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Prud'homme J, Hofer MK, Ames ME, Turner BJ. Disparities in the prevalence, frequency and trajectories of substance use and disordered eating across first-year university in sexual minority undergraduates. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:2062-2074. [PMID: 35930358 DOI: 10.1080/07448481.2022.2103373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 05/13/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
Objective. To compare the prevalence and trajectories of risky health behaviors in sexual minority (SM; lesbian/gay/bisexual/questioning/asexual) versus heterosexual undergraduates across their first year of post-secondary. Participants. First-year undergraduates (N = 704, Mage=17.97 years, 24% SM) from a midsized Canadian university. Methods. Students completed monthly (September-April) online questionnaires assessing substance use (binge drinking, tobacco, cannabis, illicit drug use) and disordered eating (binge eating, fasting, purging). Results. At the outset of the academic year, SM students endorsed more frequent cannabis use, illicit drug use, fasting, and binge eating, but less frequent tobacco use, versus heterosexual students. Over the year, SM students' binge drinking frequency declined less than that of heterosexual students, but their illicit drug use decreased while that of their heterosexual peers increased, and all students reported declining disordered eating frequency. Conclusions. Campus wellness initiatives for SM students should offer prevention and harm-reduction strategies prior to or shortly after their arrival on campus.
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Affiliation(s)
- Julie Prud'homme
- Department of Psychology, University of Victoria, Victoria, Canada
| | - Marlise K Hofer
- Department of Psychology, University of Victoria, Victoria, Canada
| | - Megan E Ames
- Department of Psychology, University of Victoria, Victoria, Canada
| | - Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, Canada
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Marino JL, Werner-Seidler A, Maston K, Lin A, Perry Y, Bista S, Davies C, Christensen H, Skinner SR. Sexuality and Gender Diversity Among Adolescents in Australia, 2019-2021. JAMA Netw Open 2024; 7:e2444187. [PMID: 39466240 DOI: 10.1001/jamanetworkopen.2024.44187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2024] Open
Abstract
Importance Sexuality- and gender-diverse (SGD) young people experience substantial health disparities relative to cisgender heterosexual peers. Little is known about SGD adolescents younger than 15 years. Objective To describe SGD prevalence and associated factors in a population-representative cohort of younger adolescents in Australia. Design, Setting, and Participants This prospective cohort study was part of the Future Proofing Study, with enrollment of year 8 students at 134 Australian secondary schools from 2019 to 2021 and annual follow-ups for 5 years. Data were analyzed from June 20, 2023, to June 6, 2024. Main Outcome and Measures Outcomes of interest were baseline self-reported gender and sexuality identities, individual characteristics, and mental health and disability diagnoses, as well as school characteristics. Results Among 6388 participants, median (IQR) age was 13.9 (13.6-15.8), with a range of 10.7 to 17.5 years. Most participants attended school in a major city (76.0%), were born in Australia (91.4%), and spoke English at home (93.7%). Approximately half (3122 participants; 48.9% [95% CI, 45.2%-59.0%]) identified as female or girls, and 46.5% (2973 participants; 95% CI, 39.8%-53.4%) identified as male or boys. The overall proportion of transgender identity was 3.3% (95% CI, 2.7%-3.9%), with 23 participants (0.4%) identifying as transgender boys, 10 participants (0.2%) identifying as transgender girls, 117 participants (1.8%) identifying as transgender nonbinary, and 59 participants (0.9%) identifying as another transgender identity. The overall proportion of sexuality diversity was 12.0% (95% CI, 10.4%-13.8%). The proportion of cisgender participants who were sexuality-diverse (13.0% [95% CI, 11.4%-14.8%] of girls and 4.7% [95% CI, 3.7%-5.9%] of boys) was lower than the proportion among gender-diverse participants, which ranged from 30.0% (95% CI, 9.3%-64.1%) of transgender girls to 91.5% (95% CI, 81.3%-96.4%) of those with another diverse gender identity. Gender diversity and sexuality diversity were strongly associated (odds ratio [OR], 66.24; 95% CI, 38.23-114.80), and both were negatively associated with age (gender diversity: OR per 1-year older, 0.61; 95% CI, 0.49-0.76; sexuality diversity: OR per 1-year older, 0.78; 95% CI, 0.65-0.93) and positively with mental health diagnosis (gender diversity: OR, 2.41; 95% CI, 1.79-3.24; sexuality diversity: OR, 2.50; 95% CI, 2.10-2.98), and disability diagnosis (gender diversity: OR, 2.39; 95% CI, 1.68-3.40; sexuality diversity: OR, 1.96; 95% CI, 1.64-2.36). While there were significant associations between individual and school characteristics and responses to gender and sexuality identity items, patterns of association differed, with no consistent association with economic disadvantage. Conclusions and Relevance This cohort study of young adolescents found higher rates of SGD than among samples of older adolescents. The significant associations with younger age, poorer mental health, and disability underscored the urgent need for inclusive programs to promote a safe and welcoming environment in schools, health care settings, and communities.
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Affiliation(s)
- Jennifer L Marino
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Aliza Werner-Seidler
- Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Kate Maston
- Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Ashleigh Lin
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Yael Perry
- The Kids Research Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Sarita Bista
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
| | - Cristyn Davies
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- School of Social Sciences, Western Sydney University, New South Wales, Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia
- Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - S Rachel Skinner
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Westmead, New South Wales, Australia
- The Children's Hospital at Westmead, Westmead, New South Wales, Australia
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3
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McCrimmon J, Widman L, Brasileiro J. Adolescent Barriers to Sexual Communication with Their Parents: Differences by Sexual and Gender Identity. JOURNAL OF SEX RESEARCH 2024:1-12. [PMID: 38905151 DOI: 10.1080/00224499.2024.2362899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
Parent-adolescent sexual communication has important health benefits for adolescents, yet not all families openly communicate about sex. In particular, adolescents often report various barriers to engaging in sexual communication with their parents. The purpose of this study was to address gaps in past research by examining barriers to communication with both mothers and fathers, separately, as well as to explore the unique barriers to communication among queer and trans adolescents. Participants were recruited via Instagram (n = 566; Mage = 16.0; 57.6% cisgender girls; 41.4% heterosexual). The most endorsed barrier to communicating with mothers was the adolescent believing they already knew enough about sexual topics. The most endorsed barrier for communicating with fathers was embarrassment. The least endorsed barriers included mother's lack of knowledge, and perceptions of anger from fathers when discussing sexuality. Several differences emerged by sexual and gender identity: cisgender girls and trans adolescents tended to agree more with barriers to communication with parents compared to cisgender boys. Additionally, queer adolescents tended to agree more with barriers to communication with parents than their heterosexual peers, although group differences depended on the particular barrier. These findings highlight specific barriers to parent-adolescent sexual communication faced by various groups of youth.
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Affiliation(s)
| | - Laura Widman
- Department of Psychology, North Carolina State University
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4
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Katz-Wise SL, Ranker LR, Korkodilos R, Conti J, Nelson KM, Xuan Z, Gordon AR. Will all youth answer sexual orientation and gender-related survey questions? An analysis of missingness in a large U.S. survey of adolescents and young adults. Psychol Methods 2024:2024-69792-001. [PMID: 38573664 PMCID: PMC11450101 DOI: 10.1037/met0000652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Some researchers and clinicians may feel hesitant to assess sexual orientation and gender-related characteristics in youth surveys because they are unsure if youth will respond to these questions or are concerned the questions will cause discomfort or offense. This can result in missed opportunities to identify LGBTQ+ youth and address health inequities among this population. The aim of this study was to examine the prevalence and sociodemographic patterns of missingness among survey questions assessing current sexual orientation, gender identity and expression (SOGIE), and past change in sexual orientation (sexual fluidity) among a diverse sample of U.S. youth. Participants (N = 4,245, ages 14-25 years; 95% cisgender, 70% straight/heterosexual, 53% youth of color), recruited from an online survey panel, completed the Wave 1 survey of the longitudinal Sexual Orientation Fluidity in Youth (SO*FLY) Study in 2021. Current SOGIE, past sexual fluidity, and sociodemographic characteristics were assessed for missingness. Overall, 95.7% of participants had no missing questions, 3.8% were missing one question, and 0.5% were missing ≥ 2 questions. Past sexual fluidity and assigned sex were most commonly missing. Sociodemographic differences between participants who skipped the SOGIE questions and the rest of the sample were minimal. Missingness for the examined items was low and similar across sociodemographic characteristics, suggesting that almost all youth are willing to respond to survey questions about SOGIE. SOGIE and sexual fluidity items should be included in surveys and clinical assessments of youth to inform clinical care, policy-making, interventions, and resource development to improve the health of all youth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Sabra L. Katz-Wise
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital
- Department of Pediatrics, Harvard Medical School
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health
| | - Lynsie R. Ranker
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital
- Department of Community Health Sciences, Boston University School of Public Health
| | - R. Korkodilos
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital
| | - Jennifer Conti
- Department of Community Health Sciences, Boston University School of Public Health
| | - Kimberly M. Nelson
- Department of Community Health Sciences, Boston University School of Public Health
- Department of Psychiatry, Boston University School of Medicine
| | - Ziming Xuan
- Department of Community Health Sciences, Boston University School of Public Health
| | - Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health
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5
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Gresham B, Thyden NH, Gailey S, Osypuk TL. Effect of a Randomized Controlled Trial of Housing Vouchers on Adolescent Risky Sexual Behavior Over a 15-Year Period. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:457-469. [PMID: 38167990 PMCID: PMC10923197 DOI: 10.1007/s10508-023-02736-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/13/2023] [Accepted: 10/24/2023] [Indexed: 01/05/2024]
Abstract
We examined whether a housing voucher intervention influenced adolescent risky sexual behavior (RSB) across 15 years in the Moving to Opportunity Study. Low-income families in public housing that resided in 5 cities were randomized to one of three treatment groups: a housing voucher to move to low-poverty neighborhoods (i.e., < 10% poverty rate), a Sect. 8 voucher but no housing relocation counseling, or a control group that could remain in public housing. Youth and their caregivers completed baseline surveys, as well as two uniform follow-ups: interim (2001-2002; 4-7 years after baseline) and final (2008-2010; 10-15 years after baseline). Approximately 4,600 adolescents (50.5% female) aged 13-20 years participated at the final timepoint. Adolescents reported on their RSB, including condom use, other contraceptive use, early sexual initiation (< 15 years old), and 2+ sexual partners in the past year. We modeled each indicator separately and as part of a composite index. We tested baseline health vulnerabilities as potential effect modifiers. The low-poverty voucher group and the Sect. 8 voucher group were combined due to homogeneity of their effects. Applying intent-to-treat (ITT) regression analyses, we found no significant main effects of voucher receipt (vs. control) on any RSB. However, we found protective effects of voucher receipt on RSB among youth with health problems that limited activity, and youth < 7 at baseline but adverse effects among females, youth > 7 at baseline, and youth who were suspended/expelled from school. Results highlight the importance of understanding how housing interventions differentially influence adolescent health and behaviors.
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Affiliation(s)
- Bria Gresham
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
- Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA
| | - Naomi H Thyden
- Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Samantha Gailey
- Department of Forestry, Michigan State University, East Lansing, MI, USA
- Department of Public Health, Michigan State University, Flint, MI, USA
| | - Theresa L Osypuk
- Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA.
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55455, USA.
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Gmelin JOH, De Vries YA, Baams L, Aguilar-Gaxiola S, Alonso J, Borges G, Bunting B, Cardoso G, Florescu S, Gureje O, Karam EG, Kawakami N, Lee S, Mneimneh Z, Navarro-Mateu F, Posada-Villa J, Rapsey C, Slade T, Stagnaro JC, Torres Y, Kessler RC, de Jonge P. Increased risks for mental disorders among LGB individuals: cross-national evidence from the World Mental Health Surveys. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2319-2332. [PMID: 35851652 PMCID: PMC9636102 DOI: 10.1007/s00127-022-02320-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 06/20/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Lesbian, gay, and bisexual (LGB) individuals, and LB women specifically, have an increased risk for psychiatric morbidity, theorized to result from stigma-based discrimination. To date, no study has investigated the mental health disparities between LGB and heterosexual AQ1individuals in a large cross-national population-based comparison. The current study addresses this gap by examining differences between LGB and heterosexual participants in 13 cross-national surveys, and by exploring whether these disparities were associated with country-level LGBT acceptance. Since lower social support has been suggested as a mediator of sexual orientation-based differences in psychiatric morbidity, our secondary aim was to examine whether mental health disparities were partially explained by general social support from family and friends. METHODS Twelve-month prevalence of DSM-IV anxiety, mood, eating, disruptive behavior, and substance disorders was assessed with the WHO Composite International Diagnostic Interview in a general population sample across 13 countries as part of the World Mental Health Surveys. Participants were 46,889 adults (19,887 males; 807 LGB-identified). RESULTS Male and female LGB participants were more likely to report any 12-month disorder (OR 2.2, p < 0.001 and OR 2.7, p < 0.001, respectively) and most individual disorders than heterosexual participants. We found no evidence for an association between country-level LGBT acceptance and rates of psychiatric morbidity between LGB and heterosexualAQ2 participants. However, among LB women, the increased risk for mental disorders was partially explained by lower general openness with family, although most of the increased risk remained unexplained. CONCLUSION These results provide cross-national evidence for an association between sexual minority status and psychiatric morbidity, and highlight that for women, but not men, this association was partially mediated by perceived openness with family. Future research into individual-level and cross-national sexual minority stressors is needed.
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Affiliation(s)
- Jan-Ole H. Gmelin
- Department of Developmental Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
| | - Ymkje Anna De Vries
- Department of Developmental Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands
- Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Laura Baams
- Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, The Netherlands
| | | | - Jordi Alonso
- Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
- Pompeu Fabra University (UPF), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Guilherme Borges
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | | | - Graca Cardoso
- Lisbon Institute of Global Mental Health and Chronic Diseases Research Center, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal
| | - Silvia Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Elie G. Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon
- Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - Zeina Mneimneh
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI USA
| | - Fernando Navarro-Mateu
- IDRAAC, Beirut, Lebanon
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Murcia, Spain
| | - José Posada-Villa
- Colegio Mayor de Cundinamarca University, Faculty of Social Sciences, Bogota, Colombia
| | - Charlene Rapsey
- Department of Psychological Medicine, University of Otago, Dunedin, Otago New Zealand
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Juan Carlos Stagnaro
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Yolanda Torres
- Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA USA
| | - Peter de Jonge
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
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7
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Houghtaling L, Osypuk TL. Health disparities among millennial veterans by sexual orientation. MILITARY PSYCHOLOGY 2022; 35:204-214. [PMID: 37133547 PMCID: PMC10157000 DOI: 10.1080/08995605.2022.2099708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The objective of this study was to examine sexual orientation-based disparities in six self-reported health outcomes among millennial aged military veterans. We collected data using The Millennial Veteran Health Study, a cross-sectional internet-based survey with extensive quality control measures. The survey was fielded April through December 2020 and targeted millennial aged veterans across the United States. A total of 680 eligible respondents completed the survey. We assessed six binary health outcomes: alcohol use, marijuana use, frequent chronic pain, opioid misuse, high psychological distress, and fair or poor health status. Using logistic regression adjusted for a range of demographic, socioeconomic, and military-based covariates, we find that bisexual veterans consistently report worse health than straight veterans for all six health outcomes tested. Results for gay or lesbian, compared to straight veterans, were less consistent. Sensitivity models with continuous outcomes, and stratified by gender, found similar results. These results have implications for improving the health of bisexual individuals, including addressing discrimination, belonging, and social identity, particularly in institutional settings that have traditionally heteronormative and masculine cultures such as the military.
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Affiliation(s)
- Laura Houghtaling
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
- Minnesota Population Center, University of Minnesota, Minneapolis, Minnesota
| | - Theresa L. Osypuk
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
- Minnesota Population Center, University of Minnesota, Minneapolis, Minnesota
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8
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Sexual violence among male sexual minority college students in Guangdong, China: a cross-sectional study. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03283-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractThis study aims to provide an estimate of lifetime sexual violence (SV) among male sexual minority college students with differing sexual orientations and contribute to the evidence base on the association between SV experience, stress, and depressive symptoms. The data stemmed from the 2019 Internet Survey on HIV/AIDS and Sexual Health in Colleges and Universities in Guangdong province, China. Lifetime SV victimisation (including non-sexual harassment, physical contact sexual harassment, and rape), level of stress, and depressive symptoms were examined among 1441 male sexual minority students from 37 colleges and universities in Guangdong province. Linear regression analyses were adopted to examine associations between independent variables and depressive symptoms. 23.4% (337/1441) of the participants reported lifetime non-contact harassment, while 8.8% (127/1441) and 2.4% (35/1441) of the participants reported physical contact sexual harassment and rape, respectively. Homosexual students reported the most physical contact sexual harassment (48/127, 37.8%) and bisexual students reported the most non-contact sexual harassment (102/337, 30.3%) and rape (10/35, 28.6%) among sexual minority participants; 85.6% participants reported high levels of stress. The experience of SV and the level of stress were significantly associated with depressive symptoms, and stress completely mediated the path from SV experiences to depressive symptoms. This study specifically showcases SV as a pervasive problem affecting Chinese male sexual minority college students and highlighting the severity of stress and depressive symptoms among this population. These findings emphasise the urgency of implementing effective practices and policies to address SV and depressive symptoms among male sexual minority college students in China.
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9
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Alley J, Jenkins V, Everett B, Diamond LM. Understanding the Link Between Adolescent Same-Gender Contact and Unintended Pregnancy: The Role of Early Adversity and Sexual Risk Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1839-1855. [PMID: 34816359 DOI: 10.1007/s10508-021-02143-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 08/20/2021] [Accepted: 08/30/2021] [Indexed: 06/13/2023]
Abstract
Past research suggests an apparent paradox: Women who engage in same-gender sexual behavior show higher rates of unintended pregnancy than women with exclusive other-gender sexual behavior. Such women also have disproportionate rates of early adversity (both harshness, such as abuse or neglect, and unpredictability, such as father absence). We used the Add Health data (N = 5,617 cisgender women) to examine the relative contributions of early adversity, adolescent same-gender sexual behavior, and general sexual risk behavior to women's risks for adult unintended pregnancy. Women who engaged in adolescent same-gender sexual behavior were more likely to report childhood adversity, and both childhood adversity and adolescent same-gender behavior made independent contributions to subsequent rates of unintended pregnancy. The association between adolescent same-gender sexual behavior and adult unintended pregnancy was partially attributable to the fact that women with adolescent same-gender sexual behavior engaged in greater sexual risk behavior more broadly. These findings suggest that same-gender sexual behavior in adolescence may relate to a broader set of sexual risk behaviors that augment future risk for unintended pregnancy, independent of sexual identity. We draw on life history theory to explain this pattern of results and suggest directions for future research.
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Affiliation(s)
- Jenna Alley
- Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84112-0251, USA.
| | - Virginia Jenkins
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Bethany Everett
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Lisa M Diamond
- Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84112-0251, USA
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10
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Goldstein EV. Examining depression care outcomes at community health centers serving larger lesbian, gay, and bisexual patient populations: Do rural vs. urban disparities exist? JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2021. [DOI: 10.1080/19359705.2021.1988025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Evan V. Goldstein
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, UT, USA
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11
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Diamond LM. The New Genetic Evidence on Same-Gender Sexuality: Implications for Sexual Fluidity and Multiple Forms of Sexual Diversity. JOURNAL OF SEX RESEARCH 2021; 58:818-837. [PMID: 33620277 DOI: 10.1080/00224499.2021.1879721] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
In September of 2019, the largest-ever (N = 477,522) genome-wide-association study of same-gender sexuality was published in Science. The primary finding was that multiple genes are significantly associated with ever engaging in same-gender sexual behavior, accounting for between 8-25% of variance in this outcome. Yet an additional finding of this study, which received less attention, has more potential to transform our current understanding of same-gender sexuality: Specifically, the genes associated with ever engaging in same-gender sexual behavior differed from the genes associated with one's relative proportion of same-gender to other-gender behavior. I review recent research on sexual orientation and sexual fluidity to illustrate how these findings speak to longstanding questions regarding distinctions among subtypes of same-gender sexuality (such as mostly-heterosexuality, bisexuality, and exclusive same-gender experience). I conclude by outlining directions for future research on the multiple causes and correlates of same-gender expression.
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Phillips II G, Wang X, Ruprecht MM, Felt D, McCuskey D, Stephens R, Perez-Bill E, Beach LB. Differential Alcohol Use Disparities by Sexual Identity and Behavior Among High School Students. Alcohol Alcohol 2021; 56:490-499. [PMID: 33290517 PMCID: PMC8522742 DOI: 10.1093/alcalc/agaa131] [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: 06/25/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 11/13/2022] Open
Abstract
AIMS Sexual minority youth (SMY) use alcohol at disproportionate rates compared to their heterosexual peers. However, sexual orientation is multidimensional. Analyzing alcohol use disparities only by one dimension of sexual orientation may result in critical disparities being obscured. METHODS Data from state and local versions of the Youth Risk Behavior Survey were pooled (2009-2017), resulting in a large, diverse sample (n = 201,671). Multivariable logistic regression models were used to analyze associations between sexual identity/sexual behavior and three alcohol use outcomes among sexually active youth: age at first drink, binge drinking and current drinking. RESULTS SMY, when categorized by sexual identity and sexual behavior, reported greater alcohol use than their heterosexual peers, though the magnitude of these disparities varied by subgroup. Both those who identified as bisexual and those who reported sexual behavior with both males and females reported the greatest levels of alcohol use. Decomposition analysis revealed that youth whose reported sexual behavior was not aligned with stereotypical behavioral expectations based on their sexual identity had higher odds of current drinking and drinking before 13 years as compared to other youth. CONCLUSIONS Results highlight the need to incorporate multiple methods of sexual orientation measurement into substance use research. Interventions based solely on identity, rather than both identity and behavior, may not be sufficient; targeted research into the causes of alcohol use disparities is needed, especially for bisexual youth, youth whose sexual behavior and sexual identity are not stereotypically aligned, and youth who report a sexual identity of 'not sure.'
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Affiliation(s)
- Gregory Phillips II
- Department of Medical Social Sciences,
Northwestern University Feinberg School of
Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL
60611, USA
| | - Xinzi Wang
- Department of Medical Social Sciences,
Northwestern University Feinberg School of
Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL
60611, USA
| | - Megan M Ruprecht
- Department of Medical Social Sciences,
Northwestern University Feinberg School of
Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL
60611, USA
| | - Dylan Felt
- Department of Medical Social Sciences,
Northwestern University Feinberg School of
Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL
60611, USA
| | - David McCuskey
- Department of Medical Social Sciences,
Northwestern University Feinberg School of
Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL
60611, USA
| | - Reno Stephens
- Department of Medical Social Sciences,
Northwestern University Feinberg School of
Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL
60611, USA
| | - Esrea Perez-Bill
- Department of Medical Social Sciences,
Northwestern University Feinberg School of
Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL
60611, USA
| | - Lauren B Beach
- Department of Medical Social Sciences,
Northwestern University Feinberg School of
Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL
60611, USA
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13
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Mantey DS, Yockey RA, Lee JGL. Sexual Minority Status and Marijuana Initiation during Adulthood: A Longitudinal Study Using Nationally Representative Data. Subst Use Misuse 2021; 56:1054-1061. [PMID: 33855928 PMCID: PMC8170695 DOI: 10.1080/10826084.2021.1906704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Sexual minorities (i.e. individuals who identify as lesbian, gay, and bisexual) are at increased risk for marijuana use. However, little is known about initiation during adulthood. This study examines: (1) sexual minority status as a risk factor for marijuana initiation, and (2) the modifying effect of sex (labeled at birth) on this relationship. Methods: We analyzed Wave 1 (2013-2014) and Wave 2 (2014-2015) of the Population Assessment of Tobacco and Health, a nationally representative survey. Participants were n = 10,756 adult never marijuana users. A multivariable logistic regression examined the relationship between sexual minority status and initiation of marijuana use at Wave 2. Multivariable logistic regressions, stratified by sex, were used to assess for effect modification. Covariates were sex, age, race/ethnicity, income, currently attending college, and mental health well-being. Results: Approximately 1.1% of adults initiated marijuana use from Wave 1 to Wave 2. Sexual minority status was associated with 1.57 (95% CI: 1.00-2.46) greater odds of marijuana initiation. In stratified analyses, sexual minority status was associated with greater odds of marijuana initiation for females (Adj OR: 1.97; 95% CI: 1.19-3.26) but not males (Adj OR: 0.84: 95% CI: 0.33-2.16). Conclusions: Sexual minority status is a risk factor for marijuana initiation during adulthood. This relationship was only consistent for females, suggesting that sex may be an effect modifier. However, research designed and powered to directly detect this effect is needed. Findings highlight a need for public health interventions that reduce disparities in marijuana use among sexual minorities.
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Affiliation(s)
- Dale S. Mantey
- School of Public Health, University of Texas, Austin, Texas, USA
| | - R. Andrew Yockey
- Department of Health Promotion and Education, University of Cincinnati, Cincinnati, Ohio, USA
| | - Joseph G. L. Lee
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
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14
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Garbarski D. The Survey Measurement of Sexual Orientation: Configurations of Sexual Identity and Attraction and Associations with Mental Health. LGBT Health 2021; 8:307-315. [PMID: 33689404 DOI: 10.1089/lgbt.2020.0270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: This study aimed to examine how configurations of sexual identity and attraction are associated with mental health outcomes. Methods: Data came from the 2015, 2016, and 2017 waves of the National Survey on Drug Use and Health, one of the few nationally representative surveys to ask about sexual attraction. Sexual identity and attraction were combined into groups that are coincident (heterosexual-opposite gender attraction, gay/lesbian-same gender attraction, or bisexual-any multiple gender attraction) or branched (heterosexual-any same gender attraction, gay/lesbian-any opposite gender attraction, bisexual-only same or opposite gender attraction). The association between these configurations and various measures of mental health and well-being-severe psychological distress, major depressive episode, suicidal ideation, and suicide plan or attempt-was examined. Results: Heterosexual coincidence-being heterosexual and only attracted to the opposite gender-was associated with lower mental health risks than all other configurations of sexual identity and attraction. In addition, bisexual with coincident attraction was often associated with worse mental health outcomes than other configurations of identity and attraction, whereas bisexual with branched attraction did not necessarily follow this pattern. Finally, heterosexual with branched attraction was associated with worse mental health outcomes than heterosexual with coincident attraction, but better mental health outcomes than some of the other sexual identity and attraction configurations. Conclusion: Including one question on sexual attraction and its intersection with sexual identity adds nuance to our understanding of disparities in mental health and well-being among previously identified sexual minority and majority groups.
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Affiliation(s)
- Dana Garbarski
- Department of Sociology, Loyola University Chicago, Chicago, Illinois, USA
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15
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McCabe SE, West BT, Matthews AK, Evans-Polce R, Lee JG, Hughes TL, Veliz P, McCabe V, Boyd CJ. Sexual Orientation, Tobacco Use, and Tobacco Cessation Treatment-Seeking: Results From a National U.S. Survey. Behav Med 2021; 47:120-130. [PMID: 32703084 PMCID: PMC7854762 DOI: 10.1080/08964289.2019.1676191] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Despite higher rates of tobacco use and smoking-related diseases among sexual minorities, tobacco cessation treatment-seeking behaviors (e.g., medication, nicotine replacement products) remain poorly understood across sexual orientation subgroups. This study examines tobacco cessation treatment-seeking behaviors associated with Diagnostic and Statistical Manual of Mental Disorders, 5th Edition tobacco use disorder (TUD) across the three major sexual orientation dimensions (identity, attraction, behavior) in U.S. adults. Prevalence estimates reflect data collected from a 2012-2013 national sample of adults 18 years and older. More than three-fourths of U.S. adults with TUD had never engaged in tobacco cessation treatment-seeking behaviors, regardless of sexual orientation. Despite having the highest rates of TUD, bisexual men and women had some of the lowest rates of tobacco cessation treatment-seeking. Men who identified as gay, reported same-sex attraction, or reported same-sex behaviors had the highest rates of tobacco cessation treatment-seeking. In contrast, women with same-sex attraction or same-sex behavior had higher rates of TUD but were less likely to engage in tobacco cessation treatment-seeking behaviors than women with only other-sex attraction or other-sex behavior, respectively. Heterosexual women were more likely to engage in tobacco cessation treatment-seeking than heterosexual men; this sex difference was not present for sexual minorities. Medications and nicotine replacement therapy products were the most prevalent forms of treatment-seeking. There were notable differences in tobacco cessation treatment-seeking behaviors based on sex and sexual orientation. Findings highlight the underutilization of tobacco cessation treatment-seeking among all U.S. adults and point to important factors to consider when working with sexual minorities who are trying to reduce or stop using tobacco.
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Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Brady T. West
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Alicia K. Matthews
- College of Nursing, Department of Health Systems Science, University of Illinois at Chicago, Chicago, Illinois
| | - Rebecca Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Joseph G.L. Lee
- Department of Health Education and Promotion, College of Health and Human Performance, and Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Tonda L. Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, New York
| | - Phil Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan,Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Vita McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan,St. Joseph Mercy Ann Arbor, St. Joseph Mercy Health System, Ypsilanti, Michigan
| | - Carol J. Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, Michigan,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, Michigan,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan,Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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16
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Associations Between LGBTQ-Affirming School Climate and Intimate Partner Violence Victimization Among Adolescents. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 22:227-236. [PMID: 33219902 DOI: 10.1007/s11121-020-01192-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
Intimate partner violence (IPV) impacts sexual minority adolescents at rates equal to or greater than the rate it impacts heterosexual adolescents. We investigated whether reports of physical and sexual IPV were less frequent in school jurisdictions with more affirming climates for lesbian, gay, bisexual, transgender, and queer (LGBTQ) students; and whether these associations varied for sexual orientation subgroups. We combined student-level data from the 2015 Youth Risk Behavior Surveys on demographics and experiences with physical and sexual IPV with jurisdiction-level data from the 2014 School Health Profiles on LGBTQ-affirming school climate. Multilevel logistic regression models examined associations between LGBTQ-affirming school climates and IPV. We stratified our data by sex and examined whether these associations differed by sexual orientation subgroups using cross-level interaction terms between school climate and sexual orientation (assessed via sexual identity and behavior). Sexual minority youth were more likely to report experiencing past-year physical and sexual IPV than their heterosexual counterparts. Attending schools with more LGBTQ-affirming climates reduced the likelihood of reporting physical IPV, but not sexual IPV, for female students. More LGBTQ-affirming school climates increased risk for sexual IPV among gay male students. Establishing LGBTQ-affirming school climates may reduce physical IPV for female students, but may have unintended consequences on sexual IPV prevalence for gay male students. More work is necessary to ensure that these climates are affirming for all sexual minority students and to address sexual violence prevention.
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17
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Gambadauro P, Carli V, Wasserman D, Balazs J, Sarchiapone M, Hadlaczky G. Serious and persistent suicidality among European sexual minority youth. PLoS One 2020; 15:e0240840. [PMID: 33064760 PMCID: PMC7567377 DOI: 10.1371/journal.pone.0240840] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/02/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Suicide is a leading cause of death among adolescents and more knowledge from high risk groups is needed in order to develop effective preventive strategies. The aim of this study was to evaluate the association between sexual minority status and suicidality in a multinational sample of European school pupils. METHODS A self-report questionnaire was delivered to 2046 adolescents (mean age 15.34±1.01; 56.3% females) recruited from 27 randomly selected schools in 6 European countries. Suicidal ideation, measured with the Paykel Suicide Scale (PSS), and lifetime suicide attempts were compared between heterosexual and sexual minority (i.e. those with a non-heterosexual orientation) youth. Poisson regression analyses studied the longitudinal association between sexual minority status and the rate of serious suicidal ideation, measured at three time-points during a 4-month period. Several variables, including alcohol and illegal drugs use, bullying, family interaction, school-related stress, economic status, and religiosity, were included in multivariable analysis. Sex-stratified analyses evaluated the association respectively among females and males. RESULTS Of 1958 pupils included in analysis (mean age 15.35±1.00; females 56.8%), 214 (10.9%) were categorized as sexual minority youth (SMY). When compared to heterosexual youth (HSY), SMY were significantly more exposed to substance abuse, bullying, school-related stress, and lower economic status. SMY pupils had significantly higher suicidal ideation scores (p<0.001; r 0.145) as well as higher prevalence of serious suicidal ideation (odds ratio [OR] 2.64, 95% confidence interval [CI] 1.83-3.79) and previous suicide attempts (OR 2.72, 95%CI 1.77-4.18), compared to their HSY peers. The rate of serious suicidal ideation reports during the study was significantly higher among SMY compared to HSY (rate ratio [RR] 2.55, 95%CI 1.90-3.43). A significant difference was found even when controlling for the pupils' country as well as after adjustment for alcohol and illegal drugs use, bullying, family interaction, school-related stress, economic status, and religiosity (adjusted RR 1.73, 95%CI 1.23-2.48). Stratified analyses showed significant associations between SMY status and persistent serious suicidal ideation for both sexes, with a notably strong association among male pupils (females aRR 1.51, 95%CI 1.01-2.24; males aRR 3.84, 95%CI 1.94-7.59). CONCLUSIONS European sexual minority youth are a high-risk group for suicidality, independently from objective factors such as victimization or substance abuse. There is a need to develop primary and secondary preventive measures for sexual minority youth, including the management of context vulnerabilities and related distal stressors, before the establishment of proximal stressors. Context-targeting interventions may effectively focus on social and economic factors, as well as on the potentially different risk profile of female and male sexual minority youth.
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Affiliation(s)
- Pietro Gambadauro
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Res Medica Sweden, Uppsala, Sweden
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Judit Balazs
- Eötvös Loránd University, Institute of Psychology, Budapest, Hungary
- Bjørknes University College, Oslo, Norway
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
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18
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Zhang L, Finan LJ, Bersamin M, Fisher DA, Paschall MJ. Sexual Orientation-Based Alcohol, Tobacco, and Other Drug Use Disparities: The Protective Role of School-Based Health Centers. YOUTH & SOCIETY 2020; 52:1153-1173. [PMID: 34321700 PMCID: PMC8315521 DOI: 10.1177/0044118x19851892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study investigated whether the presence of school-based health centers (SBHCs) was associated with six substance use behaviors among sexual minority youth (SMY) and their heterosexual peers. Data from the 2015 Oregon Healthy Teens Survey, including 13,608 11th graders in 137 schools (26 with SBHCs) were used in the current study. Multilevel logistic regression analyses were performed. Results revealed significant SBHC by SMY status interactions indicating a relatively lower likelihood of past 30-day alcohol use (23%), binge drinking (43%), use of e-cigarettes (22%), marijuana (44%), and unprescribed prescription drugs (28%) among SMY in SBHC schools compared with non-SMY at SBHC schools. Furthermore, SMY in SBHC schools reported lower likelihood of aforementioned substance use behaviors than SMY attending non-SBHC schools. Conversely, no differences in these outcomes were observed for non-SMY in SBHC and non-SBHC schools. Findings from this study suggest SBHCs may help to mitigate substance use disparities among marginalized populations, such as SMY.
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Affiliation(s)
- Lei Zhang
- Pacific Institute for Research and Evaluation, Chapel Hill, NC, USA
| | - Laura J. Finan
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - Melina Bersamin
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | | | - Mallie J. Paschall
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
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19
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Shokoohi M, Salway T, Ahn B, Ross LE. Disparities in the prevalence of cigarette smoking among bisexual people: a systematic review, meta-analysis and meta-regression. Tob Control 2020; 30:e78-e86. [PMID: 32934092 DOI: 10.1136/tobaccocontrol-2020-055747] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/22/2020] [Accepted: 07/22/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To review the bisexual-specific prevalence and likelihood of cigarette smoking relative to lesbian/gay and heterosexual individuals. DATA SOURCES We searched MEDLINE, PsycInfo, CINAHL, Scopus and LGBT Life databases (from 1995 to September 2019) for studies reporting cigarette smoking among bisexuals versus their comparators. STUDY SELECTION Observational, quantitative, peer-reviewed studies providing estimates for lifetime, past 30 days or current cigarette smoking among bisexuals and any of the two comparators were selected. DATA EXTRACTION Data on sexual orientation groups, cigarette smoking, sample type and mechanism, data collection mode, country and median year, as well as gender and age groups were extracted. DATA SYNTHESIS Random-effects meta-analysis was used to estimate the pooled OR (95% CIs) of cigarette smoking. Meta-regression was used to examine the difference in the prevalence of cigarette smoking by study and sample characteristics. Of 4663 unduplicated records, 47 unique studies were included (14, 23 and 22 studies on lifetime, past 30 days and current cigarette smoking, respectively). Compared with lesbians/gays and heterosexuals, bisexuals were 1.25 (1.15 to 1.37) and 2.18 (1.84 to 2.59) times more likely to report lifetime smoking, 1.17 (1.08 to 1.27) and 2.49 (2.20 to 2.83) times more likely to report past 30 days smoking and 1.19 (1.00 to 1.43) and 2.26 (1.97 to 2.59) times more likely to report current smoking. Gender was a significant covariate in the meta-regression models. CONCLUSIONS Cigarette smoking was more prevalent among bisexuals than lesbians/gays and heterosexuals, with the estimates showing a greater magnitude among bisexual women relative to all other sexual orientation/gender subgroups.
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Affiliation(s)
- Mostafa Shokoohi
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.,British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.,Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
| | - Benjamin Ahn
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Lori E Ross
- Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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20
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Romanelli M, Xiao Y, Lindsey MA. Sexual Identity-Behavior Profiles and Suicide Outcomes Among Heterosexual, Lesbian, and Gay Sexually Active Adolescents. Suicide Life Threat Behav 2020; 50:921-933. [PMID: 32190929 DOI: 10.1111/sltb.12634] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 01/17/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Adolescents' sexual behaviors can be incongruent with those assumed to align with their sexual identity. Identity-behavior profiles permit the characterization of youth who might remain undetected using a single-dimensional assessment of sexual orientation. This study examined suicide risks among four distinct sexual identity-behavior profiles of youth: heterosexual with other-sex partners only, heterosexual with any same-sex partners, lesbian or gay (LG) with same-sex partners only, and LG with any other-sex partners. METHOD Data were analyzed from the 2017 National Youth Risk Behavior Survey. Participants' reported sex, sexual identity, and the sex of their sexual contacts were used to construct the identity-behavior profiles. Multivariate logistic regression was used to examine the relationship between identity-behavior profiles and suicide outcomes. RESULTS Compared to heterosexual respondents with other-sex partners only, heterosexual respondents with any same-sex partners and LG respondents with same-sex partners only had greater odds of having a suicide plan; LG respondents with any other-sex partners were over seven times more likely to have suicidal thoughts and attempt suicide and 14 times more likely to have a suicide plan. CONCLUSIONS Health and mental health providers can expand the identification of youth at risk for suicide by assessing both sexual identity and behavior.
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Affiliation(s)
- Meghan Romanelli
- Silver School of Social Work, New York University, New York, NY, USA.,McSilver Institute for Poverty Policy and Research, New York, NY, USA
| | - Yunyu Xiao
- Silver School of Social Work, New York University, New York, NY, USA.,McSilver Institute for Poverty Policy and Research, New York, NY, USA
| | - Michael A Lindsey
- Silver School of Social Work, New York University, New York, NY, USA.,McSilver Institute for Poverty Policy and Research, New York, NY, USA
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21
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Hequembourg AL, Livingston JA, Wang W. Prospective associations among relationship abuse, sexual harassment and bullying in a community sample of sexual minority and exclusively heterosexual youth. J Adolesc 2020; 83:52-61. [PMID: 32736276 PMCID: PMC7484239 DOI: 10.1016/j.adolescence.2020.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 06/19/2020] [Accepted: 06/29/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Sexual minority youth (SMY) are at significantly greater risk for experiencing adolescent relationship abuse (ARA) than exclusively heterosexual youth, yet little is known about the factors that elevate their risks for such abuse. Peer victimization (i.e., bullying, sexual harassment) has been associated with ARA among heterosexual youth. SMY experience higher rates of peer victimization than heterosexual youth, suggesting that it may be a risk factor for ARA among these youth. Using longitudinal data from a community sample of adolescents recruited from the northeastern US, we examined whether sexual identity was associated prospectively with ARA, and whether that relationship would be indirect, and mediated via bullying and sexual harassment at a 12-month follow-up. We expected to find higher rates of peer victimization and ARA among SMY than heterosexual youth, and we expected that sexual harassment and bullying would predict subsequent relationship abuse. METHODS Adolescents (N = 800; 58% female; 81% European-American; 19% SMY) between 13 and 15 years (M = 14.45, SD = 0.85) completed a web survey at baseline, 6-months and 12-months. RESULTS Consistent with prior studies, SMY reported higher rates of bullying, sexual harassment, and relationship abuse than heterosexual youth. SMY who reported sexual harassment at baseline were more likely to report relationship abuse over time. Contrary to our expectations, however, bully victimization did not predict subsequent relationship abuse. CONCLUSIONS Sexual harassment can be particularly harmful for SMY because it targets gender and sexual identity at a formative developmental period and puts youth at risk for relationship abuse.
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Affiliation(s)
- Amy L Hequembourg
- School of Nursing, State University of New York at Buffalo, 3435 Main Street, Wende Hall, Buffalo, NY, 14214, USA.
| | - Jennifer A Livingston
- School of Nursing, State University of New York at Buffalo, 3435 Main Street, Wende Hall, Buffalo, NY, 14214, USA.
| | - Weijun Wang
- Clinical and Research Institute on Addictions, State University of New York at Buffalo, 1021 Main Street, Buffalo, NY, 14203, USA.
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22
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Abstract
BACKGROUND Sexual minority individuals consistently report higher rates of mental disorder than heterosexuals. However, much of the research has methodological limitations related to the classification of sexuality, the use of cross-sectional data and problematic sampling procedures such as using convenience samples. METHODS We used longitudinal data from a birth cohort enrolled in the Christchurch Health and Development Study (n = 1040). Latent class analysis was used to classify participants sexuality based on self-report data of sexual behaviour, attraction, identity and fantasy, gathered over five assessments between the ages of 18 and 35 years. Mental health and substance use outcome data were gathered at four assessments between the ages of 21 and 35 years. Potential covariate variables were collected during childhood. RESULTS The latent class analysis identified four groups interpreted as: 'heterosexual' 82%, 'mostly heterosexual' 12.6%, 'bisexual' 3.5% and 'gay/lesbian' 1.9%. In the sexual minority groups, women outnumbered men by at least 2:1. Pooled rates for mental health disorders of depression, anxiety disorders, suicidal ideation, cannabis abuse and total disorders, after adjustment for childhood covariate variables, were significantly higher in the sexual minority groups (p < 0.01). The strength of association between sexuality group and mental health outcomes did not differ according to sex. Fluidity in sexuality reports appeared unrelated to risk of mental health outcomes. CONCLUSIONS Over the life course, membership of a sexual minority group is clearly associated with mental health problems of depression, anxiety and suicidal ideation regardless of the age when same-sex attraction, behaviour, identity or fantasy is expressed.
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Affiliation(s)
- J K Spittlehouse
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
| | - J M Boden
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
| | - L J Horwood
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
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23
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Fish JN, Krueger EA. Reconsidering Approaches to Estimating Health Disparities Across Multiple Measures of Sexual Orientation. LGBT Health 2020; 7:198-207. [PMID: 32315572 DOI: 10.1089/lgbt.2019.0182] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Purpose: We propose a new theoretically grounded approach for estimating sexual orientation-related health risk that accounts for the unique and shared variance of sexual identity across other measures of sexual orientation (i.e., attraction and behavior). We argue and illustrate that this approach provides specificity not demonstrated by approaches that independently estimate and compare health risk based on sexual identity, attraction, and behavior. Methods: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III, collected in 2012-2013 (N = 36,309, ages 18 and older). The Karlson-Holm-Breen method tested the degree to which attraction- and behavior-based disparities in mental health and substance use disorders change after adjusting for sexual identity. Results: Sexual attraction- and behavior-based disparities in mental health and substance use disorders statistically varied when comparing models that did and did not adjust for sexual identity. Adjusting for sexual identity appeared to have a larger influence on attraction- and behavior-based health associations among men; sexual minority and majority differences were attenuated on nearly every outcome after adjusting for sexual identity. This attenuation was less common among women. Among women, some behavior-based disparities were wider in sexual identity-adjusted models relative to unadjusted models. Conclusion: We demonstrate more accurate approaches to capturing and comparing sexual orientation-related health disparities across multiple measures of sexual orientation, which account for the shared variance between sexual identity and measures of attraction and behavior. Adjusted estimates provide more specificity regarding relative health risk across specific subgroups of sexual minority people, and the intervention and prevention strategies needed to address them.
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Affiliation(s)
- Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Evan A Krueger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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24
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Költő A, Cosma A, Moreau N, Young H, Thorsteinsson EB, Gobina I, Godeau E, Saewyc EM, Nic Gabhainn S. Self-Reported Health and Patterns of Romantic Love in Adolescents from Eight European Countries and Regions. LGBT Health 2020; 7:90-100. [PMID: 32053046 PMCID: PMC7138602 DOI: 10.1089/lgbt.2019.0107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose: Sexual minority youth (SMY) are at increased risk of poor health, but it remains unclear whether this phenomenon is universal. In this study, nationally representative samples of 15-year olds from eight European countries and regions were investigated to test if adolescents who have been in love with same- or both-gender partners report poorer health than those exclusively in love with opposite-gender partners or who have never been in love. Methods: A subsample of 13,674 adolescents participating in the 2014 Health Behaviour in School-aged Children (HBSC) study was used. We conducted binary logistic regression, adjusted for gender, region, and relative family affluence, to analyze associations between self-reported romantic love, multiple psychosomatic symptoms, and poor self-rated health. Results: Adolescents reporting same-gender love (adjusted odds ratio [aOR] = 1.50, 95% confidence interval [CI]: 1.11-2.02) and both-gender love (aOR = 3.57, 95% CI: 2.65-4.83) had significantly higher odds for multiple psychosomatic symptoms than those who reported opposite-gender love. Similarly, both SMY groups had higher odds of poor self-rated health (aOR = 2.95, 95% CI: 1.64-5.31 and aOR = 3.08, 95% CI: 1.79-5.31, respectively). Those who reported that they have never been in love had significantly lower odds for multiple symptoms. Adjustment for sociodemographic variables and stratifying by gender did not substantially change the odds ratios. Conclusion: Adolescents in love with same- and both-gender partners reported poorer subjective health outcomes than those in love with opposite-gender partners or who reported never being in love, suggesting that SMY health inequalities are found across various European countries and regions.
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Affiliation(s)
- András Költő
- Health Promotion Research Centre, School of Health Sciences, National University of Ireland Galway, Galway, Ireland
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Alina Cosma
- Department of Interdisciplinary Social Science: Cultural Diversity and Youth, School of Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Nathalie Moreau
- Service d'Information Promotion Education Santé (SIPES), Centre de Recherche “Epidémiologie, Biostatistiques et recherche clinique,” Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Honor Young
- The Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, United Kingdom
| | - Einar B. Thorsteinsson
- School of Psychology, Faculty of Medicine and Health, University of New England, Armidale, Australia
| | - Inese Gobina
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | | | - Elizabeth M. Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, Vancouver, Canada
| | - Saoirse Nic Gabhainn
- Health Promotion Research Centre, School of Health Sciences, National University of Ireland Galway, Galway, Ireland
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Lee JGL, Shook-Sa BE, Gilbert J, Ranney LM, Goldstein AO, Boynton MH. Risk, Resilience, and Smoking in a National, Probability Sample of Sexual and Gender Minority Adults, 2017, USA. HEALTH EDUCATION & BEHAVIOR 2020; 47:272-283. [PMID: 31994418 DOI: 10.1177/1090198119893374] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. There are well-documented inequities in smoking between sexual and gender minority (SGM; e.g., lesbian, gay, bisexual, and transgender [LGBT]) and straight and cisgender people. However, there is less information about risk for and resilience against smoking among SGM people. Such information is critical for understanding etiology and developing interventions. Aims. To conduct a within-group assessment of risks and resiliencies relating to smoking status. Method. In 2017, we conducted a cross-sectional telephone survey with a national, probability-based sample of SGM adults (N = 453). We assessed theory-informed risks (adverse childhood events, substance use-oriented social environment, mental distress, stigma, discrimination, social isolation, and identity concealment) and resiliencies (advertising skepticism, identity centrality, social support, and SGM community participation). We applied survey weights, standardized predictor variables, and fit logistic regression models predicting smoking status. We stratified by age and SGM identity. Results. Patterns of risk and resilience differ by age and identity. Effects were consistently in the same direction for all groups for participating in substance use-oriented social environments, pointing to a potential risk factor for all groups. Advertising skepticism and having people you can talk to about being LGBTQ were potential protective factors. Discussion. Intervention development should address risk and resilience that differs by SGM identity. Additionally, our findings suggest interventionists should consider theoretical frameworks beyond minority stress. Conclusion. While much of the literature has focused on the role of stress from stigma and discrimination in tobacco use, addressing social norms and bolstering protective factors may also be important in SGM-targeted interventions.
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Affiliation(s)
- Joseph G L Lee
- East Carolina University, Greenville, NC, USA.,University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Jeffrey Gilbert
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Leah M Ranney
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Adam O Goldstein
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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26
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McCabe SE, Hughes TL, Matthews AK, Lee JGL, West BT, Boyd CJ, Arslanian-Engoren C. Sexual Orientation Discrimination and Tobacco Use Disparities in the United States. Nicotine Tob Res 2020; 21:523-531. [PMID: 29300994 DOI: 10.1093/ntr/ntx283] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/28/2017] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Differences in tobacco/nicotine use by sexual orientation are well documented. Development of interventions requires attention to the etiology of these differences. This study examined associations among sexual orientation discrimination, cigarette smoking, any tobacco/nicotine use, and DSM-5 tobacco use disorder (TUD) in the United States. METHODS We used data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions based on in-person interviews with a nationally representative sample of noninstitutionalized US adults. Approximately 8.3% of the target population was estimated to have same-sex sexual attraction, 3.1% had at least one same-sex sexual partner in the past-year, and 2.8% self-identified as lesbian, gay, or bisexual. RESULTS Sexual attraction, sexual behavior, and sexual identity were significantly associated with cigarette smoking, any tobacco/nicotine use, and DSM-5 TUD. Risk of all tobacco/nicotine outcomes was most pronounced for bisexual adults across all three sexual orientation dimensions. Approximately half of sexual minorities who identified as lesbian or gay and one-fourth of those who identified as bisexual reported past-year sexual orientation discrimination. Sexual minorities who experienced high levels of past-year sexual orientation discrimination had significantly greater probability of past-year cigarette smoking, any tobacco/nicotine use, and TUD relative to sexual minorities who experienced lower levels of sexual orientation discrimination or no discrimination. CONCLUSIONS Sexual minorities, especially bisexual adults, are at heightened risk of cigarette smoking, any tobacco/nicotine use, and DSM-5 TUD across all three major sexual orientation dimensions. Tobacco prevention and cessation efforts should target bisexual adults and consider the role that sexual orientation discrimination plays in cigarette smoking and treatment of TUD. IMPLICATIONS Differences in tobacco/nicotine use by sexual orientation are well documented, but little is known about differences across all three sexual orientation dimensions (attraction, behavior, and identity) or the origins of these differences. This study is the first to show that differences in tobacco/nicotine use across the three sexual orientation dimensions for respondents who were exclusively heterosexually-oriented were minimal, but varied more substantially among sexual minority women and men across the three sexual orientation dimensions. Sexual minorities who experienced high levels of past-year sexual orientation discrimination had significantly greater probability of cigarette smoking, any tobacco/nicotine use and DSM-5 tobacco use disorder.
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Affiliation(s)
- Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI.,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI
| | - Tonda L Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY
| | | | - Joseph G L Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC
| | - Brady T West
- Institute for Social Research, Survey Research Center, University of Michigan, Ann Arbor, MI
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI.,Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI.,Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Cynthia Arslanian-Engoren
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, University of Michigan, Ann Arbor, MI
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Zhang L, Finan LJ, Bersamin M, Fisher DA. Sexual Orientation-Based Depression and Suicidality Health Disparities: The Protective Role of School-Based Health Centers. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2020; 30 Suppl 1:134-142. [PMID: 30230104 PMCID: PMC6430702 DOI: 10.1111/jora.12454] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study's purpose was to examine whether school-based health centers (SBHCs) support mental health indicators among sexual minority youth (SMY). Data came from the 2015 Oregon Healthy Teens Survey with 13,608 11th graders in 137 public high schools in Oregon. Regression results revealed significant SBHC by SMY status interactions indicating relative reductions in likelihood of depressive episodes (30%), suicidal ideation (34%), and suicide attempts (43%) among SMY in schools with SBHCs. SMY students in SBHC schools reported lower likelihood of a past-year depressive episode, suicidal ideation, and suicide attempt versus those attending non-SBHC schools. Conversely, no differences in these outcomes were observed for non-SMY by SBHC status. SBHCs may help reduce mental health disparities among SMY, a marginalized, underserved population.
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Affiliation(s)
- Lei Zhang
- Pacific Institute for Research and Evaluation
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28
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Amos R, Manalastas EJ, White R, Bos H, Patalay P. Mental health, social adversity, and health-related outcomes in sexual minority adolescents: a contemporary national cohort study. THE LANCET CHILD & ADOLESCENT HEALTH 2019; 4:36-45. [PMID: 31753807 DOI: 10.1016/s2352-4642(19)30339-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/10/2019] [Accepted: 10/10/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Sexual minority adolescents are more likely to have mental health problems, adverse social environments, and negative health outcomes compared with their heterosexual counterparts. There is a paucity of up-to-date population-level estimates of the extent of risk across these domains in the UK. We analysed outcomes across mental health, social environment, and health-related domains in sexual minority adolescents compared with their heterosexual counterparts in a large, contemporary national cohort. METHODS The Millennium Cohort Study (MCS) is a birth cohort study in the UK following up children born between Sept 1, 2000, and Jan 11, 2002 across England, Wales, Scotland, and Northern Ireland. Children recruited from the MCS have been followed up over six recruitment sweeps to date at ages 9 months, 3 years, 5 years, 7 years, 11 years, and 14 years. We analysed mental health, social, and health-related outcomes in sexual minority versus heterosexual adolescents at age 14 years. Additionally, we estimated the accumulation of multiple adverse outcomes in both groups. The primary aim of the study was to assess whether sexual minority adolescents experienced more adverse outcomes than heterosexual adolescents. FINDINGS Between January, 2015, and April, 2016, 9885 adolescents provided a response about their sexual attraction. 629 (6%) of 9885 adolescents (481 female participants and 148 male participants) were identified as sexual minorities. 9256 (94%) of 9885 participants (4431 female and 4825 male) were attracted to the opposite sex or not attracted to the same sex and identified as heterosexual. Sexual minority adolescents were more likely to experience high depressive symptoms (odds ratio [OR] 5·43, 95% CI 4·32-6·83; p<0·0001), self-harm (5·80, 4·55-7·41; p<0·0001), lower life satisfaction (3·66, 2·92-4·58; p<0·0001), lower self-esteem (β 1·83, 95% CI 1·47-2·19; p<0·0001), and all forms of bullying and victimisation. Sexual minorities were more likely to have tried alcohol (OR 1·85, 95% CI 1·47-2·33; p<0·0001), smoking (2·41, 1·92 -3·03; p<0·0001), and cannabis (3·22, 2·24-4·61; p<0·0001), and also had increased odds of being less physically active (β 0·36, 95% CI 0·25-0·46; p<0·0001), perceiving themselves as overweight (OR 1·73, 95% CI 1·40-2·14; p<0·0001), and dieting to lose weight (1·98, 1·58-2·48; p<0·0001). Sexual minority adolescents had more co-occurring mental health outcomes (mean 1·43 of 3 outcomes, 95% CI 1·34-1·52) compared with heterosexual adolescents (0·40 of 3 outcomes, 0·38-0·41), and more total cumulative difficulties (mean 9·43 of 28 outcomes, 95% CI 9·09-9·76 in sexual minority adolescents vs 6·16 of 28 outcomes, 6·08-6·23 in heterosexual adolescents). INTERPRETATION Sexual minority adolescents in the UK experience disparities in mental health, social, and health-related outcomes despite living in a time of substantial progress in rights for sexual minorities. These adverse outcomes co-occur, with implications for lifelong health and social outcomes. Health and educational practitioners should be aware of the increased risk for adverse outcomes in sexual minority adolescents. FUNDING None.
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Affiliation(s)
- Rebekah Amos
- School of Psychology, University of Liverpool, Liverpool, UK.
| | | | - Ross White
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Henny Bos
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, UK
| | - Praveetha Patalay
- Centre for Longitudinal Studies and Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
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29
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Romantic Attraction and Substance Use in 15-Year-Old Adolescents from Eight European Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173063. [PMID: 31450730 PMCID: PMC6747452 DOI: 10.3390/ijerph16173063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 11/16/2022]
Abstract
Sexual minority youth are at higher risk of substance use than heterosexual youth. However, most evidence in this area is from North America, and it is unclear whether the findings can be generalized to other cultures and countries. In this investigation, we used data from the 2014 Health Behaviour in School-aged Children (HBSC) study to compare substance use in same- and both-gender attracted 15-year-old adolescents from eight European countries (n = 14,545) to that of their peers who reported opposite-gender attraction or have not been romantically attracted to anyone. Both-gender attracted, and to a lesser extent, same-gender attracted adolescents were significantly more likely to smoke cigarettes, consume alcohol, get drunk and use cannabis, or be involved in multiple substance use in the last 30 days compared to their opposite-gender attracted peers. Those adolescents who have not been in love had significantly lower odds for substance use than all other youth. The pattern of results remained the same after adjusting for country, gender and family affluence. These findings are compatible with the minority stress and romantic stress theories. They suggest that sexual minority stigma (and love on its own) may contribute to higher substance use among adolescents in European countries.
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30
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Diamond LM, Alley J. Was It Good for Her? An Alternative Perspective on Life History Theory, Female Same-Sex Sexuality, and Pleasure. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1315-1320. [PMID: 30311041 DOI: 10.1007/s10508-018-1313-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 09/20/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Lisa M Diamond
- Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84112-0251, USA.
| | - Jenna Alley
- Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84112-0251, USA
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31
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Paschen-Wolff MM, Kelvin E, Wells BE, Campbell ANC, Grosskopf NA, Grov C. Changing Trends in Substance Use and Sexual Risk Disparities among Sexual Minority Women as a Function of Sexual Identity, Behavior, and Attraction: Findings from the National Survey of Family Growth, 2002-2015. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1137-1158. [PMID: 30756210 PMCID: PMC6489449 DOI: 10.1007/s10508-018-1333-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 06/09/2023]
Abstract
Components of sexual minority (SM) status-including lesbian or bisexual identity, having same-sex partners, or same-sex attraction-individually predict substance use and sexual risk behavior disparities among women. Few studies have measured differing associations by sexual orientation components (identity, behavior, and attraction), particularly over time. Data were drawn from the 2002-2015 National Survey of Family Growth female sample (n = 31,222). Multivariable logistic regression (adjusted for age, race/ethnicity, education, marital/cohabitation status, survey cycle, and population-weighted) compared past-year sexual risk behavior, binge drinking, drug use, and sexually transmitted infection treatment among sexual minority women (SMW) versus sexual majority women (SMJW) by each sexual orientation component separately and by all components combined, and tested for effect modification by survey cycle. In multivariable models, SM identity, behavior, and attraction individually predicted significantly greater odds of risk behaviors. SM identity became nonsignificant in final adjusted models with all three orientation components; non-monosexual attraction and behavior continued to predict significantly elevated odds of risk behaviors, remaining associated with sexual risk behavior and drug use over time (attenuated in some cases). Trends in disparities over time between SMW versus SMJW varied by sexual orientation indicator. In a shifting political and social context, research should include multidimensional sexual orientation constructs to accurately identify all SMW-especially those reporting non-monosexual behavior or attraction-and prioritize their health needs.
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Affiliation(s)
- Margaret M Paschen-Wolff
- HIV Center for Clinical and Behavioral Studies, Division of Gender, Sexuality, and Health, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
| | - Elizabeth Kelvin
- CUNY Institute for Implementation Science in Population Health, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY, USA
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Brooke E Wells
- Center for Human Sexuality Studies, Widener University, Chester, PA, USA
| | - Aimee N C Campbell
- Department of Psychiatry and New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
| | - Nicholas A Grosskopf
- Department of Health and Physical Education/Gerontological Studies and Services, York College of CUNY, Jamaica, NY, USA
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Christian Grov
- CUNY Institute for Implementation Science in Population Health, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY, USA
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
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Coulter RW, Sang JM, Louth-Marquez W, Henderson ER, Espelage D, Hunter SC, DeLucas M, Abebe KZ, Miller E, Morrill BA, Hieftje K, Friedman MS, Egan JE. Pilot Testing the Feasibility of a Game Intervention Aimed at Improving Help Seeking and Coping Among Sexual and Gender Minority Youth: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e12164. [PMID: 30767903 PMCID: PMC6416896 DOI: 10.2196/12164] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/10/2018] [Indexed: 01/19/2023] Open
Abstract
Background Sexual and gender minority youth (SGMY; eg, lesbian, gay, bisexual, and transgender youth) experience myriad substance use and mental health disparities compared with their cisgender (nontransgender) heterosexual peers. Despite much research showing these disparities are driven by experiences of bullying and cyberbullying victimization, few interventions have aimed to improve the health of bullied SGMY. One possible way to improve the health of bullied SGMY is via a Web-accessible game intervention. Nevertheless, little research has examined the feasibility of using a Web-accessible game intervention with SGMY. Objective This study aimed to describe the protocol for a randomized controlled trial (RCT) pilot, testing the feasibility and limited efficacy of a game-based intervention for increasing help-seeking–related knowledge, intentions, self-efficacy, behaviors, productive coping skills use, and coping flexibility and reducing health risk factors and behaviors among SGMY. Methods We enrolled 240 SGMY aged 14 to 18 years residing in the United States into a 2-arm prospective RCT. The intervention is a theory-based, community-informed, computer-based, role playing game with 3 primary components: encouraging help-seeking behaviors, encouraging use of productive coping, and raising awareness of Web-based resources. SGMY randomized to both the intervention and control conditions will receive a list of SGMY-inclusive resources, covering a variety of health-related topics. Control condition participants received only the list of resources. Notably, all study procedures are conducted via the internet. We conveniently sampled SGMY using Web-based advertisements. Study assessments occur at enrollment, 1 month after enrollment, and 2 months after enrollment. The primary outcomes of this feasibility study include implementation procedures, game demand, and game acceptability. Secondary outcomes include help-seeking intentions, self-efficacy, and behaviors; productive coping strategies and coping flexibility; and knowledge and use of Web-based resources. Tertiary outcomes include bullying and cyberbullying victimization, loneliness, mental health issues, substance use, and internalized sexual and gender minority stigma. Results From April to July 2018, 240 participants were enrolled and randomized. Half of the enrolled participants (n=120) were randomized into the intervention condition and half (n=120) into the control condition. At baseline, 52.1% (125/240) of the participants identified as gay or lesbian, 26.7% (64/240) as bisexual, 24.2% (58/240) as queer, and 11.7% (28/240) as another nonheterosexual identity. Nearly half (113/240) of participants were a gender minority: 36.7% (88/240) were cisgender boys, and 16.3% (39/240) were cisgender girls. There were no differences in demographic characteristics between intervention and control condition participants. Conclusions Web-accessible game interventions overcome common impediments of face-to-face interventions and present a unique opportunity to reach SGMY and improve their health. This trial will provide data on feasibility and limited efficacy that can inform future Web-based studies and a larger RCT aimed at improving health equity for SGMY. Trial Registration ClinicalTrials.gov NCT03501264; https://clinicaltrials.gov/ct2/show/NCT03501264 (Archived by WebCite at http://www.webcitation.org/72HpafarW) International Registered Report Identifier (IRRID) DERR1-10.2196/12164
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Affiliation(s)
| | - Jordan M Sang
- University of Pittsburgh, Pittsburgh, PA, United States
| | | | | | - Dorothy Espelage
- College of Health and Human Performance, University of Florida, Gainesville, FL, United States
| | - Simon C Hunter
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom
| | | | | | | | | | | | | | - James E Egan
- University of Pittsburgh, Pittsburgh, PA, United States
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Friedman MR, Bukowski L, Eaton LA, Matthews DD, Dyer TV, Siconolfi D, Stall R. Psychosocial Health Disparities Among Black Bisexual Men in the U.S.: Effects of Sexuality Nondisclosure and Gay Community Support. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:213-224. [PMID: 29623533 PMCID: PMC6173653 DOI: 10.1007/s10508-018-1162-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 01/02/2018] [Accepted: 01/25/2018] [Indexed: 05/04/2023]
Abstract
Compared with Black gay men, Black bisexual men experience psychosocial health disparities, including depression, polydrug use, physical assault, and intimate partner violence (IPV). Black bisexual men are also less likely to disclose their sexuality, which may result in them receiving less sexual minority community support, exacerbating psychosocial health disparities. We assessed relationships between bisexual behavior, bisexual identity, sexuality nondisclosure, gay community support, and psychosocial morbidities among Black men who have sex with men (MSM). Between 2014 and 2017, survey data were collected from Black MSM ≥ 18 years old (n = 4430) at Black Pride events in six U.S. cities. We differentiated between bisexual-identified men reporting past-year sex with men and women (bisexual MSMW, 8.4%); gay-identified men reporting sex with men only (gay MSMO, 73.1%); gay MSMW (8.0%); and bisexual MSMO (8.4%). Multivariable regressions contrasted these groups by psychosocial morbidities, sexuality nondisclosure, and gay community support. Structural equation models assessed total, direct, and indirect effects. Compared with gay MSMO, bisexual MSMW and gay MSMW were significantly more likely to report polydrug use, depression symptoms, IPV, physical assault, sexuality nondisclosure, and lack of gay community support. Lack of gay community support had significant indirect effects on the relationships between bisexual behavior and psychosocial morbidity (p < .001) and between bisexual identity and psychosocial morbidity (p < .001). Sexuality nondisclosure had significant indirect effects on relationships between bisexual behavior (p < .001), bisexual identity (p < .001), and lack of gay community support. Psychosocial health disparities experienced by Black bisexual men are associated with both bisexual behavior and bisexual identity. Interventions decreasing biphobia will facilitate opportunities for protective sexuality disclosure and access to sexual minority community support.
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Affiliation(s)
- M Reuel Friedman
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, PO Box 7319, Pittsburgh, PA, 15213, USA.
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Leigh Bukowski
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lisa A Eaton
- Department of Human Development and Family Studies, University of Connecticut, Hartford, CT, USA
| | - Derrick D Matthews
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, PO Box 7319, Pittsburgh, PA, 15213, USA
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Typhanye V Dyer
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | | | - Ron Stall
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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Wheldon CW, Kaufman AR, Kasza KA, Moser RP. Tobacco Use Among Adults by Sexual Orientation: Findings from the Population Assessment of Tobacco and Health Study. LGBT Health 2018; 5:33-44. [PMID: 29324177 DOI: 10.1089/lgbt.2017.0175] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The aim of this study was to characterize lifetime tobacco use across two measures of sexual orientation and six types of tobacco products. METHODS We conducted a cross-sectional analysis of the Population Assessment of Tobacco and Health (Wave 1, 2013-2014, USA) to estimate the prevalence of tobacco use (cigarettes, e-cigarettes, cigars, pipes, hookah, and smokeless) stratified by gender (men/women), age (< 25/≥ 25 years old), and sexual orientation. Sexual orientation was operationalized as sexual identity and sexual attraction. RESULTS Younger lesbian/gay and bisexual women had higher relative odds of experimental use of all six tobacco products compared to heterosexual women, whereas lesbian/gay and bisexual women in both age groups had higher odds of regular use of cigarettes, e-cigarettes, cigars, and hookah than heterosexual women. Younger gay men (but not older gay men) had higher relative odds of experimental and regular use of cigarettes compared to heterosexual men. Older gay men had higher odds of experimental e-cigarette and hookah use, but lower odds of regular cigar and experimental/regular smokeless tobacco use. Measures of sexual orientation identity and sexual attraction resulted in similar estimates of tobacco use with noted differences in those who identified as "something else," as well as among those who indicated asexual attraction. CONCLUSION Our findings reflect a complex relationship between sexual orientation and tobacco use. Gender-based and product-specific approaches to tobacco prevention and control efforts are needed to address the high use of tobacco among sexual minority women.
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Affiliation(s)
- Christopher W Wheldon
- 1 Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute , Bethesda, Maryland
| | - Annette R Kaufman
- 1 Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute , Bethesda, Maryland
| | - Karin A Kasza
- 2 Department of Health Behavior, Roswell Park Cancer Institute , Buffalo, New York
| | - Richard P Moser
- 1 Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute , Bethesda, Maryland
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Blosnich JR, Cassese EC, Friedman MR, Coulter RWS, Sang JM, Matthews DD, Mair C. Religious freedom restoration acts and sexual minority population health in the United States. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2018; 89:675-681. [PMID: 30247051 DOI: 10.1037/ort0000349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Religious freedom restoration acts (RFRAs) in the United States potentially facilitate discrimination against lesbian, gay, and bisexual individuals (i.e., sexual minorities). In the current investigation, we explored whether a population health metric among sexual minority adults changed over time based on the presence, absence, or introduction of a state RFRA. Data are from 21 of the United States that gathered sexual orientation data from population-based samples of noninstitutionalized adults in the 2015 Behavioral Risk Factor Surveillance System (CDC, 2015, 2016). The analytic sample included 4,911 sexual minority individuals. Time was measured in 4 3-month quarters (i.e., Q1, Q2, Q3, Q4). For each state, the prevalence of sexual minority adults reporting ≥14 unhealthy days/30 days was calculated. Only Indiana (the only state in the sample that passed an RFRA in 2015) exhibited significant increasing proportions over time of sexual minority adults reporting ≥14 unhealthy days (Q1 = 24.5%, Q2 = 34.8%, Q3 = 41.2%, Q4 = 59.5%; β = 0.50, SE = 0.23, p = .037). Post hoc analyses revealed that unhealthy days did not increase for heterosexual adults in Indiana. Indiana's RFRA could have contributed to the increasing prevalence of unhealthy days among sexual minority adults in that state during 2015. Public health surveillance tools are needed to expedite analyses of the impact of laws on minority population health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- John R Blosnich
- Division of General Internal Medicine, School of Medicine, University of Pittsburgh School of Medicine
| | - Erin C Cassese
- Department of Political Science, West Virginia University
| | - M Reuel Friedman
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh
| | - Robert W S Coulter
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh
| | - Jordan M Sang
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh
| | - Derrick D Matthews
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh
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Lee JGL, Wimark T, Ortiz KS, Sewell KB. Health-related regional and neighborhood correlates of sexual minority concentration: A systematic review. PLoS One 2018; 13:e0198751. [PMID: 29949611 PMCID: PMC6021065 DOI: 10.1371/journal.pone.0198751] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 05/24/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A growing literature explores spatial patterns of regional and neighborhood correlates of sexual minority (e.g., lesbian, gay, bisexual) concentration. Such patterns have implications for health and wellbeing if there are differences in health-promoting or health-hindering resources in neighborhoods or regions. We conducted a systematic review to assess sexual minority concentration in relation to area unit characteristics. METHODS We included only records published after 1973 and made no exclusions by geography or language. We searched 11 databases (Academic Search Complete, CINAHL, Embase, GeoBase, GeoRef, LGBT Life, PsycINFO, PubMed/MEDLINE, Scopus, Sociological Abstracts, Web of Science) on November 19-21, 2016. We searched reference lists of included records. We used the following inclusion criteria: (1) Record is a quantitative study (that is, it uses statistics to describe or associate two or more variables); (2) Record is about (a) migration or internal migration of, (b) area unit selection by, or (c) concentration of sexual minority people (defined by identity, behavior, or attraction); (3) Criterion 2 is linked to the characteristics of regions or neighborhoods (at any spatial scale). RESULTS Dual independent coding resulted in 51 records meeting inclusion criteria from the original pool of 5,591. From these records, we identified the 647 reported results linking sexual minority concentration with area unit characteristics. Of these, 132 were unadjusted relationships between sexual minority concentration and four theory-informed domains of neighborhood influence on health. We identified greater concentration of sexual minorities in regions with more resources and in more urban regions. A limited but troubling literature at the neighborhood level suggested potentially higher concentrations of sexual minorities in neighborhoods with fewer resources. CONCLUSIONS There are substantial gaps in the literature. We discuss the implications of our findings and gaps in relation to key theories of sexual minority health. REGISTRATION The review was not registered with PROSPERO because it was not eligible for registration at the time of the research project's initiation due to the outcome of interest.
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Affiliation(s)
- Joseph G. L. Lee
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, North Carolina, United States of America
| | - Thomas Wimark
- Department of Human Geography, Stockholm University, Stockholm, Sweden
| | - Kasim S. Ortiz
- Department of Sociology & Criminology, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Kerry B. Sewell
- Laupus Health Sciences Library, East Carolina University, Greenville, North Carolina, United States of America
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Coulter RWS, Mair C, Miller E, Blosnich JR, Matthews DD, McCauley HL. Prevalence of Past-Year Sexual Assault Victimization Among Undergraduate Students: Exploring Differences by and Intersections of Gender Identity, Sexual Identity, and Race/Ethnicity. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2018; 18:726-736. [PMID: 28210919 DOI: 10.1007/s11121-017-0762-8] [Citation(s) in RCA: 153] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A critical step in developing sexual assault prevention and treatment is identifying groups at high risk for sexual assault. We explored the independent and interaction effects of sexual identity, gender identity, and race/ethnicity on past-year sexual assault among college students. From 2011 to 2013, 71,421 undergraduate students from 120 US post-secondary education institutions completed cross-sectional surveys. We fit multilevel logistic regression models to examine differences in past-year sexual assault. Compared to cisgender (i.e., non-transgender) men, cisgender women (adjusted odds ratios [AOR] = 2.47; 95% confidence interval [CI] 2.29, 2.68) and transgender people (AOR = 3.93; 95% CI 2.68, 5.76) had higher odds of sexual assault. Among cisgender people, gays/lesbians had higher odds of sexual assault than heterosexuals for men (AOR = 3.50; 95% CI 2.81, 4.35) but not for women (AOR = 1.13; 95% CI 0.87, 1.46). People unsure of their sexual identity had higher odds of sexual assault than heterosexuals, but effects were larger among cisgender men (AOR = 2.92; 95% CI 2.10, 4.08) than cisgender women (AOR = 1.68; 95% CI 1.40, 2.02). Bisexuals had higher odds of sexual assault than heterosexuals with similar magnitude among cisgender men (AOR = 3.19; 95% CI 2.37, 4.27) and women (AOR = 2.31; 95% CI 2.05, 2.60). Among transgender people, Blacks had higher odds of sexual assault than Whites (AOR = 8.26; 95% CI 1.09, 62.82). Predicted probabilities of sexual assault ranged from 2.6 (API cisgender men) to 57.7% (Black transgender people). Epidemiologic research and interventions should consider intersections of gender identity, sexual identity, and race/ethnicity to better tailor sexual assault prevention and treatment for college students.
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Affiliation(s)
- Robert W S Coulter
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261, USA. .,Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - John R Blosnich
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Veterans Affairs, Center for Health Equity Research and Promotion, Pittsburgh, PA, USA
| | - Derrick D Matthews
- Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Heather L McCauley
- Department of Human Development and Family Studies, College of Social Science, Michigan State University, East Lansing, MI, USA
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Fish JN, Russell ST. Have Mischievous Responders Misidentified Sexual Minority Youth Disparities in the National Longitudinal Study of Adolescent to Adult Health? ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1053-1067. [PMID: 28477095 PMCID: PMC5671920 DOI: 10.1007/s10508-017-0993-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 04/18/2017] [Accepted: 04/19/2017] [Indexed: 05/12/2023]
Abstract
The National Longitudinal Study of Adolescent to Adult Health (Add Health) has been instrumental in identifying sexual minority youth health disparities. Recent commentary suggested that some Wave 1 youth responders, especially males, intentionally mismarked same-sex attraction and, as a result, published reports of health disparities from these data may be suspect. We use two recently developed approaches to identify "jokesters" and mischievous responding and apply them to the Add Health data. First, we show that Wave 1 same-sex attracted youth, including those who later reported completely heterosexual identities in adulthood, were no more likely than different-sex attracted youth and consistently heterosexual participants to be "jokesters." Second, after accounting for mischievous responses, we replicated six previously established disparities: depressive symptoms, suicidal ideation and behaviors, alcohol use, cocaine use, parental satisfaction, and school connectedness. Accounting for mischievousness resulted in the elimination of one observed disparity between heterosexual and sexual minority youth: suicidal ideation for males who reported romantic attraction to both sexes. Results also showed that accounting for mischievous responding may underestimate disparities for sexual minority youth, particularly females. Overall, results presented here support previous studies that identified health disparities among sexual minority youth using these data.
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Affiliation(s)
- Jessica N Fish
- Population Research Center, Department of Human Development and Family Sciences, University of Texas at Austin, 305 E. 23rd St., Stop G1800, Austin, TX, 78712, USA.
| | - Stephen T Russell
- Department of Human Development and Family Sciences, Population Research Center, University of Texas at Austin, Austin, TX, USA
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Lytle MC, Blosnich JR, De Luca SM, Brownson C. Association of Religiosity With Sexual Minority Suicide Ideation and Attempt. Am J Prev Med 2018; 54:644-651. [PMID: 29550162 PMCID: PMC10782832 DOI: 10.1016/j.amepre.2018.01.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 01/17/2018] [Accepted: 01/17/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The purpose of this study is to explore how the associations between importance of religion and recent suicide ideation, recent suicide attempt, and lifetime suicide attempt vary by sexual orientation. METHODS Survey data were collected from the 2011 University of Texas at Austin's Research Consortium data from 21,247 college-enrolled young adults aged 18-30 years. Respondents reported sexual identity as heterosexual, gay/lesbian, bisexual, or questioning. Two sets of multivariable models were conducted to explore the relations of religious importance and sexual orientation with the prevalence of suicidal behavior. The first model was stratified by sexual orientation and the second model was stratified by importance of religion. To explore potential gender differences in self-directed violence, the models were also stratified by gender identity. The main outcome measures were recent suicidal ideation, recent suicide attempt, and lifetime suicide attempt. RESULTS Overall, increased importance of religion was associated with higher odds of recent suicide ideation for both gay/lesbian and questioning students. The association between sexual orientation and self-directed violence were mixed and varied by strata. Lesbian/gay students who viewed religion as very important had greater odds for recent suicidal ideation and lifetime suicide attempt compared with heterosexual individuals. Bisexual and questioning sexual orientations were significantly associated with recent suicide ideation, recent attempt, and lifetime attempt across all strata of religious importance, but the strongest effects were among those who reported that religion was very important. CONCLUSIONS Religion-based services for mental health and suicide prevention may not benefit gay/lesbian, bisexual, or questioning individuals. Religion-based service providers should actively assure their services are open and supportive of gay/lesbian, bisexual, or questioning individuals.
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Affiliation(s)
- Megan C Lytle
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York
| | - John R Blosnich
- Injury Control Research Center, West Virginia University, Morgantown, West Virginia; Center for Health Equity Research and Promotion, VA Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
| | - Susan M De Luca
- School of Social Work, University of Texas at Austin, Austin, Texas; Population Research Center, Austin, Texas
| | - Chris Brownson
- Counseling and Mental Health Center, University of Texas at Austin, Austin, Texas; Department of Educational Psychology, College of Education, Austin, Texas
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Watson RJ, Lewis NM, Fish JN, Goodenow C. Sexual minority youth continue to smoke cigarettes earlier and more often than heterosexuals: Findings from population-based data. Drug Alcohol Depend 2018; 184:64-70. [PMID: 29402681 PMCID: PMC8573613 DOI: 10.1016/j.drugalcdep.2017.11.025] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 11/21/2017] [Accepted: 11/22/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND An established body of research documents that sexual minority (i.e., lesbian, gay, and bisexual) populations are at higher risk for several adverse health behaviors and outcomes compared to their heterosexual counterparts. Smoking is one behavior where the gap is especially large, particularly among youth. Researchers have increasingly drawn attention to contextual determinants of health behaviors affecting sexual minority youth. PURPOSE Although these factors have evolved over time, few scholars have examined time as a contextual factor that affects sexual minority health behaviors or the level of inequality with heterosexual populations. We aimed to fill this gap. PROCEDURES We used eight years of data from the Massachusetts Youth Risk Behavior Survey (MYRBS), pooled into four waves, to determine whether gaps between sexual minority and heterosexual youth have widened or narrowed for three different indicators of smoking: having ever smoked, early onset smoking, and daily cigarette smoking in the past 30 days. RESULTS We find that, though rates of smoking for all youth in Massachusetts have declined since the late 1990s, significant disparities remain between sexual minority and heterosexual youth. CONCLUSIONS Findings may suggest that targeted tobacco control programs in Massachusetts are needed; perhaps shifts in social attitudes toward smoking have affected smoking behaviors in diverse segments of society.
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Affiliation(s)
- Ryan J. Watson
- Department of Human Development and Family Studies, University of Connecticut, Storrs, CT, United States,Corresponding author at: 348 Mansfield Rd U1058 Storrs, CT, 06269, Department of Human Development and Family Studies, University of Connecticut, United States
| | - Nathaniel M. Lewis
- Department of Geography and Environment, University of Southampton, United Kingdom
| | - Jessica N. Fish
- Population Research Center, Human Development and Family Sciences, University of Texas at Austin, TX, United States
| | - Carol Goodenow
- Independent Research/Evaluation Consultant, Northborough, MA, United States
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Harper CR, Clayton HB, Andrzejewski J, Johns MM. Health risks among discordant heterosexual high school students. JOURNAL OF LGBT YOUTH 2018; 15:149-161. [PMID: 38464593 PMCID: PMC10921992 DOI: 10.1080/19361653.2018.1451802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Limited information exists on heterosexual youth with sexual contact with same-sex partners in the United States (i.e., discordant heterosexual). We compared the prevalence of health risks between discordant heterosexual, heterosexual with only opposite-sex sexual contact, lesbian/gay, and bisexual students using the 2015 national Youth Risk Behavior Survey (YRBS). Nationwide, 3.2% of students were identified as discordant heterosexuals. The prevalence of several risk behaviors was significantly higher among discordant heterosexual students than their heterosexual peers with only opposite-sex sexual contact. Clinicians should consider sexual identity and sex of sexual partners when conducting risk-assessments to ensure they appropriately target populations for intervention.
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Affiliation(s)
- Christopher R. Harper
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia, USA
| | - Heather B. Clayton
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia, USA
| | | | - Michelle M. Johns
- Centers for Disease Control and Prevention, Division of Adolescent and School Health, Atlanta, Georgia, USA
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Sexual orientation measurement and chronic disease disparities: National Health and Nutrition Examination Survey, 2009-2014. Ann Epidemiol 2017; 28:72-85. [PMID: 29275950 DOI: 10.1016/j.annepidem.2017.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 12/29/2022]
Abstract
PURPOSE To examine chronic disease disparities by sexual orientation measurement among sexual minorities. METHODS We pooled data from the 2009-2014 National Health and Nutrition Examination Survey to examine differences in chronic disease prevalence between heterosexual and sexual minority people as defined by sexual identity, lifetime sexual behavior, 12-month sexual behavior, and concordance of lifetime sexual behavior and sexual identity. RESULTS Self-identified lesbian women reported greater odds of asthma (adjusted odds ratio [aOR], 3.19; 95% confidence intervals [CI], 1.37-7.47) and chronic bronchitis (aOR, 2.64; 95% CI, 1.21-5.72) than self-identified heterosexual women. Self-identified sexual minority women with a history of same-sex sexual behavior reported greater odds of arthritis (aOR, 1.67; 95% CI, 1.02-2.74). Compared with heterosexual men, gay men reported greater odds of chronic bronchitis when sexual orientation was defined by sexual identity (aOR, 4.68; 95% CI, 1.90-11.56) or 12-month sexual behavior (aOR, 3.22; 95% CI, 1.27-8.20), as did bisexual men defined by lifetime sexual behavior (aOR, 2.36; 95% CI, 1.14-4.89). Bisexual men reported greater odds of asthma when measured by lifetime sexual behavior (aOR, 1.90; 95% CI, 1.12-3.19), as did self-identified heterosexual men with a history of same-sex sexual behavior (aOR, 2.21; 95% CI, 1.10-4.46). CONCLUSIONS How we define sexual orientation influences our understanding of chronic disease prevalence. Capturing subgroups of sexual minority people in health surveillance is essential for identifying groups most at risk and developing targeted interventions to reduce chronic disease disparities.
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Health Care Use, Health Behaviors, and Medical Conditions Among Individuals in Same-Sex and Opposite-Sex Partnerships: A Cross-Sectional Observational Analysis of the Medical Expenditures Panel Survey (MEPS), 2003-2011. Med Care 2017; 54:547-54. [PMID: 26974678 DOI: 10.1097/mlr.0000000000000529] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prior research documents disparities between sexual minority and nonsexual minority individuals regarding health behaviors and health services utilization. However, little is known regarding differences in the prevalence of medical conditions. OBJECTIVES To examine associations between sexual minority status and medical conditions. RESEARCH DESIGN We conducted multiple logistic regression analyses of the Medical Expenditure Panel Survey (2003-2011). We identified individuals who reported being partnered with an individual of the same sex, and constructed a matched cohort of individuals in opposite-sex partnerships. SUBJECTS A total of 494 individuals in same-sex partnerships and 494 individuals in opposite-sex partnerships. MEASURES Measures of health risk (eg, smoking status), health services utilization (eg, physician office visits), and presence of 15 medical conditions (eg, cancer, diabetes, arthritis, HIV, alcohol disorders). RESULTS Same-sex partnered men had nearly 4 times the odds of reporting a mood disorder than did opposite-sex partnered men [adjusted odds ratio (aOR)=3.96; 95% confidence interval (CI), 1.85-8.48]. Compared with opposite-sex partnered women, same-sex partnered women had greater odds of heart disease (aOR=2.59; 95% CI, 1.19-5.62), diabetes (aOR=2.75; 95% CI, 1.10-6.90), obesity (aOR=1.92; 95% CI, 1.26-2.94), high cholesterol (aOR=1.89; 95% CI, 1.03-3.50), and asthma (aOR=1.90; 95% CI, 1.02-1.19). Even after adjusting for sociodemographics, health risk behaviors, and health conditions, individuals in same-sex partnerships had 67% increased odds of past-year emergency department utilization and 51% greater odds of ≥3 physician visits in the last year compared with opposite-sex partnered individuals. CONCLUSIONS A combination of individual-level, provider-level, and system-level approaches are needed to reduce disparities in medical conditions and health care utilization among sexual minority individuals.
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Wolff M, Wells B, Ventura-DiPersia C, Renson A, Grov C. Measuring Sexual Orientation: A Review and Critique of U.S. Data Collection Efforts and Implications for Health Policy. JOURNAL OF SEX RESEARCH 2017; 54:507-531. [PMID: 28010119 DOI: 10.1080/00224499.2016.1255872] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
The U.S. Department of Health and Human Services' (HHS) Healthy People 2020 goals sought to improve health outcomes among sexual minorities; HHS acknowledged that a dearth of sexual orientation items in federal and state health surveys obscured a broad understanding of sexual minority-related health disparities. The HHS 2011 data progression plan aimed to advance sexual orientation data collection efforts at the national level. Sexual orientation is a complex, multidimensional construct often composed of sexual identity, sexual attraction, and sexual behavior, thus posing challenges to its quantitative and practical measurement and analysis. In this review, we (a) present existing sexual orientation constructs; (b) evaluate current HHS sexual orientation data collection efforts; (c) review post-2011 data progression plan research on sexual minority health disparities, drawing on HHS survey data; (d) highlight the importance of and (e) identify obstacles to multidimensional sexual orientation measurement and analysis; and (f) discuss methods for multidimensional sexual orientation analysis and propose a matrix for addressing discordance/branchedness within these analyses. Multidimensional sexual orientation data collection and analysis would elucidate sexual minority-related health disparities, guide related health policies, and enhance population-based estimates of sexual minority individuals to steer health care practices.
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Affiliation(s)
- Margaret Wolff
- a Department of Community Health and Social Science , CUNY Graduate School of Public Health and Health Policy
| | - Brooke Wells
- b Center for Human Sexuality Studies , Widener University
| | - Christina Ventura-DiPersia
- a Department of Community Health and Social Science , CUNY Graduate School of Public Health and Health Policy
- c Department of Physician Assistant Studies , Hofstra University
| | - Audrey Renson
- d Department of Epidemiology and Biostatistics , CUNY Graduate School of Public Health and Health Policy
| | - Christian Grov
- a Department of Community Health and Social Science , CUNY Graduate School of Public Health and Health Policy
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Blosnich JR. Sexual Orientation Differences in Satisfaction with Healthcare: Findings from the Behavioral Risk Factor Surveillance System, 2014. LGBT Health 2017; 4:227-231. [PMID: 28358625 DOI: 10.1089/lgbt.2016.0127] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE In the United States, the Affordable Care Act and marriage equality may have eased sexual orientation-based differences in access to healthcare coverage, but limited research has investigated sexual orientation-based differences in healthcare satisfaction. The purpose of this study was to examine whether satisfaction with healthcare varied by sexual orientation in a large population-based sample of adults. METHODS Data are from the 2014 Behavioral Risk Factor Surveillance System, including items about sexual orientation and healthcare (n = 113,317). Healthcare coverage included employer-based insurance; individually purchased insurance; Medicare; Medicaid; or TRICARE, VA, or military care. Respondents indicated whether they were "very satisfied, somewhat satisfied, or not at all satisfied" with healthcare. RESULTS After adjusting for several sociodemographic covariates, lesbian, gay, and bisexual status was associated with lower satisfaction with healthcare with individually purchased insurance (adjusted odds ratio = 1.49, 95% confidence interval = 1.24-1.80). CONCLUSION Efforts are needed to examine and reduce sexual orientation differences in satisfaction with healthcare.
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Affiliation(s)
- John R Blosnich
- Center for Health Equity Research and Promotion , VA Pittsburgh Healthcare System, Department of Veterans Affairs, Pittsburgh, Pennsylvania
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Watson RJ, Adjei J, Saewyc E, Homma Y, Goodenow C. Trends and disparities in disordered eating among heterosexual and sexual minority adolescents. Int J Eat Disord 2017; 50:22-31. [PMID: 27425253 PMCID: PMC5768430 DOI: 10.1002/eat.22576] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 05/19/2016] [Accepted: 05/26/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Disordered eating has decreased for all youth over time, but studies have not focused specifically on lesbian, gay, and bisexual (LGB) youth. Research has found that LGB youth report disordered eating behaviors more often compared to their heterosexual counterparts, but no studies have documented trends over time for LGB youth and considered whether these disparities are narrowing or widening across sexual orientation groups. METHOD We use pooled data from the 1999 to 2013 Massachusetts Youth Risk Behavior Surveys (N = 26,002) to investigate trends in purging, fasting, and using diet pills to lose or control weight for heterosexual and sexual minority youth. We used crosstabs, logistic regression, and interactions in regression models, stratified by sex. RESULTS The prevalence of disordered eating has decreased on all three measures across nearly all groups of heterosexual and sexual minority youth. However, we found disparities in reported disordered eating behaviors for LGB youth persisted across all survey years, with LGB students reporting significantly higher prevalence of disordered eating than heterosexuals. The disparities in fasting to control weight widened between the first and last survey waves between lesbian adolescents and heterosexual females. DISCUSSION The significant reductions over time in prevalence of disordered eating among some youth are encouraging, but the disparities remain. Indeed, the increasing prevalence of fasting, diet pill use, and purging to control weight among lesbians may warrant targeted prevention and intervention programs. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:22-31).
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Affiliation(s)
| | | | | | | | - Carol Goodenow
- Independent Research/Evaluation Consultant, Northborough, MA
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Goodenow C, Watson RJ, Adjei J, Homma Y, Saewyc E. Sexual Orientation Trends and Disparities in School Bullying and Violence-Related Experiences, 1999-2013. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2016; 3:386-396. [PMID: 29322064 DOI: 10.1037/sgd0000188] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Numerous recent studies have demonstrated that schools are often unsafe for lesbian, gay, and bisexual (LGB) adolescents, who are more likely than heterosexual peers to be bullied, harassed, or victimized in school contexts. Virtually all of these studies call for change, yet none investigate whether or not it has occurred. Using repeated waves of a population-based high school survey, we examine (1) the extent to which sexual orientation differences in school bullying and violence-related experiences are reported by lesbian/gay, bisexual, and heterosexual male and female adolescents; (2) trends in school bullying and violence-related experiences for each gender/orientation group, and (3) whether disparities have changed over time. Data were drawn from eight Massachusetts biennial Youth Risk Behavior Surveys from 1999 to 2013, grouped into 4 waves totaling 24,845 self-identified heterosexual, 270 lesbian/gay, and 857 bisexual youth. Disparities between LGB and heterosexual peers were found in all indicators. Heterosexual youth and gay males saw significant reductions in every outcome between the first and last waves. Among bisexual males, skipping school due to feeling unsafe, carrying weapons in school, and being bullied all decreased, but among lesbians and bisexual females only fighting in school declined significantly. Improvement trends in school safety were more consistent for heterosexual youth and gay males than for bisexual or lesbian females. Notably, despite these improvements, almost no reduction was seen in sexual orientation disparities. Future research should identify influences leading to reduced school victimization, especially focusing on ways of eliminating persistent sexual orientation disparities. Future research should identify influences leading to reduced school victimization, especially focusing on ways of eliminating persistent sexual orientation disparities.
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Affiliation(s)
- Carol Goodenow
- Independent Research/Evaluation Consultant, Northborough, MA
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Thomeer MB, Reczek C. Happiness and Sexual Minority Status. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:1745-58. [PMID: 27102605 PMCID: PMC5679422 DOI: 10.1007/s10508-016-0737-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 01/26/2016] [Accepted: 03/07/2016] [Indexed: 05/13/2023]
Abstract
We used logistic regression on nationally representative data (General Social Survey, N = 10,668 and N = 6680) to examine how sexual minority status related to happiness. We considered two central dimensions of sexual minority status-sexual behavior and sexual identity. We distinguished between same-sex, both-sex, and different-sex-oriented participants. Because individuals transition between sexual behavior categories over the life course (e.g., from both-sex partners to only same-sex partners) and changes in sexual minority status have theoretical associations with well-being, we also tested the associations of transitions with happiness. Results showed that identifying as bisexual, gay, or lesbian, having both male and female partners since age 18, or transitioning to only different-sex partners was negatively related to happiness. Those with only same-sex partners since age 18 or in the past 5 years had similar levels of happiness as those with only different-sex partners since age 18. Additional tests showed that the majority of these happiness differences became non-significant when economic and social resources were included, indicating that the lower happiness was a product of structural and societal forces. Our findings clearly and robustly underscored the importance of taking a multi-faceted approach to understanding sexuality and well-being, demonstrating that not all sexual minority groups experience disadvantaged happiness. Our study calls for more attention to positive aspects of well-being such as happiness in examinations of sexual minorities and suggests that positive psychology and other happiness subfields should consider the role of sexual minority status in shaping happiness.
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Affiliation(s)
- Mieke Beth Thomeer
- Department of Sociology, University of Alabama at Birmingham, HHB 460, 1720 2nd Ave South, Birmingham, AL, 35294, USA.
| | - Corinne Reczek
- Department of Sociology, The Ohio State University, Columbus, OH, USA
- Department of Women's, Gender, and Sexuality Studies, The Ohio State University, Columbus, OH, USA
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