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Ramsay A, Ziino J, Hirschmann J. Self-described religious and spiritual identities of patients receiving gender-affirming surgeries: Implications for chaplaincy practice. J Health Care Chaplain 2024:1-12. [PMID: 39052496 DOI: 10.1080/08854726.2024.2379710] [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: 07/27/2024]
Abstract
Studies of the U.S. population in general and transgender and gender diverse (TGD) communities specifically suggest that religion and spirituality (R/S) can function in both positive and negative ways, including on health outcomes. Patients recovering from gender-affirming surgeries were asked by chaplains, during the course of spiritual care visits, to describe their R/S identities in their own words. Seventy-five responses were included in the study and were coded. Six themes and 10 sub-themes were identified. The themes were (1) centeredness in self; (2) transcendent belief system; (3) non-religious belief systems; (4) importance of prayer; (5) R/S identity and practice as fixed and consistent; and (6) R/S identity and practice as flexible, contextual, and transforming. The findings broadly reflected national data about R/S belonging, including trends related to the growing share of the population that identifies as atheist, agnostic, or spiritual but not religious; ambivalent relationships with R/S communities due to transphobia; and R/S beliefs and practices as supportive. Implications for chaplaincy practice are discussed, including the need for chaplains to understand both demographic trends and the intersections of R/S and transphobia.
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Affiliation(s)
- Alyxandra Ramsay
- Center for Transgender Medicine and Surgery, Mount Sinai Health System, New York, NY, USA
| | - Jabe Ziino
- Department of Spiritual Care and Education, Mount Sinai Beth Israel, New York, NY, USA
| | - Jo Hirschmann
- Center for Spirituality and Health, Mount Sinai Health System, New York, NY, USA
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Sekher TV, Pai M, Muhammad T. Subjective social status and socio-demographic correlates of perceived discrimination among older adults in India. BMC Geriatr 2024; 24:617. [PMID: 39030500 PMCID: PMC11265011 DOI: 10.1186/s12877-024-05114-x] [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: 11/11/2023] [Accepted: 05/29/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Considering India's diversity, marked by differences in caste, class, ethnicity, religion, region, and language, discrimination can take on varying forms across social-structural locations. We examined the association between subjective social status (SSS) and perceived discrimination, and assessed the sociodemographic correlates of perceived discrimination among older persons in India. METHODS Data come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 30,253 adults 60 years or older. SSS was examined using the Macarthur scale with a ladder technique. Perceived discrimination was evaluated with the Everyday Discrimination Scale. Multivariable logistic regression models examined the odds of reporting discrimination by its types and attributions. RESULTS 39% of older adults reported low SSS, whereas 7.3% reported high SSS. Older adults with low SSS had significantly higher odds of experiencing some discrimination than those with high SSS. Compared to high-SSS peers, low-SSS individuals attributed age, gender, caste, financial, and health status as reasons for discrimination. Older women attributed gender as a reason for discrimination. Caste was reported as a reason for discrimination by rural but not urban dwellers. Relative to northerners, those from southern India reported age, financial, and health statuses as reasons for discrimination. CONCLUSIONS That low-SSS older adults reported age, gender, caste, financial status, and health status as reasons for discrimination and that this association persisted after considering objective indicators of socioeconomic status (SES) is suggestive of SSS as independently consequential for perceived discrimination. These findings are useful for care providers and practitioners as they encourage older patients -- especially those with low SSS who may feel stigmatized -- to seek care, comply with care regimen, and engage in behaviors that protect and promote health.
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Affiliation(s)
- T V Sekher
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Manacy Pai
- Department of Sociology and Criminology, Kent State University, Kent, OH, 44242, USA
| | - T Muhammad
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, 16802, USA.
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Atkins K, Wiginton JM, Carpino T, Sanchez TH, Murray SM, Baral SD. Transactional sex, HIV, and bacterial STIs among U.S. men who have sex with men. Am J Prev Med 2024:S0749-3797(24)00231-9. [PMID: 39002886 DOI: 10.1016/j.amepre.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 07/02/2024] [Accepted: 07/02/2024] [Indexed: 07/15/2024]
Abstract
INTRODUCTION Men who have sex with men (MSM) and are engaged in transactional sex (MSM-TS) experience complex social and structural vulnerabilities that increase their HIV risk. This study aimed to estimate the prevalence of TS and associations between TS and sexually transmitted infection (STI) outcomes among cisgender MSM in the U.S. METHODS Using 2017-2021 data from an online survey of US MSM, characteristics of MSM-TS were summarized and adjusted prevalence ratios (aPRs) calculated for the associations between past-year TS and bacterial STI diagnosis, HIV status, and either antiretroviral or pre-exposure prophylaxis (PrEP) use. Analyses were conducted in 2023. RESULTS TS prevalence was 3.7% (n=1,848/49,539). Compared to other MSM, MSM-TS more commonly reported homelessness, being uninsured, condomless anal sex (CAS) with partners of any HIV status and CAS with serodifferent partners, and illicit drug use. TS was associated with increased HIV (aPR 1.44, 95% CI 1.25-1.66) and bacterial STI prevalence (aPR 2.40, 95% CI=2.09-2.52) and lower antiretroviral therapy use (among MSM living with HIV; PR 0.92, 95% CI=0.87-0.97). CONCLUSIONS Structural and behavioral risks converged among US MSM engaging in TS leading to greater HIV and bacterial STI prevalence in this group. HIV interventions for US MSM-TS should address individual as well as structural risks, including poverty and housing instability.
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Affiliation(s)
- Kaitlyn Atkins
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.
| | - John Mark Wiginton
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California-San Diego, La Jolla, CA, USA; San Diego State University, San Diego, CA, USA
| | - Thomas Carpino
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Travis H Sanchez
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA USA
| | - Sarah M Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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Koh H, Farrant B, Fenaughty J, Ameratunga S, Peris-John R, Bavin L. Asian Rainbow Youth in New Zealand: Protective Factors. J Adolesc Health 2024:S1054-139X(24)00262-3. [PMID: 38980245 DOI: 10.1016/j.jadohealth.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE To explore the impacts of double minority status (ethnic and sexual/gender minority) and protective factors associated with the emotional wellbeing and mental health of Asian Rainbow (sexual/gender minority) youth in New Zealand. METHODS The data were extracted from the Youth19 Rangatahi survey, which surveyed 7,374 students from 45 mainstream secondary schools. The comparison groups were Asian non-Rainbow youth and Pākehā (New Zealand European) Rainbow youth. A secondary analysis was performed examining the associations between postulated protective factors and the emotional wellbeing and mental health outcomes of Asian Rainbow youth. RESULTS Asian Rainbow youth had higher odds of depressive symptoms, anxiety, and suicidal thoughts and attempts and lower odds of good emotional wellbeing compared to Asian non-Rainbow youth. However, Asian Rainbow youth had lower odds of anxiety compared to Pākehā Rainbow youth. Among Asian Rainbow youth, family acceptance and feeling safe at school were associated with higher odds of good emotional wellbeing, and lower odds of depressive symptoms, anxiety, and suicidal thoughts. Several other protective factors were also associated with 1 or more (but not all) of the emotional wellbeing and mental health indicators. DISCUSSION This study suggests that family acceptance and feeling safe at school may serve as important buffers mitigating risks of adverse emotional wellbeing experienced by Asian Rainbow youth.
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Affiliation(s)
- How Koh
- Kidz First, Te Whatu Ora Counties Manukau, New Zealand
| | - Bridget Farrant
- Kidz First, Te Whatu Ora Counties Manukau, New Zealand; Department of Paediatrics, Faculty of Medical Health Sciences, University of Auckland, Auckland, New Zealand.
| | - John Fenaughty
- School of Counselling, Human Services and Social Work, Faculty of Education and Social Work, University of Auckland, Auckland, New Zealand
| | - Shanthi Ameratunga
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand; Te Whatu Ora - Service Improvement & Innovation, Population Health Gain Team, Counties Manukau, New Zealand
| | - Roshini Peris-John
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Lynda Bavin
- Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
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Terry E, Pharr JR, Batra R, Batra K. Protective and Risk Factors for Suicidal Ideation and Behavior Among Sexual Minority Women in the United States: A Cross-Sectional Study. LGBT Health 2024; 11:392-405. [PMID: 38324060 DOI: 10.1089/lgbt.2023.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Purpose: The purpose of this study was to understand the factors associated with suicidal ideation and behavior and serious suicidal ideation and behavior among sexual minority women (SMW), including resilience, discrimination, mental health, and sociodemographic characteristics. Methods: Web-based surveys were conducted with SMW from across the United States during January-February, 2022 using psychometric valid tools. Bivariate, hierarchical regression, and logistic regression analyses were used to analyze the data. Results: Of 497 participants, 70% were identified as bisexual and 30% as lesbian. The mean scores for anxiety, depression, and stress were significantly higher among bisexual women compared to their lesbian counterparts (p < 0.05). The proportion of serious suicidal ideation and behavior was higher among bisexual women compared to lesbian women (53.9% vs. 41.2%, p = 0.012). Conversely, the mean scores of resilience were lower among bisexual women compared to lesbian women (139.7 ± 33.4 vs. 147.5 ± 33.6, p = 0.024). Lesbian women had nearly 57.4% lower odds of having serious suicidal ideation and behavior as compared to bisexual women (adjusted odds ratio = 0.426; p = 0.023). Experiencing anxiety, depression, victimization distress, and family discrimination distress were positively associated with serious suicidal ideation and behavior, whereas personal resilience and family cohesion were negatively associated with serious suicidal ideation and behavior. Conclusions: Tackling structural inequities such as racism and homophobia remains vital to improving the mental health of SMW. Interventions to strengthen social and familial supports may be particularly impactful, especially at the family level.
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Affiliation(s)
- Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Ravi Batra
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
- Office of Research, Kirk Kerkorian School of Medicine at UNLV, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
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Toussaint DJ, Schweitzer R, Mitchell R. Discrimination, Internalized Sexual Prejudice and the Post-Sex Experience Among Members of Sexual Minorities. JOURNAL OF HOMOSEXUALITY 2024:1-15. [PMID: 38923914 DOI: 10.1080/00918369.2024.2364881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Postcoital dysphoria (PCD) refers to a counter-intuitive experience of sadness, tearfulness, irritability or dysphoria following an otherwise satisfactory and consensual sexual experience. Research to date has primarily focused on heteronormative samples. The current study explored the prevalence of PCD, and potential correlates of internalized sexual prejudice, perceived discrimination, and sex life satisfaction within a LGBTQIA+ population. One hundred and seventy-two adults identifying as LGBTQIA+ completed an online survey. Main outcome measures included the Post Sex Experience Scale (p-SES), Everyday Discrimination Scale (EDS), Internalized Homophobia Scale (IHS), Satisfaction with Sex Life Scale (SWSLS), and study specific questions. Prevalence of PCD was 42% of males attracted to other males and 81% of participants identifying as bisexual/sexual fluid. A significant and a moderate inverse correlation was found between sex life satisfaction and PCD (r = -.75) for individuals identifying as bisexual/fluid sexual orientation. Significant correlations were found between perceived discrimination and PCD (weak positive correlation, r = .28), and sex life satisfaction and PCD (moderate negative correlation, r = -.59) in men attracted to men. This research suggests being a member of a sexual minority is associated with sex-related dysphoria and dissatisfaction. Further research is needed to further elucidate PCD.
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Affiliation(s)
- Derrek J Toussaint
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Robert Schweitzer
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Rohani Mitchell
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
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Town MA, Freeman I, Cool RJ, Klein CH. The HIV Environmental Riskscape: The Roles of HIV Sexual Risk and Resilience Factors among Black Men Who Have Sex with Men: Findings from the Real Talk Project. AIDS Behav 2024:10.1007/s10461-024-04418-8. [PMID: 38900312 DOI: 10.1007/s10461-024-04418-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2024] [Indexed: 06/21/2024]
Abstract
Black and African American men who have sex with men (Black MSM) experience the greatest proportion of new HIV infections in the United States. To address this challenge, a better understanding of the HIV environment riskscape including both risk and resilience factors is warranted among Black MSM. Research indicates that stress is associated with increased HIV sexual risk behaviors. Further, behavioral factors such as serosorting and community level factors including social support and community connection are resilience factors that protect against risk behaviors. The present study examines whether everyday stress is associated with HIV sexual risk behavior, as well as the role of risk and resilience factors among 125 Black MSM recruited in the Real Talk study. The Real Talk project examined the relationships between resilience, HIV risk behaviors, and HIV prevention strategy among a sample of Black MSM. Using generalized estimating equations, our results indicate a positive association between everyday stress and engaging in condomless anal intercourse only after adjusting for risk, resilience, and correlate variables. Similarly, having multiple sex partners and using substances during sex also show positive associations with condomless anal intercourse. Resilience factors of engaging in serosorting and being connected to both the Black and gay communities were negatively associated with condomless anal intercourse. Future prevention research and programming should focus on both risk and resilience factors to mitigate new HIV infections among Black MSM.
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Affiliation(s)
- Matthew Alan Town
- School of Social Work, Portland State University, 1800 SW 6th Ave, Portland, OR, 97201, USA.
| | - Ilana Freeman
- Oregon Health and Sciences University, Portland, OR, USA
| | - Ronnie James Cool
- Respiratory Therapy Program, Concorde Career College, Portland, OR, USA
| | - Charles H Klein
- Department of Anthropology, Portland State University, Portland, OR, USA
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Brennan-Ing M, Haberlen S, Ware D, Meanley S, Palella FJ, Bolan R, Cook JA, Okafor CN, Friedman MR, Plankey MW. Does Resilience Mediate the Relationship Between Negative Self-Image and Psychological Distress in Middle-Aged and Older Gay and Bisexual Men? Res Aging 2024:1640275241261414. [PMID: 38886913 DOI: 10.1177/01640275241261414] [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: 06/20/2024]
Abstract
Aging gay and bisexual men may have negative self-images due to body image dissatisfaction and internalized ageism, resulting in psychological distress. Gay and bisexual men with HIV may be at greater risk for distress because of research linking HIV to accelerated aging. We examined associations between self-image and psychological distress, and potential mediating effects (resilience, fitness engagement), and whether these relationships were moderated by HIV serostatus. We tested our hypotheses with structural equation modeling using data from gay and bisexual men with HIV (n = 525, Mage = 57.6) and without HIV (n = 501, Mage = 62.2). We observed significant positive associations between self-image and distress and significant mediation effects (resilience, fitness engagement) that were moderated by HIV serostatus (resilience was only significant for men with HIV). We conclude that resilience interventions may be beneficial in alleviating distress from negative self-image among aging gay and bisexual men with HIV.
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Affiliation(s)
- Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, the City University of New York, New York, NY, USA
| | - Sabina Haberlen
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Deanna Ware
- Department of Medicine, Division of General Internal Medicine, Georgetown University, Washington, DC, USA
| | - Steven Meanley
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Frank J Palella
- Feinberg School of Medicine, Northwestern Medicine, Northwestern University, Chicago, IL, USA
| | - Robert Bolan
- Department of Family Medicine, University of Southern California, Los Angeles, CA, USA
| | - Judith A Cook
- Center on Mental Health Services Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Chukwuemeka N Okafor
- Division of Infectious Diseases, Department of Medicine, Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - M Reuel Friedman
- School of Public Health, Rutgers the State University of New Jersey, New Brunswick, NJ, USA
| | - Michael W Plankey
- Department of Medicine, Division of General Internal Medicine, Georgetown University, Washington, DC, USA
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Mazursky N. Discovering sources of resilience among homeless LGBTQ+ youth in out-of-home care in Israel: An ecological framework. CHILD ABUSE & NEGLECT 2024; 154:106886. [PMID: 38852430 DOI: 10.1016/j.chiabu.2024.106886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/07/2024] [Accepted: 05/31/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND LGBTQ+ youth in out-of-home care experience multiple stressors due to being a minority group, in out-of-home care, and rejected by their families. Therefore, they tend to be vulnerable. OBJECTIVE The purpose of this study is to explore the sources of the resilience of homeless LGBTQ+ youth in out-of-home care in the Israeli context. The research question was: What are the experiences, perceptions, and constructions of "resilience" among LGBTQ+ youth who aged out of out-of-home care for homeless LGBTQ+ youth in Israel? METHODS The study employed a critical constructivist grounded theory approach. Thirty-one in-depth semi-structured interviews were conducted with LGBTQ+ youth aged 16 to 32 (average age of 21.5) and analyzed. RESULTS The data analysis presents the sources of resilience according to four levels. (1) The individual level refers to self-acceptance, faith and hope, and creativity and productiveness. (2) The interpersonal level refers to friends and peer groups, educational institutions, employment environments, professionals, and LGBTQ+ out-of-home care services. (3) The macro level refers to public visibility of the LGBTQ+ community and financial support. (4) Finally, the chrono level refers to the development of rights and recognition over time. CONCLUSIONS An ecological model was implemented to conceptualize resilience among LGBTQ+ youth in out-of-home care in Israel. This multidimensional model was used to construct resilience sources that could assist in overcoming adversities among these youth. Implications for practice and future research are discussed.
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Affiliation(s)
- Nofar Mazursky
- Marron Institute of Urban Management, New York University, USA.
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Engstrom CW, West BT, Schepis TS, McCabe SE. Does the approach used to measure sexual identity affect estimates of health disparities differently by race? A randomized experiment from the National Survey of Family Growth. Soc Sci Med 2024; 350:116887. [PMID: 38678646 DOI: 10.1016/j.socscimed.2024.116887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 04/09/2024] [Accepted: 04/13/2024] [Indexed: 05/01/2024]
Abstract
The inclusion of "something else" as a response option for survey questions about sexual identity has been shown to significantly moderate estimated differences between sexual identity subgroups in the distributions of various health outcomes in national health surveys, specifically for substance use/misuse and reproductive health. This moderation effect may be larger depending on the respondent's race, possibly due to the intersectionality of multiple minority identities and compounding minority stressors. To test this hypothesis, we conducted secondary analyses of data from five consecutive years of the National Survey of Family Growth (2015-2019) [n = 18,903 (8510 males, 10,393 females)] in the United States, where respondents were randomly assigned to receive either a four-category version of the sexual identity question that included "something else" as a response option along with lesbian/gay, bisexual, and heterosexual, or a three-category version that omitted "something else." We focused on model-based estimates of distributions of health outcomes across subgroups defined by both race and sexual identity and tested the race moderation hypothesis using three-way interactions involving sexual identity, question type received (four-category vs. three-category), and race (Black, White, and other). Based on this randomized experiment, we found evidence of significant differences between the four-category and three-category question versions of sexual identity, in terms of the associations between sexual identity and several health outcomes, along with moderation of these differences by the respondent's race. For some outcomes, such as wanting a child or another child, the magnitudes of the estimated sexual identity differences among racial minority individuals, specifically between bisexual and heterosexual women, were sensitive to the measurement of sexual identity. These results further suggest a need for improved sexual minority measurement, especially among racial minorities. These differences were also mostly found among women, suggesting further intersectionality of groups exposed to specific stressors.
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Affiliation(s)
- Curtiss W Engstrom
- Program in Survey and Data Science, University of Michigan-Ann Arbor, Ann Arbor, MI, USA.
| | - Brady T West
- Survey Research Center, Institute for Social Research, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
| | - Ty S Schepis
- Department of Psychology, Texas State University, San Marcos, TX, USA
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11
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Lee YH, Chang YC, Shelley M, López Castillo H. Sexual minority identifiers and their perception of illicit drug use risks in the US: Results from a National Survey. J Psychiatr Res 2024; 175:183-191. [PMID: 38735263 DOI: 10.1016/j.jpsychires.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE This study examined the relationship between sexual identities and perception of risks associated with illicit drug use among a nationally representative sample of US adults. METHODS We analyzed data from five waves of the National Survey on Drug Use and Health (NSDUH, 2015-2019), with 205,418 adult participants. Six survey questions assessing participants' perceptions of the risks associated with illicit drug use (LSD, heroin, and cocaine) were subjected to principal component analysis. Sex-stratified ordered logistic regressions were used to explore potential disparities in perceptions regarding the risk associated with illicit drug use among sexual minority identifiers. RESULTS Among male participants, approximately 11.3% and 1.8% of them perceived illicit drug use as moderate and low risks, respectively. About 6.0% of female participants perceived illicit drug use as moderate risk, and 1.1% of female participants perceived it as low risk. The sex-stratified regression models demonstrated that participants who identified as lesbian/gay or bisexual all had higher odds of reporting low perception of illicit drug use risks as compared to their heterosexual counterparts (all p < 0.01). CONCLUSIONS Illicit drug use prevention strategies should consider risk perception disparities by sexual minority populations.
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Affiliation(s)
- Yen-Han Lee
- Department of Health Sciences, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida. Orlando, FL, United States
| | - Yen-Chang Chang
- Center for General Education, National Tsing Human University, Taiwan
| | - Mack Shelley
- Departments of Statistics and Political Science, College of Liberal Arts and Sciences, Iowa State University. Ames, IA, United States
| | - Humberto López Castillo
- Department of Health Sciences, College of Health Professions and Sciences, Academic Health Sciences Center, University of Central Florida. Orlando, FL, United States; Department of Population Health Sciences, College of Medicine, Academic Health Sciences Center, University of Central Florida. Orlando, FL, United States.
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12
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DeSon JJ, Andover MS. Microaggressions Toward Sexual and Gender Minority Emerging Adults: An Updated Systematic Review of Psychological Correlates and Outcomes and the Role of Intersectionality. LGBT Health 2024; 11:249-268. [PMID: 37906109 DOI: 10.1089/lgbt.2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Abstract
Purpose: Quantitative data on the psychological effects of microaggressions toward sexual and gender minority individuals have grown substantially. Sexual orientation-based and transgender and gender-diverse (trans+) identity-based microaggressions have been thematically identified in prior research. In addition, combined lesbian, gay, bisexual, transgender and gender-diverse, queer/questioning, and other non-heterosexual (LGBTQ) microaggressions can be examined intersectionally with other marginalized identities. This systematic review synthesizes research on the relationships among these microaggressions and psychological correlates and outcomes. Methods: Forty-five quantitative studies examining sexual orientation-, trans+ identity-, or intersectional identity-based microaggressions and various psychological outcomes were identified from systematic searches of PsycINFO, PsycARTICLES, MEDLINE, and PubMed databases. Data regarding microaggressions were extracted, synthesized, and grouped by mental health outcome or correlate. Results: Sexual orientation-based microaggressions were risk factors for depression, anxiety, and internalized stigma and were positively associated with psychological distress, traumatic stress symptoms, alcohol use and abuse, cannabis use and problems, suicidal ideation, and suicide attempt. Trans+ identity-based microaggressions were positively associated with depression, suicide attempt, and cannabis use. LGBTQ intersectional identity-based microaggressions concerning race/ethnicity were associated with depression, anxiety, and suicidal ideation. Research on other intersectional identity-based microaggressions is scarce. Conclusion: These findings emphasize the psychological harm inflicted by various microaggressions on LGBTQ late adolescents and early adults. Future work should focus on microaggressions toward individuals with trans+ and intersectional identities and protective factors for these experiences. This review also highlights the distinct need for community-based research on implementing microintervention strategies in family, school, and work environments to mitigate the harmful effects of these microaggressions.
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Affiliation(s)
- Joshua J DeSon
- Department of Psychology, Fordham University, Bronx, New York, USA
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Gesselman AN, Kaufman EM, Weeks LYS, Moscovici Z, Bennett-Brown M, Adams OR, Campbell JT, Piazza M, Bhuyan L, Dubé S, Hille JJ, Garcia JR. Exploring patterns in mental health treatment and interests of single adults in the United States: a secondary data analysis. Front Public Health 2024; 12:1292603. [PMID: 38711766 PMCID: PMC11073498 DOI: 10.3389/fpubh.2024.1292603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/15/2024] [Indexed: 05/08/2024] Open
Abstract
Objective The objective of this study is to examine mental health treatment utilization and interest among the large and growing demographic of single adults in the United States, who face unique societal stressors and pressures that may contribute to their heightened need for mental healthcare. Method We analyzed data from 3,453 single adults, focusing on those with possible mental health treatment needs by excluding those with positive self-assessments. We assessed prevalence and sociodemographic correlates of mental health treatment, including psychotherapy and psychiatric medication use, and interest in attending psychotherapy among participants who had never attended. Results 26% were in mental health treatment; 17% were attending psychotherapy, 16% were taking psychiatric medications, and 7% were doing both. Further, 64% had never attended psychotherapy, of which 35% expressed interest in future attendance. There were differences in current psychotherapy attendance and psychiatric medication use by gender and sexual orientation, with women and gay/lesbian individuals more likely to engage in both forms of mental health treatment. Additionally, interest in future psychotherapy among those who had never attended varied significantly by age, gender, and race. Younger individuals, women, and Black/African-American participants showed higher likelihoods of interest in psychotherapy. Conclusion Our research highlights a critical gap in mental health treatment utilization among single adults who may be experiencing a need for those services. Despite a seemingly higher likelihood of engagement in mental health treatment compared to the general population, only a minority of single adults in our sample were utilizing mental health treatment. This underutilization and the observed demographic disparities in mental health treatment underscore the need for targeted outreach, personalized treatment plans, enhanced provider training, and policy advocacy to ensure equitable access to mental healthcare for single adults across sociodemographic backgrounds.
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Affiliation(s)
- Amanda N. Gesselman
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Ellen M. Kaufman
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Lee Y. S. Weeks
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender Studies, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Zoe Moscovici
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender Studies, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Margaret Bennett-Brown
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Communication Studies, College of Media and Communications, Texas Tech University, Lubbock, TX, United States
| | - Olivia R. Adams
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender, Sexuality, and Women’s Studies, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, United States
| | - Jessica T. Campbell
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Malia Piazza
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Anthropology, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
| | - Lucy Bhuyan
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Counseling and Educational Psychology, School of Education, Indiana University Bloomington, Bloomington, IN, United States
| | - Simon Dubé
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Psychology, Faculty of Arts and Science, Concordia University, Montreal, QC, Canada
| | - Jessica J. Hille
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
| | - Justin R. Garcia
- Kinsey Institute, Indiana University Bloomington, Bloomington, IN, United States
- Department of Gender Studies, College of Arts and Sciences, Indiana University Bloomington, Bloomington, IN, United States
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14
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Lim G, Bourne A, Hill A, McNair R, Lyons A, Amos N. Community connection is associated with lower psychological distress for sexual minority women who view community connection positively. CULTURE, HEALTH & SEXUALITY 2024; 26:513-530. [PMID: 37452686 DOI: 10.1080/13691058.2023.2231043] [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: 12/14/2022] [Accepted: 06/26/2023] [Indexed: 07/18/2023]
Abstract
We examined factors associated with sexual minority women's evaluations of belonging to the lesbian, gay, bisexual, transgender and queer (LGBTQ) community in Australia, and assessed whether a positive view of community participation impacted levels of psychological distress. 2424 cisgender sexual minority women participated in a national, online, cross-sectional survey of LGBTIQ adult Australians' health and well-being. Multivariable regression analyses were conducted to investigate sociodemographic factors associated with sexual minority women's belonging to the LGBTQ community, feelings towards community connection, and associations between community connection and recent psychological distress. Most sexual minority women (58.9%) reported feeling that they are part of the LGBTQ community, and a majority of the participants felt positive about being connected to this community (68.5%). Participants who were bisexual, non-university educated, and who resided in an outer-suburban location were least likely to evaluate participation in the LGBTQ community positively. Feeling positive about community connection was associated with lower levels of psychological distress. Feeling a part of LGBTQ community was associated with lower psychological distress, but this link appears contingent upon positive feelings about community participation. Sexual minority women's' relationships to the LGBTQ community are often complex, and community connection and participation in and of itself is not a panacea for the negative outcomes associated with sexual minority stressors.
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Affiliation(s)
- Gene Lim
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Adam Bourne
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Adam Hill
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Ruth McNair
- Department of General Practice, University of Melbourne, Melbourne, VIC, Australia
| | - Anthony Lyons
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - Natalie Amos
- Australian Research Centre for Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
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15
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Ching THW, Finkelstein-Fox L, Lee SY, Watson RJ. Effects of sexual and gender minority stress on depressive symptoms among adolescents of color in the United States. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2024; 30:309-318. [PMID: 36048116 PMCID: PMC9975117 DOI: 10.1037/cdp0000562] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE There is a need for more research on minority stress theory (MST) with sexual and gender minority (SGM) adolescents of color, because of their disproportionate risk for depression. METHOD We recruited 1,627 SGM adolescents of color in the United States to complete measures assessing lesbian, gay, bisexual, transgender, and queer (LGBTQ) climate, LGBTQ microaggressions within one's ethnoracial community, internalized LGBTQ stigma, stress management ability, and depressive symptoms. Using structural equation modeling, a hybrid measurement-structural model was tested, indicating good model fit. RESULTS Multiple significant indirect pathways linking LGBTQ climate and depressive symptoms emerged. A less positive LGBTQ climate was associated with more microaggression-related stress, more internalized LGBTQ stigma, and worse stress management ability, all of which were associated with greater depressive symptoms. A serial mediation with more microaggression-related stress being associated with greater internalized LGBTQ stigma approached significance. CONCLUSIONS Our findings generally support MST processes in terms of depressive symptoms in SGM adolescents of color, suggesting that psychosocial interventions targeting these processes may have meaningful implications for the mental health of this vulnerable group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | - Sharon Y. Lee
- Warren Alpert Medical School of Brown University, Providence, RI
| | - Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT
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16
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Gómez-Chica P, Rueda-Ruzafa L, Aparicio-Mota A, Rodriguez-Arrastia M, Ropero-Padilla C, Rodriguez-Valbuena C, Román P. Examining suicide risk in sexual and gender minority youth: A descriptive observational study on depressive symptoms, social support and self-esteem. J Clin Nurs 2024. [PMID: 38533544 DOI: 10.1111/jocn.17147] [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: 09/28/2023] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
AIM To understand the factors that contribute to the risk of suicide among lesbian, gay, bisexual, transgender, queer, intersex and asexual (sexual minorities) youth. BACKGROUND The increase in the likelihood of suicide has made it an urgent issue in public health, particularly among young people, where it now ranks as the fourth leading cause of death. This issue becomes even more significant when focusing on sexual minorities. METHODS A cross-sectional study was performed in targeted young individuals (15-29 years). Several variables were assessed, including suicide risk, self-esteem, presence and severity of depressive symptoms, perceived social support and self-reported levels of anxiety and depression. RESULTS Statistically significant disparities were observed in suicide risk, presence of depressive symptoms and self-reported levels of anxiety and depression, all of which were more pronounced in sexual minority youth compared to heterosexual cisgender individuals. Likewise, statistically significant differences were noted concerning self-esteem and family support, both of which were lower in sexual minority youth. CONCLUSION This study has identified risk factors, such as anxiety, depression and limited social support, as well as protective factors, like higher self-esteem and self-concept. Understanding and addressing all these factors are essential in reducing the elevated rates of suicide among sexual minority youth. Consequently, evidence-based interventions such as Gender and Sexuality Alliances, which empower and create safe spaces for sexual minority youth, possess substantial potential for effectively addressing this issue. IMPLICATIONS FOR THE PROFESSION Given sexual minorities vulnerability, healthcare pros, especially nurses, must grasp suicide risk factors. They can help by educating, offering care, assessing risk and fighting stigma. This guarantees safety and access to mental health services for at-risk individuals from sexual minorities. REPORTING METHOD The reporting follows the STROBE checklist. PATIENT CONTRIBUTION People who were invited to participate voluntarily completed a range of questionnaires.
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Affiliation(s)
| | - Lola Rueda-Ruzafa
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Adrián Aparicio-Mota
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Andalusian Public Foundation for Biomedical Research in Eastern Andalusia (FIBAO), University Hospital Torrecárdenas, Almería, Andalusía, Spain
| | - Miguel Rodriguez-Arrastia
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Carmen Ropero-Padilla
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Cristian Rodriguez-Valbuena
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
| | - Pablo Román
- Research Group CTS-1114 Advances and Innovation in Health, University of Almería, Almería, Andalusía, Spain
- Faculty of Health Sciences, Department of Nursing Science, Physiotherapy and Medicine, University of Almería, Almería, Andalusía, Spain
- Health Research Center CEINSA, University of Almería, Almería, Andalusía, Spain
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17
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Vincent W. Willingness to Use Digital Health Screening and Tracking Tools for Public Health in Sexual Minority Populations in a National Probability Sample: Quantitative Intersectional Analysis. J Med Internet Res 2024; 26:e47448. [PMID: 38457790 PMCID: PMC10960216 DOI: 10.2196/47448] [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: 03/20/2023] [Revised: 11/29/2023] [Accepted: 12/20/2023] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Little is known about sexual minority adults' willingness to use digital health tools, such as pandemic-related tools for screening and tracking, outside of HIV prevention and intervention efforts for sexual minority men, specifically. Additionally, given the current cultural climate in the United States, heterosexual and sexual minority adults may differ in their willingness to use digital health tools, and there may be within-group differences among sexual minority adults. OBJECTIVE This study compared sexual minority and heterosexual adults' willingness to use COVID-19-related digital health tools for public health screening and tracking and tested whether sexual minority adults differed from each other by age group, gender, and race or ethnicity. METHODS We analyzed data from a cross-sectional, national probability survey (n=2047) implemented from May 30 to June 8, 2020, in the United States during the height of the public health response to the COVID-19 pandemic. Using latent-variable modeling, heterosexual and sexual minority adults were tested for differences in their willingness to use digital health tools for public health screening and tracking. Among sexual minority adults, specifically, associations with age, gender, and race or ethnicity were assessed. RESULTS On average, sexual minority adults showed greater willingness to use digital health tools for screening and tracking than heterosexual adults (latent factor mean difference 0.46, 95% CI 0.15-0.77). Among sexual minority adults, there were no differences by age group, gender, or race or ethnicity. However, African American (b=0.41, 95% CI 0.19-0.62), Hispanic or Latino (b=0.36, 95% CI 0.18-0.55), and other racial or ethnic minority (b=0.54, 95% CI 0.31-0.77) heterosexual adults showed greater willingness to use digital health tools for screening and tracking than White heterosexual adults. CONCLUSIONS In the United States, sexual minority adults were more willing to use digital health tools for screening and tracking than heterosexual adults. Sexual minority adults did not differ from each other by age, gender, or race or ethnicity in terms of their willingness to use these digital health tools, so no sexual orientation-based or intersectional disparities were identified. Furthermore, White heterosexual adults were less willing to use these tools than racial or ethnic minority heterosexual adults. Findings support the use of digital health tools with sexual minority adults, which could be important for other public health-related concerns (eg, the recent example of mpox). Additional studies are needed regarding the decision-making process of White heterosexual adults regarding the use of digital health tools to address public health crises, including pandemics or outbreaks that disproportionately affect minoritized populations.
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Affiliation(s)
- Wilson Vincent
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, United States
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18
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Marbaniang I, Moodie EEM, Latimer E, Skakoon-Sparling S, Hart TA, Grace D, Moore DM, Lachowsky NJ, Jollimore J, Lambert G, Zhang T, Dvorakova M, Cox J. Using an intersectionality-based approach to evaluate mental health services use among gay, bisexual and other men who have sex with men in Montreal, Toronto and Vancouver. Epidemiol Psychiatr Sci 2024; 33:e10. [PMID: 38438301 PMCID: PMC10940056 DOI: 10.1017/s2045796024000143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/18/2024] [Accepted: 01/30/2024] [Indexed: 03/06/2024] Open
Abstract
AIMS To cope with homonegativity-generated stress, gay, bisexual and other men who have sex with men (GBM) use more mental health services (MHS) compared with heterosexual men. Most previous research on MHS among GBM uses data from largely white HIV-negative samples. Using an intersectionality-based approach, we evaluated the concomitant impact of racialization and HIV stigma on MHS use among GBM, through the mediating role of perceived discrimination (PD). METHODS We used baseline data from 2371 GBM enrolled in the Engage cohort study, collected between 2017 and 2019, in Montreal, Toronto and Vancouver, using respondent-driven sampling. The exposure was GBM groups: Group 1 (n = 1376): white HIV-negative; Group 2 (n = 327): white living with HIV; Group 3 (n = 577): racialized as non-white HIV-negative; Group 4 (n = 91): racialized as non-white living with HIV. The mediator was interpersonal PD scores measured using the Everyday Discrimination Scale (5-item version). The outcome was MHS use (yes/no) in the prior 6 months. We fit a three-way decomposition of causal mediation effects utilizing the imputation method for natural effect models. We obtained odds ratios (ORs) for pure direct effect (PDE, unmediated effect), pure indirect effect (PIE, mediated effect), mediated interaction effect (MIE, effect due to interaction between the exposure and mediator) and total effect (TE, overall effect). Analyses controlled for age, chronic mental health condition, Canadian citizenship, being cisgender and city of enrolment. RESULTS Mean PD scores were highest for racialized HIV-negative GBM (10.3, SD: 5.0) and lowest for white HIV-negative GBM (8.4, SD: 3.9). MHS use was highest in white GBM living with HIV (GBMHIV) (40.4%) and lowest in racialized HIV-negative GBM (26.9%). Compared with white HIV-negative GBM, white GBMHIV had higher TE (OR: 1.71; 95% CI: 1.27, 2.29) and PDE (OR: 1.68; 95% CI: 1.27, 2.24), and racialized HIV-negative GBM had higher PIE (OR: 1.09; 95% CI: 1.02, 1.17). Effects for racialized GBMHIV did not significantly differ from those of white HIV-negative GBM. MIEs across all groups were comparable. CONCLUSIONS Higher MHS use was observed among white GBMHIV compared with white HIV-negative GBM. PD positively mediated MHS use only among racialized HIV-negative GBM. MHS may need to take into account the intersecting impact of homonegativity, racism and HIV stigma on the mental health of GBM.
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Affiliation(s)
- Ivan Marbaniang
- Department of Epidemiology, McGill University, Montreal, QC, Canada
| | - Erica E. M. Moodie
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Eric Latimer
- Mental Health and Society Division, Douglas Research Centre, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Shayna Skakoon-Sparling
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Trevor A. Hart
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - David M. Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Department of Medicine, Division of Infectious Disease, University of British Columbia, Vancouver, BC, Canada
| | - Nathan J. Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | | | - Gilles Lambert
- Institut National de Santé Publique du Québec, Montreal, QC, Canada
| | - Terri Zhang
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Milada Dvorakova
- Clinical Outcomes Research and Evaluation, Research Institute–McGill University Health Centre, Montreal, QC, Canada
| | - Joseph Cox
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Clinical Outcomes Research and Evaluation, Research Institute–McGill University Health Centre, Montreal, QC, Canada
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19
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Charmaraman L, Zhang A, Wang K, Chen B. Sexual Minorities and Loneliness: Exploring Sexuality through Social Media and Gender-Sexuality Alliance (GSA) Supports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:300. [PMID: 38541299 PMCID: PMC10970596 DOI: 10.3390/ijerph21030300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 04/13/2024]
Abstract
We examined online and offline social supports for sexual minority adolescents, underscoring the understudied developmental period of early adolescence and the mental outcome of loneliness. Stemming from a larger study in the northeast U.S., 967 youth participants were 26% sexual minority, 53% female, 45% male, and 2% other/nonbinary (mean age = 13.1, SD = 1.52). LGBTQ+ youth reported significantly higher levels of loneliness compared to their heterosexual counterparts. To understand potential sources of social support while exploring their sexual identities, we compared the experiences of LGBTQ+ youth at both ends of the loneliness spectrum. Gaining knowledge about their sexual orientation from LGBTQ+ organization websites, participating in gender-sexuality alliances, and using TikTok or Instagram were associated with lower levels of loneliness. Providing social support to online friends was associated with lower loneliness; however, receiving online support was not associated with lower loneliness. Furthermore, proactive social media engagement such as posting uplifting content, joining online communities, or raising awareness about social issues were associated with lower levels of loneliness. The results provide guidance on specific youth behaviors and online communities beyond a focus on screen time while highlighting the continued need for social support to ameliorate loneliness, such as gender-sexuality alliance networks.
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Affiliation(s)
- Linda Charmaraman
- Youth, Media, & Wellbeing Research Lab, Wellesley Centers for Women, Wellesley College, Wellesley, MA 02481, USA
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20
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Allison K, Power R, Ussher JM, Perz J. "Queer people are excellent caregivers, but we're stretched so very thin": Psychosocial wellbeing and impacts of caregiving among LGBTQI cancer carers. BMC Cancer 2024; 24:36. [PMID: 38182998 PMCID: PMC10768402 DOI: 10.1186/s12885-023-11732-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 12/08/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND LGBTQI (lesbian, gay, bisexual, transgender, queer and/or intersex) communities are increasingly recognized as a vulnerable and high-risk population in oncology. LGBTQI cancer carers, including carers who are LGBTQI and other carers of LGBTQI people, experience many of the same stressors as LGBTQI patients but their support needs are often overlooked in the cancer literature. METHOD This mixed-methods study examined distress and quality of life in LGBTQI cancer carers. Online surveys were completed by 129 carers and 31 carers took part in a one-to-one semi-structured interview. Analyses of variance (ANOVAs) tested for differences in psychosocial outcomes and carer experiences by gender, sexuality, age, carer relationship and carer/patient LGBTQI status. Reflexive thematic analysis of interviews and open-ended survey responses facilitated in-depth examination of subjective experiences. RESULTS 42.6% of participants reported high or very high distress. Distress was significantly positively correlated with discrimination in cancer care, health impact, financial impact and lack of family support; it was negatively correlated with comfort in LGBTQI sexuality and gender identity, social support and quality of life. Four themes were identified in thematic analysis of qualitative data: (1) Identity on the sidelines: LGBTQI sexuality and gender pushed aside during cancer caregiving; (2) Fear of being shut-out: rejection and exclusion of LGBTQI cancer carers; (3) Lack of support for LGBTQI caregivers; and (4) Closer and stronger relationships due to a culture of mutual caregiving. CONCLUSIONS LGBTQI cancer carers must contend with typical caregiving demands whilst also managing additional minority stressors, including discrimination, rejection from family, isolation from LGBTQI communities, and invisibility in healthcare and support services. Despite this, LGBTQI carers showed resilience in building their own mutually supportive networks to rally around the person with cancer, which were reported to ameliorate psychosocial vulnerabilities. Service providers need to recognize the needs of LGBTQI cancer carers through inclusive and reflective practices. This will facilitate trust and patient and carer sexuality and gender identity disclosure, with positive consequences for wellbeing and satisfaction with cancer care.
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Affiliation(s)
- Kimberley Allison
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Rosalie Power
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
| | - Jane M Ussher
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia.
| | - Janette Perz
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, Australia
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21
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Paudel K, Bhandari P, Gautam K, Wickersham JA, Ha T, Banik S, Shrestha R. Mediating role of food insecurity in the relationship between perceived MSM related stigma and depressive symptoms among men who have sex with men in Nepal. PLoS One 2024; 19:e0296097. [PMID: 38166131 PMCID: PMC10760890 DOI: 10.1371/journal.pone.0296097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/05/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Previous studies have indicated the association between stigma and depressive symptoms among frequently stigmatized groups, such as men who have sex with men (MSM). While this association has been suggested in the literature, there is a dearth of evidence that examines whether food insecurity statistically mediates the relationship between stigma and depressive symptoms. METHODS This cross-sectional study conducted between October and December 2022 among a sample of 250 MSM in Kathmandu, Nepal, recruited through respondent-driven sampling. An unadjusted model including the exposure (stigma), mediator (food insecurity), and outcome variables (depressive symptoms) and an adjusted model that controlled for sociodemographic, behavioral, and health-related confounders were used. Bootstrapping was utilized to estimate the coefficients of these effects and the corresponding 95% confidence intervals. Via bootstrap approach, we find out the mediating role of food insecurity in the association between stigma and depressive symptoms. RESULTS Depressive symptoms, stigma, and food insecurity were 19.6%, 24.4%, and 29.2%, respectively, among MSM. Food insecurity was associated with higher age (b = 0.094; 95% CI = 0.039, 0.150) and monthly income (b = -1.806; 95% CI = -2.622, -0.985). Depressive symptoms were associated with condom-less sex in past six months (b = -1.638; 95% CI = -3.041, -0.092). Stigma was associated with higher age (b = 0.196; 95% CI = 0.084, 0.323) and PrEP uptake (b = 2.905; 95% CI = 0.659. 5.248). Food insecurity statistically mediated 20.6% of the indirect effect of stigma in depressive symptoms. CONCLUSION Our findings show that food insecurity affects the relationship between stigma and depressive symptoms in this population. Reducing food insecurity and addressing the stigma surrounding sexual orientation should be a priority when addressing mental health concerns among MSM in Nepal and other resource-limited countries with similar socio-cultural settings.
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Affiliation(s)
- Kiran Paudel
- Nepal Health Frontiers, Tokha-5, Kathmandu, Nepal
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States of America
| | | | - Kamal Gautam
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States of America
| | - Jeffrey A. Wickersham
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, United States of America
| | - Toan Ha
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Swagata Banik
- Baldwin Wallace University, Berea, OH, United States of America
| | - Roman Shrestha
- Nepal Health Frontiers, Tokha-5, Kathmandu, Nepal
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States of America
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, United States of America
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West BT, Engstrom CW, Schepis TS, Tani IJ, McCabe SE. How a "Something Else" Response Option for Sexual Identity Affects National Survey Estimates of Associations Between Sexual Identity, Reproductive Health, and Substance Use. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:107-126. [PMID: 37853260 PMCID: PMC10794379 DOI: 10.1007/s10508-023-02710-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/28/2023] [Accepted: 09/14/2023] [Indexed: 10/20/2023]
Abstract
This randomized experiment tested whether the inclusion of a "something else" response option for a question about sexual identity in a national health survey would significantly moderate estimated differences between sexual identity subgroups in terms of various health outcomes, including substance use and reproductive health. We conducted secondary analyses of data from five consecutive years of the National Survey of Family Growth (NSFG; 2015-2019), where two large national half-samples were randomly assigned to receive one of two different versions of a question about sexual identity (a four-category version that included a "something else" response option or a three-category version omitting this option). We focused on national estimates of differences between subgroups defined by sexual identity. Multivariable models indicated that the estimated subgroup differences changed in a statistically significant fashion when using the four-category version of the sexual identity question for several measures, including 16% of male measures (household size, past-year cigarette use, and past-year illicit drug use) and 15% of female measures (wanting a/another child, ever had a sexually transmitted disease, and past-year marijuana use). The absence of a "something else" response option for questions about sexual identity in national health surveys may cause respondents to select options that do not accurately describe their identities, and this can have a significant effect on national estimates of differences between sexual identity subgroups in terms of selected health outcomes.
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Affiliation(s)
- Brady T West
- Survey Research Center, 4118 Institute for Social Research, University of Michigan-Ann Arbor, 426 Thompson St., Ann Arbor, MI, 48106, USA.
| | - Curtiss W Engstrom
- Program in Survey and Data Science, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
| | - Ty S Schepis
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Ilmul J Tani
- Program in Survey and Data Science, University of Michigan-Ann Arbor, Ann Arbor, MI, USA
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Parchem B, Wheeler A, Talaski A, Molock SD. Comparison of anxiety and depression rates among LGBTQ college students before and during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:31-39. [PMID: 34919495 DOI: 10.1080/07448481.2021.2013238] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 09/16/2021] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To compare rates of anxiety and depression among LGBTQ college students before and during the COVID-19 pandemic and examine pandemic-related stressors and protective factors. PARTICIPANTS Two cohorts of LGBTQ college students, aged 18-25, sampled before (N = 3,484) and during (N = 1,647) the pandemic. METHODS The Healthy Minds Study (HMS) is an annual mental health survey administered to college students in the United States, which included additional items related to the COVID-19 pandemic. RESULTS Mean anxiety symptoms were significantly lower mid-pandemic compared to pre-pandemic, but no differences in mean depressive symptoms were detected. Results varied by sexual and gender minority status. Financial stress, pandemic-related concerns, and witnessing discrimination were risk factors while academic persistence, positive mental health, and formal support were protective factors. CONCLUSIONS Mental health and instrumental support from institutions will be critical for college students during the pandemic. Affirming and empowering spaces for LGBTQ college students may leverage protective factors.
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Affiliation(s)
- Benjamin Parchem
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Adam Wheeler
- Healthy Minds Network, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Amber Talaski
- Healthy Minds Network, Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sherry Davis Molock
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
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Yuen AWH, Sang JM, Wang L, Barath J, Lachowsky NJ, Lal A, Elefante J, Hart TA, Skakoon-Sparling S, Grey C, Grace D, Cox J, Lambert G, Noor SW, Apelian H, Parlette A, Card KG, Hull MW, Jollimore J, Moore DM. Attitudes of Gay, Bisexual, and Other Men Who Have Sex with Men (GBM) toward Their Use of Amphetamine-Type Stimulants and Relation to Reducing Use in Three Canadian Cities. Subst Use Misuse 2023; 59:278-290. [PMID: 37867395 DOI: 10.1080/10826084.2023.2269577] [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] [Indexed: 10/24/2023]
Abstract
BACKGROUND We explored attitudes of gay, bisexual, and other men who have sex with men (GBM) toward their amphetamine-use and associations with reduced use over time. METHODS We recruited sexually-active GBM aged 16+ years in Montreal, Toronto, and Vancouver, Canada, from 02-2017 to 08-2019, with follow-up visits every 6-12 months until November 2020. Among participants who reported past-six-month (P6M) amphetamine-use at enrollment, we used logistic regression to identify demographic, psychological, social, mental health, other substance-use, and behavioral factors associated with reporting needing help reducing their substance-use. We used mixed-effects logistic regression to model reduced P6M amphetamine-use with perceived problematic-use as our primary explanatory variable. RESULTS We enrolled 2,449 GBM across sites. 15.5-24.7% reported P6M amphetamine-use at enrollment and 82.6 - 85.7% reported needing no help or only a little help in reducing their substance use. Reporting needing a lot/of help or completely needing help in reducing substance-use was associated with group sex participation (AOR = 2.35, 95%CI:1.25-4.44), greater anxiety symptomatology (AOR = 2.11, 95%CI:1.16-3.83), greater financial strain (AOR = 1.35, 95%CI:1.21-1.50), and greater Escape Motive scores (AOR = 1.07, 95%CI:1.03-1.10). Reductions in P6M amphetamine-use were less likely among GBM who perceived their amphetamine-use as problematic (AOR = 0.17 95% CI 0.10 - 0.29). CONCLUSIONS Most amphetamine-using GBM did not feel they needed help reducing their substance use, and many reported reduced amphetamine-use at subsequent visits. Those who perceived their use as problematic were less likely to reduce their use. Further interventions to assist GBM in reducing their use are needed to assist those who perceive their use as problematic.
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Affiliation(s)
| | - Jordan M Sang
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Justin Barath
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Nathan J Lachowsky
- University of Victoria, Victoria, BC, Canada
- Community-Based Research Centre, Vancouver, BC, Canada
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | | | - Trevor A Hart
- Toronto Metropolitan University, Toronto, ON, Canada
- University of Toronto, ON, Canada
| | | | | | | | - Joseph Cox
- McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Gilles Lambert
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Institut national de santé publique du Québec, Montréal, QC, Canada
| | - Syed W Noor
- Toronto Metropolitan University, Toronto, ON, Canada
- Louisiana State University Shreveport, Shreveport, Louisiana, USA
| | - Herak Apelian
- McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | | | - Kiffer G Card
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- University of Victoria, Victoria, BC, Canada
- Simon Fraser University, Burnaby, BC, Canada
| | - Mark W Hull
- University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | | | - David M Moore
- University of British Columbia, Vancouver, BC, Canada
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Teixeira da Silva D, Valente PK, Lin W, Hightow-Weidman L, Mayer K, Biello K, Bauermeister J. Psychosocial and structural stressors and engagement in medical care among young sexual minority men across racial identities. Behav Med 2023:1-9. [PMID: 38126713 DOI: 10.1080/08964289.2023.2277931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/17/2023] [Indexed: 12/23/2023]
Abstract
Psychosocial and structural stressors and low engagement in medical care likely contribute to the disproportionate burden of chronic disease among sexual minority men (SMM) across the life course. However, how these stressors impact engagement in medical care among young SMM (YSMM) across racial identities remains understudied. The association of psychosocial and structural stressors with forgoing care among YSMM across racial identities was examined using race-stratified adjusted logistic regression of cross-sectional data. Among 737 HIV-negative SMM aged 16-24 years, nearly all (93%) experienced discrimination in their daily lives. Non-Hispanic/Latinx Black participants reported significantly higher levels of discrimination, exposure to community violence, and food insecurity. Medical mistrust and mental health were not significantly different across racial groups. In the full sample model, education, food insecurity, and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx White sample, medical mistrust and discrimination were associated with forgoing care. Among the non-Hispanic/Latinx Black sample, discrimination was associated with forgoing care. Among the Hispanic/Latinx sample, food insecurity was associated with forgoing care. Psychosocial and structural stressors were common in this YSMM cohort, and significantly different across racial/ethnic identities. Race-stratified analysis revealed differences in the association of stressors with forgoing care among YSMM across racial identities, not appreciated in the analysis limited to the total study population. Our findings may support efforts to address health inequity and improve engagement in medical care among SMM.
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Affiliation(s)
| | - Pablo K Valente
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Willey Lin
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kenneth Mayer
- The Fenway Institute at Fenway Health, Boston, MA, USA
| | - Katie Biello
- The Fenway Institute at Fenway Health, Boston, MA, USA
- School of Public Health, Brown University, Providence, RI, USA
| | - José Bauermeister
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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26
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Encina E, Waratworawan W, Kongjareon Y, Desai MM, Guadamuz TE. Sexual orientation disclosure and depression among Thai gay, bisexual, and other men who have sex with men: The roles of social support and intimate partner violence. PLoS One 2023; 18:e0294496. [PMID: 37992077 PMCID: PMC10664870 DOI: 10.1371/journal.pone.0294496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/02/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Among gay, bisexual, and other men who have sex with men (GBM), sexual orientation disclosure to social groups can act as a significant risk for depression. The primary goal of this research is to understand the association between disclosure and depression, the association of social support and intimate partner violence (IPV) experiences, depression, and disclosure. METHODS This project uses a secondary dataset of Thailand from a larger cross-sectional study distributed in the Greater Mekong Sub-Region. This study utilized web-based answers from 1468 Thai GBM respondents between the ages of 15-24 years. RESULTS Prevalence of depression was over 50%. Across the social groups of interest, those who disclosed to everyone had the lowest depression prevalence. This association was statistically significant for all groups (p<0.050) except for "Family members" (p = 0.052). There was a statistically significant association illustrated between full disclosure to social groups and increased social support. Most respondents (43.9%) had low social support, and additionally this group had the highest level of depression, compared to those with high social support. There was a statistically significant association for lowered depression outcomes and increased social support. IPV experiences that occurred within the last six months had a statistically significant relationship with depression (p = 0.002). There was a notable association between those with experiences of being a victim of IPV, alone and in conjunction with experience of being a perpetrator of IPV, which was associated with increased odds of depression. However, the type of IPV experiences an individual had did not differ based on disclosure status. DISCUSSION This study provides strengthened evidence of the impact that differences in supportive networks can have on mental health outcomes. In addition, they provided a wider consideration for how people may have different IPV experiences, either as a perpetrator, victim, or both, and how those shapes health outcomes of depression. GBM communities still face adversity and challenges that affect their long-term health outcomes, even if they do live in what is considered an accepting country.
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Affiliation(s)
- Eduardo Encina
- Mahidol Center for Health, Behavior and Society, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States of America
| | - Worawalan Waratworawan
- Mahidol Center for Health, Behavior and Society, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Yamol Kongjareon
- Mahidol Center for Health, Behavior and Society, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Mayur M. Desai
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, United States of America
| | - Thomas E. Guadamuz
- Mahidol Center for Health, Behavior and Society, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- John F. Kennedy School of Government, Harvard University, Cambridge, MA, United States of America
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Prada K, de Moissac D, Gueye NR, Hardy S, Avanthay-Strus J. Living in a liminal space: Experiences of 2SLGBTQ + official language minority Canadians during the COVID-19 pandemic. CULTURE, HEALTH & SEXUALITY 2023; 25:1465-1482. [PMID: 36593120 DOI: 10.1080/13691058.2022.2160016] [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: 08/15/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
The intersecting identities of those identifying with multiple minorities, such as 2SLGBTQ + and ethnolinguistic minorities, bring individuals to have unique experiences, especially concerning health and wellness. This topic is particularly poorly understood among French-speaking official language minority 2SLGBTQ + populations in Canada. Hence, this study was conducted to generate insights into their needs and experiences, through the lens of intersectionality. This quantitative community-based study, a first of its kind in Western Canada, describes the sociodemographic profile, experiences of discrimination and stigmatisation, and needs and challenges pertaining to mental health and social supports of this double minority group. Data were obtained by an online survey conducted in the Canadian province of Manitoba in June 2020. The participant sample was largely homogenous: most were under the age of 55 years, white, educated, and from urban areas. Many reported experiencing dual marginalisation, feeling unaccepted by both of their minority communities (Francophone and 2SLGBTQ+). A sense of isolation, as well as a lack of social connectedness and psychological support, were often reported. Social initiatives and mental health support within environments proactively affirming of the official language of the minority and inclusive of diverse 2SLGBTQ + identities are needed.
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Affiliation(s)
- Kevin Prada
- Psychology, Université de Saint-Boniface, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, Canada
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Lorabi S, Sánchez-Teruel D, Robles-Bello MA, Ruiz-García A. Variables that enhance the development of resilience in young gay people affected by the COVID-19 pandemic. Early Interv Psychiatry 2023; 17:1107-1115. [PMID: 36669465 DOI: 10.1111/eip.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 10/19/2022] [Accepted: 01/01/2023] [Indexed: 01/21/2023]
Abstract
AIMS Sexual and gender minorities are more likely to suffer from depression and anxiety caused by COVID-19. However, they also have specific variables that have been little studied but which may protect them from this adverse situation. The aim of this study was to find out whether there were differences in socio-demographic and psychosocial variables in two groups of Spanish gay young people (high and low resilience), and predictors of risk and protective factors were examined. METHODS Nine hundred and seventy-nine young homosexuals (389; 39.73% self-reported as women) aged between 18 and 26 years old who experienced mandatory confinement due to COVID-19, completed an anonymous online questionnaire. Hope, perceived self-efficacy, reappraisal index, coping humour, anxiety, depression were assessed along with socio-demographic information. Data were collected between 15 and 26 April 2020. RESULTS Socio-demographic variables that were predictive of highly resilient behaviour included being between 24 and 26 years old, living with LGBTI+ peers and living in big cities, protective psychosocial variables included reframing in reappraising the confinement situation, humour as coping, social support from significant others and self-efficacy. CONCLUSION This is one of the first studies on this subject of compulsory COVID-19 confinement on young homosexuals in Spain. Mental health professionals and organizations should also include work on psychosocial protective factors, not just risk factors, to enhance resilient outcomes in this group.
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Affiliation(s)
- Souhib Lorabi
- Psychology Department, University of Jaen, Jaen, Spain
| | - David Sánchez-Teruel
- Faculty of Psychology, University of Granada, Granada, Spain
- Member of the Spanish Society of Suicidology, Madrid, Spain
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Fowler JA, Buckley L, Muir M, Viskovich S, Paradisis C, Zanganeh P, Dean JA. Digital mental health interventions: A narrative review of what is important from the perspective of LGBTQIA+ people. J Clin Psychol 2023; 79:2685-2713. [PMID: 37528773 DOI: 10.1002/jclp.23571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/19/2023] [Accepted: 07/15/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES Digital mental health interventions are a promising therapeutic modality to provide psychological support to LGBTQIA+ (lesbian, gay, bisexual, trans, Queer, intersex, asexual, plus other gender, sexual, and romantic minority identities) people. The aim of this narrative review is to explore how the LGBTQIA+ community has been engaged in the design of digital mental health interventions, how content has been tailored to the LGBTQIA+ community, and features identified as important by LGBTQIA+ participants. METHODS A total of 33 studies were included in this review from a larger yield of 1933 identified from systematic searches of five databases (PsycINFO, PubMed, Scopus, CINAHAL, and Medline). Data were analyzed narratively and using content analysis. RESULTS Only half of the studies reported engaging the LGBTQIA+ community in intervention designs. Interventions have been tailored in a variety of ways to support LGBTQIA+ individuals-such as through affirming imagery, recruitment through LGBTQIA+ networks, and designing content to focus specifically on LGBTQIA+ issues. A range of features were identified as important for participants, namely how content was tailored to LGBTQIA+ experiences, providing connection to community, and links to other relevant LGBTQIA+ resources. While not a primary aim, results also showed that a wide range of digital modalities can significantly improve a range of mental health problems. CONCLUSION Digital interventions are an acceptable and effective form of therapeutic intervention, but future research needs to focus on meaningful engagement of community members to inform design and implementation.
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Affiliation(s)
- James A Fowler
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Lisa Buckley
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Miranda Muir
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Shelley Viskovich
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Chris Paradisis
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Parnian Zanganeh
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
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30
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Gordon JD, Whitfield DL, Mammadli T, Escobar-Viera CG. Social Support-Seeking Strategies on Social Media at the Intersection of Lesbian, Gay, Bisexual, Transgender, and Queer Identity, Race, and Ethnicity: Insights for Intervention From a Qualitative Study. JMIR Form Res 2023; 7:e51702. [PMID: 37862069 PMCID: PMC10625079 DOI: 10.2196/51702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals experience a disproportionately higher prevalence of mental health challenges when compared to their heterosexual and cisgender counterparts. Moreover, they exhibit increased engagement with social media platforms relative to their peers. Understanding the intersectional dynamics of their identities is crucial in elucidating effective and safe approaches to garnering social support through social media channels. This exploration holds significance for informing future research endeavors and shaping targeted interventions to address the unique mental health needs of LGBTQ+ individuals. OBJECTIVE The purpose of this study was to explore the strategies used by Black, Hispanic, and non-Hispanic White LGBTQ+ young adults to acquire social support from social media. The study aimed to examine how these strategies may differ by race and ethnicity. METHODS We conducted semistructured interviews with LGBTQ+ young adults aged between 18 and 30 years recruited in the United States from social media. Of 52 participants, 12 (23%) were Black, 12 (23%) were Hispanic, and 28 (54%) were non-Hispanic White. Thematic analysis was used to analyze the collected data. RESULTS The analysis uncovered both divergent and convergent strategies among participants of different races and ethnicities. Black and Hispanic young adults exhibited a preference for connecting with individuals who shared similar identities, seeking safety and tailored advice. Conversely, non-Hispanic White participants demonstrated minimal preference for identity-based advice. Seeking support from anonymous sources emerged as a strategy to avoid unwanted disclosure among Hispanic participants. Furthermore, all participants emphasized the importance of content filtering with family members to cultivate positive and supportive social media experiences. CONCLUSIONS This study sheds light on the strategies used by LGBTQ+ individuals of different racial and ethnic backgrounds to seek social support from social media platforms. The findings underscore the importance of considering race and ethnicity when examining social support-seeking behaviors on social media in LGBTQ+ populations. The identified strategies provide valuable insights for the development of interventions that aim to leverage social support from social media to benefit the mental health of Black, Hispanic, and non-Hispanic White LGBTQ+ young adults.
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Affiliation(s)
- Jacob D Gordon
- Institute for Sexual and Gender Minority Health and Wellbeing, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Darren L Whitfield
- School of Social Work, University of Maryland, Baltimore, MD, United States
| | - Tural Mammadli
- School of Social Work, University of Maryland, Baltimore, MD, United States
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Tang FFY, Kosana P, Jit M, Terris-Prestholt F, Wu D, Ong JJ, Tucker JD. Pay-it-forward influenza vaccination among older adults and children: A cost-effectiveness analysis in China. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001590. [PMID: 37651349 PMCID: PMC10470923 DOI: 10.1371/journal.pgph.0001590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 07/11/2023] [Indexed: 09/02/2023]
Abstract
A quasi-experimental study was conducted to evaluate the effectiveness of a pay-it-forward strategy for increasing influenza vaccination among children and older adults compared to a self-paid vaccination strategy in China. Pay-it-forward is an innovative community-engaged intervention in which participants receive a free influenza vaccination and are then asked if they would like to donate or create a message to support subsequent vaccinations. This economic evaluation used a decision-tree model to compare pay-it-forward to a standard of care arm in which patients had to pay for their own influenza vaccine. The analysis was performed from the healthcare provider perspective and costs were calculated with 2020 United States dollars. The time horizon was one year. In the base case analysis, pay-it-forward was more effective (111 vs 55 people vaccinated) but more costly than standard-of-care ($4477 vs $2725). Pay-it-forward spurred 96.4% (107/111) of individuals to voluntarily donate to support influenza vaccination for high-risk groups in China. Further costing and implementation research is needed to inform scale up.
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Affiliation(s)
- Fanny Fong-Yi Tang
- Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, SAR, China
| | - Priya Kosana
- School of Public Health, Yale University, New Haven, CT, United States of America
| | - Mark Jit
- Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Fern Terris-Prestholt
- UNAIDS, Geneva, Switzerland
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dan Wu
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Nanjing Medical University, Nanjing, China
| | - Jason J. Ong
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Melbourne Sexual Health Centre, Monash University, Melbourne, Australia
| | - Joseph D. Tucker
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Institute for Global Health and Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
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Vinitchagoon T, Wongpipit W, Phansuea P. Gender Expression, Weight Status, and Risk of Experiencing Eating Disorders among Gender-Diverse Adults Assigned Male at Birth in Bangkok, Thailand. Nutrients 2023; 15:3700. [PMID: 37686732 PMCID: PMC10489815 DOI: 10.3390/nu15173700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
This study examines the association between gender expression, weight status, and the risk of experiencing eating disorders among gender-diverse adults assigned male at birth living in Bangkok, Thailand. Participants completed self-administered questionnaires to provide demographic data and anthropometric measures, and an Eating Attitude Test-26 (EAT-26) to determine the risk of experiencing eating disorders. The associations between gender expression, weight status, and the risk of experiencing eating disorders were analyzed using multivariable logistic regression models. No significant differences were observed in weight-related variables based on gender expression. Participants self-described as feminine/androgynous had lower odds of experiencing a high risk of eating disorders compared to those self-described as masculine (odds ratio (OR) = 0.49; 95% confidence interval (95% CI) = 0.27, 0.88). A higher body mass index (BMI) (OR = 1.07; 95% CI = 1.01, 1.14) and BMI discrepancy (OR = 1.13; 95% CI = 1.03, 1.24) were associated with higher odds of engaging in extreme weight-control behaviors. The risk of experiencing eating disorders among Thai gender-diverse adults assigned male at birth could differ across gender expression and weight status. Further research is needed to expand the understanding of these relationships and develop tailored intervention programs to mitigate the risk.
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Affiliation(s)
- Thanit Vinitchagoon
- Food and Nutrition Academic and Research Cluster, Institute of Nutrition, Mahidol University, Nakhon Pathom 73170, Thailand;
| | - Waris Wongpipit
- Department of Curriculum and Instruction, Faculty of Education, Chulalongkorn University, Bangkok 10330, Thailand;
- Department of Sports Science and Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Phenphop Phansuea
- Food and Nutrition Academic and Research Cluster, Institute of Nutrition, Mahidol University, Nakhon Pathom 73170, Thailand;
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Sharareh N, Bybee S, Goldstein E, Jones S, Hess R, Wallace A, Seligman H, Wilson FA. Disparities in food insecurity between sexual minority and heterosexual adults - a higher burden on bisexual individuals. Front Public Health 2023; 11:1237091. [PMID: 37608986 PMCID: PMC10441544 DOI: 10.3389/fpubh.2023.1237091] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
Background Sexual minorities-individuals who identify as gay/lesbian, bisexual, or other non-heterosexual individuals-experience higher rates of food insecurity (FI) compared to heterosexual individuals. During the COVID-19 pandemic, discrimination and structural racism, which are known risk factors for food insecurity, were perpetuated against sexual and racial/ethnic minorities. However, to our knowledge, a nationally representative analysis of the impact of the pandemic on food insecurity by sexual minority status and based on race/ethnicity is missing. We aimed to determine the degree of association between FI and sexual minority adults overall, before (2019) and during (2020-2021) the pandemic, and stratified by race/ethnicity. Methods We used nationally representative data from the 2019-2021 National Health Interview Survey (NHIS). We specified multivariable logistic regression models to determine the association between FI and identifying as a sexual minority adult (≥18 years old), including gay/lesbian, bisexual, and other non-heterosexual individuals. Results Overall, we only observed FI disparities between bisexuals and heterosexuals (aOR 1.61 [95% CI 1.31-1.99]). Stratified by year, this association was significant only during the pandemic. Stratified by race/ethnicity, non-Hispanic white and non-Hispanic black individuals identifying as bisexual also experienced a significantly higher FI rate than their heterosexual counterparts. Conclusion Our results may be a manifestation of the disproportionate impact of discrimination on bisexual individuals' FI experiences. With the growing number of legislative bills targeting the rights of sexual minorities, we expect to see a higher burden of FI among bisexuals, particularly, bisexual people of color. Future intersectional research regarding FI among bisexual and racial/ethnic minority individuals would further elucidate how membership in multiple minority groups may contribute to a higher risk of FI.
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Affiliation(s)
- Nasser Sharareh
- Department of Population Health Sciences, Spence Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Sara Bybee
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Evan Goldstein
- Department of Population Health Sciences, Spence Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Shannon Jones
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, United States
| | - Rachel Hess
- Department of Population Health Sciences, Spence Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Andrea Wallace
- Department of Population Health Sciences, Spence Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Hilary Seligman
- Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Fernando A. Wilson
- Department of Population Health Sciences, Spence Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, United States
- Matheson Center for Health Care Studies, University of Utah, Salt Lake City, UT, United States
- Department of Economics, College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, United States
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Liu C, Yuan GF, Li X, Fung HW, Wong MYC, Zhao J, Feng X. Associations among internalized and perceived stigma, state mindfulness, self-efficacy, and depression symptoms among men who have sex with men in China: A serial mediation model. Arch Psychiatr Nurs 2023; 45:81-88. [PMID: 37544707 DOI: 10.1016/j.apnu.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/23/2023] [Accepted: 06/01/2023] [Indexed: 08/08/2023]
Abstract
Previous research has demonstrated that stigma is strongly related to depressive symptoms among men who have sex with men (MSM). However, data are limited regarding the associations between stigma, state mindfulness, self-efficacy, and depression symptoms. The current study aimed to analyze state mindfulness and self-efficacy as possible mediators between internalized and perceived stigma and depression symptoms. A sample of 2610 Chinese MSM (Mage = 23.99, SD = 6.09, age range: 18-68 years) was recruited from an online survey platform and completed the HIV and Homosexuality Related Stigma Scale, Patient Health Questionnaire-9, the short version of Five Facet Mindfulness Questionnaire, and the Chinese General Self-Efficacy Scale. Results indicated that state mindfulness significantly mediated the linkage between internalized and perceived stigma and depressive symptoms, and self-efficacy significantly mediated the relation between state mindfulness and depression symptoms. Furthermore, internalized and perceived stigma were associated with depression symptoms through a serial mediation of state mindfulness and self-efficacy. This study highlights that state mindfulness and self-efficacy might play important roles in the psychological response of MSM to stigmatization and psychopathology symptoms.
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Affiliation(s)
- Caimeng Liu
- College of Teacher Education, Institute of Education Science, Leshan Normal University, Leshan, China
| | - Guangzhe Frank Yuan
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA.
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, USA
| | - Hong Wang Fung
- Department of Social Work, Faculty of Social Sciences, The Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Ming Yu Claudia Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong
| | - Jingjing Zhao
- Department of Psychology, Beijing Forestry University, Beijing, China
| | - Xueyou Feng
- Center for Mental Health Education and Counseling, Guangzhou College of Commerce, Guangzhou, China
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Batra K, Pharr JR, Kachen A, Godbey S, Terry E. Investigating the Psychosocial Impact of COVID-19 Among the Sexual and Gender Minority Population: A Systematic Review and Meta-Analysis. LGBT Health 2023; 10:416-428. [PMID: 37022764 DOI: 10.1089/lgbt.2022.0249] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Purpose: The purpose of this study was to utilize a systematic review and meta-analysis to assess the existing body of literature to understand the mental health impacts of the coronavirus disease-19 (COVID-19) pandemic among sexual and gender minority (SGM) people. Methods: The search strategy was developed by an experienced librarian and used five bibliographical databases, specifically PubMed, Embase, APA PsycINFO (EBSCO), Web of Science, and LGBTQ+ Source (EBSCO), for studies (published 2020 to June, 2021) examining the psychological impact of the COVID-19 pandemic among SGM people. Articles were screened by two reviewers. The quality of the articles was assessed using the National Institutes of Health quality assessment tool for observational studies. A double extraction method was used for data abstraction. Heterogeneity among studies was assessed by I2 statistic. The random-effects model was utilized to obtain the pooled prevalence. Publication bias was assessed by Funnel plot and Egger's linear regression test. Results: Of a total of 37 studies, 15 studies were included in the meta-analysis with 17,973 SGM participants. Sixteen studies were U.S. based, seven studies were multinational studies, and the remaining studies were from Portugal, Brazil, Chile, Taiwan, the United Kingdom, France, Italy, Canada, and several other countries. A majority of studies used psychometric valid tools for the cross-sectional surveys. The pooled prevalence of anxiety, depression, psychological distress, and suicidal ideation was 58.6%, 57.6%, 52.7%, and 28.8%, respectively. Conclusions: Findings of this study serve as evidence to develop appropriate interventions to promote psychological wellbeing among vulnerable population subgroups, such as SGM individuals.
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Affiliation(s)
- Kavita Batra
- Department of Medical Education, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
- Office of Research, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Axenya Kachen
- School of Medicine, University of Reno, Reno, Nevada, USA
| | - Samantha Godbey
- Library Liaison Program, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
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Cox AB, Jaiswal J, LoSchiavo C, Witte T, Wind S, Griffin M, Halkitis PN. Medical Mistrust Among a Racially and Ethnically Diverse Sample of Sexual Minority Men. LGBT Health 2023; 10:471-479. [PMID: 37418567 PMCID: PMC10623470 DOI: 10.1089/lgbt.2022.0252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023] Open
Abstract
Purpose: Medical mistrust is a barrier to health care utilization and is associated with suboptimal health outcomes. Research on mistrust among sexual minority men (SMM) is limited and largely focuses on Black SMM and HIV, with few studies assessing mistrust among SMM of other race/ethnicities. The purpose of this study was to examine differences in medical mistrust among SMM by race. Methods: From February 2018 to February 2019, a mixed-methods study examined the health-related beliefs and experiences of young SMM in New York City. The Group-Based Medical Mistrust Scale (GBMMS) was used to measure medical mistrust related to race, and a modified version of the scale assessed mistrust related to one's "sexual/gender minority" status (Group-Based Medical Mistrust Scale-Sexual/Gender Minority [GBMMS-SGM]). With an analytic sample of 183 cisgender SMM, a one-way multivariate analysis of variance was used to examine differences in GBMMS and GBMMS-SGM scores by race/ethnicity [Black, Latinx, White, "Another Racial Group(s)"]. Results: There were significantly different GBMMS scores by race, with participants of color reporting higher levels of race-based medical mistrust than White participants. This finding is supported by effect sizes ranging from moderate to large. Differences in GBMMS-SGM scores by race were borderline; however, the effect size for Black and White participants' GBMMS-SGM scores was moderate, indicating that higher GBMMS-SGM scores among Black participants is meaningful. Conclusion: Multilevel strategies should be used to earn the trust of minoritized populations, such as addressing both historical and ongoing discrimination, moving beyond implicit bias trainings, and strengthening the recruitment and retention of minoritized health care professionals.
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Affiliation(s)
- Amanda B. Cox
- Department of Health Science, University of Alabama, Tuscaloosa, Alabama, USA
| | - Jessica Jaiswal
- Department of Health Science, University of Alabama, Tuscaloosa, Alabama, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, Connecticut, USA
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, New Jersey, USA
| | - Caleb LoSchiavo
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Rutgers University, Newark, New Jersey, USA
| | - Tricia Witte
- Department of Human Development and Family Studies, University of Alabama, Tuscaloosa, Alabama, USA
| | - Stefanie Wind
- Department of Educational Studies in Psychology, Research Methodology and Counseling, University of Alabama, Tuscaloosa, Alabama, USA
| | - Marybec Griffin
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, New Jersey, USA
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Rutgers University, Newark, New Jersey, USA
| | - Perry N. Halkitis
- Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), Rutgers School of Public Health, Newark, New Jersey, USA
- Department of Urban-Global Public Health, Rutgers School of Public Health, Rutgers University, Newark, New Jersey, USA
- Department of Biostatistics & Epidemiology, Rutgers School of Public Health, Rutgers University, Newark, New Jersey, USA
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Sprott RA, Herbitter C, Grant P, Moser C, Kleinplatz PJ. Clinical Guidelines for Working with Clients Involved in Kink. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:978-995. [PMID: 37439228 DOI: 10.1080/0092623x.2023.2232801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
People involved in kink (BDSM or fetish) subcultures often encounter stigma and bias in healthcare settings or when seeking psychotherapy. Such individuals typically encounter well-meaning clinicians who are not prepared to provide culturally competent care or who have not recognized their own biases. Over a two-year period, a team of 20 experienced clinicians and researchers created clinical practice guidelines for working with people involved with kink, incorporating an extensive literature review and documentation of clinical expertise. This article summarizes the guidelines and discusses relevant issues facing clinicians and their clients, as well as implications for clinical practice, research and training.
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Affiliation(s)
- Richard A Sprott
- Human Development and Women's Studies, California State University, East Bay, CA, USA
| | - Cara Herbitter
- School of Medicine, Veteran Affairs Boston Healthcare System Boston University, West Roxbury, MA, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, US
| | - Patrick Grant
- Clinical Psychology, Michael E. Debakey Veterans Affairs Medical Center, USA
| | - Charles Moser
- Diverse Sexualities Research and Education Institute (DSREI.org), San Francisco, CA, USA
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Marciano A, David Y, Antebi-Gruszka N. Facebook use and body dissatisfaction moderate the association between discrimination and suicidality among LGBQ individuals. COMPUTERS IN HUMAN BEHAVIOR 2023. [DOI: 10.1016/j.chb.2023.107729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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McAuliffe C, Walsh RJ, Cage E. " My whole life has been a process of finding labels that fit": A Thematic Analysis of Autistic LGBTQIA+ Identity and Inclusion in the LGBTQIA+ Community. AUTISM IN ADULTHOOD 2023; 5:127-138. [PMID: 37346993 PMCID: PMC10280209 DOI: 10.1089/aut.2021.0074] [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: 11/13/2022]
Abstract
Background Being nonheterosexual and noncisgender appears to be more common among autistic people. This intersection of identities is often stigmatized in research and society. However, we know that community involvement can protect against negative mental health outcomes associated with being a minority; researchers found this effect in separate studies examining participation in the autistic and Lesbian, Gay, Bisexual, Trans, Queer, Intersex, Asexual plus other gender and sexual orientation-based identity (LGBTQIA+) communities. This study examined how autistic LGBTQIA+ individuals navigate their multiple marginalized identities and the LGBTQIA+ community. Methods Twelve autistic LGBTQIA+ people from the United Kingdom took part in semistructured interviews. Questions focused on identity and community. We analyzed the interviews using reflexive thematic analysis. Results We identified four overarching themes-Identity (Re)Development, Navigating Authenticity, Exclusion from Community Spaces, and Creating Change. Participants viewed accessing a community of similar others as a means of increasing understanding, self-knowledge, and self-acceptance. We identified several barriers to inclusion, including accessibility and gatekeeping. Participants discussed strategies to combat these obstacles, such as the creation of intersectional community spaces and activism and representation as a means of increasing autism understanding. Conclusions This study suggests that similar to other marginalized groups, autistic LGBTQIA+ individuals are motivated to engage in communities relevant to their identities. However, community spaces for autistic LGBTQIA+ are often inaccessible due to social, sensory, and identity-based barriers. Participants highlighted autism understanding as a barrier to coming out both in community and noncommunity settings. This suggests that improving autism acceptance and understanding is crucial to achieve accessible, intersectional, and inclusive community spaces.
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Affiliation(s)
| | - Reubs J. Walsh
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit, Amsterdam, Netherlands
- Centre for Applied Transgender Studies, Chicago, Illinois, USA
| | - Eilidh Cage
- Department of Psychology, University of Stirling, Stirling, Scotland
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Behler AC, George N, Collibee C, Hamilton L, Oleson EB, Thamotharan S. A conceptual framework for queer, black womxn sexual assault survivors: an adaptation of the minoritised stress model. CULTURE, HEALTH & SEXUALITY 2023; 25:791-802. [PMID: 35900895 DOI: 10.1080/13691058.2022.2089734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 06/10/2022] [Indexed: 06/02/2023]
Abstract
Queer, Black womxn experience sexual assault at an alarming rate in the USA leading to adverse mental and physical health outcomes in survivors. A synthesis of the literature was conducted to understand their unique lived experiences and needs. This article proposes an adapted Meyer's Minoritised Stress framework to understand salient clinical factors impacting Queer, Black womxn sexual assault survivors, including those associated with multiple minoritised identities: Queer-based trauma, race-based trauma, cultural betrayal trauma, and misogynoir. Given the high rates of victimisation, marginalisation and discrimination, psychologists and others working with members of this population should engage with and address these factors to provide culturally responsive, sexually affirming and effective mental health treatment and care.
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Affiliation(s)
| | - Nevita George
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Charlene Collibee
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Lindsey Hamilton
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Erik B Oleson
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - Sneha Thamotharan
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
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Mitchell KM, Knittel ML. Navigating the Role of LGBTQ+ Identity in Self-Disclosure and Strategies Used for Uncertainty Reduction in Online Dating. JOURNAL OF SEX RESEARCH 2023; 60:645-655. [PMID: 36800920 DOI: 10.1080/00224499.2023.2179009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Online dating platforms pose novel challenges for personal privacy, self-disclosure, and uncertainty management. Emerging evidence suggests that LGBTQ+ users may be especially impacted by issues like personal privacy and misrepresentation online. LGBTQ+ identity disclosure is often fraught with pressures related to stigma, fear of accidental disclosure to unintended, undesired audiences, and the possibility of facing harassment and violence. How these identity concerns may manifest in uncertainty reduction strategies in online dating contexts has not yet been examined. To understand this relationship, we replicated and extended precious work examining self-disclosure concerns and uncertainty reduction strategies when online dating with a focus on LGBTQ+ users. Participants were surveyed on the amount of personal information they disclosed, the uncertainty reduction strategies they used, and concerns about disclosure. We found that use of uncertainty reduction strategies was predicted by concerns of personal security, misrepresentation of communication partners, and the possibility of being recognized. We also found that using these strategies predicted the frequency of specific self-disclosure in online dating situations. These findings support the value in continuing to understand the ways in which online information sharing and relationship development are influenced by social identity.
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Affiliation(s)
| | - Megan L Knittel
- College of Communication Arts & Sciences, Michigan State University
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Katz BW, Chang CJ, Dorrell KD, Selby EA, Feinstein BA. Aspects of positive identity buffer the longitudinal associations between discrimination and suicidal ideation among bi+ young adults. J Consult Clin Psychol 2023; 91:313-322. [PMID: 36729515 PMCID: PMC10198870 DOI: 10.1037/ccp0000788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Prior research has demonstrated that discrimination is associated with suicidal ideation among bi + individuals, but little is known about resilience factors (both general and bi + specific) that may buffer these associations. This prospective study examined the main and interactive effects of antibisexual discrimination and resilience factors, including general resilience and positive bi + identity factors (community, authenticity, and intimacy), in predicting suicidal ideation at 1- and 2-month follow-up. METHOD Participants were bi + young adults (N = 396; ages 18-29; 42.7% cisgender men, 42.2% cisgender women, 15.2% transgender/gender diverse individuals; 37.9% racial and ethnic minority individuals) who completed measures of antibisexual discrimination (Brief Antibisexual Experiences Scale), positive bi + identity (Lesbian, Gay, and Bisexual Positive Identity Measure), general resilience (Brief Resilience Scale), and suicidal ideation (Beck Scale for Suicide Ideation) at baseline, and suicidal ideation again at 1- and 2-month follow-up. RESULTS Greater antibisexual discrimination was significantly associated with increases in suicidal ideation at 1-month follow-up at low levels of community, authenticity, and intimacy, and increases in suicidal ideation at 2-month follow-up at low levels of authenticity. In addition, at high levels of authenticity, greater antibisexual discrimination was significantly associated with decreases in suicidal ideation at 1-month follow-up. In contrast, general resilience did not moderate the associations between antibisexual discrimination and suicidal ideation at 1- or 2-month follow-up. CONCLUSIONS Results suggest that promoting positive aspects of bi + identity (community, authenticity, and intimacy), but not general resilience, may help attenuate the effects of antibisexual discrimination on suicidal ideation over time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Benjamin W. Katz
- Department of Psychology, University of Wisconsin-Milwaukee Milwaukee, WI, United States
| | - Cindy J. Chang
- Graduate School of Applied and Professional Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, United States
| | - Kate D. Dorrell
- Department of Psychology, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Edward A. Selby
- Department of Psychology, Rutgers University, Piscataway, NJ, United States
| | - Brian A. Feinstein
- Department of Psychology, College of Health Professions, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
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Young LE, Tang JL, Schneider JA. Demographic and HIV Status Diversities as Mechanisms of Social Integration and Segregation Among Black Sexual and Gender Minorities Enrolled in a Community-Based Social Network Intervention. SOCIAL NETWORKS 2023; 73:51-61. [PMID: 36684039 PMCID: PMC9850821 DOI: 10.1016/j.socnet.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Drawing on a social integration and intersectionality framework, this study advances a dynamic network understanding of the mechanisms that enable differential patterns of within-group social integration and segregation among Black sexual and gender minorities (BSGM). Specifically, in a cohort of BSGM (18-35 years of age, n = 340) participating in a community-based network intervention for HIV prevention, we examine how sexual, gender, age, and HIV status diversities contribute to friendship formation and maintenance patterns over the 12-month study enrollment period. We found attenuated social integration (or social activity) among non-gay-identified and older BSGM and evidence of social segregation (or homophily) on the basis sexual identity and age similarities. Accounting for the moderating effects of the intervention revealed that the attenuated integration of non-gay-identified and older BSGM were stronger for participants who received the peer leadership training and integration challenges were also found for transgender BSGM who received the peer leadership training. Meanwhile, BSGM living with HIV who received the peer leadership training were significantly more integrated than their counterparts in the control arm. These findings help us understand the complicated social fabric among BSGM and the dynamics that interventions for this community may have to contend with or alter.
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Affiliation(s)
- Lindsay E Young
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA
| | - Jack Lipei Tang
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL
- Departments of Medicine and Public Health Sciences, University of Chicago, Chicago, IL
- Crown School of Social Work Practice and Policy, University of Chicago, Chicago, IL
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Priddle T, Crawford T, Power T. The inclusion and representation of LGBTIQ+ content in undergraduate nurse education: A scoping review. NURSE EDUCATION TODAY 2023; 124:105771. [PMID: 36889046 DOI: 10.1016/j.nedt.2023.105771] [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: 12/15/2022] [Revised: 02/11/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES The aim of this review was to gain an overview of existing empirical literature examining LGBTIQ+ content in undergraduate nursing curricula. DESIGN An international scoping review was conducted using librarian assisted search strategies. DATA SOURCES The databases CINAHL, SCOPUS and ERIC were searched. A total of 30 studies meeting the eligibility criteria were included in this review. REVIEW METHODS Following a quality appraisal, thematic analysis was conducted to identify six key themes. RESULTS 30 studies spanning 8 countries, across 5 continents were included in this review. 6 themes emerged 1) Level of Knowledge Regarding LGBTIQ+ People and Their Specific Health Needs, 2) Comfort and Preparedness in the Provision of Care to LGBTIQ+ People, 3) Attitudes Toward LGBTIQ+ People, 4) Inclusion of LGBTIQ+ Educational Content, 5) Framing of LGBTIQ+ Educational Content, 6) Pedagogical Strategies to Incorporate LGBTIQ+ Content. CONCLUSIONS Nurse education is dominated by heteronormativity, deficit discourses, stereotypes, binary ideologies and western cultural perspectives. The body of literature surrounding LGBTIQ+ content in nurse education is largely quantitative, insular and contributes to the erasure of unique identities under the LGBTIQ+ umbrella.
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Affiliation(s)
- Tyler Priddle
- Level 8, D18 - Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW, 2006, Australia.
| | - Tonia Crawford
- Level 8, D18 - Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW, 2006, Australia.
| | - Tamara Power
- Level 8, D18 - Susan Wakil Health Building, The University of Sydney, Gadigal Country, Camperdown, NSW, 2006, Australia.
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Turpin RE, Dangerfield DT, Oke T, Hickson DA. Parental Sexuality Disclosure, Discrimination, and Depression Among Black Sexual Minority Men and Black Transgender Women. FAMILY & COMMUNITY HEALTH 2023; 46:95-102. [PMID: 36799942 PMCID: PMC9942094 DOI: 10.1097/fch.0000000000000360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Racial and sexuality-based discrimination can induce depressive symptoms among Black sexual minority men and transgender women (BSMM/BTW). BSMM and BTW who disclose their sexuality to parents may be better prepared to cope with discrimination. We explored the relationship between discrimination and depression among BSMM and BTW and whether parental disclosure modified this relationship. Secondary analysis of The MARI Study was used to test the relationship between discrimination and depression modified by level of disclosure of sexuality to parents among 580 BSMM and BTW in Jackson, Mississippi, and Atlanta, Georgia. Bivariate tests and linear regression models were stratified by sexuality disclosure to parents. Discrimination was associated with greater depression, with significant dose-response modification across levels of disclosure. After adjustment, maximum discrimination scores were associated with depression scores 10.7 units higher among participants with very open disclosure (95% CI, 10.4-11.8), 15.3 units higher among participants with somewhat open disclosure (95% CI, 3.7-26.9), and 19.5 units higher among participants with no disclosure (95% CI, 10.2-26.8). Disclosure of sexuality to supportive parents can substantially benefit the mental health of BSMM and BTW. Future studies should explore intervention approaches to providing social support for BSMM and BTW in unsupportive families.
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Affiliation(s)
- Rodman E Turpin
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia (Dr Turpin); George Washington University, Milken Institute School of Public Health, Washington, District of Columbia (Dr Dangerfield); School of Social Work, University at Buffalo, Buffalo, New York (Mr Oke); and Us Helping Us, People Into Living Inc, Washington, District of Columbia (Drs Hickson and Dangerfield, and Mr Oke)
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Miller LR. Queer Aging: Older Lesbian, Gay, and Bisexual Adults' Visions of Late Life. Innov Aging 2023; 7:igad021. [PMID: 37063703 PMCID: PMC10101047 DOI: 10.1093/geroni/igad021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Indexed: 03/06/2023] Open
Abstract
Background and Objectives Diversity in aging has received increased attention in recent years in the field of gerontology. However, older lesbian, gay, and bisexual (LGB) people have largely been missing from these conversations. In this study, I examine older LGB people's subjective views on the aging process, focusing specifically on visions of late life. Research Design and Methods Life story interviews were conducted with 60 LGB individuals over the age of 55 who reside in the Southeastern and Midwestern portions of the United States. Inductive coding (e.g., line-by-line, focused) and analyses were conducted. Results Four major themes emerged from the data: (1) financial distress linked to past events of homophobic discrimination, (2) anxieties regarding staying in paid care settings, (3) desires to age in place or "in community" with other lesbian, gay, bisexual, transgender, and queer people, and (4) a prioritization of quality of life over longevity via plans to pursue assisted suicide. Discussion and Implications The findings of this study suggest that views of aging and visions of late life are tied to social group membership, highlighting the need for gerontologists to further consider cumulative inequality processes. The study also offers evidence of queer aging, wherein queer culture, history, and experience produce distinct meanings of aging.
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Affiliation(s)
- Lisa R Miller
- Department of Sociology, Behavioral Sciences, Eckerd College, Saint Petersburg, Florida, USA
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Ghabrial MA, Andersen JP. Identity affirmation is associated with adaptive cardiovascular flexibility in response to stress among sexual and gender minority people of color. Soc Sci Med 2023; 320:115703. [PMID: 36716696 DOI: 10.1016/j.socscimed.2023.115703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/18/2022] [Accepted: 01/17/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Research with sexual and gender minority (e.g., lesbian, gay, bisexual, queer, asexual, trans, non-binary) people of Color (SGM-PoC) has largely focused on risk and negative health outcomes. The existing strengths-based mental health research suggests that identity affirmation may be associated with psychological resilience and good mental health among SGM-PoC, but little is known about predictors of physiological resilience and biomarkers of physical health in this population. Adaptive cardiovascular flexibility is an indicator of physiological resilience and physical health in that it enables the body to mobilize resources to adapt to challenges. This study explored the association between identity affirmation and physiological resilience, observed through cardiovascular flexibility in response to stress among SGM-PoC. METHODS Participants were 95 SGM-PoC of varying ethnoracial backgrounds, sexual orientations, and gender identities, residing in Canada. Participants completed questionnaires on sociodemographic and psychosocial variables, including a measure of identity affirmation, the Queer People of Color Identity Affirmation Scale (QPIAS). In a laboratory setting, we induced stress using the Trier Social Stress Test and measured heart rate variability (HRV) over time using wearable electrocardiogram devices. RESULTS Results from multilevel modeling analyses revealed that high QPIAS scores were associated with adaptive cardiovascular flexibility, as evidenced by reduced HRV during stress exposure, followed by HRV increase during recovery. As QPIAS scores increased, the shape of HRV trajectory increasingly reflected our predicted pattern of adaptive cardiovascular flexibility. Meanwhile, low QPIAS scores were not associated with this pattern and appeared to predict a more flatlined HRV activity during the experiment. CONCLUSIONS Findings indicate that Queer People of Color identity affirmation may be related to physiological resilience, observed through a more adaptive cardiovascular profile when responding to stress. Identity affirmation may thus be a protective factor for SGM-PoC, pointing to the critical importance of affirming resources and strengths-based health research.
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Affiliation(s)
- Monica A Ghabrial
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, Canada; Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada.
| | - Judith P Andersen
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada.
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Toh GW, Koh WL, Ho J, Chia J, Maulod A, Tirtajana I, Yang P, Lee M. Experiences of conflict, non-acceptance and discrimination are associated with poor mental well-being amongst LGBTQ-identified individuals in Singapore. EQUALITY, DIVERSITY AND INCLUSION: AN INTERNATIONAL JOURNAL 2023. [DOI: 10.1108/edi-10-2021-0270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PurposeHealth disparities affecting lesbian, gay, bisexual, transgender and queer (LGBTQ) populations have been reported in many countries. For Singapore, no large quantitative studies on mental health and well-being in the local LGBTQ community have been published. The authors conducted a community-based survey (National LGBT Census Singapore, 2013; NLCS2013) that covered a comprehensive set of demographic, social and health indicators. Here, the authors investigated mental health status and its correlates in 2,350 LGBTQ individuals within the NLCS2013 sample.Design/methodology/approachThe NLCS2013 was an anonymous online survey conducted amongst self-identified LGBTQ adults (aged ≥ 21 years) residing in Singapore. The survey included the World Health Organisation Well-being Index (WHO-5) as a measure of mental well-being, with low WHO 5 scores (<13/25) indicating poor mental well-being. The authors analysed relationships between low WHO-5 score and a range of respondent characteristics using multivariate logistic regression.FindingsStrikingly, 40.9% of 2,350 respondents analysed had low WHO-5 scores, indicating poor mental well-being. Parental non-acceptance, experience of conflict at home and bullying/discrimination in the workplace or educational environments were all significantly associated with poor mental well-being. Conversely, community participation appeared protective for mental well-being, as respondents who participated in LGBTQ community organisations or events were less likely to have poor mental well-being than non-participants.Originality/valueThe NLCS2013 represents one of the first broad-based efforts to comprehensively and quantitatively capture the sociodemographic and health profile, including mental health status, within Singapore’s resident LGBTQ population. These findings affirm the need to address the mental health needs of LGBTQ individuals in Singapore and to foster safe spaces and allyship.
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Shepherd BF, Maki JL, Zelaya DG, Warner Ş, Wilson A, Brochu PM. Development and Validation of the Gay-Specific Intraminority Stigma Inventory (G-SISI): Initial Evidence Underpinned by Intraminority Stress Theory. Eur J Investig Health Psychol Educ 2023; 13:170-186. [PMID: 36661763 PMCID: PMC9858161 DOI: 10.3390/ejihpe13010013] [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: 10/31/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
There is currently a lack of measures testing intraminority stress within gay men. Therefore, the current study sought to develop and psychometrically test the Gay-Specific Intraminority Stigma Inventory (G-SISI). Based on a content review of the literature and a panel of experts, a pool of items assessing gay men's perceived exposure to a range of discriminatory attitudes from other gay men was generated. Utilizing a randomly split sample of 1723 gay men between the ages of 19 and 79 years, an exploratory factor analysis was first performed (n = 861). The remaining unexamined data were then used to conduct a confirmatory factor analysis (n = 862). The results support a six-factor model: (1) Age Stigma, (2) Socioeconomic Stigma, (3) Gay Non-Conformity Stigma, (4) Racial Stigma, (5) Gender Expression Stigma, and (6) Body Stigma. Cronbach's alpha for the total scale was 0.90 and for the subscales ranged from 0.60 to 0.85. Sociodemographic factors and measures of community involvement were differentially associated with the G-SISI subscales, providing evidence of construct validity. The findings demonstrate initial support for the dimensionality and validity of the G-SISI, which targets modifiable factors (e.g., identity-based stigma) that may increase stress and reduce community coping resources among gay men with diverse identities.
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Affiliation(s)
- Benjamin F. Shepherd
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Correspondence:
| | - Justin L. Maki
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
| | - David G. Zelaya
- School of Public Health, Brown University, Providence, RI 02903, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Şeniz Warner
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
| | - Adriana Wilson
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
| | - Paula M. Brochu
- Department of Clinical and School Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
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Sang JM, Cui Z, Wang L, Bacani N, Lachowsky NJ, Lal A, Card KG, Roth EA, Montaner JSG, Howard T, Hogg RS, Moore DM. Treatment interruptions and community connectedness among gbMSM living with HIV in Metro Vancouver, Canada. AIDS Care 2023; 35:139-147. [PMID: 36345611 DOI: 10.1080/09540121.2022.2142927] [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: 11/10/2022]
Abstract
HIV treatment interruptions are a major public health concern that demonstrate a lack of engagement in care and is detrimental to the health of people living with HIV. Community connectedness have demonstrated a protective effect for psychosocial health but are not well understood for HIV treatment outcomes. We explored associations between community connectedness and treatment interruptions among gay, bisexual and other men who have sex with men (gbMSM) living with HIV in Vancouver, British Columbia. We analyzed survey data from the Momentum Health Study and identified treatment interruptions through data linkages with the provincial HIV Drug Treatment Program as episodes lasting more than 60 days beyond an expected antiretroviral therapy refill date from February 2012 to July 2019. We built a mixed-effects logistic regression model, adjusting for confounders. Of 213 gbMSM living with HIV, 54 experienced treatment interruption (25.4%) over a median five-year follow-up. Multivariable results found the number gbMSM who spoken to in the past month (aOR = 0.995; 95% CI = 0.991, 1.000 (per 100-unit increase)) and attending a gay community meeting more than once per month (aOR = 0.32; 95% CI = 0.11, 0.89) were associated with lower odds of treatment interruptions. These results highlight the importance of social connections in facilitating effective HIV care.
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Affiliation(s)
- Jordan M Sang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Zishan Cui
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Nicanor Bacani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Nathan J Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Kiffer G Card
- School of Public Health and Social Policy, University of Victoria, Victoria, Canada
| | - Eric A Roth
- Department of Anthropology, University of Victoria, Victoria, Canada
| | - Julio S G Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Terry Howard
- Momentum Health Study Community Advisory Board, Vancouver, Canada
| | - Robert S Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby Canada
| | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, Canada
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