Physical and Psychological Abuse among Seropositive African American MSM 50 Aged Years and Older

Predicting the risk of HIV infection among internal migrant MSM in China: An optimal model based on three variable selection methods

Introduction

Internal migrant Men who have sex with men (IMMSM), which has the dual identity of MSM and floating population, should be more concerned among the vulnerable groups for HIV in society. Establishing appropriate prediction models to assess the risk of HIV infection among IMMSM is of great significance to against HIV infection and transmission.

Methods

HIV and syphilis infection were detected using rapid test kits, and other 30 variables were collected among IMMSM through questionnaire. Taking HIV infection status as the dependent variable, three methods were used to screen predictors and three prediction models were developed respectively. The Hosmer-Lemeshow test was performed to verify the fit of the models, and the net classification improvement and integrated discrimination improvement were used to compare these models to determine the optimal model. Based on the optimal model, a prediction nomogram was developed as an instrument to assess the risk of HIV infection among IMMSM. To quantify the predictive ability of the nomogram, the C-index measurement was performed, and internal validation was performed using bootstrap method. The receiver operating characteristic (ROC) curve, calibration plot and dynamic component analysis (DCA) were respectively performed to assess the efficacy, accuracy and clinical utility of the prediction nomogram.

Results

In this study, 12.52% IMMSMs were tested HIV-positive and 8.0% IMMSMs were tested syphilis-positive. Model A, model B, and model C fitted well, and model B was the optimal model. A nomogram was developed based on the model B. The C-index of the nomogram was 0.757 (95% CI: 0.701-0.812), and the C-index of internal verification was 0.705.

Conclusions

The model established by stepwise selection methods incorporating 11 risk factors (age, education, marriage, monthly income, verbal violence, syphilis, score of CUSS, score of RSES, score of ULS, score of ES and score of DS) was the optimal model that achieved the best predictive power. The risk nomogram based on the optimal model had relatively good efficacy, accuracy and clinical utility in identifying internal migrant MSM at high-risk for HIV infection, which is helpful for developing targeted intervention for them.

The Aging Experiences of LGBTQ Ethnic Minority Elders: A Systematic Review

BACKGROUND AND OBJECTIVES

In gerontological research and practice, an increasing amount of attention is being paid to lesbian, gay, bisexual, transgender and queer (LGBTQ) older people and how their experiences differ from their heterosexual and cisgender counterparts. However, LGBTQ elders themselves are not a homogenous group. Moreover, as the immigrant populations in industrialized nations age, the number of LGBTQ elders from ethnic minority backgrounds will only grow. This systematic review hence investigates the experiences of LGBTQ ethnic minority elders.

RESEARCH DESIGN AND METHODS

Following the PRISMA guidelines, we conducted a systematic search in five databases for English peer-reviewed studies. The retrieved articles were coded and analyzed inductively using an intersectional framework to tease out the varying influences of ethnicity, age, gender and sexual identity on the LGBTQ ethnic minority elders' experiences.

RESULTS

A total of 30 articles across 17 studies (13 qualitative, seven quantitative and one mixed methods) were identified. Six key themes emerged from the studies: stigma and discrimination; isolation, support and belonging, interactions with services and institutions, self-acceptance, resilience and agency; mental health and wellbeing; and uncertain futures.

DISCUSSION AND IMPLICATIONS

The experiences of LGBTQ ethnic minority elders echo those of LGBTQ ethnic majority elders when they are shaped by gender and sexual identity factors. Nevertheless, significant differences in experiences -both positive and negative-emerge when cultural and ethnicity-related factors come to the fore. These findings emphasize the need for intersectional aging policies and services that go beyond catering for LGBTQ elders to include the diversity within this sub-population.

[Recommendations to Nursing Practice with Sexual and Gender Diversity Older Adults : A Scoping Review]

Context : The elder population is growing up and sexual and gender diversity older adults (SGDOA) live discrimination from healthcare professionals. In this context, this scoping review sought to describe the extent of knowledge about nursing practice among SGDOA and to synthesize the implications for clinical nursing practice. Method : The scoping review method according to the framework of Peters et al. of the Joanna Briggs Institute has been adopted. Results : The recommendations were grouped into five axes : raising awareness of the existence of SGDOA, their historical context and their health problems ; refrain from heterocissexist and heterocisnormative assumptions by adopting an inclusive language and an open attitude ; support SGDOA and their caregivers or their family of choice ; create a safe and confidential environment ; and promote the inclusion of SGDOA in the health care system. Conclusion : The results could be used by nurses and other health professionals to optimize the quality of care for SGDOA and to promote their inclusion.