Nation's Largest Segment of Missing Children. Pediatrics 2020; 145:peds.2019-3752. [PMID: 31964756 DOI: 10.1542/peds.2019-3752] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The largest segment of missing children in the United States includes runaways, children who run away from home, and thrownaways, children who are told to leave or stay away from home by a household adult. Although estimates vary, as many as 1 in 20 youth run away from home annually. These unaccompanied youth have unique health needs, including high rates of trauma, mental illness, substance use, pregnancy, and sexually transmitted infections. While away, youth who run away are at high risk for additional trauma, victimization, and violence. Runaway and thrownaway youth have high unmet health care needs and limited access to care. Several populations are at particular high risk for runaway episodes, including victims of abuse and neglect; lesbian, gay, bisexual, transgender, and questioning youth; and youth in protective custody. Pediatricians and other health care professionals have a critical role to play in supporting runaway youth, addressing their unique health needs, fostering positive relationships within their families and with other supportive adults, and connecting them with available community resources. This report provides clinical guidance for pediatricians and other health care professionals regarding (1) the identification of adolescents who are at risk for running away or being thrown away and (2) the management of the unique medical, mental health, and social needs of these youth. In partnership with national, state, and local resources, pediatricians can significantly reduce risk and improve long-term outcomes for runaway youth.
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LoSchiavo C, Krause KD, Singer SN, Halkitis PN. The Confluence of Housing Instability and Psychosocial, Mental, and Physical Health in Sexual Minority Young Adults: The P18 Cohort Study. J Health Care Poor Underserved 2020; 31:1693-1711. [PMID: 33416747 PMCID: PMC7794398 DOI: 10.1353/hpu.2020.0127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Sexual and gender minority (SGM) youth experience housing instability, including homelessness, at higher rates than heterosexuals. Few studies have examined differences within SGM populations and intersections of housing and health. Data were drawn from a study of SGM young adults who were assigned male at birth. Nearly one-quarter of the sample reported homelessness, unstable housing, or both in the six months prior to assessment. Housing instability was higher among those of lower income and educational attainment. Additionally, those who experienced any housing instability reported higher levels of depression, poorer self-rated health, and greater gay-related stigma; in multivariable models, only self-rated health was related to housing status. Stigma and discrimination may lead to poorer mental health; housing instability and homelessness may be a manifestation of stigma perpetuated by social conditions and mental health burdens directed by familial rejection. Findings indicate the importance of a biopsychosocial perspective in addressing housing instability in SGM youth.
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Abstract
Adolescence is the transitional bridge between childhood and adulthood; it encompasses developmental milestones that are unique to this age group. Healthy cognitive, physical, sexual, and psychosocial development is both a right and a responsibility that must be guaranteed for all adolescents to successfully enter adulthood. There is consensus among national and international organizations that the unique needs of adolescents must be addressed and promoted to ensure the health of all adolescents. This policy statement outlines the special health challenges that adolescents face on their journey and transition to adulthood and provides recommendations for those who care for adolescents, their families, and the communities in which they live.
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Affiliation(s)
- Elizabeth M Alderman
- Division of Adolescent Medicine, Department of Pediatrics, Albert Einstein College of Medicine and The Children's Hospital at Montefiore, Bronx, New York; and
| | - Cora C Breuner
- Division of Adolescent Medicine, Departments of Pediatrics and Orthopedics and Sports Medicine, University of Washington and Seattle Children's Hospital, Seattle, Washington
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Wagner J, Sackett-Taylor AC, Hodax JK, Forcier M, Rafferty J. Psychosocial Overview of Gender-Affirmative Care. J Pediatr Adolesc Gynecol 2019; 32:567-573. [PMID: 31103711 DOI: 10.1016/j.jpag.2019.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 05/05/2019] [Accepted: 05/09/2019] [Indexed: 12/23/2022]
Abstract
Transgender and gender-diverse youth and their families are increasingly presenting to adolescent gynecological providers for education, care, and referrals. These youth more often face mental health and social disparities that frequently go unrecognized or unaddressed by providers. A gender-affirmative approach focuses on providing emotional validation, psychological safety, and support to young patients and their families. With better understanding of the unique needs of transgender and gender-diverse populations, gynecological care can be personalized and delivered in a nuanced fashion to better address the sexual and reproductive needs of gender minority patients. In this article we review essential psychological and social considerations in caring for transgender and gender-diverse youth, including concepts relating to gender identity, affirmative approaches, means of assessing for risk and resiliency, and family dynamics. Ultimately, adolescent gynecological providers have an important role in promoting the emotional health and positive development of transgender and gender-diverse youth.
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Affiliation(s)
- Jill Wagner
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Division of Adolescent Medicine, Hasbro Children's Hospital, Providence, Rhode Island.
| | - Andrew C Sackett-Taylor
- Department of Outpatient Clinical Services, Gándara Mental Health Center, Springfield, Massachusetts
| | - Juanita K Hodax
- Department of Pediatrics, University of Washington, Seattle, Washington; Division of Endocrinology, Seattle Children's Hospital, Seattle, Washington
| | - Michelle Forcier
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Division of Adolescent Medicine, Hasbro Children's Hospital, Providence, Rhode Island
| | - Jason Rafferty
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Division of Adolescent Medicine, Hasbro Children's Hospital, Providence, Rhode Island; Department of Child Psychiatry, Emma Pendleton Bradley Hospital, Riverside, Rhode Island; Department of Pediatrics, Thundermist Health Centers, Woonsocket, Rhode Island
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Kidd S, Thistle J, Beaulieu T, O'Grady B, Gaetz S. A national study of Indigenous youth homelessness in Canada. Public Health 2019; 176:163-171. [DOI: 10.1016/j.puhe.2018.06.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 03/19/2018] [Accepted: 06/12/2018] [Indexed: 01/04/2023]
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