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Al-sahli NH, Alhammaqi ZE, Alruwailiy RF, Alzahrani SA, Hakami AA, Al Mansour AS, Khawaji OAY, Bakhsh H. Assessing Women's Knowledge and Awareness of Sexually Transmitted Infections in Saudi Arabia: A Comprehensive Study. Healthcare (Basel) 2024; 12:1437. [PMID: 39057580 PMCID: PMC11276229 DOI: 10.3390/healthcare12141437] [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: 06/09/2024] [Revised: 07/05/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
This study aimed to comprehensively assess the knowledge, awareness, and misconceptions regarding sexually transmitted infections (STIs) among women in Saudi Arabia. A cross-sectional survey was conducted with 600 women aged 18-55 from various regions across the country. The findings revealed moderate overall STI knowledge, with gaps in understanding transmission routes (31.7%), recognizing symptoms (40.8%), and awareness of prevention methods (35.2%). Prevalent misconceptions included the belief that STIs can spread through casual contact (38%), only individuals with multiple partners are at risk (30%), and STIs are always symptomatic (32%). Demographic factors such as age, education level, and marital status significantly influenced STI knowledge, while residential area did not. Higher education, particularly bachelor's degrees and above, was strongly associated with better awareness. Digital platforms like the internet and social media emerged as significant sources of STI information. Undergoing STI testing, discussing STIs with partners, using protection, and receiving the HPV vaccine were linked to higher knowledge levels. This study highlights the need for targeted educational interventions, integration of sexual health education into curricula, training healthcare providers, community engagement, and leveraging digital platforms to enhance STI awareness and prevention efforts among Saudi women.
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Affiliation(s)
- Nujud Hassan Al-sahli
- Collage of Nursing, Princess Nora Bint Abdul Rahman University, Riyadh 11564, Saudi Arabia;
| | - Zahra Essa Alhammaqi
- Faculty of Medical Sciences, Medicine, University of Groningen, 9712 CP Groningen, The Netherlands
| | | | | | - Asma Ahmed Hakami
- College of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (A.A.H.); (O.A.Y.K.)
| | | | | | - Hanadi Bakhsh
- Obstetrics and Gynecology Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
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2
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Anderson JN, Paladino AJ, Robles A, Krukowski RA, Graetz I. "I don't just say, Hi! I'm gay": Sexual Orientation Disclosures in Oncology Clinic Settings Among Sexual Minority Women Treated for Breast Cancer in the U.S. South. Semin Oncol Nurs 2023; 39:151452. [PMID: 37331879 PMCID: PMC10524252 DOI: 10.1016/j.soncn.2023.151452] [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: 01/25/2023] [Revised: 04/17/2023] [Accepted: 05/15/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVES Few studies examine sexual orientation disclosures (SODs) among women with breast cancer; fewer examine the impact of culture and geography on disclosure processes. This study explores how sexual minority women (SMW) in the Southern United States engage in SODs with oncology clinicians. DATA SOURCES We conducted in-depth interviews with SMW (eg, lesbian, bisexual) treated for early-stage (stages I-III), hormone receptor-positive breast cancer (N = 12), using a semistructured interview guide. Participants completed an online survey prior to the 60-minute interview. Data was analyzed using an adapted pile sorting approach and thematic analysis conventions. CONCLUSION Average age of participants was 49.5 years (range: 30-69), all self-identified as cisgender; 83.3% as lesbian, 58.3% were married, 91.7% had completed a 4-year college degree or higher, 66.7% identified as non-Hispanic White, 16.7% as Black, and 16.7% as Hispanic/Latina. Half of the sample had not engaged in SODs with an oncology clinician. Key themes were: (1) religious and political conservatism in the South create SOD barriers; (2) oncologist-specific barriers to SODs; (3) "straight passing" as a discrimination mitigation strategy; and (4) SOD facilitators in oncology settings (ie, strategic disclosures, medical privilege, and lesbian, gay, bisexual, and transgender-friendly branding of oncology centers). IMPLICATIONS FOR NURSING PRACTICE SMW with breast cancer living in the U.S. South navigate unique interpersonal barriers to SODs in oncology settings. Clinicians could encourage SODs by fostering inclusive environments via nonheteronormative language, inclusive intake forms, and respect for SMW's SOD navigation processes. Oncology clinicians require culturally relevant, geographic-specific communication training to facilitate SODs among SMW.
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Affiliation(s)
- Janeane N Anderson
- Assistant Professor, Department of Community and Population Health, College of Nursing, University of Tennessee Health Science Center, Memphis, Tennessee.
| | - Andrew J Paladino
- Medical Student, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Andrew Robles
- Early-phase regulatory coordinator, Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Rebecca A Krukowski
- Professor, Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia
| | - Ilana Graetz
- Associate Professor, Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia
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3
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Staten MC, Webster A, Carter G. Do Ask, Do Tell: Understanding Disclosure of Sexuality and Implications Among MSM Active Duty Service Members. Mil Med 2023; 188:1656-1663. [PMID: 35860852 DOI: 10.1093/milmed/usac209] [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: 03/14/2022] [Revised: 04/18/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Men who have sex with men (MSM) account for over half of new diagnoses of human immunodeficiency virus (HIV) every year in the United States, with over one-third of this population being unaware of their HIV status. The U.S. Military requires biannual HIV testing for all service members. Although this may be an appropriate recommendation for the military at large, current health protection agencies suggest more frequent testing for those at increased risk of HIV transmission, such as those in the MSM community. However, more frequent testing for those at higher risk relies heavily on the preliminary step of patient disclosure of sexual practices to health care providers. MATERIALS AND METHODS An exploratory cross-sectional study was conducted in order to gain a better understanding of the relationship between sexual health variables and the disclosure of sexual identity to health care providers by MSM service members. A convenience sample of MSM currently serving in the U.S. military services (N = 354) was used to collect demographic data, sexual health and history, and opinions concerning medical treatment and HIV. Analyses of the data were conducted using univariate analysis and multivariate regression. RESULTS Men of color were more likely to report a higher degree of sexual identification transparency with their health care providers, which deviates from the civilian population. Pre-exposure prophylaxis (PrEP) uptake was increased among individuals who were more transparent with their health care providers. CONCLUSIONS Findings from this study indicate that feeling more comfortable sharing one's sexual identification with a health care provider results in increased engagement with HIV prevention measures. Potential implications for the Military Health System are the advancement of preventive sexual health screening procedures and the development and revision of policies that promote positive outcomes for gender and sexual minorities.
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Affiliation(s)
- M Colten Staten
- Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Alicia Webster
- Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Gregory Carter
- Indiana University School of Nursing, Bloomington, IN 47401, USA
- The Kinsey Institute, Bloomington, IN 47405, USA
- Rural Center for AIDS and STD Prevention, Bloomington, IN 47405, USA
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4
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Goldberg JM, Gong J, Blennerhassett CJ, Ross LE. A secondary mixed methods analysis examining midwives' responses regarding patient sexual orientation and gender identity (SOGI) disclosure. Midwifery 2023; 120:103648. [PMID: 36871488 DOI: 10.1016/j.midw.2023.103648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/31/2023] [Accepted: 02/09/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVE Recent research suggests that midwives generally have positive attitudes towards sexual and gender minority (SGM) clients; however, little research has examined whether and how these attitudes translate into specific clinical practices. In this study, we performed a secondary mixed methods analysis to examine midwives' beliefs and practices regarding the importance of asking and knowing their patients' sexual orientation and gender identity (SOGI). METHODS A confidential, anonymous paper survey was mailed to all midwifery practice groups (n = 131) in Ontario, Canada. Participants were midwives who were members of the Association of Ontario Midwives who responded to the survey (n = 267). Sequential explanatory mixed methods analysis was employed: quantitative SOGI questions were analyzed first, followed by qualitative open response comments to explain and contextualize the quantitative findings. FINDINGS Midwives' responses indicated that it was not important to know or ask about clients' SOGI because (1) it is not necessary to be able to provide the best care to everyone, and (2) the onus is on the client to disclose SOGI. Midwives indicated that they would like more training and knowledge to be able to confidently care for SGM. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Midwives' hesitancy to ask or know SOGI demonstrates that positive attitudes do not necessarily translate into current best practices for obtaining SOGI data in the context of SGM care provision. Midwifery education and training programs should address this gap.
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Affiliation(s)
- Jennifer M Goldberg
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, College St., Toronto, Canada; Registered Midwife, Ontario 500-155, Canada.
| | - Jenny Gong
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - C J Blennerhassett
- Master of Health Administration Candidate, School of Health Administration, Dalhousie University, Sir Charles Tupper Medical Building 2nd floor, 5850 College Street, PO Box 15000, Halifax, NS B3H 4R2, Canada; Registered Midwife, Nova Scotia, Canada
| | - Lori E Ross
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, College St., Toronto, Canada
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Valentine R, Mills R, Nichols T, Doyle L. Disclosure and comfort during genetic counseling sessions with LGBTQ+ patients: An updated assessment. J Genet Couns 2023. [PMID: 36840411 DOI: 10.1002/jgc4.1692] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/26/2023]
Abstract
Disclosure is the act of sharing a stigmatized identity, and members of the LGBTQ+ community make decisions related to disclosure multiple times throughout their life. Disclosure in medical settings can impact perceptions of care and outcomes for LGBTQ+ patients; however, little is understood about the process of decision-making regarding disclosure in the genetic counseling setting. As such, this study aimed to explore LGBTQ+ experiences in genetic counseling sessions and their disclosure behaviors. Fifty-five LGBTQ+ individuals who attended a genetic counseling session and 91 genetic counselors completed online surveys. The patient survey assessed for disclosure behaviors, experiences of discrimination, and comfort in genetic counseling sessions. The counselor survey evaluated comfort with the LGBTQ+ population in a counseling setting, whether counselors facilitate disclosure in sessions, and whether counseling is tailored for the LGBTQ+ population. Eighty-two percent of genetic counselors "rarely" or "never" ask about sexual orientation, and 69% "rarely" or "never" ask about gender identity. The majority of patients indicated they were not asked about their sexual orientation (87%) or gender identity (80%). Some patients reported experiencing discrimination or homo/transphobia in their genetic counseling sessions, with 6.12% of LGBQ+ patients experiencing discrimination and 24.1% of trans+ patients reporting discrimination. Over half of genetic counselors reported receiving training in LGBTQ+ healthcare and the majority reported comfort with providing care to LGBTQ+ patients. However, discrepancies between patient-reported experiences and genetic counselors' descriptions of their care for the LGBTQ+ population warrant further research and suggest additional training or changes in practice may be necessary.
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Affiliation(s)
- Rozalia Valentine
- MS Genetic Counseling Program, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Rachel Mills
- MS Genetic Counseling Program, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Tracy Nichols
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Lauren Doyle
- MS Genetic Counseling Program, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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Rahman M, Fikslin RA, Matthews E, Vazquez Sanchez MA, Ahn GO, Kobrak PH, Lovinger ES, Golub SA. Exploring Factors Affecting Patient-Provider Interactions and Healthcare Engagement Among a Diverse Sample of Women Who Have Sex with Women in New York City. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:833-849. [PMID: 36478134 PMCID: PMC9886640 DOI: 10.1007/s10508-022-02478-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 11/02/2022] [Accepted: 11/11/2022] [Indexed: 06/17/2023]
Abstract
Women who have sex with women (WSW) have lower rates of engagement in health care and preventive screenings than women who have sex exclusively with men. Existing literature provides limited insight into how intersecting and overlapping identities, such as race, ethnicity, sexual orientation, gender identity, and identities related to gender expression, may shape individuals' experiences within health care. We conducted qualitative interviews in New York City with 30 people who identified as women, reported sex with people who identify as women, were age 18-65, and were diverse in race, ethnicity, and sexual orientation and gender identity. The semi-structured questionnaire asked participants about positive and negative healthcare experiences to elicit what could encourage or prevent seeking care, with a focus on provider-related factors. Factors that led to positive healthcare experiences included having a provider who was knowledgeable about LGBTQ experience and health and who affirmed their sexuality, gender identity, and other intersecting identities. Factors that contributed to negative healthcare experiences included poor interactions with providers, and providers' perceived heteronormativity and lack of awareness of WSW healthcare needs. WSW of different races, ethnicities, sexual orientations, and gender identities seek validating healthcare experiences that acknowledge and affirm their identities. We present a visual summary of the main thematic factors that contributed to positive and negative WSW healthcare experiences. Increasing access to care requires training providers on how to engage WSW patients, including WSW of diverse race/ethnicity and gender identity and expression.
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Affiliation(s)
- Musarrat Rahman
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY, 11101, USA.
| | - Rachel A Fikslin
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
- Basic and Applied Social Psychology (BASP) PhD Program, Department of Psychology, Graduate Center of the City University of New York, New York, NY, USA
- Hunter Alliance for Research and Translation (HART), New York, NY, USA
| | - Eugene Matthews
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
- Hunter Alliance for Research and Translation (HART), New York, NY, USA
| | - Maria A Vazquez Sanchez
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY, 11101, USA
| | | | - Paul H Kobrak
- New York City Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY, 11101, USA
| | | | - Sarit A Golub
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
- Basic and Applied Social Psychology (BASP) PhD Program, Department of Psychology, Graduate Center of the City University of New York, New York, NY, USA
- Hunter Alliance for Research and Translation (HART), New York, NY, USA
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7
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Burdick S, Nicholus S. A Pilot Study of Latinx Lesbian, Gay, and Bisexual Adolescent Patients' Goal Prioritizations in Patient-Provider Sexual Orientation and Health Disclosures. HEALTH COMMUNICATION 2022; 37:1215-1228. [PMID: 34334073 DOI: 10.1080/10410236.2021.1957213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This pilot study provides a theoretically-driven explanation of the dilemmas young Latinx LGB patients may experience surrounding disclosure of personal sexual orientation and sexual health information to a health care provider (HCP). The research team conducted face-to-face semi-structured interviews with LGB Latinx individuals (N= 29) ages 18-22 about their experiences, concerns, and preferences regarding divulging this type of information to an HCP. Interviews were thematically analyzed to identify (a) participants' instrumental, identity, and relational goals during the potential and real disclosures and (b) patterns of how the participants prioritized their goals. Thematic analysis revealed four distinct goal prioritization patterns detailed in this study. Participants' goals were shaped by (a) cultural upbringing, (b) beliefs about human sexuality, (c) perception of data leakage risk, (d) individual personality, (e) medical situation, and (f) the geographic location of clinic.
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Affiliation(s)
- Suzanne Burdick
- Department of Communication Studies, University of Texas at Austin
| | - Sarah Nicholus
- Women's, Gender, and Sexuality Studies, University of Texas at Austin
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8
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Friley LB, Venetis MK. Decision-Making Criteria When Contemplating Disclosure of Transgender Identity to Medical Providers. HEALTH COMMUNICATION 2022; 37:1031-1040. [PMID: 33567931 DOI: 10.1080/10410236.2021.1885774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
As identified in HealthyPeople 2020, the transgender population faces various barriers in accessing quality health care. One barrier includes the fear of negative response or refusal of treatment after disclosing one's transgender identity. In an effort to address this concern, it is essential to understand the criteria that transgender patients consider when determining if they will disclose their gender identity. The disclosure decision-making model (DD-MM) describes how individuals make decisions to share non-visible, health-relevant information with others. Applying the information assessment component of the DD-MM, the present study investigated the salient information assessment themes that contribute to transgender patients' decisions to disclose or withhold their gender identity from medical providers. The sample (N = 26) included transgender individuals who participated in in-depth interviews and described instances and criteria of disclosure decisions. Results revealed that when gauging stigma, participants consider cultural attitudes, how providers may attribute health concerns to their transgender identity, and if providers will perceive them as "trans enough" to provide access to transition-related care. When transition-related care is not necessary, participants' disclosure decision criteria include thoughts on how providers will perceive their gender expression and whether their transgender identity is salient to the medical interaction. Findings also highlighted opportunities for extending prior theoretical conceptualizations and practical implications for transgender care.
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Affiliation(s)
- L Brooke Friley
- Department of Communication & Media, Texas A&M University-Corpus Christi
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9
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Chernichky-Karcher S, Venetis MK, Gettings PE. Revealing Mental Health Information in Friendships: The Role of Disclosure Strategy and Perceived Recipient Response on Disclosure Outcomes. HEALTH COMMUNICATION 2022; 37:909-918. [PMID: 33557635 DOI: 10.1080/10410236.2021.1876325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Processes of revealing, or disclosures, take various forms, and are sometimes referred to as disclosure strategies. How individuals share information influences how recipients respond, which may have important consequences that shape perceptions of the overall interaction and relationship satisfaction. This research explores mental health disclosures among friends to understand how (a) one's disclosure strategy predicts their perceptions of the recipient response, (b) perceived recipient response predicts perceptions of disclosure outcomes, and (c) perceived recipient response potentially mediates the relationships between disclosure strategies and disclosure outcomes (e.g., interaction success, relationship satisfaction). Participants were 144 individuals who had disclosed their mental health condition to a friend. Analyses revealed that when disclosing mental health information to a friend, strategy use was, in part, predictive of perceived recipient response which, in turn, predicted discloser's ratings of disclosure outcomes. This manuscript discusses implications of findings and suggests directions for future research.
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10
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Ussher JM, Power R, Perz J, Hawkey AJ, Allison K. LGBTQI Inclusive Cancer Care: A Discourse Analytic Study of Health Care Professional, Patient and Carer Perspectives. Front Oncol 2022; 12:832657. [PMID: 35619900 PMCID: PMC9127408 DOI: 10.3389/fonc.2022.832657] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/11/2022] [Indexed: 12/01/2022] Open
Abstract
Background Awareness of the specific needs of LGBTQI cancer patients has led to calls for inclusivity, cultural competence, cultural safety and cultural humility in cancer care. Examination of oncology healthcare professionals' (HCP) perspectives is central to identifying barriers and facilitators to inclusive LGBTQI cancer care. Study Aim This study examined oncology HCPs perspectives in relation to LGBTQI cancer care, and the implications of HCP perspectives and practices for LGBTQI patients and their caregivers. Method 357 oncology HCPs in nursing (40%), medical (24%), allied health (19%) and leadership (11%) positions took part in a survey; 48 HCPs completed an interview. 430 LGBTQI patients, representing a range of tumor types, sexual and gender identities, age and intersex status, and 132 carers completed a survey, and 104 LGBTQI patients and 31 carers undertook an interview. Data were analysed using thematic discourse analysis. Results Three HCP subject positions - ways of thinking and behaving in relation to the self and LGBTQI patients - were identified:'Inclusive and reflective' practitioners characterized LGBTQI patients as potentially vulnerable and offered inclusive care, drawing on an affirmative construction of LGBTQI health. This resulted in LGBTQI patients and their carers feeling safe and respected, willing to disclose sexual orientation and gender identity (SOGI) status, and satisfied with cancer care. 'Egalitarian practitioners' drew on discourses of ethical responsibility, positioning themselves as treating all patients the same, not seeing the relevance of SOGI information. This was associated with absence of LGBTQI-specific information, patient and carer anxiety about disclosure of SOGI, feelings of invisibility, and dissatisfaction with healthcare. 'Anti-inclusive' practitioners' expressed open hostility and prejudice towards LGBTQI patients, reflecting a cultural discourse of homophobia and transphobia. This was associated with patient and carer distress, feelings of negative judgement, and exclusion of same-gender partners. Conclusion Derogatory views and descriptions of LGBTQI patients, and cis-normative practices need to be challenged, to ensure that HCPs offer inclusive and affirmative care. Building HCP's communicative competence to work with LGBTQI patients needs to become an essential part of basic training and ongoing professional development. Visible indicators of LGBTQI inclusivity are essential, alongside targeted resources and information for LGBTQI people.
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Hao Z, Guo Y, Bowling J, Ledenyi M. Facilitators and Barriers of HPV Vaccine Acceptance, Initiation, and Completion among LGBTQ Community in the U.S.: A Systematic Review. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2021; 34:291-307. [PMID: 38596525 PMCID: PMC10903696 DOI: 10.1080/19317611.2021.1989535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/22/2021] [Accepted: 09/25/2021] [Indexed: 04/11/2024]
Abstract
Objective: This study aims to identify facilitators and barriers of Human Papillomavirus (HPV) vaccine acceptance, initiation, and completion among LGBTQ (lesbian, gay, bisexual, trans, and queer) individuals. Method: A systematic review of qualitative and quantitative studies on HPV vaccine acceptance, initiation, and completion from 2006 to June 15, 2020 was performed in each database. Results: Twenty-six studies focusing on HPV vaccination among LGBTQ individuals were reviewed. Conclusions: Knowledge of HPV vaccine and healthcare providers' recommendations were identified as facilitators to receive HPV vaccinate, while high co-pay cost and concerns of the effectiveness and safety were identified as barriers.
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Affiliation(s)
- Zhichao Hao
- College of State Governance, Southwest University, Chongqing, China
| | - Yuqi Guo
- School of Social Work, University of North Carolina at Charlotte, Charlotte, NC, USA
- School of Data Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Jessamyn Bowling
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Madeleine Ledenyi
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
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12
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Hsieh N, Shuster SM. Health and Health Care of Sexual and Gender Minorities. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2021; 62:318-333. [PMID: 34528481 DOI: 10.1177/00221465211016436] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Research on the social dimensions of health and health care among sexual and gender minorities (SGMs) has grown rapidly in the last two decades. However, a comprehensive review of the extant interdisciplinary scholarship on SGM health has yet to be written. In response, we offer a synthesis of recent scholarship. We discuss major empirical findings and theoretical implications of health care utilization, barriers to care, health behaviors, and health outcomes, which demonstrate how SGMs continue to experience structural- and interactional-level inequalities across health and medicine. Within this synthesis, we also consider the conceptual and methodological limitations that continue to beleaguer the field and offer suggestions for several promising directions for future research and theory building. SGM health bridges the scholarly interests in social and health sciences and contributes to broader sociological concerns regarding the persistence of sexuality- and gender-based inequalities.
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Affiliation(s)
- Ning Hsieh
- Michigan State University, East Lansing, MI, USA
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13
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Banerjee SC, Staley JM, Alexander K, Walters CB, Parker PA. Encouraging patients to disclose their lesbian, gay, bisexual, or transgender (LGBT) status: oncology health care providers' perspectives. Transl Behav Med 2021; 10:918-927. [PMID: 30476333 DOI: 10.1093/tbm/iby105] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A compelling touted strategy for reducing discrimination towards lesbian, gay, bisexual, and transgender (LGBT) patients is improving communicative competence of health care providers (HCPs); however, evidence base for describing communication practices between HCPs and LGBT patients is scarce. The purpose of this study was to qualitatively examine HCP experiences and perspectives as they relate to patient sexual orientation and gender identity (SOGI) disclosure, perceived communication and structural/administrative challenges in interactions with LGBT patients, and suggestions for improving care of LGBT patients. The sample consisted of 1,253 HCPs, who provided open-ended responses to an online cross-sectional survey conducted at a Comprehensive Cancer Center in the Northeastern United States. The open-ended responses were inductively and deductively coded for key themes and sub-themes. The results demonstrated an array of useful communication strategies employed by oncology HCPs to encourage LGBT patients' SOGI disclosure (direct questions regarding sexual orientation, use of the term "partner," and using correct pronouns), communication and structural/administrative challenges faced by HCPs in providing care (HCP own fears and biases, transgender patient care, insurance issues, and procedural challenges for LGBT patients), and suggested recommendations from oncology HCPs to improve their care delivery for LGBT patients (more provider-based training, improving awareness of LGBT-friendly resources, establishing trusting relationships, and not assuming sexuality or gender identity). These findings have implications for developing and evaluating training programs to improve LGBT sensitivity and communication among HCPs, and encourage SOGI disclosure in an open and judgment-free health care environment.
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Affiliation(s)
- Smita C Banerjee
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jessica M Staley
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Koshy Alexander
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Chasity B Walters
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Patricia A Parker
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Chubb LA, Fouché CB. Domestic stigmatisation: refocusing interventions for people living with HIV. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2021; 19:276-286. [PMID: 33337981 DOI: 10.2989/16085906.2020.1834416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Domestic stigmatisation serves as an umbrella term for acts of enacted or felt stigma experienced in a person's domestic environment. This article reports on the term which transpired from a narrative inquiry in 2011 with people living with HIV (PLWH) who reported humiliation or segregation, experienced or perceived, within the domestic environment that rendered the individual disabled, diseased, unworthy, unhealthy, or deficient. A literature review about this form of stigma was conducted using the following inclusion criteria: 1) a peer-reviewed source; 2) published between 2011 and 2018; 3) access to full-text articles; 4) accessible in English; 5) reported from any country; and 6) using qualitative or mixed-method approaches. A total of 37 studies were included in the review - documenting 51 specific experiences of domestic stigmatisation (referred to as acts for the purpose of the review) across all studies. A matrix was developed detailing each study's' publication date, geographical context, participant gender (where possible) and the reported acts. A critical analysis is offered on the concept "domestic stigmatisation" and its relevance to domestic or family interventions. Deliberate attention to this concept can potentially refocus HIV stigma-reducing interventions to benefit families and promote coping strategies to reduce stigma-related stress associated with seropositive identities.
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Affiliation(s)
- Laura Ann Chubb
- Department of Counselling, Human Services and Social Work, University of Auckland, Auckland, New Zealand
| | - Christa B Fouché
- Department of Counselling, Human Services and Social Work, University of Auckland, Auckland, New Zealand
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Schuller KA, Crawford RP. Impact of interpersonal client–provider relationship on satisfaction with mental healthcare among the LGBTQ+ population. J Ment Health 2020; 31:634-641. [DOI: 10.1080/09638237.2020.1793126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Sexual Orientation and Patient-Provider Communication About Sexual Problems or Concerns Among US Adults. J Gen Intern Med 2019; 34:2505-2511. [PMID: 31452036 PMCID: PMC6848742 DOI: 10.1007/s11606-019-05300-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 05/02/2019] [Accepted: 07/17/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Limited patient-provider communication about sexual health is a crucial barrier to patients receiving treatment for sexual problems, and little is known about how patient sexual orientation is associated with patient-provider communication about sexual problems. OBJECTIVE To describe the prevalence of patient-provider communication about sexual problems and the associations between communication and (1) persistent sexual problems and (2) whether those who identified as lesbian, gay, or bisexual had disclosed their sexual orientation to their clinicians. DESIGN Cross-sectional, online survey PARTICIPANTS: 4325 English-speaking US adults from KnowledgePanel®, a probability-based sample of the civilian, noninstitutionalized population. MAIN MEASURES Sexual orientation, disclosure of sexual orientation (being "out") to a health care provider, communication with health care providers regarding sexual problems or concerns, and persistent sexual problems or concerns. KEY RESULTS In the past year, 8-15% of US adults discussed a sexual problem or concern with a health care provider. Between 23 and 42% of US adults reported persistent sexual problem(s) in the past year, and of those, 18% of gay/lesbian women, 20% of heterosexual women, 22% of bisexual women, 30% of gay men, 31% of heterosexual men, and 37% of bisexual men had discussed a sexual concern with a clinician. Eighty percent of gay/lesbian women and 70% of gay men had disclosed their sexual orientation to their regular health care provider, versus only 24% of bisexual men and women. Among those who were "out," 30% had ever talked to a clinician about a sexual problem compared with 17% of those who were not "out." A smaller proportion of lesbian women had ever received care or treatment for a sexual problem, 6% compared with 14-23% in the other groups. CONCLUSIONS There are significant unmet needs among US adults with regard to patient-provider communication about sexual problems or concerns. Improving patient-provider communication about sexual health is critical.
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Fish J, Williamson I, Brown J. Disclosure in lesbian, gay and bisexual cancer care: towards a salutogenic healthcare environment. BMC Cancer 2019; 19:678. [PMID: 31291940 PMCID: PMC6617610 DOI: 10.1186/s12885-019-5895-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 06/30/2019] [Indexed: 11/15/2022] Open
Abstract
Background The literature on sexual orientation disclosure is arguably one of the most developed in the field of lesbian, gay and bisexual (LGB) people in healthcare in English speaking countries however, relatively little research has been conducted into disclosure in cancer care. Studies have been mainly undertaken in primary care where distinct circumstances pertain and where the benefits of disclosure include obtaining appropriate health information, treatment advice and avoiding misdiagnosis. Methods We conducted an in-depth qualitative study primarily recruiting patients through oncology care in hospital settings and through LGB community cancer support groups. Data were gathered through semi-structured interviews with 30 LGB patients with different cancer types. Results Data were analysed using thematic analysis and interpreted and interrogated through salutogenesis theory which offers a useful lens through which to consider the health promoting effects of sexual orientation disclosure in cancer care. We present three themes as part of the analysis: Authenticity as a driver for disclosure in cancer care, Partners as a (potential) salutogenic resource and Creating safe, healing environments conducive to disclosure. The findings are reported and discussed in relation to three inter-related concepts from current salutogenesis theorising including a sense of coherence, generalised resistance resources and healing environments which can facilitate sexual orientation disclosure. Conclusion Our findings enable a more nuanced approach to understanding disclosure in this context. This study contributes to the literature through its articulation of the salutogenic potential of disclosure (if responded to appropriately) for LGB patients as individuals, in relationship to their partners or carers and the role of creating a visible healing-oriented optimal environment to promote quality of life and recovery. Electronic supplementary material The online version of this article (10.1186/s12885-019-5895-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julie Fish
- Centre for LGBTQ Research, De Montfort University, The Gateway, Leicester, LE1 9BH, UK.
| | - Iain Williamson
- Division of Psychology, De Montfort University, Leicester, LE1 9BH, UK
| | - Jayne Brown
- Leicester Academy for the Study of Ageing (LASA) The Leicester School of Nursing and Midwifery, De Montfort University, The Gateway, Leicester, LE1 9BH, UK
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Hudak N, Bates BR. In Pursuit of "queer-friendly" Healthcare: An Interview Study of How Queer Individuals Select Care Providers. HEALTH COMMUNICATION 2019; 34:818-824. [PMID: 29482359 DOI: 10.1080/10410236.2018.1437525] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
LGBQ+ individuals experience worse health outcomes than do other individuals. Some communication research finds that LGBQ+ individuals report receiving poor care during the mid- to post-health care, but this research assumes that LGBQ+ individuals have already received care. Little research has examined the pre- to early encounter experience of LGBQ+ individuals. This study presents exploratory research into how LGBQ+ individuals seek "queer-friendly" health care during pre- and early encounter experiences. Using an interview methodology, we report the facilitators and barriers to seeking queer-friendly care reported by LGBQ+ individuals. We offer implications for how health care providers and systems can better promote queer-friendly healthcare.
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Affiliation(s)
- Nicole Hudak
- a School of Communication Studies , Ohio University
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Greene MZ, Carpenter E, Hendrick CE, Haider S, Everett BG, Higgins JA. Sexual Minority Women's Experiences With Sexual Identity Disclosure in Contraceptive Care. Obstet Gynecol 2019; 133:1012-1023. [PMID: 30969215 PMCID: PMC6483879 DOI: 10.1097/aog.0000000000003222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To describe a group of young sexual minority women's experiences with and preferences for sexual identity disclosure in the context of contraceptive care. METHODS In Chicago, Illinois, Salt Lake City, Utah, and Madison, Wisconsin, investigators conducted five focus groups (n=22) and 11 interviews with women aged 20-30 years who identified as something other than heterosexual. Focus groups explored social norms regarding contraceptive care; interviews documented individual experiences with contraceptive care. Using a qualitative descriptive approach and combined deductive and inductive content analysis, investigators coded transcripts for themes related to disclosing sexual orientation to contraceptive providers. RESULTS Participants described the process of sexual identity disclosure in contraceptive care in three stages: 1) listening for whether, when, and how health care providers asked about sexual orientation, 2) deciding whether or not to disclose sexual identity to providers, and 3) evaluating responses from providers after disclosure. Participants wanted providers to: avoid assumptions and ask about both sexual identity and sexual behaviors, signal their openness and competence around the health of sexual minority women during contraceptive encounters, and focus discussions on the individual patient's priorities and needs for contraceptive care. CONCLUSION Decisions made by sexual minority women about sexual identity disclosure in contraceptive contexts are influenced by previous and current interactions with health care providers. Contraceptive providers should ask all patients about sexual identity and sexual behavior, avoid assumptions about use of and need for contraception, and acknowledge the prevalence of marginalization, discrimination, and stigma experienced by sexual minority women and their communities in health care contexts.
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Affiliation(s)
- Madelyne Z Greene
- Schools of Medicine and Public Health and Social Work and the Department of Gender and Women's Studies, University of Wisconsin-Madison, Madison, Wisconsin; the University of Chicago School of Medicine, Chicago, Illinois; and the Department of Sociology, University of Utah, Salt Lake City, Utah
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Tan RKJ, Teo AKJ, Kaur N, Harrison-Quintana J, Wong CS, Chen MIC. Extent and selectivity of sexual orientation disclosure and its association with HIV and other STI testing patterns among gay, bisexual and other men who have sex with men. Sex Transm Infect 2019; 95:273-278. [PMID: 30918119 PMCID: PMC6585276 DOI: 10.1136/sextrans-2018-053866] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/14/2019] [Accepted: 02/16/2019] [Indexed: 01/27/2023] Open
Abstract
Objectives Gay, bisexual and other men who have sex with men (GBMSM) in Singapore may fear disclosing their sexual orientation to others due to negative societal attitudes, and the law that criminalises sexual relations between men, which may, in turn, impede access to HIV/sexually transmitted infection (STI)-related health services. This study attempts to determine how selective disclosure to varying social groups, and the extent of disclosure, may serve to impact HIV/STI testing patterns among GBMSM. Methods In this observational study, we recruited GBMSM in Singapore through an online cross-sectional survey disseminated via the smartphone app Grindr from 14 January to 11 February 2018. Respondents provided information on their sociodemographic characteristics, disclosure of sexual orientation towards other lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals, non-LGBTQ family members, non-LGBTQ friends and non-LGBTQ colleagues, along with their HIV/STI testing patterns. Extent of disclosure was defined as the number of social groups that a participant had disclosed his sexual orientation to. Statistical analyses were conducted through descriptive statistics, multivariable binary, ordinal, and multinomial logistic regression models. Results We recruited 1339 respondents, of which 1098 who had provided their response to questions on HIV/STI testing were included in the analytic sample. Multivariable analyses indicated that disclosure towards non-LGBTQ family members (adjusted OR [aOR] 1.85, 95% CI 1.12 to 3.07) and other LGBTQ individuals (aOR 1.63, 95% CI 1.12 to 2.37) were positively associated with recent HIV testing, whereas disclosure towards non-LGBTQ colleagues (aOR 1.56, 95% CI 1.09 to 2.22) was positively associated with regular HIV testing. Extent of disclosure exhibited a positive, dose–response relationship with all testing outcomes. Conclusions Results indicate how the fear of being identified as an LGBTQ individual may deter GBMSM from getting tested for HIV and other STIs. Health services should bridge the gaps to accessing healthcare among individuals who fear being stigmatised for attending sexual health-specific clinics or being identified as GBMSM.
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Affiliation(s)
- Rayner Kay Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Alvin Kuo Jing Teo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Nashwinder Kaur
- National Centre for Infectious Diseases, Singapore, Singapore
| | | | - Chen Seong Wong
- National Centre for Infectious Diseases, Singapore, Singapore
| | - Mark I-Cheng Chen
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,National Centre for Infectious Diseases, Singapore, Singapore
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Venetis MK, Chernichky-Karcher S, Gettings PE. Disclosing Mental Illness Information to a Friend: Exploring How the Disclosure Decision-Making Model Informs Strategy Selection. HEALTH COMMUNICATION 2018; 33:653-663. [PMID: 28281785 DOI: 10.1080/10410236.2017.1294231] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Within the context of mental illness disclosure between friends, this study tested the disclosure decision-making model (DD-MM; Greene, 2009) to comprehensively investigate factors that predict disclosure enactment strategies. The DD-MM describes how individuals determine whether they will reveal or conceal non-visible health information. Processes of revealing, called disclosures, take various forms including preparation and rehearsal, directness, third-party disclosure, incremental disclosures, entrapment, and indirect mediums (Afifi & Steuber, 2009). We explore the disclosure decision-making process to understand how college students select to disclose their mental illness information with a friend. Participants were 144 students at a Midwestern university who had disclosed their mental illness information to a friend. Structural equation modeling analyses revealed that college students choose strategies based on their evaluation of information assessment and closeness, and that for some strategies, efficacy mediates the relationship between information assessment and strategy. This manuscript discusses implications of findings and suggests direction for future research.
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Hudak NC, Carmack HJ. Waiting for the doctor to ask: influencers of lesbian, gay, and bisexual identity disclosure to healthcare providers. QUALITATIVE RESEARCH IN MEDICINE & HEALTHCARE 2018. [DOI: 10.4081/qrmh.2018.7157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Lesbian, gay, and bisexual (LGB) individuals encounter multiple barriers in healthcare, resulting in problematic care. Many LGB patients wrestle with whether to disclose their sexuality to healthcare providers. This article explored what influences LGB patients’ decision to disclose their sexuality to healthcare providers. Guided by Communication Privacy Management theory, the authors conducted in-depth interviews with 20 LGB patients. LGB patients heavily relied on boundary management when negotiating the disclosure of their sexuality. The findings suggest several factors influence LGB patients’ disclosure of sexuality: i) experience with family; ii) fear of gossip and connections; iii) concern for provider care refusal; iv) religion; v) age; and vi) level of trust with providers. Boundary turbulence can be created between patient and provider when there is uncertainty about if and when sexuality is considered private information. Additionally, a site of tension for LGB patients was their concern about providers sharing private information outside the clinic setting.
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Brooks H, Llewellyn CD, Nadarzynski T, Pelloso FC, De Souza Guilherme F, Pollard A, Jones CJ. Sexual orientation disclosure in health care: a systematic review. Br J Gen Pract 2018; 68:e187-e196. [PMID: 29378698 PMCID: PMC5819984 DOI: 10.3399/bjgp18x694841] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 07/10/2017] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Significant health disparities between sexual minority individuals (that is, lesbian, gay, bisexual, or transgender [LGBT]) and heterosexual individuals have been demonstrated. AIM To understand the barriers and facilitators to sexual orientation (SO) disclosure experienced by LGBT adults in healthcare settings. DESIGN AND SETTING Mixed methods systematic review, including qualitative, quantitative, and mixed methods papers following PRISMA guidelines. METHOD Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT) and a qualitative synthesis was performed. Studies were included if their participants were aged ≥18 years who either identified as LGBT, had a same-sex sexual relationship, or were attracted to a member of the same sex. RESULTS The review included 31 studies representing 2442 participants. Four overarching themes were identified as barriers or facilitators to SO disclosure: the moment of disclosure, the expected outcome of disclosure, the healthcare professional, and the environment or setting of disclosure. The most prominent themes were the perceived relevance of SO to care, the communication skills and language used by healthcare professionals, and the fear of poor treatment or reaction to disclosure. CONCLUSION The facilitators and barriers to SO disclosure by LGBT individuals are widespread but most were modifiable and could therefore be targeted to improve healthcare professionals' awareness of their patients' SO. Healthcare professionals should be aware of the broad range of factors that influence SO disclosure and the potential disadvantageous effects of non-disclosure on care. The environment in which patients are seen should be welcoming of different SOs as well as ensuring that healthcare professionals' communication skills, both verbal and non-verbal, are accepting and inclusive.
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Affiliation(s)
| | | | - Tom Nadarzynski
- Department of Psychology, University of Southampton, Southampton, UK
| | | | | | | | - Christina J Jones
- Department of Clinical Medicine, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
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Banerjee SC, Walters CB, Staley JM, Alexander K, Parker PA. Knowledge, Beliefs, and Communication Behavior of Oncology Health-care Providers (HCPs) regarding Lesbian, Gay, Bisexual, and Transgender (LGBT) Patient Health care. JOURNAL OF HEALTH COMMUNICATION 2018; 23:329-339. [PMID: 29521575 PMCID: PMC5961501 DOI: 10.1080/10810730.2018.1443527] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Delivery of culturally competent care toward lesbian, gay, bisexual, and transgender (LGBT) patients depends on how health-care providers (HCPs) communicate with them; however, research about knowledge, attitude, and behavior of HCPs toward LGBT patients is scant. The objectives of our study were to describe oncology HCPs' knowledge and examine if beliefs about LGB and transgender patients mediate the effects of LGBT health-care knowledge on open communication behaviors with LGB and transgender patients, respectively. A total of 1253 HCPs (187 physicians, 153 advance practice professionals (APPs), 828 nurses, and 41 others) at a Comprehensive Cancer Center completed an online survey that included the following measures: LGBT health-care knowledge, beliefs, communication behaviors, willingness to treat LGBT patients, encouraging LGBT disclosure, and perceived importance of LGBT sensitivity training. Only 50 participants (5%) correctly answered all 7 knowledge items, and about half the respondents answered 3 (out of 7) items correctly. Favorable beliefs about LGBT health care mediated the effect of higher LGBT health-care knowledge on open communication behaviors with transgender patients, controlling for effects of type of profession, religious orientation, gender identity, sexual orientation, and having LGBT friends/family. The results of this study demonstrated an overall lack of medical knowledge and the need for more education about LGBT health care among oncology HCPs.
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Affiliation(s)
- Smita C Banerjee
- a Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center , New York , NY , USA
| | - Chasity B Walters
- b Office of the Physician-in-Chief, Memorial Sloan-Kettering Cancer Center , New York , NY , USA
| | - Jessica M Staley
- a Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center , New York , NY , USA
| | - Koshy Alexander
- c Department of Medicine , Memorial Sloan-Kettering Cancer Center , New York , NY , USA
| | - Patricia A Parker
- a Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center , New York , NY , USA
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