Sense of coherence as a protective factor for psychological distress among gay men: a prospective cohort study

Psychological factors and the use of psychoactive substances in relation to sexual orientation: A study on Israeli young adults

In the context of sexual minorities and the distress they may experience, recent years have witnessed a trend emphasizing the idea that protective factors may curb risk behaviors, while stressing that not all sexual minorities do experience distress. However, protective factors have been studied less frequently than have risk factors. To the extent that protective factors are identified among those at risk for psychological distress and risk behaviors, strategies can seek to address risk by enhancing these protective factors. The current study aimed to expand the knowledge in this area by simultaneously examining protective and risk factors as well as by examining the association between sexual orientation, psychological distress, sense of coherence (SOC), social support (e.g., parental and peer relationships), and alcohol and cannabis use among Israeli young adults. A self-reported questionnaire was distributed to 496 young adults: 254 heterosexual participants and 242 homosexual participants. As hypothesized, participants with a same-sex orientation reported higher psychological distress, lower SOC, a weaker relationship with their parents, and a greater use of alcohol and cannabis than did heterosexual participants. Regression analyses indicated that low SOC, low family support, and low peer support predicted higher psychological distress. However, sexual orientation was not found to predict distress levels among young adults in Israel. Similarly, no associations were found between alcohol and cannabis use and psychological distress. The results are discussed within the framework of resilience factors that can serve as a barrier to distress and to the use of psychoactive substances among young adults in general and sexual minorities in particular.

Risk and Protective Factors for Social Anxiety Among Sexual Minority Individuals

Minority stress processes represent clear determinants of social anxiety among sexual minority populations. Yet sources of resilience to social anxiety are less explored as are stressors experienced from within sexual minority communities (i.e., intraminority stress). Based on minority stress theory and the psychological mediation framework, we hypothesized that experiences of discrimination and intraminority stress would predict proximal minority stress processes, including internalized homonegativity, sexual concealment behavior, and rejection sensitivity, as well as two resilience factors-sense of coherence and LGBTQ community connectedness-to explain social anxiety among sexual minority individuals. Self-identified cisgender sexual minority women (n = 245) and men (n = 256) residing in the Republic of Ireland completed an online survey. Results from a structural equation modeling analysis indicated that the data fit the hypothesized model well for both women and men. For both sexual minority women and men, experiences of discrimination and intraminority stress were indirectly associated with social anxiety via two paths (1) increased rejection sensitivity and (2) reduced sense of coherence. Intraminority stress was indirectly associated with social anxiety via increased concealment behavior for sexual minority men only. Experiences of discrimination were indirectly associated with social anxiety via a sequential pathway through increased proximal minority stress (i.e., concealment behavior and internalized homonegativity), and reduced LGBTQ community connectedness solely among sexual minority women. Findings are discussed in terms of implications for future research and clinical practice with sexual minority individuals who suffer from social anxiety.

Aging Perceptions in Older Gay and Bisexual Men in Portugal: A Qualitative Study

Aims and Objectives The purpose of this study was to explore the perceptions toward aging among Portuguese gay and bisexual men over 60 years old. Background Despite the growth of the older population, and the increased visibility and acceptance of lesbian, gay, and bisexual people in Western countries, the experience of aging in older gay and bisexual men is only beginning to be understood. Design We used a qualitative research methodology, based on critical gerontology, for establishing research questions and to identify the perspectives on the aging process in older gay and bisexual individuals. Methods We used a structured electronic inquiry with 25 gay and bisexual men over 60 years of age from Portugal. Data were analyzed using thematic analysis to help identify repeated patterns of meaning in the data set. Results The recurrent themes in the narratives of the aging experiences of the participants in the study were as follows: positive perceptions of aging, negative perceptions of aging, coping with being a gay/bisexual man and family ties, professional care, homophobia/discrimination, relationships and social support, intergenerational differences, mediating role of sexual orientation, sociopolitical changes, and personal characteristics. Conclusion Analysis of perceptions about the aging process in older gay and bisexual men emphasized the desire for normalization in the social awareness of sexual orientation. It is important to continue doing research on this topic and disseminate this information among professionals who work with older lesbian, gay, and bisexual people so that they may better understand how they can meet the specific needs of this population.

HIV Futures 8: Protocol for a Repeated Cross-sectional and Longitudinal Survey of People Living with HIV in Australia

Introduction

More than 27,000 Australians currently live with HIV. Most of these people have access to quality clinical care and antiretroviral treatment (ART) and can expect good general health. However, HIV-related stigma is a problem and many people living with HIV experience poorer than average mental health. Issues of aging are also of increasing concern. This paper describes the methods and sample for the HIV Futures 8 study, a national survey of people living with HIV in Australia that aimed to identify factors that support health and well-being among this population. HIV Futures 8 forms part of a series of cross-sectional surveys (The “HIV Futures” studies) that have been repeated periodically since 1997. In the most recent survey, participants were able to opt into a prospective longitudinal study.

Materials and equipment

HIV Futures 8 was open to people aged over 17 who were living with HIV. Data were collected in 2015/2016 using a self-complete survey that contained approximately 250 items related to physical and mental health, use of ART, HIV exposure and testing, financial security, social connectedness, relationships, life satisfaction, resilience, stigma, use of health and support services, and health literacy. To enable comparison of cross-sectional data over time, questionnaire items were consistent with those used in previous HIV Futures surveys. In HIV Futures 8, participants were invited to volunteer coded information that will allow longitudinal follow-up when participants complete subsequent HIV Futures surveys. The survey was advertised through the networks of HIV organizations, on social media and through HIV clinics and services. HIV Futures 8 was completed by 895 participants. This represents approximately 3.8% of the total number of people living with diagnosed HIV in Australia in 2014.

Expected impact of the study on public health

Findings from HIV Futures 8 will contribute important insights into the complexity of factors that support physical and mental well-being among people living with HIV. The findings will also assist HIV services to align with broader public health goals related to increasing ART use and improving quality of life among people living with HIV.

Social Support and the Mental Health of Older Gay Men: Findings From a National Community-Based Survey

This study examines different types and sources of social support in relation to psychological distress levels among older Australian gay men. A national community-based survey was conducted involving 242 gay-identified men aged 50 years and older. In univariable regressions, psychological distress was less likely if men were receiving emotional support, practical support, or had a sense of belonging, and also if they had a greater number of close friends and received some or a lot of support from family and gay friends but not from straight friends. Of all these factors, a multivariable regression showed that receiving emotional support was the only significant independent factor. Emotional support appears to play a greater role in the mental health of older gay men than many other types and sources of support. Ensuring access to emotional support may need to be considered when promoting healthier aging among gay men.

Assessing the applicability of e-therapies for depression, anxiety, and other mood disorders among lesbians and gay men: analysis of 24 web- and mobile phone-based self-help interventions

Background

Lesbians and gay men have disproportionately high rates of depression and anxiety, and report lower satisfaction with treatments. In part, this may be because many health care options marginalize them by assuming heterosexuality, or misunderstand and fail to respond to the challenges specifically faced by these groups. E-therapies have particular potential to respond to the mental health needs of lesbians and gay men, but there is little research to determine whether they do so, or how they might be improved.

Objective

We sought to examine the applicability of existing mental health e-therapies for lesbians and gay men.

Methods

We reviewed 24 Web- and mobile phone-based e-therapies and assessed their performance in eight key areas, including the use of inclusive language and content and whether they addressed mental health stressors for lesbians and gay men, such as experiences of stigma related to their sexual orientation, coming out, and relationship issues that are specific to lesbians and gay men.

Results

We found that e-therapies seldom addressed these stressors. Furthermore, 58% (14/24) of therapies contained instances that assumed or suggested the user was heterosexual, with instances especially prevalent among better-evidenced programs.

Conclusions

Our findings, and a detailed review protocol presented in this article, may be used as guides for the future development of mental health e-therapies to better accommodate the needs of lesbians and gay men.