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Salway T, Delgado-Ron JA, Rich AJ, Dharma C, Baams L, Fish J. Trends in mental health and smoking disparities between sexual minority and heterosexual adults in Canada, 2003-2020. SSM Popul Health 2024; 27:101697. [PMID: 39072350 PMCID: PMC11277742 DOI: 10.1016/j.ssmph.2024.101697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/30/2024] Open
Abstract
Sexual minority populations experience a higher burden of mental health and substance use/misuse conditions than heterosexual comparators-a health inequality that has predominantly been attributed to forms of minority stress experienced by the former group. Sexual minority-affirming legislative and policy advances, as well as improvements in social attitudes toward sexual minorities in recent decades, should presumably reduce experiences of minority stress, thereby attenuating these disparities. We conducted temporal trend analyses of annual prevalence of anxiety, depression, poor self-rated mental health, and cigarette smoking, stratified by sexual orientation and gender/sex subgroups using the Canadian Community Health Survey, 2003-2020. Descriptive analyses were used to display temporal trends; joinpoint regression was used to identify significant changes in prevalence data during 2003-2020; and prevalence ratios were estimated by year to detect any reduction in disparities. The prevalence of self-rated mental health and mood and anxiety disorders increased, whereas the prevalence of smoking decreased, between 2003 and 2020, among both sexual minority and heterosexual people in Canada. We observed a significant inflection point in 2009 in the self-rated mental health trend among bisexual women, where rates of poor mental health initially decreased from 2003 but then increased drastically from 2009 to 2020. Significant inflection points in current smoking trends were observed in 2012 among bisexual and heterosexual women and in 2013 among heterosexual men; in all three groups, both segments demonstrated decreasing trends, however, the slope of the trend became more pronounced in the latter period. Consistent with other North American studies, we found that relative differences between sexual minority and heterosexual groups for all four outcomes remained the same or increased during this 18-year period. Findings highlight the need to better understand mechanisms bolstering sexual orientation health disparities.
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Affiliation(s)
- Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300-8888 University Drive, Burnaby, BC, V5A 1S6, Canada
- Centre for Gender and Sexual Health Equity, 1190 Hornby St. (11th floor), Vancouver, BC, V6Z 2K5, Canada
- British Columbia Centre for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
| | - Jorge Andrés Delgado-Ron
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300-8888 University Drive, Burnaby, BC, V5A 1S6, Canada
- Centre for Gender and Sexual Health Equity, 1190 Hornby St. (11th floor), Vancouver, BC, V6Z 2K5, Canada
| | - Ashleigh J. Rich
- Centre for Gender and Sexual Health Equity, 1190 Hornby St. (11th floor), Vancouver, BC, V6Z 2K5, Canada
- Department of Social Medicine, University of North Carolina, Chapel Hill, NC, 27599-7240, United States
| | - Christoffer Dharma
- Dalla Lana School of Public Health, University of Toronto, 155 college street, 6th floor, Toronto, ON, M5T 3M7, Canada
| | - Laura Baams
- Department of Pedagogy and Educational Sciences, University of Groningen, 9712 CP, Groningen, Netherlands
| | - Jessica Fish
- Department of Family Science, University of Maryland, 1142 School of Public Health, 2242 Valley Dr, College Park, MD, 20742, United States
- University of Maryland Prevention Research Center, Building #255, Rm. 2302, 4200 Valley Drive, Room 1242L, College Park, MD, 20742-2611, United States
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Coulaud PJ, Salway T, Adams N, Ball W, Larmarange J, Kelly-Irving M, Knight R. Knowledge gaps in existing research exploring sexual fluidity and mental health among young adults. J Epidemiol Community Health 2024; 78:556-560. [PMID: 38944417 DOI: 10.1136/jech-2023-221844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 06/18/2024] [Indexed: 07/01/2024]
Abstract
While there is a large body of evidence indicating that sexual minority youth experience inequitably high rates of mental health problems (eg, depression, suicidality), we know little about how temporal changes in sexual attractions, identities and behaviour may impact mental health (and other) outcomes. In this essay, we review existing research regarding sexual fluidity and mental health among young adults in order to identify critical knowledge gaps with respect to an epidemiological understanding of the relationship between these factors. We describe three gaps that in turn inform a larger public health research agenda on this topic. First, there are a number of methodological challenges given that fluidity can occur over short or long periods of time and across multiple dimensions of sexual orientation (eg, attractions, identities and behaviour) with various patterns (eg, directionality of change). Tailored measures that accurately and inclusively reflect diversities of sexual fluidity trajectories are needed. Second, causal relationships between sexual fluidity and mental health remain uncertain and unquantified. Third, little is known about how features of context (eg, gender norms and political climate) influence youth experiences with sexual fluidity and mental health. Finally, we propose a set of recommendations to address these knowledge gaps to improve the quality of epidemiological research involving young people.
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Affiliation(s)
- Pierre-Julien Coulaud
- École de Santé Publique, Département de Médecine Sociale et Préventive, Université de Montréal, Montréal, Québec, 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
| | - Nick Adams
- School of Nursing Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, Scotland
| | - William Ball
- School of Nursing Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, Scotland
| | - Joseph Larmarange
- Centre Population et Développement (UMR 196 Université Paris Cité, IRD), SageSud (ERL INSERM 1244), Institut de Recherche pour le Développement, Paris, France
| | - Michelle Kelly-Irving
- Centre for Epidemiology and Research in Population Health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
| | - Rod Knight
- École de Santé Publique, Département de Médecine Sociale et Préventive, Université de Montréal, Montréal, Québec, Canada
- Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
- Centre de Recherche en Santé Publique (CReSP), Montréal, Québec, Canada
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3
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Ferlatte O, Dromer E, Salway T, Bourne A, Kia H, Gaudette M, Moullec G, Knight R, Oliffe JL. Self-Perceived Reasons for Suicide Attempts in Sexual and Gender Minorities in Canada. JOURNAL OF HOMOSEXUALITY 2024:1-21. [PMID: 39101722 DOI: 10.1080/00918369.2024.2384939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
The aim of this study was to examine the self-perceived reasons of suicide attempts among sexual and gender minorities (SGM). We surveyed SGM living in Canada (n = 2778) and respondents who had attempted suicide answered open-ended questions about their perceived reason(s) of their first/only attempt (FOA) and last attempt (LA) (for those who attempted multiple times). Responses were double-coded and categorized as discrete findings. A quarter (25%, n = 695) of the total sample reported a history of suicide attempt, of whom 72% reported multiple attempts. Respondents described a wide variety of reasons for their suicide attempts, with an important number of individuals reporting multiple reasons (corresponding to 47.5% of FOA and 43% of LA). Emotional issues (FOA:42.1%, LA:44.0%) were the most prevalent category of reasons for suicide attempts followed by experience of mental illness (FOA:30.1%, LA:36.1%). Other common reasons included violence (FOA:23.2%, LA:10.2%), interpersonal conflict (FOA:13.4%, LA:6.0%), stress related to life circumstances (FOA:9.5%, LA:16.7%), relationship issues (FOA:7.9%, LA:13.3%), and minority stress related to sexuality (FOA:11.1%, LA:6.2%) and gender identity (FOA:5.0%, LA:6.8%). SGM assessments of the reasons underlying their suicide attempts yielded a variety of factors, many of which were absent from the literature on SGM suicide but amenable to tailored interventions.
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Affiliation(s)
- Olivier Ferlatte
- Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal, Montreal, QC, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Elisabeth Dromer
- Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal, Montreal, QC, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- British Columbia Centre for Disease Control, Vancouver, Canada
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, Latrobe University, Melbourne, Australia
- Kirby Institute, University of New South Wales, Sidney, Australia
| | - Hannah Kia
- School of Social Work, University of British Columbia, Vancouver, Canada
| | - Maxi Gaudette
- Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal, Montreal, QC, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Gregory Moullec
- Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal, Montreal, QC, Canada
- CIUSSS Nord-de-l'Île-de-Montréal - Hôpital du Sacré-Cœur de Montréal, Montreal, Canada
| | - Rod Knight
- Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal, Montreal, QC, Canada
| | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
- Department of Nursing, University of Melbourne, Victoria, Australia
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Gewirtz-Meydan A, Koós M, Nagy L, Kraus SW, Demetrovics Z, Potenza MN, Ballester-Arnal R, Batthyány D, Bergeron S, Billieux J, Burkauskas J, Cárdenas-López G, Carvalho J, Castro-Calvo J, Chen L, Ciocca G, Corazza O, Csako R, Fernandez DP, Fujiwara H, Fernandez EF, Fuss J, Gabrhelík R, Gjoneska B, Gola M, Grubbs JB, Hashim HT, Islam MS, Ismail M, Jiménez-Martínez MC, Jurin T, Kalina O, Klein V, Költő A, Lee SK, Lewczuk K, Lin CY, Lochner C, López-Alvarado S, Lukavská K, Mayta-Tristán P, Miller DJ, Orosová O, Orosz G, Ponce FP, Quintana GR, Quintero Garzola GC, Ramos-Diaz J, Rigaud K, Rousseau A, De Tubino Scanavino M, Schulmeyer MK, Sharan P, Shibata M, Shoib S, Sigre-Leirós V, Sniewski L, Spasovski O, Steibliene V, Stein DJ, Strong C, Ünsal BC, Vaillancourt-Morel MP, Van Hout MC, Bőthe B. Global cross-cultural validation of a brief measure for identifying potential suicide risk in 42 countries. Public Health 2024; 229:13-23. [PMID: 38382177 DOI: 10.1016/j.puhe.2023.12.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/11/2023] [Accepted: 12/29/2023] [Indexed: 02/23/2024]
Abstract
OBJECTIVES This study aimed to examine the psychometric properties of the P4 suicide screener in a multinational sample. The primary goal was to evaluate the reliability and validity of the scale and investigate its convergent validity by analyzing its correlation with depression, anxiety, and substance use. STUDY DESIGN The study design is a cross-sectional self-report study conducted across 42 countries. METHODS A cross-sectional, self-report study was conducted in 42 countries, with a total of 82,243 participants included in the final data set. RESULTS The study provides an overview of suicide ideation rates across 42 countries and confirms the structural validity of the P4 screener. The findings indicated that sexual and gender minority individuals exhibited higher rates of suicidal ideation. The P4 screener showed adequate reliability, convergence, and discriminant validity, and a cutoff score of 1 is recommended to identify individuals at risk of suicidal behavior. CONCLUSIONS The study supports the reliability and validity of the P4 suicide screener across 42 diverse countries, highlighting the importance of using a cross-cultural suicide risk assessment to standardize the identification of high-risk individuals and tailoring culturally sensitive suicide prevention strategies.
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Affiliation(s)
- A Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel. Agewirtz-@univ.haifa.ac.il
| | - M Koós
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Forensic Psychiatry and Sex Research, University of Duisburg-Essen, Essen, Germany
| | - L Nagy
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - S W Kraus
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Z Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
| | - M N Potenza
- Yale University School of Medicine, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA
| | - R Ballester-Arnal
- Departmento de Psicología Básica, Clínica y Psicobiología, University Jaume I of Castellón, Spain
| | - D Batthyány
- Institute for Behavioural Addictions, Sigmund Freud University Vienna, Austria
| | - S Bergeron
- Département de Psychologie, Université de Montréal, Montréal, Canada
| | - J Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - J Burkauskas
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
| | - G Cárdenas-López
- Virtual Teaching and Cyberpsychology Laboratory, School of Psychology, National Autonomous University of Mexico, Mexico
| | - J Carvalho
- William James Center for Research, Departamento de Educação e Psicologia, Universidade de Aveiro, Aveiro, Portugal
| | - J Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Spain
| | - L Chen
- Department of Psychology, College of Humanity and Social Science, Fuzhou University, China
| | - G Ciocca
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - O Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, UK; Department of Psychology and Cognitive Science, University of Trento, Italy
| | - R Csako
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | | | - H Fujiwara
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Decentralized Big Data Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | | | - J Fuss
- Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - R Gabrhelík
- Charles University, First Faculty of Medicine, Department of Addictology, Prague, Czech Republic; General University Hospital in Prague, Department of Addictology, Czech Republic
| | - B Gjoneska
- Macedonian Academy of Sciences and Arts, Macedonia
| | - M Gola
- Institute of Psychlogy, Polish Academy of Sciences, Poland; Institute for Neural Computations, University of California San Diego, USA
| | - J B Grubbs
- University of New Mexico, Albuquerque, USA; Center for Alcohol, Substance Use, And Addiction (CASAA), University of New Mexico, Albuquerque, USA
| | - H T Hashim
- University of Baghdad, College of Medicine, Iraq
| | - M S Islam
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka 1342, Bangladesh; Centre for Advanced Research Excellence in Public Health, Savar, Dhaka 1342, Bangladesh
| | - M Ismail
- University of Baghdad, College of Medicine, Iraq
| | - M C Jiménez-Martínez
- Universidad Pedagógca y Tecnológica de Colombia, Colombia; Grupo de Investigación Biomédica y de Patología, Colombia
| | - T Jurin
- Department of Psychology, Humanities and Social Sciences, University of Zagreb, Croatia
| | - O Kalina
- Department of Educational Psychology and Psychology of Health, Pavol Jozef Safarik University in Kosice, Slovakia
| | - V Klein
- School of Psychology, University of Southampton, UK
| | - A Költő
- Health Promotion Research Centre, University of Galway, Ireland, UK
| | - S-K Lee
- Department of Psychiatry, Hallym University Chuncheon Sacred Heart Hospital, South Korea; Chuncheon Addiction Management Center, South Korea
| | - K Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - C-Y Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - C Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Stellenbosch University, South Africa
| | | | - K Lukavská
- Charles University, First Faculty of Medicine, Department of Addictology, Prague, Czech Republic; Charles University, Faculty of Education, Department of Psychology, Prague, Czech Republic
| | - P Mayta-Tristán
- Facultad de Medicina, Universidad Científica del Sur, Lima, Peru
| | - D J Miller
- College of Healthcare Sciences, James Cook University, Australia
| | - O Orosová
- Pavol Jozef Safarik University in Kosice, Department of Educational Psychology and Psychology of Health, Slovakia
| | | | - F P Ponce
- Facultad de Psicología, Universidad de Talca, Chile
| | - G R Quintana
- Departamento de Psicología y Filosofía, Facultad de Ciencias Sociales, Universidad de Tarapacá, Arica, Arica y Parinacota, Chile
| | - G C Quintero Garzola
- Florida State University, Panama; Sistema Nacional de Investigación (SNI), SENACYT, Panama
| | - J Ramos-Diaz
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Perú
| | | | - A Rousseau
- Leuven School for Mass Communication, KU Leuven, Leuven, Belgium
| | - M De Tubino Scanavino
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, Brazil; Experimental Pathophisiology Post Graduation Program, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | | | - P Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - M Shibata
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - S Shoib
- Department of Psychology, Shardha University, India; Department of Health Kashmir, India
| | - V Sigre-Leirós
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland; Institute of Legal Psychiatry, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - L Sniewski
- Auckland University of Technology, New Zealand
| | - O Spasovski
- Faculty of Philosophy, Ss. Cyril and Methodius University in Skopje, Macedonia; Faculty of Philosophy, University of Ss. Cyril and Methodius in Trnava, Slovakia
| | - V Steibliene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Lithuania
| | - D J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa
| | - C Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - B C Ünsal
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - M-P Vaillancourt-Morel
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - M C Van Hout
- Public Health Institute, Faculty of Health, Liverpool John Moores University, UK
| | - B Bőthe
- Département de Psychologie, Université de Montréal, Montréal, Canada; Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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Dharma C, Liu E, Grace D, Logie C, Abramovich A, Mitsakakis N, Baskerville B, Chaiton M. Factors associated with the use of psychedelics, ketamine and MDMA among sexual and gender minority youths in Canada: a machine learning analysis. J Epidemiol Community Health 2024; 78:248-254. [PMID: 38262735 DOI: 10.1136/jech-2023-220748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Substance use is increasing among sexual and gender minority youth (SGMY). This increase may be due to changes in social norms and socialisation, or due to SGMY exploring the potential therapeutic value of drugs such as psychedelics. We identified predictors of psychedelics, MDMA and ketamine use. METHODS Data were obtained from 1414 SGMY participants who completed the ongoing longitudinal 2SLGBTQ+ Tobacco Project in Canada between November 2020 to January 2021. We examined the association between 80 potential features (including sociodemographic factors, mental health-related factors and substance use-related factors) with the use of psychedelics, MDMA and ketamine in the past year. Random forest classifier was used to identify the predictors most associated with reported use of these drugs. RESULTS 18.1% of participants have used psychedelics in the past year; 21.9% used at least one of the three drugs. Cannabis and cocaine use were the predictors most strongly associated with any of these drugs, while cannabis, but not cocaine use, was the one most associated with psychedelic use. Other mental health and 2SLGBTQ+ stigma-related factors were also associated with the use of these drugs. CONCLUSION The use of psychedelics, MDMA and ketamine among 2SLGBTQ+ individuals appeared to be largely driven by those who used them together with other drugs. Depression scores also appeared in the top 10 factors associated with these illicit drugs, suggesting that there were individuals who may benefit from the potential therapeutic value of these drugs. These characteristics should be further investigated in future studies.
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Affiliation(s)
- Christoffer Dharma
- University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Esther Liu
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Human Biology, University of Toronto, Toronto, Ontario, Canada
| | - Daniel Grace
- University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Carmen Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- United Nations University Institute for Water Environment and Health, Hamilton, Ontario, Canada
| | - Alex Abramovich
- University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- University of Toronto Department of Psychiatry, Toronto, Ontario, Canada
| | - Nicholas Mitsakakis
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, Ontario, Canada
| | - Bruce Baskerville
- School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada
| | - Michael Chaiton
- University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Institute for Medical Science, University of Toronto, Toronto, Ontario, Canada
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Ontario, Canada
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Clark KA, Blosnich JR. Sexual Orientation and Disclosure of Suicidal Thoughts Before Suicide Mortality. Am J Prev Med 2023; 65:953-963. [PMID: 37429387 PMCID: PMC10772205 DOI: 10.1016/j.amepre.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/03/2023] [Accepted: 07/03/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION Disclosure of suicidal thoughts and behaviors represents an opportunity to intervene before suicide mortality, representing a cornerstone for suicide prevention. Sexual minority (e.g., lesbian/gay, bisexual) people experience sharply elevated suicide risk, yet there is scant research on patterns of disclosure of suicidal thoughts and behaviors before suicide that might uncover missed opportunities for suicide prevention. Thus, authors leveraged postmortem suicide data to evaluate associations among sexual orientation, sex, and disclosure of suicidal thoughts and behaviors in the month preceding death. METHODS Data on suicides from the 2013-2019 National Violent Death Reporting System (N=155,516) were classified for sexual orientation and denoted disclosure of suicidal thoughts and behaviors and to whom suicidal thoughts and behaviors were disclosed in the month preceding death. Logistic regression models stratified by sex and adjusted for sociodemographic covariates assessed the associations between sexual orientation and suicidal thoughts and behaviors disclosure. Analyses were conducted from October 2022 to February 2023. RESULTS Among females, sexual minority decedents were 65% more likely to disclose suicidal thoughts and behaviors than heterosexual decedents (95% CI=37%, 99%, p<0.001). No difference in suicidal thoughts and behaviors disclosure was observed between sexual minority and heterosexual men. Of decedents who disclosed suicidal thoughts and behaviors, one in five sexual minority decedents disclosed to a friend/colleague, whereas fewer than 5% disclosed to a healthcare professional. Among sexual minority females, younger age, intimate partner problems, and physical health problems were positively associated with disclosing suicidal thoughts and behaviors. CONCLUSIONS These findings suggest that reducing suicide mortality in sexual minority populations will require considering contexts beyond the healthcare system, including engaging peer networks. Gatekeeper training for suicide prevention may be an especially promising approach for reducing suicide among sexual minority women.
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Affiliation(s)
- Kirsty A Clark
- Department of Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee.
| | - John R Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
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7
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Moody RL, Carter JA, Talan A, Sizemore KM, Russell ST, Rendina HJ. Associations of adverse and protective childhood experiences with thwarted belongingness, perceived burdensomeness, and suicide risk among sexual minority men. Psychol Med 2023; 53:5615-5624. [PMID: 36117279 PMCID: PMC10024646 DOI: 10.1017/s0033291722002823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 08/04/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sexual minority men (SMM) experience higher suicidal ideation and suicide attempts than the general population. We examined the associations of adverse childhood experiences (ACES) and protective and compensatory childhood experiences (PACES) with suicidal ideation and suicide attempts in adulthood via thwarted belongingness and perceived burdensomeness among SMM. METHODS Data are from the UNITE study, a national longitudinal cohort study of HIV-negative SMM from the 50 U.S. states and Puerto Rico. Between 2017 and 2019, participants (N = 6303) completed web-based assessments at baseline and 12-month follow-up. ACES and PACES occurring before the age of 18, and current symptoms of thwarted belongingness and perceived burdensomeness were assessed at baseline. Past-week suicidal ideation and past-year suicide attempt were assessed at follow-up. RESULTS 424 (6.7%) participants reported past-week suicidal ideation and 123 (2.0%) reported a past-year suicide attempt. The results of our multivariate model suggest that each additional adverse childhood experience was prospectively associated with 14% higher odds of past-week suicidal ideation (AOR = 1.14, 95% CI 1.09-1.19) and 19% higher odds of past-year suicide attempt (AOR = 1.19, 95% CI 1.11-1.29). Each additional protective childhood experience was prospectively associated with 15% lower odds of past-week suicidal ideation (AOR = 0.85, 95% CI 0.81-0.90) and 11% lower odds of past-year suicide attempt (AOR = 0.89, 95% CI 0.82-0.98). Perceived burdensomeness partially mediated these prospective associations. CONCLUSION To reduce suicide, screening and treating perceived burdensomeness among SMM with high ACES may be warranted. PACES may decrease perceived burdensomeness and associated suicide risk.
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Affiliation(s)
- Raymond L. Moody
- Department of Epidemiology, Columbia University Mailman School of Public Health, 772 West 181st Street, New York, NY 10032, USA
| | - Joseph A. Carter
- Department of Psychology, City University of New York Graduate Center, Health Psychology and Clinical Sciences Program, New York, NY, USA
| | - Ali Talan
- Whitman-Walker Institute, Washington, DC, USA
| | - K. Marie Sizemore
- Department of Psychiatry, Rutgers University Institute for Health, Health Care Policy, and Aging, New Brunswick, NJ, USA
| | - Stephen T. Russell
- Department of Human Development and Family Sciences, University of Texas at Austin School of Human Ecology, Austin, TX, USA
| | - H. Jonathon Rendina
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, and Whitman-Walker Institute, Washington, DC, USA
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8
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Cooper S, Péloquin T, Lachowsky NJ, Salway T, Oliffe JL, Klassen B, Brennan DJ, Houle J, Ferlatte O. Conformity to Masculinity Norms and Mental Health Outcomes Among Gay, Bisexual, Trans, Two-Spirit, and Queer Men and Non-Binary Individuals. Am J Mens Health 2023; 17:15579883231206618. [PMID: 37886907 PMCID: PMC10612460 DOI: 10.1177/15579883231206618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/21/2023] [Accepted: 09/14/2023] [Indexed: 10/28/2023] Open
Abstract
Homophobia and biphobia negatively impact the mental health of gay, bisexual, trans, Two-Spirit, and queer men and non-binary individuals (GBT2Q) and sexual and gender minority men, but little is known about the impact of gender-related oppression. The current study examines the impact of pressure to conform to masculine norms in Canada-based GBT2Q individuals. Specifically, the associations between (a) gender expression and pressure to be masculine and (b) pressure to be masculine and depression, anxiety, and self-rated mental health were investigated. Drawing from an online national cross-sectional survey of 8,977 GBT2Q individuals and sexual and gender minority men living in Canada aged 15 years or older, 56.4% (n = 5,067) of respondents reported experiencing pressure to conform to masculine norms. Respondents were more likely to report masculine pressure if they were younger than 30 years, described their gender expression as fluid, identified their sexuality as queer, were an ethnoracial minority, and were trans. Pressure to be masculine was associated with increased odds of depression, anxiety, and reporting poor or fair mental health. The current study provides evidence of the detrimental impact of pressure to conform to masculine norms on the mental health of gay, bisexual, trans, Two-Spirit, and queer men and non-binary peoples.
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Affiliation(s)
- Sarah Cooper
- École de Santé Publique de l’Université de Montréal, Montréal, Quebec, Canada
- Centre de Recherche en Santé Publique, Montréal, Quebec, Canada
| | - Tristan Péloquin
- École de Santé Publique de l’Université de Montréal, Montréal, Quebec, Canada
| | - Nathan J. Lachowsky
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- School of Public Health & Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Travis Salway
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- BC Centre for Disease Control, Vancouver, British Columbia, Canada
- Centre for Gender & Sexual Health Equity, Vancouver, British Columbia, Canada
| | - John L. Oliffe
- School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
- Department of Nursing, The University of Melbourne, Parkville, Victoria, Australia
| | - Benjamin Klassen
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - David J. Brennan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Janie Houle
- Department of Psychology, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Olivier Ferlatte
- École de Santé Publique de l’Université de Montréal, Montréal, Quebec, Canada
- Centre de Recherche en Santé Publique, Montréal, Quebec, Canada
- Community-Based Research Centre, Vancouver, British Columbia, Canada
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9
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Cimpian JR, Timmer JD, Kim TH. Mitigating invalid and mischievous survey responses: A registered report examining risk disparities between heterosexual and lesbian, gay, bisexual, or questioning youth. Child Dev 2023; 94:1136-1161. [PMID: 37363898 DOI: 10.1111/cdev.13957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 01/07/2023] [Accepted: 04/05/2023] [Indexed: 06/28/2023]
Abstract
In a Registered Report, the authors propose a new survey-bias-mitigation method-incorporating inverse probability weighting via boosted regression-to better understand lesbian, gay, bisexual, or questioning (LGBQ)-heterosexual youth risk disparities. This method is tested using the 2019 US Centers for Disease Control and Prevention-collected Youth Risk Behavior Survey (YRBS) national data, which contain 12,847 observations (ages 12-18 [M = 16, SD = 1.25]; 49.1% male [8.7% LGBQ] and 50.9% female [22.4% LGBQ]; nationally representative regarding race and ethnicity). Looking across 44 outcomes, the authors found that the YRBS contains responses that are potentially biased against LGBQ youth in systematic ways, inflating perceived risk for this group in some outcomes. This potential bias is more pronounced among reported males than among reported females, and it is more pronounced for low-incidence outcomes. For example, the steroid-use disparity estimate among reported males reduced by 67%, while the reduction in bullying victimization was small and not statistically significant. The authors discuss robustness of results, the new method, and data policy implications.
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Affiliation(s)
| | | | - Taek H Kim
- Gangneung-Wonju National University, Gangneung, Republic of Korea
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10
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Blosnich JR. Interpersonal and self-directed violence among sexual and gender minority populations: Moving research from prevalence to prevention. CURR EPIDEMIOL REP 2022; 9:142-160. [PMID: 36845319 PMCID: PMC9957556 DOI: 10.1007/s40471-022-00299-4] [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] [Accepted: 06/27/2022] [Indexed: 11/03/2022]
Abstract
Purpose of review This scoping review of reviews aimed to detail the breadth of violence research about sexual and gender minorities (SGM) in terms of the three generations of health disparities research (i.e., documenting, understanding, and reducing disparities). Recent findings Seventy-three reviews met inclusion criteria. Nearly 70% of the reviews for interpersonal violence and for self-directed violence were classified as first-generation studies. Critical third-generation studies were considerably scant (7% for interpersonal violence and 6% for self-directed violence). Summary Third-generation research to reduce or prevent violence against SGM populations must account for larger scale social environmental dynamics. Sexual orientation and gender identity (SOGI) data collection has increased in population-based health surveys, but administrative datasets (e.g., health care, social services, coroner and medical examiner offices, law enforcement) must begin including SOGI to meet the needs of scaled public health interventions to curb violence among SGM communities.
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Affiliation(s)
- John R. Blosnich
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W 34 St., Los Angeles, CA 90089, USA
- Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania 15240, USA
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11
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Clark KA, Blosnich JR. "If I Had Access to a Gun, I Think I Would Have Used it Instead": Motivations for Method Choice Among Sexual and Gender Minority Adults Who Made a Recent Near-Fatal Suicide Attempt. LGBT Health 2022; 9:276-281. [PMID: 35363061 PMCID: PMC9150126 DOI: 10.1089/lgbt.2021.0389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: We examined motivations for suicide attempt method choice among sexual and/or gender minority (SGM) adults who attempted suicide in the previous 18 months. Methods: Individual semistructured interviews (N = 22) explored participants' motivations. Results: Five reasons influenced method choices: accessibility, perceived lethality, familiarity, not having access to a firearm, and concerns about pain and violence involved with other methods. Conclusion: Methods of suicide attempt are critical for informing SGM suicide prevention efforts. Future research should investigate whether and how lethal means restriction efforts are implemented within the contexts in which SGM people live and obtain mental health care (e.g., SGM community centers).
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Affiliation(s)
- Kirsty A. Clark
- Department of Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee, USA
| | - John R. Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
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12
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Liu J, Afful A, Mansell H, Ma Y. Bias analysis for misclassification errors in both the response variable and covariate. AM STAT 2022. [DOI: 10.1080/00031305.2022.2066725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Juxin Liu
- Department of Mathematics and Statistics, University of Saskatchewan, Saskatoon, S7N 5E6, Canada
| | - Annshirley Afful
- Department of Mathematics and Statistics, University of Saskatchewan, Saskatoon, S7N 5E6, Canada
| | - Holly Mansell
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, S7N 5E5, Canada
| | - Yanyuan Ma
- Department of Statistics, Pennsylvania State University, University Park, PA 16802
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13
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McGraw JS, Peer SO, McManimen S, Chinn J, Mahoney A. Comparison of Lifetime Suicide Attempts and Recent Suicidal/Self-Harming Thoughts Among Sexual Minority and Heterosexual Utahns: Results from a Population-Based Survey. Arch Suicide Res 2022; 26:961-967. [PMID: 32783705 DOI: 10.1080/13811118.2020.1806159] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE We sought to be the first published article to report differences in population-representative prevalence of suicidal thoughts and attempts by sexual orientation. METHOD Data from Utah's Behavioral Risk Factor Surveillance System (BRFSS) collected for 2016 (N = 10,988) and 2017 (N = 10,251) were examined to determine differences in the prevalence of suicidal thoughts in the past 2 weeks and the lifetime prevalence of suicide attempts (i.e., any, single, and multiple) by sexual orientation. RESULTS 3.5% of heterosexuals Utahns reported recent suicidal/self-harming thoughts in the last 2 weeks compared to 14.7% of LGB Utahns (OR = 4.73 95% CI [2.67, 8.36]). 5.8% of heterosexuals reported a lifetime prevalence of any suicidal attempts compared to 37.2% of LGB folx (OR = 9.58 95% CI [7.16, 12.81]) with similar differences occurring for single and multiple attempts. Comparing LG versus B, there was no difference in ideation or prevalence of any attempt, but bisexuals reported higher rates of multiple suicide attempts. CONCLUSION LGB folx in Utah are drastically more likely to have thought about suicide/self-harming in the last 2 weeks and to have attempted suicide in their lifetime when compared to heterosexuals in Utah.
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14
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St-Jean M, Closson K, Salway T, Card K, Patterson TL, Hogg RS, Lima VD. Sexual minority status modifies the association between HIV risk behavior and prevalent mood or anxiety disorders in British Columbia, Canada. Soc Psychiatry Psychiatr Epidemiol 2022; 57:207-218. [PMID: 34279694 DOI: 10.1007/s00127-021-02141-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 07/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed at determining to what extent sexual minority status modifies the association between HIV risk behavior and prevalent mood or anxiety disorder diagnosis in British Columbia (BC), Canada, using a population-based survey. METHODS This analysis was based on the cross-sectional 2013-2014 Canadian Community Health Survey. The sample was restricted to respondents in BC with valid responses to the survey items considered. A multivariable logistic model, where the behavioral HIV risk score exposure was nested into the sexual minority status modifier, estimated the odds of having a prevalent mood or an anxiety disorder. The behavioral HIV risk score (0, 1, 2, ≥ 3) included the following five measures: (1) age at first intercourse < 14 years, (2) condom use during last intercourse, (3) history of sexually transmitted infections, (5) number of sexual partners in the past 12 months (< 4, ≥ 4), and substance use in the past 12 months. RESULTS Of the weighted sample (2,521,252), 97% (95% confidence interval (CI) 97-98) were heterosexual, while 3% (95% CI 2-3) were lesbian, gay, and bisexual (LGB). The prevalence of a mood or anxiety disorder diagnosis was 12% (95% CI 11-13). For every 1-level increment in the behavioral HIV risk score, the adjusted odds ratio of having a prevalent mood or anxiety disorder diagnosis was 1.29 (95% CI 1.03-1.54) for heterosexual respondents and 2.37 (95% CI 1.84-2.90) for LGB respondents. CONCLUSION Sexual minority status modified the relationship between HIV risk behavior and prevalent mood or anxiety disorders, with a stronger association among LGB respondents. Healthcare providers should prioritize integrated care that addresses the intersectionality between sexual risk, substance use, and mood or anxiety disorders.
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Affiliation(s)
- Martin St-Jean
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Kalysha Closson
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.,Division of Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, Canada
| | - Kiffer Card
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | | | - Robert S Hogg
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Viviane D Lima
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. .,Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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15
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Moallef S, Salway T, Phanuphak N, Kivioja K, Pongruengphant S, Hayashi K. The relationship between sexual and gender stigma and suicide attempt and ideation among LGBTQI + populations in Thailand: findings from a national survey. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1987-1997. [PMID: 35599251 PMCID: PMC9477892 DOI: 10.1007/s00127-022-02292-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 04/12/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE Thailand has one of the highest suicide rates in Southeast Asia; yet, little is known about suicidality among lesbian, gay, bisexual, trans, queer, intersex, and other gender and sexually diverse (LGBTQI +) people living in the region, who may experience elevated risk for suicide. We sought to identify the prevalence of lifetime suicidal attempts and ideation among a nationally recruited sample of LGBTQI + people in Thailand. We further examined the relationship between levels of sexual/gender stigma and suicidal attempt and ideation. METHODS Data were derived from a national online survey of Thai LGBTQI + individuals between January and March 2018. Multivariable logistic regression was used to examine the relationship between sexual/gender stigma scales, adapting a previously validated instrument, and suicide attempt and ideation. RESULTS Among 1,290 LGBTQI + participants, the median age was 27 years. The prevalence of suicide attempt and ideation was 16.8% and 50.7%, respectively. In multivariable analyses, after adjusting for potential confounders, experiences of perceived and enacted sexual/gender stigma were independently and positively associated with suicide attempt (adjusted odds ratio [AOR] = 1.25; 95% confidence interval CI:1.10-1.41 and AOR = 1.31; 95% CI:1.11-1.55, respectively) and ideation (AOR = 1.30; 95% CI:1.17-1.43 and AOR = 1.34; 95% CI:1.14-1.58, respectively). CONCLUSION One-sixth of the sample reported a suicide attempt, while a half reported ever contemplating suicide. Both experiences of perceived and enacted sexual/gender stigma were associated with lifetime suicide attempt and ideation. Multi-level interventions are needed to decrease stigma and in turn suicide among LGBTQ + people in Thailand, including anti-discrimination policies and support for mental health and well-being.
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Affiliation(s)
- Soroush Moallef
- United Nations Development Programme, Bangkok, Thailand ,British Columbia Centre On Substance Use, St. Paul’s Hospital, Vancouver, BC Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC Canada ,British Columbia Centre for Disease Control, Vancouver, BC Canada ,Centre for Gender and Sexual Health Equity, Vancouver, BC Canada
| | | | - Katri Kivioja
- United Nations Development Programme, Bangkok, Thailand
| | | | - Kanna Hayashi
- British Columbia Centre On Substance Use, St. Paul's Hospital, Vancouver, BC, Canada. .,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
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16
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Gibb JK, Shokoohi M, Salway T, Ross LE. Sexual orientation-based disparities in food security among adults in the United States: results from the 2003-2016 NHANES. Am J Clin Nutr 2021; 114:2006-2016. [PMID: 34551071 DOI: 10.1093/ajcn/nqab290] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/11/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Access to sufficient, safe, culturally appropriate, and nutritious food is essential for maintaining both physical and mental health. Despite a growing body of evidence suggesting that sexual minority (SM) people experience significant disparities in socioeconomic and material resource security, there remains a paucity of empirical studies examining the prevalence of food insecurity among SM people relative to their heterosexual peers. OBJECTIVES To determine the prevalence of adult and household food insecurity across sexual orientation groups in the United States after adjusting for multiple covariates. METHODS We combined 7 cycles of US NHANES, 2003-2016 (N = 21,300) to examine sexual orientation-based disparities in adult food security among lesbian/gay (n = 373), bisexual (n = 606), same-sex experienced (SSE, n = 693), other sexual minorities (OSMs, n = 88), and heterosexual (n = 19,540) people. Food (in)security was measured using the US Food Security Survey Module and categorized as secure, marginally insecure, moderately insecure, and severely insecure. RESULTS Severe adult food insecurity was higher among bisexuals (17.16%; 95% CI: 14.36, 20.38), SSE (13.71%; 95% CI: 11.34, 16.48), OSMs (12.50%; 95% CI: 7.04, 21.24), and lesbians/gays (13.14%; 95% CI: 10.07, 16.97) compared with heterosexuals (8.23%; 95% CI: 7.85, 8.62). Multivariable multinomial logistic regression analysis adjusting for gender, race/ethnicity, age, citizenship, education, household size, income, cycle year, emergency food use, and Supplemental Nutrition Assistance Program participation showed that bisexuals, OSMs, SSE, and lesbians/gays were more likely to experience moderate to severe food insecurity compared with heterosexuals. CONCLUSIONS SM people are significantly more likely to experience increased likelihood of food insecurity relative to their heterosexual peers.
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Affiliation(s)
- James K Gibb
- Department of Health & Society, University of Toronto, Scarborough, Ontario, Canada.,Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Mostafa Shokoohi
- Dalla Lana School of Public Health, University of 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
| | - Lori E Ross
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
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17
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Goodyear T, Slemon A, Richardson C, Gadermann A, Salway T, Dhari S, Knight R, Jenkins E. Increases in Alcohol and Cannabis Use Associated with Deteriorating Mental Health among LGBTQ2+ Adults in the Context of COVID-19: A Repeated Cross-Sectional Study in Canada, 2020-2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12155. [PMID: 34831910 PMCID: PMC8620284 DOI: 10.3390/ijerph182212155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/05/2021] [Accepted: 11/17/2021] [Indexed: 11/30/2022]
Abstract
Lesbian, gay, bisexual, trans, other queer, and Two-Spirit (LGBTQ2+) people are particularly at risk for the psycho-social consequences of the COVID-19 pandemic, though population-tailored research within this context remains limited. This study examines the extent of, and associations between, increased alcohol and cannabis use and deteriorating mental health among LGBTQ2+ adults in Canada during the COVID-19 pandemic. Data are drawn from LGBTQ2+ respondents to a repeated, cross-sectional survey administered to adults living in Canada (May 2020-January 2021). Bivariate cross-tabulations and multivariable logistic regression models were utilized to examine associations between increased alcohol and cannabis use, and self-reported mental health, overall coping, and suicidal thoughts. Five-hundred and two LGBTQ2+ participants were included in this analysis. Of these, 24.5% reported increased alcohol use and 18.5% reported increased cannabis use due to the pandemic. In the adjusted analyses, increased alcohol use was associated with poor overall coping (OR = 2.28; 95% CI = 1.28-4.07) and worse self-reported mental health (OR = 1.98; 95% CI = 1.21-3.25), whereas increased cannabis use was associated with suicidal thoughts (OR = 2.30; 95% CI = 1.16-4.55). These findings underscore the need for population-tailored, integrated substance use and mental health supports to address interrelated increases in alcohol/cannabis use and worsening mental health among LGBTQ2+ adults, in the context of the COVID-19 pandemic and beyond.
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Affiliation(s)
- Trevor Goodyear
- School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada; (T.G.); (A.S.); (S.D.)
- British Columbia Centre on Substance Use, Vancouver, BC V6Z 2A9, Canada;
| | - Allie Slemon
- School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada; (T.G.); (A.S.); (S.D.)
| | - Chris Richardson
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (C.R.); (A.G.)
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, BC V6Z 1Y6, Canada
| | - Anne Gadermann
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada; (C.R.); (A.G.)
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, BC V6Z 1Y6, Canada
- The Human Early Learning Partnership, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Travis Salway
- British Columbia Centre for Disease Control, Vancouver, BC V5Z 4R4, Canada;
- Centre for Gender and Sexual Health Equity, Vancouver, BC V6Z 1Y6, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Shivinder Dhari
- School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada; (T.G.); (A.S.); (S.D.)
| | - Rod Knight
- British Columbia Centre on Substance Use, Vancouver, BC V6Z 2A9, Canada;
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Emily Jenkins
- School of Nursing, University of British Columbia, Vancouver, BC V6T 2B5, Canada; (T.G.); (A.S.); (S.D.)
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18
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Salway T, Butt ZA, Wong S, Abdia Y, Balshaw R, Rich AJ, Ablona A, Wong J, Grennan T, Yu A, Alvarez M, Rossi C, Gilbert M, Krajden M, Janjua NZ. A Computable Phenotype Model for Classification of Men Who Have Sex With Men Within a Large Linked Database of Laboratory, Surveillance, and Administrative Healthcare Records. Front Digit Health 2021; 2:547324. [PMID: 34713035 PMCID: PMC8521949 DOI: 10.3389/fdgth.2020.547324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/02/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Most public health datasets do not include sexual orientation measures, thereby limiting the availability of data to monitor health disparities, and evaluate tailored interventions. We therefore developed, validated, and applied a novel computable phenotype model to classify men who have sex with men (MSM) using multiple health datasets from British Columbia, Canada, 1990-2015. Methods: Three case surveillance databases, a public health laboratory database, and five administrative health databases were linked and deidentified (BC Hepatitis Testers Cohort), resulting in a retrospective cohort of 727,091 adult men. Known MSM status from the three disease case surveillance databases was used to develop a multivariable model for classifying MSM in the full cohort. Models were selected using "elastic-net" (GLMNet package) in R, and a final model optimized area under the receiver operating characteristics curve. We compared characteristics of known MSM, classified MSM, and classified heterosexual men. Findings: History of gonorrhea and syphilis diagnoses, HIV tests in the past year, history of visit to an identified gay and bisexual men's clinic, and residence in MSM-dense neighborhoods were all positively associated with being MSM. The selected model had sensitivity of 72%, specificity of 94%. Excluding those with known MSM status, a total of 85,521 men (12% of cohort) were classified as MSM. Interpretation: Computable phenotyping is a promising approach for classification of sexual minorities and investigation of health outcomes in the absence of routinely available self-report data.
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Affiliation(s)
- Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada.,Centre for Gender and Sexual Health Equity, Vancouver, BC, Canada
| | - Zahid A Butt
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Stanley Wong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Younathan Abdia
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Robert Balshaw
- George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada
| | - Ashleigh J Rich
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Aidan Ablona
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Jason Wong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Troy Grennan
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Amanda Yu
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Maria Alvarez
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Carmine Rossi
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Mark Gilbert
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Mel Krajden
- British Columbia Centre for Disease Control (BCCDC) Public Health Laboratory, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Naveed Z Janjua
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada
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19
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Salway T, Juwono S, Klassen B, Ferlatte O, Ablona A, Pruden H, Morgan J, Kwag M, Card K, Knight R, Lachowsky NJ. Experiences with sexual orientation and gender identity conversion therapy practices among sexual minority men in Canada, 2019-2020. PLoS One 2021; 16:e0252539. [PMID: 34081740 PMCID: PMC8174694 DOI: 10.1371/journal.pone.0252539] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/15/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND "Conversion therapy" practices (CTP) are organized and sustained efforts to avoid the adoption of non-heterosexual sexual orientations and/or of gender identities not assigned at birth. Few data are available to inform the contemporary prevalence of CTP. The aim of this study is to quantify the prevalence of CTP among Canadian sexual and gender minority men, including details regarding the setting, age of initiation, and duration of CTP exposure. METHODS Sexual and gender minority men, including transmen and non-binary individuals, aged ≥ 15, living in Canada were recruited via social media and networking applications and websites, November 2019-February 2020. Participants provided demographic data and detailed information about their experiences with CTP. RESULTS 21% of respondents (N = 9,214) indicated that they or any person with authority (e.g., parent, caregiver) ever tried to change their sexual orientation or gender identity, and 10% had experienced CTP. CTP experience was highest among non-binary (20%) and transgender respondents (19%), those aged 15-19 years (13%), immigrants (15%), and racial/ethnic minorities (11-22%, with variability by identity). Among the n = 910 participants who experienced CTP, most experienced CTP in religious/faith-based settings (67%) or licensed healthcare provider offices (20%). 72% of those who experienced CTP first attended before the age of 20 years, 24% attended for one year or longer, and 31% attended more than five sessions. INTERPRETATION CTP remains prevalent in Canada and is most prevalent among younger cohorts, transgender people, immigrants, and racial/ethnic minorities. Legislation, policy, and education are needed that target both religious and healthcare settings.
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Affiliation(s)
- 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
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- * E-mail:
| | - Stephen Juwono
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- Faculty of Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ben Klassen
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Olivier Ferlatte
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- l’École de santé publique de l’Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche en Santé Publique, Montréal, Québec, Canada
| | - Aidan Ablona
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Harlan Pruden
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Jeffrey Morgan
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Kwag
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Kiffer Card
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- University of Victoria, Victoria, British Columbia, Canada
| | - Rod Knight
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathan J. Lachowsky
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- University of Victoria, Victoria, British Columbia, Canada
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20
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Salway T, Gesink D, Ferlatte O, Rich AJ, Rhodes AE, Brennan DJ, Gilbert M. Age, period, and cohort patterns in the epidemiology of suicide attempts among sexual minorities in the United States and Canada: detection of a second peak in middle adulthood. Soc Psychiatry Psychiatr Epidemiol 2021; 56:283-294. [PMID: 32789562 DOI: 10.1007/s00127-020-01946-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 08/07/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Sexual minority adults experience fivefold greater risk of suicide attempt, as compared with heterosexuals. Establishing age-specific epidemiological patterns of suicide is a prerequisite to planning interventions to redress the sexual orientation suicide inequity, and such patterns must be carefully interpreted in light of correlated period and cohort effects. We, therefore, combined US and Canadian data (1985-2017) from primary (two pooled multi-year national surveys, N = 15,477 and N = 126,463) and secondary (published, meta-analytic, N = 122,966) sources to separately estimate age, period, and cohort trends in self-reported suicide attempts among sexual minorities. METHODS Age- and gender-stratified cross-sectional data were used to infer age and cohort effects. Age-collapsed meta-analyzed data were used to infer period effects among sexual minorities of all genders. RESULTS We identified a bimodal age distribution in recent suicide attempts for sexual minorities across genders, though more pronounced among sexual minority men: one peak in adolescence (18-20 years of age for both genders) and one peak nearing mid-life (30-35 years of age for men; 35-40 years of age for women). This pattern was also apparent using recall data within birth cohorts of sexual minority men, suggesting it is not an artifact of birth cohort effects. Finally, we observed decreasing trends in lifetime suicide attempt prevalence estimates for both sexual minorities and heterosexuals, though these decreases did not affect the magnitude of the sexual orientation disparity. CONCLUSION In the context of exclusively adolescent-focused suicide prevention interventions for sexual minorities, tailored suicide prevention for sexual minority adults should be pursued throughout the life course.
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Affiliation(s)
- Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall 11300, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada. .,Clinical Prevention Services, British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada. .,Centre for Gender and Sexual Health Equity, 1190 Hornby Street, 11th Floor, Vancouver, BC, V6Z 2K5, Canada.
| | - Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, ON, M5T 3M7, Canada
| | - Olivier Ferlatte
- École de santé Publique, Université de Montréal, 7101 Park Avenue, Montreal, QC, H3N 1X9, Canada.,Centre de Recherche en santé Publique, Université de Montréal et CIUSS du Centre-Sud-de-l'Île-de-Montréal, 1301, rue Sherbrooke Est, Montreal, QC, H3L 1M3, Canada
| | - Ashleigh J Rich
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Anne E Rhodes
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, ON, M5T 3M7, Canada.,Department of Psychiatry, University of Toronto, 585 University Avenue, Toronto, ON, M5G 2N2, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration-B3, 100 West 5th, Hamilton, ON, L8N 3K7, Canada.,Offord Centre for Child Studies, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
| | - David J Brennan
- Factor-Inwentash School of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada
| | - Mark Gilbert
- Clinical Prevention Services, British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada.,School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
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21
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Salway T, Ferlatte O, Gesink D, Lachowsky NJ. Prevalence of Exposure to Sexual Orientation Change Efforts and Associated Sociodemographic Characteristics and Psychosocial Health Outcomes among Canadian Sexual Minority Men. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:502-509. [PMID: 31984758 PMCID: PMC7298582 DOI: 10.1177/0706743720902629] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Sexual orientation change efforts (SOCE), or "conversion therapy," are pseudoscientific practices intended to suppress or deny sexual attraction to members of the same gender/sex. There are currently no data available to inform estimates of the prevalence of SOCE exposure in Canada. The objective of this study is therefore to describe the prevalence, social-demographic correlates, and health consequences of SOCE among Canadian sexual minority men. METHODS Sex Now 2011 to 2012 was a cross-sectional nonprobability survey of Canadian sexual minority men. Respondents were asked about lifetime SOCE exposure. We estimated prevalence of SOCE exposure by sociodemographic characteristics and examined psychosocial health outcomes among those exposed to SOCE. RESULTS Of N = 8,388 respondents, 3.5% (95% confidence interval, 3.2% to 4.1%) reported having ever been exposed to SOCE. Exposure to SOCE was higher among gay men (as compared with bisexual men), transgender respondents (as compared with cisgender respondents), those who were "out" about their sexuality (as compared with those who were not "out"), Indigenous men (as compared with White men), other racial minorities (as compared with White men), and those earning a personal income <$30,000 (as compared with those earning ≥$60,000 CAD). Exposure to SOCE was positively associated with loneliness, regular illicit drug use, suicidal ideation, and suicide attempt. CONCLUSIONS SOCE exposure remains prevalent and associated with substantial psychosocial morbidity among sexual minority men in Canada. All levels of government in Canada should consider action to ban SOCE. SOCE survivors likely require intervention and support from the Canadian health-care system.
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Affiliation(s)
- 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
| | - Olivier Ferlatte
- École de santé publique, Université de Montréal, Montréal, Québec, Canada
| | - Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Nathan J Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada.,Community-Based Research Centre, Vancouver, British Columbia, Canada
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22
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Cimpian JR, Timmer JD. Mischievous Responders and Sexual Minority Youth Survey Data: A Brief History, Recent Methodological Advances, and Implications for Research and Practice. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1097-1102. [PMID: 32086642 DOI: 10.1007/s10508-020-01661-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/10/2020] [Accepted: 02/10/2020] [Indexed: 05/25/2023]
Affiliation(s)
- Joseph R Cimpian
- Department of Applied Statistics, Social Science, and Humanities, Steinhardt School of Culture, Education, and Human Development, New York University, 246 Greene Street, New York, NY, 10003, USA.
| | - Jennifer D Timmer
- Peabody College of Education and Human Development, Vanderbilt University, Nashville, TN, USA
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23
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Abstract
We examined factors associated with reporting sex with men among men who inject drugs in Vancouver, Canada. Data were drawn from three open prospective cohorts of people who use drugs between 2005 and 2014. Generalized estimating equations were used to identify factors associated with reporting non-transactional sex with men (MSM) in the previous 6 months. Of 1663 men who used injection drugs, 225 (13.5%) were MSM over the study period. Sex with men was independently associated with younger age [Adjusted Odds Ratio (AOR) = 0.96], childhood sexual abuse (AOR = 2.65), sex work (AOR = 3.33), crystal methamphetamine use (AOR = 1.30), borrowing used syringes (AOR = 1.39), inconsistent condom use (AOR = 1.76), and HIV seropositivity (AOR = 3.82). MSM were less likely to be Hepatitis C-positive (AOR = 0.43) and to have accessed addiction treatment in the previous 6 months (AOR = 0.83) (all p < 0.05). Findings highlight vulnerabilities and resiliencies among MSM-PWID and indicate a need for trauma-informed and affirming harm reduction and substance use treatment services for MSM-PWID.
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24
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Salway TJ, Morgan J, Ferlatte O, Hawkins B, Lachowsky NJ, Gilbert M. A Systematic Review of Characteristics of Nonprobability Community Venue Samples of Sexual Minority Individuals and Associated Methods for Assessing Selection Bias. LGBT Health 2019; 6:205-215. [DOI: 10.1089/lgbt.2018.0241] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Travis J. Salway
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Jeffrey Morgan
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Olivier Ferlatte
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada
| | - Blake Hawkins
- Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathan J. Lachowsky
- Community-Based Research Centre, Vancouver, British Columbia, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Mark Gilbert
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
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