Loneliness in sexual minority and heterosexual individuals: a comparative meta-analysis

Self-Disclosure of Loneliness by LGBTQ+ Twitter Users During COVID-19

Mental health in LGBTQ+ community is often challenged by stigma, prejudice, and discrimination. The "social distancing" public health measures during COVID-19 epidemic have exacerbated the trend. During the pandemic, many took to social media as an outlet for sharing their feelings and in search of connection. Social media may help alleviate loneliness-an increasingly prevalent condition associated with both physical and mental health issues. In this study, we examine 147,736 Twitter posts mentioning loneliness by users who self-identify as part of the LGBTQ+ community, posted before and during the COVID-19 lockdowns. We find that, compared to the year before COVID-19, these users posted 67% more loneliness self-disclosures during the first year of COVID-19. Examining the emotional content of these tweets, we find frequent references to depression, dysphoria, and suicidal ideation. During COVID-19, the users mentioned more "pain" and "numbness" in association with the lack of social and physical contact. However, many found Twitter to be a safe space to express these feelings. The replies to these disclosures were rare: only about 29% received one. Using a large dataset of self-disclosures, we reveal quantitatively and qualitatively the disclosure around loneliness by LGBTQ+ users at an unprecedented time of social isolation.

Religious Affiliation, Internalized Homonegativity and Depressive Symptoms: Unveiling Mental Health Inequalities among Brazilian Gay Men

INTRODUCTION

Different religious narratives associate same-sex sexuality, in its various manifestations, with moral deviation or sin. Gay men who are socialized in more religious communities appear to experience and internalize greater levels of homonegativity, as well as to present greater indicators of depressive symptoms. The purpose of this study was to evaluate indicators of perceived homonegativity in the community and internalized, and signs/symptoms of depression reported by Brazilian gay men with a nominal religion and compare them to those reported by Atheists or Agnostics.

METHOD

Our sample comprised 194 Brazilian gay men, distributed into three groups: Christians (Protestants and Catholics, n = 71; 36.6%); Spiritualists (Kardecists or religions of African origin, n = 52; 26.8%) and Atheists or Agnostics (n = 71; 36.6%). The following measurement instruments were used: sociodemographic questionnaire, Internalized Homophobia Scale and Beck Depression Scale.

RESULTS

High mean scores of depression were verified in all groups, and 60% of the sample presented some level of depression. There was a higher level of self-reported homonegativity among Christians and Spiritualists compared to that reported by Atheists or Agnostics, with the differences between the groups being significant. The regression analysis indicated a significant effect of religion on homonegativity, but not on depression.

CONCLUSION

Our results suggest that gay men's chronic exposure to non-affirming religious affiliation contexts may harm the construction of a positive gay identity and should be taken into consideration when addressing mental health inequalities of sexual minorities.

Ethnic and sexual orientation inequalities in mental health-obesity comorbidity, self-harm, and attempted suicide among British adolescents

PURPOSE

Mental illness and obesity (MH-OB) may co-occur in adolescence and have a strong risk to track into adulthood. Using an intersectional framework, we explored associations between ethnic-sexual identities and MH-OB comorbidity in adolescents. We examined the risk of self-harm (SH) and attempted suicide (AS) by comorbidity status and ethnic-sexual identities.

METHODS

Participants included 9,789 adolescents (aged 17 years) from the UK-wide Millennium Cohort Study with data on self-identified ethnicity and sexuality. Participants were categorised as White-heterosexual, White-sexual minority (SM), Ethnic Minority (EM) heterosexual or EM-SM adolescents. We used multivariable logistic regression to examine associations between 1.dual ethnic-sexual identities and MH-OB comorbidity, 2.risk for self-harm (or attempted suicide) in relation to comorbidity and ethnic-sexual identities (including interactions between the comorbidity and ethnic-sexual identities variables to assess whether risk for self-harm differed by ethnic-sexual identities and comorbidity status).

RESULTS

Comorbidity was higher among White-SM (OR = 3.73, 95%CI 2.42-5.75) and EM-SM (OR = 1.96, 1.03-3.73) adolescents. SM identities (OR = 3.02, 2.41-3.78 for White-SM) and having comorbidity (OR = 2.83, 2.03-3.95) were independently associated with SH or AS. Risk of SH among White-heterosexual individuals was greater among comorbid individuals (40%) relative to non-comorbid individuals (19%). Risk of SH was higher in SM individuals (58% vs. 41% in White-SM and 50% vs. 29% in EM-SM individuals with and without comorbidity, respectively). Risk of AS was 5% and 19% in comorbid and non-comorbid White-heterosexual individuals, respectively; the corresponding figures for White-SM individuals were 14% and 17%.

CONCLUSION

Irrespective of ethnicity, SM adolescents have a significantly greater risk of SH and AS. Comorbidity further amplifies this risk.

A Multigroup Structural Equation Modeling Approach for Analyzing Differences Among Sexually Diverse Youth

High rates of negative behavioral health outcomes among sexually diverse (SD) youth are consistently documented, but population-level trends obscure within-group differences. Social dynamics intersect in youths' lives in ways that cannot be accounted for by summing their independent effects. An intersectional perspective is essential to understanding the behavioral health outcomes of SD youth. We performed multigroup structural equation modeling using an SD subset of New Mexico Youth Risk and Resiliency Survey (N = 10,037) respondents to examine the moderating role of supportive adult relationships for lesbian, gay, and bisexual youth across 12 intersecting (sexual orientation by race/ethnicity by sex) identity categories. Standardized estimates show that supportive relationships are associated with moderate reductions in psychological distress among lesbians (β = -0.459 for Native, β = -0.303 for Hispanic, and β = -0.421 for white) and female bisexual youth (β = -0.352 for Native, β = -0.376 for Hispanic, and β = -0.393 for white). Among male youth, supportive relationships are associated with reduced likelihood of substance use for gay (β = -0.330 for Native, β = -0.464 for Latinx and β = -0.591 for white) and bisexual youth (β = -0.442 for Native, β = -0.306 for Latinx and β = -0.290 for white). This study challenges monolithic characterizations of SD youth, illustrating that the health-promotive benefits of support differ based on sexual orientation, race/ethnicity, and sex.

The role of loneliness in the association between sexual orientation and depressive symptoms among older adults: A prospective cohort study

BACKGROUND

This study aims to understand the mechanisms contributing to the elevated risk of depression among sexual minority older adults compared to heterosexuals. Specifically, the role of loneliness as a potential mediator is investigated to inform targeted interventions for preventing depression in sexual minority populations.

METHODS

Data from the English Longitudinal Study of Ageing, focusing on adults aged over 50, were analysed. Sexual orientation (sexual minority or heterosexual) and loneliness scores (UCLA scale) were assessed at wave six (2010-2011), while depressive symptoms (CESD) were assessed at wave seven (2013-14). Linear regression models and mediation analyses, using g-computation formula and adjusted for confounders, were conducted.

RESULTS

The sample included 6794 participants, with 478 (7.0 %) identifying as sexual minorities. After adjustments, sexual minorities scored higher on depressive symptoms at wave seven (mean difference): 0.23, 95 % CI 0.07 to 0.39) and loneliness at wave six (MD: 0.27, 95 % CI 0.08 to 0.46). Loneliness was positively associated with depressive symptoms (coefficient: 0.27, 95 % CI 0.26 to 0.29). In mediation analyses, loneliness explained 15 % of the association between sexual orientation and subsequent depressive symptoms.

LIMITATIONS

The dataset used sexual behaviour rather than desire and identity, potentially skewing representation of sexual minorities. Additionally, transgender older adults were not included due to limited gender diversity reported within the ELSA dataset.

CONCLUSIONS

Loneliness appears to be a significant modifiable mechanism contributing to the heightened risk of depressive symptoms in sexual minority older adults compared with their heterosexual counterparts.

Loneliness, Lack of Social and Emotional Support, and Mental Health Issues - United States, 2022

Loneliness and lack of social connection are widespread and negatively affect physical and mental health and well-being. Data are limited for persons disproportionately affected by social disconnection, especially those who do not identify as heterosexual and cisgender. Using data from the 2022 Behavioral Risk Factor Surveillance System in 26 U.S. states, CDC examined associations of loneliness and lack of social and emotional support to mental health variables. Prevalence estimates for the mental health variables were significantly higher among adults who reported loneliness and lack of social and emotional support than among those adults who did not. The prevalence of loneliness was highest among respondents who identified as bisexual (56.7%) and transgender (range = 56.4%-63.9%). Prevalence of lack of social and emotional support was highest among those who identified as transgender female (44.8%), transgender gender nonconforming (41.4%), and those with household income below $25,000 (39.8%). Prevalences of stress, frequent mental distress, and history of depression were highest among bisexual (34.3%-54.4%) and transgender adults (36.1%-67.2%). Addressing the threat to mental health among sexual and gender minority groups should include consideration of loneliness and lack of social and emotional support. Providing access to health services that are affirming for sexual and gender minority groups and collecting data to address health inequities might help improve the delivery of culturally competent care.

Loneliness, Methamphetamine Use, and Cardiovascular Risk Factors Among Sexual Minority Men in the COVID-19 Era

BACKGROUND

Important gaps exist in our understanding of loneliness and biobehavioral outcomes among sexual minority men (SMM), such as faster HIV disease progression. At the same time, SMM who use methamphetamine are approximately one-third more likely than non-users to develop cardiovascular disease. This study examined associations of loneliness, stimulant use, and cardiovascular risk in SMM with and without HIV.

METHOD

Participants were enrolled from August 2020 to February 2022 in a 6-month prospective cohort study. The study leveraged self-report baseline data from 103 SMM, with a subset of 56 SMM that provided a blood sample to measure markers of cardiovascular risk.

RESULTS

Loneliness showed negative bivariate associations with total cholesterol and LDL cholesterol in the cardiometabolic subsample (n = 56). SMM with methamphetamine use (t(101) = 2.03, p < .05; d = .42) and those that screened positive for a stimulant use disorder (t(101) = 2.07, p < .05; d = .46) had significantly higher mean loneliness scores. In linear regression analyses, negative associations of loneliness with LDL and total cholesterol were observed only among SMM who used methamphetamine.

CONCLUSION

We observed lower cholesterol in SMM reporting loneliness and methamphetamine use. Thus, in addition to the observed associations of loneliness with cholesterol, there are important medical consequences of methamphetamine use including cardiovascular risk, higher HIV acquisition risk and progression, as well as stimulant overdose death. This cross-sectional study underscores the need for clinical research to develop and test interventions targeting loneliness among SMM with stimulant use disorders.

Young people's views on the acceptability and feasibility of loneliness interventions for their age group

BACKGROUND

Loneliness is a frequently reported problem for young people aged 16 to 24 years old. A variety of interventions have been developed (but in most cases not extensively evaluated) to try and tackle loneliness in this age group. These include interpersonal, intrapersonal, and social approaches that vary in their content and mechanisms of action. The current study aimed to qualitatively examine young peoples' views on the acceptability and feasibility of different loneliness interventions.

METHODS

Young people from 16 to 24 years old living in the United Kingdom who self-identified as having experienced loneliness were recruited to participate in this study. We conducted semi-structured qualitative interviews to assess their views on the acceptability and feasibility of loneliness interventions for their age group. Interviews were analysed using inductive reflexive thematic analysis.

RESULTS

Our analysis of 23 individual interview transcripts identified six themes. These related to the appropriate stage for intervention and how different types of strategies may be best suited to particular contexts; the key facilitators and barriers to engaging young people in an intervention; considerations for optimising the delivery of an intervention; divergent views on technology use in strategies to manage loneliness; the scope of an intervention and whether it takes a targeted or general approach; and the idea of combining different options within an intervention to allow tailoring to individual preferences and nature of loneliness.

CONCLUSIONS

These findings demonstrate the need for continued development of individualised interventions designed to help manage loneliness in this age group. Future loneliness strategies should be co-produced with young people to ensure that they suit the varying needs of this population.

Sexual Minority Status and Psychotic Experiences Among Young Adult College Students in the United States

2020-2021 Healthy Minds Study, and used multivariable logistic regression to examine the associations between sexual minority status and psychotic experiences, adjusting for age, gender, and race/ethnicity. We then tested whether psychosocial factors accounted for the association. Sexual minority status was associated with 1.87 times greater odds of having psychotic experiences over the past 12 months (aOR: 1.87; 95% CI: 1.77-1.99; N = 110,551). Several factors mediated the association between sexual orientation and psychotic experiences such as loneliness (26.93%), anxiety (30.90%), depression (33.18%), and marijuana use (13.95%); all factors together accounted for 59.01% of the association between sexual minority status and psychotic experiences. Food insecurity, recent abuse, and discrimination did not significantly mediate the association. Findings should raise clinical awareness that psychotic experiences are more common among sexual minorities than among heterosexuals, which is largely explained by mental health factors, calling for targeted outreach and intervention.

Characterizing Social Connectedness and Associated Mental Health Symptoms among Sexual Minority Men Enrolled in a Substance Use Recovery Support Program

BACKGROUND

Sexual minority men (SMM; gay, bisexual, and other men who have sex with men) report higher rates of substance use compared to other populations. Social connectedness is a critical component for promoting and maintaining recovery from substance use disorders. However, the degree of social connectedness among SMM who report substance use is largely unknown.

OBJECTIVES

We examined substance use, social connectedness (past 30-d participation in formal recovery support, past 30-d interaction with supportive family/friends, relationship satisfaction, and types of support) and mental health among SMM at the time of their enrollment in a behavioral substance use program from September 2019 to October 2021.

RESULTS

Of the107 SMM, 80% of the sample reported past 30-d illicit substance use, with methamphetamine representing the most commonly reported drug used (53%). Participants used a variety of social connections for support, including self-help groups (44% voluntary; 5% religious-affiliated; 20% other) and family/friends (81%). Importantly, 15% reported they had no one to turn to when having trouble and 36% were either dissatisfied or very dissatisfied with their relationships. Participants who endorsed significant depressive (58%) and anxiety (70%) symptoms were more likely to endorse relationship dissatisfaction than participants who did not endorse symptoms (p < 0.01).

CONCLUSIONS

One-third of SMM enrolled in a substance use recovery program expressed relationship dissatisfaction, particularly those struggling with depression or anxiety. Future research and programming should examine ways of leveraging existing social connectedness or forging new social supports to enhance mental health and substance use recovery for SMM using substances.

The Experience of Loneliness Among Gay Men in Israel: A Qualitative Study

The aim of this qualitative study is to explore the experience of loneliness among Israeli gay men in their early and mid-adulthood, ages 30-50 (N = 14). The findings demonstrate three main categories of loneliness that study participants experienced: childhood loneliness as an initial experience of gay identity; loneliness in the context of other gay men, via sexual encounters, friendships, and the use of dating apps; and loneliness in the context of heterosexual society. The findings point to the centrality of the experience of loneliness among Israeli gay men in their mid-adulthood years and emphasize how this loneliness is rooted in socio-cultural and political perceptions concerning hetero-normative as well as gay identities.

Neighbourhood effects on loneliness among adolescents

BACKGROUND

Loneliness is a growing public health concern, but little is known about how place affects loneliness, especially during adolescence. This is the first study to examine the influence of neighbourhoods on loneliness in early-to-mid adolescence.

METHODS

Baseline data from the #BeeWell cohort study in Greater Manchester (England), including 36 141 adolescents (aged 12-15 years) across 1590 neighbourhoods, were linked to neighbourhood characteristics using administrative data at the level of lower super output areas and analysed using multilevel regression.

RESULTS

Neighbourhood differences explained 1.18% of the variation in loneliness. Ethnic, gender and sexual orientation inequalities in loneliness varied across neighbourhoods. Several neighbourhood characteristics predicted loneliness at the individual level, including skills deprivation among children and young people, lower population density and perceptions of the local area (feeling safe; trust in local people; feeling supported by local people; seeing neighbours as helpful; the availability of good places to spend free time). Finally, a longer distance from home to school was associated with significantly higher loneliness.

CONCLUSIONS

Neighbourhoods account for a small but significant proportion of the variation in adolescent loneliness, with some neighbourhood characteristics predicting loneliness at the individual level, and loneliness disparities for some groups differing across neighbourhoods.

Problematic Substance Use among Sexual Minority and Heterosexual Young Adults during COVID-19

Sexual minority young adults (SMYAs), compared to heterosexual young adults (HYAs), are a uniquely high-risk population for problematic substance use, a disparity perhaps exacerbated by the COVID-19 pandemic. This study tested whether SMYAs had more problematic substance use than HYAs during the pandemic due to isolation and loneliness as well as lower family closeness. Participants (N = 141) aged 23-29 completed self-report surveys in 2014-2015 as college students and in the summer of 2021 as young adults (59% White, 26% Black/African American, 9% Asian/Middle Eastern, 6% Hispanic/Latino, and <1% American Indian/Alaska Native). Results of multivariate regression and multiple group path analyses did not support hypothesized effects-SMYAs did not have greater increases in problematic substance use compared to HYAs, isolation and loneliness were not significant mediators, and family closeness was not a significant moderator. However, SMYAs experienced a lack of social safety-increased loneliness and decreased family closeness-compared to HYAs. Further research is needed to investigate both the impact and underlying processes of this decreased social safety on SMYA well-being beyond the pandemic to better inform tailored supports and interventions.

Supporting LGBTIQA+ communities in small rural settings: a case study of health promotion in a community health service

People from LGBTIQA+ communities living in rural areas experience significant disparities across a range of health and wellbeing indicators, high levels of stigma and discrimination, and difficulty accessing inclusive health and support services. This article discusses a targeted health promotion intervention designed to build supportive health and social programs to address these problems. We describe the initial needs assessment undertaken to inform the intervention, the role and activities of the health promotion officer funded through the program, and present evaluation data on program outcomes. The article demonstrates that modest funding for health promotion can make a positive contribution to connecting and supporting individuals in a small regional community, leading to better health and wellbeing outcomes.

The Relationship between Minority Stress and Depressive Symptoms in the LGBTQA Population from Poland

The cross-sectional study examines minority stress and depression symptoms regarding various sexual and gender minority (SGM) identities in lesbian, gay, bisexual, transgender, queer, and asexual (LGBTQA) individuals from Poland. The online survey was conducted among 509 people. Participants aged between 18 and 47 (M = 22.39, SD = 4.78). Gender identity included 262 cisgender women, 74 cisgender men, 31 transgender women, 53 transgender men, and 89 nonbinary individuals. Sexual identity comprises 197 bisexual, 150 homosexual, 78 pansexual, 33 asexual, 21 undefined, 14 heterosexual, 9 demisexuals, 6 queer, and 1 sapiosexual individual. The Daily Heterosexist Experiences Questionnaire (DHEQ) and the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) were used to measure minority stress and depression symptoms, respectively. Among LGBTQA participants, 99.80% declared minority stress at least once during the past year. In particular, vicarious trauma was experienced in 99.80% of participants, vigilance in 95.87%, harassment and discrimination in 80.35%, stress related to the family of origin in 69.16%, and to gender expression in 68.76% of respondents. Depression symptoms were found in 62.50% of respondents. Significantly higher rates of depression and minority stress were presented in dual than single SGM individuals. Binomial logistic regression showed that such sources of minority stress as vigilance, harassment, and gender expression could predict depression symptoms. Therefore, prevention and intervention programs should be designed for the LGBTQA population focusing on coping with these sources of minority stress, especially among those of dual SGM identity.

Mental health and loneliness in Scottish schools: A multilevel analysis of data from the health behaviour in school-aged children study

BACKGROUND

Adolescent loneliness and poor mental health represent dual public health concerns. Yet, associations between loneliness and mental health, and critically, how these associations vary in school settings are less understood.

AIMS

Framed by social-ecological theory, we aimed to identify key predictors of adolescent mental health and examine school-level variation in the relationship between loneliness and mental health.

SAMPLE

Cross-sectional data on adolescents from the 2018 wave of the Health Behaviour in School-aged Children study (HBSC) in Scotland were used (N = 5286).

METHODS

Mental health was measured as a composite variable containing items assessing nervousness, irritability, sleep difficulties and feeling low. Loneliness was measured via a single item assessing how often adolescents felt 'left out'. Multilevel models were used to identify social-ecological predictors of mental health, associations with loneliness and between-school variation.

RESULTS

Loneliness, as well as demographic, social and school factors, was found to be associated with mental health. Mental health varied across schools, with the between-school difference greater among adolescents with high levels of loneliness. Additionally, the negative effect of loneliness on mental health was stronger in schools with lower average mental health scores.

CONCLUSIONS

The findings suggest that schools can play an important role in shaping adolescent mental health. Our study uniquely identifies that school-based interventions targeting mental health may be especially necessary among lonely adolescents, and programmes aimed at tackling loneliness may be more beneficial in schools with poorer mental health.

Insights into barriers and facilitators in PrEP uptake and use among migrant men and transwomen who have sex with men in Belgium

BACKGROUND

PrEP uptake is low among non-Belgian men and transwomen who have sex with men, although the HIV epidemic among men who have sex with men in Belgium is diversifying in terms of nationalities and ethnicity. We lack an in-depth understanding of this gap.

METHODS

We conducted a qualitative study using a grounded theory approach. The data consists of key informants interviews and in-depth interviews with migrant men or transwomen who have sex with men.

RESULTS

We identified four underlying determinants which shape our participants' experiences and contextualize the barriers to PrEP use. These include (1) the intersectional identities of being migrant and men and transwomen who have sex with men, (2) migration related stressors, (3) mental health and (4) socio-economic vulnerability. Identified barriers include: the accessibility of services; availability of information, social resources and providers' attitudes. These barriers influence PrEP acceptance and mediated by individual agency this influences their PrEP uptake.

CONCLUSION

An interplay of several underlying determinants and barriers impacts on PrEP uptake among migrant men and transwomen who have sex with men, illustrating a social gradient in access to PrEP. We need equitable access to the full spectrum of HIV prevention and care for all priority populations, including undocumented migrants. We recommend social and structural conditions that foster exercising these rights, including adapting PrEP service delivery, mental health and social support.

Shiver Me Tinders and Ring a Ding for a Fling-Sex Tech Use during COVID-19: Findings from a UK Study

Existing research surrounding dating apps has primarily focused on younger people with few studies exploring usage of such apps by middle aged and older adults. The worldwide COVID-19 pandemic challenged social behaviours and forced people to adapt intimacy and wider relationship conduct. The objective of this study was to examine how older adults utilized dating apps during the lockdowns of the UK pandemic (December 2020-May 2021). Findings presented here focus on qualitative data collected from an online survey and eight online, one-to-one interviews with adults aged 40-54 years. The online survey targeted adults across the UK while interviewees were located across England. Employing interpretative phenomenological analysis, findings identified three key themes: 1. Morality, health, and law breaking and COVID-19; 2. Self-surveillance and moral signalling; 3. Loneliness and social isolation. Qualitative findings show engaging with apps was a proxy which alleviated feelings of loneliness and social isolation. Some users used the premise of their social bubble as a way of meeting other people. Using the same premise, others justified breaking the law to engage in physical and sexual intimacy to mitigate their loneliness. The work presented here contributes to the fields of social sciences, gerontology, and human computer interaction. The inter- and multi-disciplinary impact of this study intersects across those fields and offers a cross-sectional insight into behaviours and engagement with technology during one of the most extraordinary global events.

Retrospective cross-sectional study examining the association between loneliness and unmet healthcare needs among middle-aged and older adults using the Canadian Longitudinal Study of Aging (CLSA)

OBJECTIVES

Our primary objective was to estimate the association between loneliness and unmet healthcare needs and if the association changes when adjusted for demographic and health factors. Our secondary objective was to examine the associations by gender (men, women, gender diverse).

DESIGN, SETTING, PARTICIPANTS

Retrospective cross-sectional data from 44 423 community-dwelling Canadian Longitudinal Study on Aging participants aged 45 years and older were used.

PRIMARY OUTCOME MEASURE

Unmet healthcare needs are measured by asking respondents to indicate (yes, no) if there was a time when they needed healthcare in the last 12 months but did not receive it.

RESULTS

In our sample of 44 423 respondents, 8.5% (n=3755) reported having an unmet healthcare need in the previous 12 months. Lonely respondents had a higher percentage of unmet healthcare needs (14.4%, n=1474) compared with those who were not lonely (6.7%, n=2281). Gender diverse had the highest percentage reporting being lonely and having an unmet healthcare need (27.3%, n=3), followed by women (15.4%, n=887) and men (13.1%, n=583). In our logistic regression, lonely respondents had higher odds of having an unmet healthcare need in the previous 12 months than did not lonely (adjusted odd ratios (aOR) 1.80, 95% CI 1.64 to 1.97), adjusted for other covariates. In the gender-stratified analysis, loneliness was associated with a slightly greater likelihood of unmet healthcare needs in men (aOR 1.90, 95% CI 1.64 to 2.19) than in women (aOR 1.73, 95% CI 1.53 to 1.95). In the gender diverse, loneliness was also associated with increased likelihood of having an unmet healthcare need (aOR 1.38, 95% CI 0.23 to 8.29).

CONCLUSIONS

Loneliness was related to unmet healthcare needs in the previous 12 months, which may suggest that those without robust social connections experience challenges accessing health services. Gender-related differences in loneliness and unmet needs must be further examined in larger samples.

Examining Differences, Relationships, and Predictors for Loneliness in an Adult Population: The Roles of Personal Characteristics, Place of Residence, Leisure Activities, Mental Health, and Social Outcomes

Loneliness is associated with poor mental and social outcomes globally. The literature suggests an association between loneliness and personal characteristics, place of residence, and leisure activities. However, the current literature has produced inconsistent findings and has focused largely on older adults. This study is one of the first to examine the differences, relationships, and predictors of loneliness in an adult population, and the roles of personal characteristics, place of residence, leisure activities, mental health, and social outcomes. A cross-sectional online survey was undertaken. A sample of 155 adults responded, with a mean age of 34.5 years (SD = 13.2), and with 54.1% identifying as female. An analysis revealed experiences of loneliness across the sample. In addition, age was moderately associated with loneliness, while psychological distress, depressive symptoms, and social networks were significantly associated with loneliness. Depressive symptoms were a positive predictor for loneliness, and social networks were a negative predictor for loneliness. This study has confirmed findings from previous research and provided new information on loneliness, which can guide future research and interventions to prevent or support people who suffer from loneliness.

From Physical Distancing to Social Loneliness among Gay Men and Other Men Having Sex with Men in Belgium: Examining the Disruption of the Social Network and Social Support Structures

Since the start of the SARS-CoV-2 pandemic, levels of loneliness have increased among the general population and especially among sexual minorities, such as gay men and other men who have sex with men, who already experienced more problems with social isolation before the pandemic. We analyzed how the disruption of the social network and social support structures by containment measures impact loneliness among gay and other men having sex with men. Our sample consisted of gay and other men having sex with men who had in person communication with family as well as heterosexual friends and homosexual friends before the lockdown (N = 461). Multivariate regression analyses were performed with social provisions (social interaction and reliable alliance) and loneliness as dependent variables. A change from in-person communication with gay peers before the pandemic to remote-only or no communication with gay peers during the pandemic, mediated by change in social integration, was related to an increased feeling of loneliness during the pandemic compared with before the pandemic. There were some unexpected findings, which should be interpreted in the specific social context of the SARS-CoV-2 pandemic. On average, social integration and reliable alliance among MSM increased during the lockdown, even though in-person communication decreased and loneliness increased. Our results show it is critical to maintain a view of social support and social loneliness as lodged within larger social and cultural contexts that ultimately shape the mechanisms behind them.

Sexual minority status, religiosity, and suicidal behaviors among college students in the United States

BACKGROUND

Religiosity has been protective against suicidal behaviors, though it is unclear whether the protective effects extend to the high-risk group of sexual minorities.

METHODS

We analyzed data from the Healthy Minds Study, which was administered to college students enrolled in one of 140 campuses across the United States (N = 104,463) from September through December 2020, and from January to June 2021. We limited the sample to emerging adulthood (i.e., ages 18-30). We calculated the prevalence of suicidal behaviors and the mean of importance of religion, stratifying by sexual minority status. We used multivariable logistic regression to examine the associations between predictors (sexual minority status, importance of religion) and outcomes (suicidal ideation, suicide plan, and suicide attempt), adjusting for age, gender, and race/ethnicity. We then tested to see whether the association between importance of religion and suicidal behaviors was conditional on sexual minority status.

RESULTS

Significantly larger proportions of sexual minority students reported suicidal behaviors than heterosexual students. A larger proportion of heterosexual students viewed religion to be very important in their lives when compared with sexual minority students. Being a sexual minority was associated with greater odds of all suicidal behaviors, and greater importance of religion was associated with lower odds. The importance of religion was significantly associated with lower odds of suicidal behaviors for heterosexual students when compared with sexual minority students.

CONCLUSION

The association between importance of religion and suicidal behaviors was conditional on sexual minority status.

Mental Health and Social Support of Sexual and Gender Diverse People from Québec, Canada During the COVID-19 Crisis

Purpose: Sexual and gender minority (SGM) people are at increased risk for psychological distress compared with cisgender heterosexual people. Specific SGM subgroups include lesbian, gay, bisexual, gender diverse, and asexual people who each experience unique psychosocial challenges that can result in different mental health outcomes. The coronavirus disease 2019 (COVID-19) pandemic may have further exacerbated mental health disparities among these groups. The aim of this study was to compare lesbian, gay, bisexual, gender diverse, asexual, and cisgender heterosexual people's mental health and social support during the first 4 months of the COVID-19 crisis. Methods: This study used a cross-sectional online survey from March 26th, 2020 to July 7th, 2020 in Québec, Canada. A total of 2908 individuals (n = 304 SGM people, n = 2604 cisgender heterosexual people) completed questionnaires measuring perceived social support, perceived stress, symptoms of depression and anxiety, as well as loneliness. Results: SGM people presented worse health outcomes than cisgender heterosexual people on all questionnaires (p < 0.001). Post hoc analyses showed that particularly marginalized SGM subgroups, including bisexual and asexual people, reported the poorest mental health. Moderation analyses revealed that the buffering effect of social support on depressive symptoms was four times stronger among SGM people (ΔR² = 0.041; p < 0.001) than among cisgender heterosexual people (ΔR² = 0.010; p < 0.001). Conclusion: This study suggests that fostering social connectedness among SGM people may be especially beneficial in buffering against distress in the face of a crisis.

Statewide Evaluation of SARS-CoV-2 Diagnoses and Sexual Orientation and Gender Identity

OBJECTIVE

Understanding and identifying disparities in COVID-19 testing outcomes can help allocate resources to where they are most needed. The objective of this study was to estimate the association between lesbian, gay, bisexual, transgender, and queer (LGBTQ+) identity and SARS-CoV-2 test positivity.

METHODS

Data were from the Rhode Island SARS-CoV-2 surveillance database and included tests scheduled from June 8, 2020, through January 15, 2021. We used multivariable generalized estimating equations accounting for repeat testing to estimate the odds of receiving a positive test result for SARS-CoV-2 by LGBTQ+ identity and race/ethnicity, adjusting for sociodemographic and temporal confounders.

RESULTS

In multivariable analysis of 232 025 tests, LGBTQ+ people had lower odds of receiving a positive test result than cisgender heterosexual people (5.4% vs 8.7%; adjusted odds ratio [aOR] = 0.63; 95% CI, 0.59-0.68). Compared with cisgender heterosexual White people, LGBTQ+ White people were significantly less likely (aOR = 0.67; 95% CI, 0.61-0.73) and cisgender heterosexual people of color were significantly more likely (aOR = 1.71; 95% CI, 1.64-1.78) to receive a positive test result. LGBTQ+ people of color had similar test positivity (aOR = 0.90; 95% CI, 0.79-1.02) as cisgender heterosexual White people. People in sexual minority groups were significantly less likely than heterosexual people to receive a positive test result, but we found no significant differences in test results among cisgender, transgender, and gender nonconforming people.

CONCLUSIONS

LGBTQ+ people may be less likely than heterosexual people to receive a positive test result for SARS-CoV-2, potentially related to protective health practices and greater social isolation. Addressing racial and ethnic disparities among both LGBTQ+ people and cisgender heterosexual people should be a priority of the public health workforce.