1
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Xavier Hall CD, Ryan D, Hayford C, Morgan E, Tabidze I, D’Aquila R, Mustanski B. Syphilis Prevalence, Incidence, and Demographic Differences in a Longitudinal Study of Young Sexual and Gender Minority Adults Assigned Male at Birth. J Infect Dis 2024; 229:232-236. [PMID: 37816091 PMCID: PMC10786243 DOI: 10.1093/infdis/jiad256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 07/05/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Syphilis rates in the United States have increased. Few studies have examined syphilis incidence and prevalence prospectively among young sexual and gender minorities (YSGM). METHODS This study of YSGM assigned male at birth comes from a Chicago-based prospective cohort at 2 visits 6 months apart (N = 882). Syphilis cases were identified through serologic test results and self-reported history. RESULTS In this sample, 25.1% had a lifetime prevalence, and 3.3% were incident cases with a crude incidence rate of 6.76 per 100 person-years. CONCLUSIONS Lifetime syphilis and incidence are high in this sample of YSGM relative to general population samples.
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Affiliation(s)
- Casey D Xavier Hall
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida
- Department of Medical Social Sciences, Feinberg School of Medicine
| | - Daniel Ryan
- Institute for Sexual and Gender Minority Health and Wellbeing
| | - Christina Hayford
- Institute for Sexual and Gender Minority Health and Wellbeing
- Third Coast Center for AIDS Research, Northwestern University, Chicago, Illinois
| | - Ethan Morgan
- College of Nursing, Ohio State University, Columbus, Ohio
| | - Irina Tabidze
- Chicago Department of Public Health, Chicago, Illinois
| | - Richard D’Aquila
- Department of Medicine (Infectious Diseases), Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine
- Institute for Sexual and Gender Minority Health and Wellbeing
- Department of Medicine (Infectious Diseases), Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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2
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Wang L, Harris R, Simoni JM, Yue Q, Fu J, Zheng H, Ning Z, Xavier Hall CD, Burns PA, Wong FY. Health Service Utilization and Its Associations with Depression and Sexual Risk Behaviors Among Transgender Women in Shanghai, China. Transgend Health 2023; 8:516-525. [PMID: 38130986 PMCID: PMC10732171 DOI: 10.1089/trgh.2021.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose Given the limited research on health care utilization among transgender women in China, we described the use of primary health care and gender-affirming health care, and the associations between utilization of gender-affirming health care and depression and sexual risk behaviors. Methods We conducted a cross-sectional survey in 2017 among a purposive sample of transgender women in Shanghai, China (N=199). We examined correlates of health care utilization and its association with depression and sexual risk behaviors with Chi-square (χ2), Fisher's exact tests, and analysis of variance. Results The majority of the sample (78.5%) only had physician appointments when having an illness, while about one-fifth of the sample had physician appointments for yearly checkups. Nineteen out of 199 participants (9.5%) received gender-affirming surgery, among which only five used hormone therapy prescribed by a doctor (26.3%). Receiving some form of gender-affirming surgery was associated with higher depression scores [Welch's F(2, 12.22)=4.16, p=0.04], engagement in sex work (p=0.001), having 7 or more male sexual partners in the last 30 days (p=0.003), lifetime unprotected sex with a man (p=0.050), and unprotected sex with a main partner (p=0.043). Compared with transgender women who received both breast augmentation and vulvo-vaginoplasty (mean=5.86), those who received breast augmentation only (mean=12.33) scored higher on depression (p=0.04). Conclusions Access to gender-affirming health care is low among transgender women in this study. The utilization of gender-affirming surgery is associated with depression and sexual risk behaviors. Findings suggest China should establish national guidelines on transgender-related health care and set up more clinics to provide consultation and services for the transgender population in China.
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Affiliation(s)
- Liying Wang
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Rachel Harris
- Center for Population Sciences and Health Equity, Florida State University, Tallahassee, Florida, USA
- College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Jane M. Simoni
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Qing Yue
- Department of HIV/STD Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Jie Fu
- Department of HIV/STD Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Huang Zheng
- Shanghai Piaoxue Multicultural Media Ltd., Shanghai, China
| | - Zhen Ning
- Department of HIV/STD Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH), Northwestern University, Evanston, Illinois, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Evanston, Illinois, USA
| | - Paul A. Burns
- Department of Population Health Science, John D. Bower School of Population Health, University Mississippi Medical Center, Jackson, Mississippi, USA
| | - Frank Y. Wong
- Center for Population Sciences and Health Equity, Florida State University, Tallahassee, Florida, USA
- Department of Population Health Science, John D. Bower School of Population Health, University Mississippi Medical Center, Jackson, Mississippi, USA
- Department of Psychology, University of Hawaiʽi at Mānoa, Honolulu, Hawaiʽi, USA
- School of Public Health, Fudan University, Shanghai, China
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3
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Signorelli MC, Guimarães da Rocha RW, Xavier Hall CD, Prado SM, Evans DP. "Everything That Is Here, I Have Lived": A Triangulated Analysis of an Intimate Partner Violence Assessment Tool in Curitiba, Brazil. Violence Against Women 2023:10778012231216719. [PMID: 38013218 DOI: 10.1177/10778012231216719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Using a mixed-methods triangulation approach we piloted the Composite Abuse Scale-Brazilian version (CAS-Brazil) at the House of the Brazilian Woman of Curitiba among 62 survivors of intimate partner violence and four professionals serving survivors to assess its feasibility for use. Quantitative data were tabulated using descriptive statistics while qualitative data were recorded, coded, and thematically analyzed. Four qualitative domains emerged: (a) conceptual understanding; (b) item definitions; (c) women's experiences; and (d) professionals' perspectives. Comprehension of the CAS-Brazil appeared high across participants from diverse backgrounds. Professionals viewed it as highly feasible for use in Brazilian cross-sectoral services to support survivor decision-making.
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Affiliation(s)
| | | | | | | | - Dabney P Evans
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
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4
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Wang L, Hong C, He N, Xavier Hall CD, Simoni JM, Wong FY. Depression as a mediator between intimate partner violence (IPV) and CD4 cell count among men who have sex with men (MSM) living with HIV in China. AIDS Care 2023; 35:1667-1676. [PMID: 37018752 DOI: 10.1080/09540121.2023.2195608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 03/20/2023] [Indexed: 04/07/2023]
Abstract
Intimate partner violence (IPV) is associated with adverse mental and physical outcomes among men who have sex with men (MSM) living with HIV. Few studies focus on psychological IPV, such as verbal threats. This study examined the associations between different forms of IPV and depression and CD4+ cell count, with depression as a mediator for the association between IPV and CD4+ cell count. Data for these analyses were derived from a larger cross-sectional study on HIV-HCV co-infection among MSM in Shanghai, China (N = 1623). We estimated the average causal mediation effects (ACME) and average direct effects (ADE) through three steps. About 16% of participants experienced IPV, with forced sex (7%), verbal threats (5%), and thrown objects (4%) being most common. Verbal threats showed the strongest link with depression and low CD4+ cell count. Depression fully mediated the relationship between verbal abuse and low CD4+ cell count, suggesting it as a potential pathway between psychological IPV and poorer HIV-related health outcomes. More research on psychological IPV is warranted to examine its health impacts. Mental health could be a potential focus of intervention to enhance HIV-related health outcomes among MSM with IPV experience.
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Affiliation(s)
- Liying Wang
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Chenglin Hong
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA
| | - Na He
- School of Public Health, Fudan University, Shanghai, People's Republic of China
| | - Casey D Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing (ISGMH), Northwestern University, Chicago, IL, USA
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Gender, Women & Sexuality Studies, University of Washington, Seattle, WA, USA
| | - Frank Y Wong
- School of Public Health, Fudan University, Shanghai, People's Republic of China
- Center for Population Sciences and Health Equity, Florida State University, Tallahassee, FL, USA
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA
- John D. Bower School of Population Health, Department of Population Health Science, University Mississippi Medical Center, Jackson, MS, USA
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5
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Gomillia CE, Burns PA, Xavier Hall CD, Beach LB. The Association of Depression, Social Determinants and PrEP Uptake Among Black Sexual Minority Men in the Deep South. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01793-1. [PMID: 37702972 DOI: 10.1007/s40615-023-01793-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023]
Abstract
Despite its known efficacy in reducing HIV acquisition, pre-exposure prophylaxis (PrEP) uptake and utilization remains alarmingly low among key populations, including Black sexual minority men (SMM). Additionally, research has shown that SMM are at elevated risk of adverse mental health outcomes, including depression, anxiety, illegal drug use, and suicidality. However, there is limited data examining the impact of depression on PrEP uptake among Black SMM. This study analyzes survey data obtained from the ViiV ACCELERATE! Initiative between January 2016 and September 2017 to examine the association between depressive symptoms and uptake of PrEP among a sample of HIV-negative Black SMM ages 18-65 years (N=170) residing in Mississippi, the poorest state in the USA. We found that PrEP-eligible Black SMM reporting depressive symptoms were 60% less likely to take PrEP (aOR = 0.40, CI: 0.18-0.74, p = 0.05). Similarly, PrEP-eligible men lacking health insurance were 63% less likely to start PrEP (aOR = 0.37; CI: 0.17-0.94; p = 0.035). Given the low uptake of PrEP among Black SMM, there is an urgent need for the development and implementation of combination HIV prevention interventions that incorporate access to mental health services among this highly stigmatized and marginalized population.
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Affiliation(s)
- Courtney E Gomillia
- Department of Population Health Science, University of Mississippi Medical Center, 2500 N State Street, TR202, Jackson, MS, 39216, USA.
| | - Paul A Burns
- Department of Population Health Science, University of Mississippi Medical Center, 2500 N State Street, TR202, Jackson, MS, 39216, USA
| | - Casey D Xavier Hall
- College of Nursing, Florida State University, Tallahassee, FL, USA
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Lauren B Beach
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
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Xavier Hall CD, Harris R, Burns P, Girod C, Yount KM, Wong FY. Utilizing Latent Class Analysis to Assess the Association of Intersectional Stigma on Mental Health Outcomes Among Young Adult Black, Indigenous, and Sexual Minority Women of Color. LGBT Health 2023; 10:463-470. [PMID: 36951670 PMCID: PMC10468552 DOI: 10.1089/lgbt.2022.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
Purpose: Discrimination has detrimental effects on mental health, particularly among Black, Indigenous, and people of color who are also sexual minority women (BIPOC SMW); however, measurement of multiple intersecting forms of discrimination (e.g., race, gender, and sexual identity discrimination among BIPOC SMW) poses methodological challenges. This analysis uses latent class analysis (LCA) to examine the influences of discrimination on mental health in a convenience sample of BIPOC SMW. Methods: Online survey data from BIPOC SMW aged 18-29 years (n = 324) were used to estimate latent classes for discrimination type (race, gender, and sexual identity). Data for this study were collected from July to October 2018. Adjusted linear regressions examined the influences of discrimination profiles on perceived stress and depressive symptoms. Results: Utilizing LCA, the following four classes emerged: (1) low discrimination; (2) mid-level discrimination; (3) high racial, medium gender, and low sexual identity discrimination; (4) high discrimination. Classes 3 and 4 were positively associated with perceived stress and depressive symptoms relative to Class 1 in adjusted models. Conclusion: This analysis highlights the importance of intersectionality and the adverse impact of multiple forms of discrimination on mental health outcomes for BIPOC SMW. Respondents reporting higher levels of racial or multiple forms of discrimination had poorer mental health outcomes. LCA is a promising analytical tool for investigating intersectional stigma and discrimination. There is an urgent need to develop tailored, culturally appropriate intersectional mental health interventions to address the multiple identities and oppressions faced by BIPOC SMW.
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Affiliation(s)
- Casey D. Xavier Hall
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Rachel Harris
- College of Social Work, Florida State University, Tallahassee, Florida, USA
| | - Paul Burns
- John D. Bower School of Population Health, Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Kathryn M. Yount
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Sociology, Emory University, Atlanta, Georgia, USA
| | - Frankie Y. Wong
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida, USA
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
- Department of Epidemiology, Fudan University, Shanghai, China
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7
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Harris RM, Xavier Hall CD, Mills JC, Pence BW, Bgneris J, Wong FY. Beyond Viral Suppression-The Impact of Cumulative Violence on Health-Related Quality of Life Among a Cohort of Virally Suppressed Patients. J Acquir Immune Defic Syndr 2023; 92:59-66. [PMID: 36099083 PMCID: PMC11079852 DOI: 10.1097/qai.0000000000003099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 09/06/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To elucidate how and in what ways cumulative violence affects health-related quality of life (HRQoL) among a clinical cohort of virally stable people living with HIV. DESIGN We used data from the University of North Carolina Center for AIDS Research HIV clinical cohort. Our analysis was limited to participants with an undetectable viral load (<200) and those who completed the Clinical, Sociodemographic, and Behavioral Survey between 2008 and 2017 ( n = 284). METHODS A path analysis was used to test our primary hypothesis that the effect of cumulative violence on HRQoL would be mediated through symptoms of post-traumatic stress disorder (PTSD), depressive symptoms, and HIV symptom distress. RESULTS The impact of cumulative violence on HRQoL was fully mediated by symptoms of PTSD, depressive symptoms, and HIV symptom distress. Greater exposure to violence was associated with higher odds of PTSD symptoms ( P <0.001), increased depressive symptoms ( P <0.001), and increased HIV symptom distress ( P < 0.01). HIV symptom distress displayed the largest association with HRQoL ( P < 0.001), followed by depressive symptoms ( P = 0.001) and PTSD symptoms ( P < 0.001). These factors explained approximately 51% of the variance in HRQoL ( R2 = 0.51, P < 0.001). CONCLUSIONS Our findings indicate that addressing physical and mental health symptoms rooted in violent victimization should be a point of focus in efforts to improve HRQoL among people living with HIV who are virally stable.
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Affiliation(s)
- Rachel M Harris
- Center for Population Sciences and Health Equity College of Social Work, Florida State University, FL
| | - Casey D Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing, Center for Population Sciences and Health Equity, Northwestern University, Florida State University, FL
| | - Jon C Mills
- College of Medicine, Center for Population Sciences and Health Equity, Florida State University, FL
| | - Brian W Pence
- Gillings School of Global Public Health, University of North Carolina, Chape Hill, NC
| | - Jessica Bgneris
- Center for Population Sciences and Health Equity, Graduate College of Social Work, Florida State University, University of Houston, TX; and
| | - Frankie Y Wong
- Center for Population Sciences and Health Equity, Florida State University, FL
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8
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Xavier Hall CD, Bundy C, Foran JE, Newcomb ME, Carrillo H, Watkins-Hayes C, Mustanski B. Identifying Strategies for Improving Pre-exposure Prophylaxis Adherence: Perspectives from a Sample of Highly Adherent Young Men Who have Sex with Men. AIDS Behav 2023; 27:506-517. [PMID: 35906443 PMCID: PMC9884315 DOI: 10.1007/s10461-022-03785-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2022] [Indexed: 02/04/2023]
Abstract
Most research on pre-exposure prophylaxis (PrEP) adherence and persistence uses a deficit-based approach to identify negative influences on PrEP adherence; however, an alternative set of approaches (such as resilience, asset-based, and positive variation) may identify equally important positive influences on PrEP adherence. Thus, the current study presents qualitative perspectives of PrEP adherence strategies from a sample of adherent YMSM. PrEP-using YMSM living in the Chicago area from a larger cohort study were recruited into a 90-day diary study that measured sexual health behaviors including PrEP use. A subset (n = 28) were then recruited for in-depth interviews between April and September 2020 covering topics of PrEP use and adherence. Thematic analysis was used to interpret patterns within the data. The analytic sample (n = 19) consistently reported high levels of adherence. Adherence strategies were organized into three broader categories: psychological (e.g. mindfulness, pill auditing), technical/instrumental (e.g. automated reminders, pill organizers), and social strategies (e.g. checking in with friends, or getting suggestions from friends). The majority of participants described using multiple strategies and changing strategies to respond to barriers to adherence. Other themes that were related to adherence included having a daily medication history and a generally positive outlook toward the PrEP regimen. Those who had medication histories were able to draw from experience to develop strategies for PrEP adherence. Findings suggest the need for pre-emptive counseling for PrEP-initiators on the use of multiple strategies, how to prepare for PrEP adherence, to adapt to challenges, and to adopt a range of potential strategies for adherence.
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Affiliation(s)
- Casey D. Xavier Hall
- grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL USA
| | - Camille Bundy
- grid.16753.360000 0001 2299 3507Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL USA
| | - James E. Foran
- grid.16753.360000 0001 2299 3507Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL USA
| | - Michael E. Newcomb
- grid.16753.360000 0001 2299 3507Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA ,grid.16753.360000 0001 2299 3507Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL USA
| | - Héctor Carrillo
- grid.16753.360000 0001 2299 3507Department of Sociology, Northwestern University, Evanston, IL USA
| | - Celeste Watkins-Hayes
- grid.214458.e0000000086837370Ford School of Public Policy, University of Michigan, Ann Arbor, MI USA ,grid.214458.e0000000086837370Department of Sociology, University of Michigan, Ann Arbor, MI USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. .,Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA.
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Bundy C, Xavier Hall CD, Foran JE, Jozsa K, Newcomb ME, Mustanski B. Reassessing the Importance of PrEP Use Given Reduced Sex During the COVID-19 Pandemic: Perspectives From a Sample of Young Sexual Minority Men. AIDS Educ Prev 2022; 34:441-452. [PMID: 36454133 PMCID: PMC9979445 DOI: 10.1521/aeap.2022.34.6.441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Research has begun to examine sexual behavior during the COVID-19 pandemic using quantitative methods, but less is known about the context surrounding these changes using qualitative methods, including corresponding changes in risk reduction methods. This qualitative study, guided by the Integrated Behavioral Model, examines the pandemic's impact on PrEP adherence among young men who have sex with men in Chicago. PrEP-using participants from a cohort study were recruited into a 90-day diary study measuring sexual behaviors and PrEP use. Between April and September 2020, a subset of participants was recruited for qualitative interviews (n = 28) exploring prevention strategies, including the impact of the pandemic. Although most were highly adherent pre-pandemic, many took fewer pills or discontinued during the pandemic due to decreased sex. Findings suggest the importance of counseling for PrEP reinitiation as "seasons of HIV risk" increase, as well as use of telehealth as a facilitator of PrEP use throughout the pandemic.
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Affiliation(s)
- Camille Bundy
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
| | - Casey D. Xavier Hall
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - James E. Foran
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
| | - Kyle Jozsa
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
| | - Michael E. Newcomb
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Brian Mustanski
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
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10
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Gabster A, Xavier Hall CD, Yu Pon A, Millender E, Wong F(Y, Pascale JM. Dating violence prevalence and risk factors among adolescents (14-19 years) in urban public schools in Panama. Lancet Reg Health Am 2022; 17:100383. [PMID: 36776569 PMCID: PMC9904058 DOI: 10.1016/j.lana.2022.100383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/26/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022]
Abstract
Background Adolescent dating violence (ADV) can have lasting effects on youth's well-being and development. However, few studies in Latin America have described its prevalence and risk factors for having experienced ADV. Methods We conducted a multisite, cross-sectional study using two-stage cluster sampling among adolescents (14-19 years) attending public high schools in the urban districts of Panama, San Miguelito, Colón, and Arraiján/La Chorrera from 2015 to 2018 (N = 2469). All completed a tablet-based, self-administered questionnaire. Random effects logistic regression was used to identify risk factors for each ADV type among adolescent boys and girls separately. Findings Participants reported experiencing a range of ADV at least once (girls: emotional 61.6%, physical 7.9%, sexual 21.0%; boys: emotional 73.4%, physical 24.1%, sexual 28.9%). In adjusted models, participants with a history of sexual intercourse had greater odds of ADV than those without such history across types (boys: emotional and sexual; girls: emotional, physical, and sexual). Additionally, participants who reported three or more romantic partners in the past year had greater odds of ADV than those with one partner (boys: emotional, physical; girls: physical). Girls with an earlier sexual debut (≤14 years vs ≥15 years) had greater odds of reporting ADV (emotional and sexual violence). No associations were found between reporting dating violence survival and the sex of romantic partners in the past year or the age of the current/most recent sex partner. Interpretation This study reveals a high prevalence of ADV among adolescents in urban public schools in Panama. These findings support the need for program implementation to address ADV. Funding Funding to undertake this study was acquired from Panama's Ministry of Economics and Finance, project number 009044.049.
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Affiliation(s)
- Amanda Gabster
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama,National Research System, National Secretariat of Science, Technology and Innovation, Panama City, Panama,Center of Population Sciences for Health Equity, Florida State University, Tallahassee, FL, USA,Corresponding author. Gorgas Memorial Institute for Health Studies, Ave Justo Arosemena, Calle 36, Panama City, Panama.
| | - Casey D. Xavier Hall
- Center of Population Sciences for Health Equity, Florida State University, Tallahassee, FL, USA,College of Nursing, Florida State University, Tallahassee, FL, USA,Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Anyi Yu Pon
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama
| | - Eugenia Millender
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama,Center of Population Sciences for Health Equity, Florida State University, Tallahassee, FL, USA,College of Nursing, Florida State University, Tallahassee, FL, USA,Department of Social Science Studies, Florida State University-Panama, Panama City, Panama
| | - Frank (“Frankie”) Y. Wong
- Department of Genomics and Proteomics, Gorgas Memorial Institute for Health Studies, Panama City, Panama,Center of Population Sciences for Health Equity, Florida State University, Tallahassee, FL, USA,College of Nursing, Florida State University, Tallahassee, FL, USA,Department of Social Science Studies, Florida State University-Panama, Panama City, Panama
| | - Juan Miguel Pascale
- General Director, Gorgas Memorial Institute for Health Studies, Panama City, Panama,Faculty of Medicine, University of Panama, Panama City, Panama
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Xavier Hall CD, Wood CV, Hurtado M, Moskowitz DA, Dyar C, Mustanski B. Identifying leaks in the STEM recruitment pipeline among sexual and gender minority US secondary students. PLoS One 2022; 17:e0268769. [PMID: 35658021 PMCID: PMC9165784 DOI: 10.1371/journal.pone.0268769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 05/06/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose Research establishes the critical need to address the underrepresentation of women and racial/ethnic minorities in science, technology, engineering, and mathematics (STEM). While emergent research addresses similar challenges for sexual and gender minorities (SGM), this research remains scant and focuses on adult experiences. This analysis examines subgroup differences and the impact of bullying on STEM engagement outcomes among a national sample of SGM secondary students in the U.S. Method This report provides descriptive and multivariable regression analysis of national survey data (n = 539) on the experiences of pre-college students who identify as SGM, including the effects of within-school anti-SGM bullying on STEM identity, perceptions of STEM climate, and STEM intentions. Results Roughly 50% of the sample intended to enter a STEM field (compared to 25% in previous general samples). Bullying in school was negatively associated with STEM identity and perceptions of STEM climate. Sense of belonging is positively associated with perceptions of STEM climate and STEM intentions. Being non-binary and being a transgender man were associated with decreased sense of belonging and negative perception of STEM climate. Conclusion This report is the first to identify factors influencing STEM engagement among SGM secondary students and suggests that issues of STEM engagement are already present in adolescence. Moreover, the findings also establish the relationship between anti-SGM bullying and STEM outcomes highlighting the importance of this marginalization experience. Future research should further examine sub-group differences and the persistence of these effects. These findings highlight the need for research and intervention addressing STEM outcomes in SGM populations. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT03511131.
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Affiliation(s)
- Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States of America
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, United States of America
| | - Christine V. Wood
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, United States of America
| | - Manuel Hurtado
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States of America
| | - David A. Moskowitz
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, United States of America
| | - Christina Dyar
- College of Nursing, Ohio State University, Columbus, OH, United States of America
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States of America
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, United States of America
- * E-mail:
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12
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Xavier Hall CD, Feinstein BA, Rusie L, Phillips Ii G, Beach LB. Race and Sexual Identity Differences in PrEP Continuum Outcomes Among Latino Men in a Large Chicago Area Healthcare Network. AIDS Behav 2022; 26:1943-1955. [PMID: 34993667 PMCID: PMC8736294 DOI: 10.1007/s10461-021-03544-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 01/08/2023]
Abstract
U.S. HIV incidence is threefold higher among Latino individuals than non-Latino Whites. Pre-exposure prophylaxis (PrEP) uptake remains low among Latino men. Most HIV studies view Latino communities as a monolithic group, ignoring racial and sexual diversity. This analysis examines PrEP-related outcomes including eligibility, first prescription, and second prescription across race and sexual identity in a sample of Latino cisgender men (n = 8271) who sought services from a healthcare network in Chicago in 2012-2019. Logistic regression was used to calculate adjusted odds ratios. Latino-only participants had lower odds of PrEP eligibility and first prescription compared to White-Latino participants. No other significant differences by race were detected. While bisexual participants had equivalent odds of PrEP eligibility, they had lower odds of first PrEP prescription compared to gay participants. Heterosexual participants also had lower odds of PrEP eligibility and initiation. Future research should address unique factors shaping PrEP-related outcomes among diverse Latino populations.
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Affiliation(s)
- Casey D Xavier Hall
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL, 60611, USA.
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA.
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | | | - Gregory Phillips Ii
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, 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
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
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13
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Sarno EL, Swann G, Xavier Hall CD, Newcomb ME, Mustanski B. Minority Stress, Identity Conflict, and HIV-Related Outcomes Among Men Who Have Sex with Men, Transgender Women, and Gender Nonbinary People of Color. LGBT Health 2022; 9:411-417. [PMID: 35594255 PMCID: PMC9499444 DOI: 10.1089/lgbt.2021.0401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: This study investigated conflict between sexual orientation and racial/ethnic identities as a mechanism linking minority stress to HIV-related outcomes among men who have sex with men (MSM), transgender women and gender nonbinary (TGN) people of color (POC). Methods: We tested longitudinal mediation models with sexual orientation microaggressions, internalized heterosexism (IH), and sexual orientation concealment at Time 1, and pre-exposure prophylaxis (PrEP) use and number of condomless anal sex (CAS) partners at Time 3, mediated by identity conflict at Time 2. Participants were 337 MSM and TGN POC. Data were collected in Chicago, Illinois, from September 2018 to February 2021. Results: Indirect associations of IH and sexual orientation concealment, respectively, at Time 1 with CAS partners at Time 3 through identity conflict at Time 2 were significant. Mediation models with sexual orientation microaggressions as the predictor and PrEP use as the outcome were not significant. Conclusion: Minority stress may contribute to identity conflict and increase CAS by isolating MSM and TGN POC from sexual and gender minority communities, thus restricting access to safer sex resources, and by increasing psychological distress and decreasing self-care (e.g., condom use).
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Affiliation(s)
- Elissa L Sarno
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA.,Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Gregory Swann
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA.,Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Casey D Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA.,Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA.,Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA.,Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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14
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Xavier Hall CD, Javanbakht M, Iyer C, Costales C, Napolitano JC, Johnson T, Castro CF, Newcomb ME, Kipke MD, Shoptaw S, Gorbach PM, Mustanski B. Examining the impact of social distancing and methamphetamine use on sexual risk and intimate partner violence in sexual and gender minority young adults during the COVID-19 pandemic. Drug Alcohol Depend 2022; 232:109231. [PMID: 35033952 PMCID: PMC8704723 DOI: 10.1016/j.drugalcdep.2021.109231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND During the COVID-19 pandemic in 2020, concerns were raised about the potential impact of pandemic-related social distancing measures on existing health disparities among sexual and gender minority (SGM) young adults, including HIV transmission risk and intimate partner violence (IPV). Another concern was the potential for increased methamphetamine use during the pandemic, which is a known risk factor for HIV transmission and IPV. METHODS The present analysis examines the impact of COVID-19 social distancing (social distancing and quarantining) and methamphetamine use on HIV risk and IPV in a combined dataset from 3 cohort studies of SGM young adults (two in Los Angeles and one in Chicago) from May 2020 to April 2021 (n = 1142). Bivariate analyses and multivariable logistic regressions were estimated. RESULTS The median age was 26. All participants were assigned male at birth and most participants were men (93.8%). The largest racial groups were Hispanic/Latinx (44.6%) and Black (29.0%). In adjusted models methamphetamine use was consistently associated with having a new sex partner, higher numbers of sex partners, and experience of IPV, during the pandemic. Reporting no social distancing and reporting one social distancing behavior, were associated with experience of IPV relative to reporting 2 social distancing behaviors. Social distancing was not associated with sexual risk behavior or Pre-exposure Prophylaxis use. CONCLUSIONS SGM young adults live at the intersection of multiple vulnerabilities during the COVID-19 pandemic. Addiction services, HIV prevention services, and violence support services should be prepared to support young adult SGM needs, particularly those who use methamphetamine.
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Affiliation(s)
- Casey D Xavier Hall
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Chitra Iyer
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Cocoa Costales
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Julia C Napolitano
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Tony Johnson
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Christian Felix Castro
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Michele D Kipke
- Childrens Hospital, University of Southern California, Los Angeles, CA, USA
| | - Steven Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA.
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15
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Hall CDX, Newcomb ME, Dyar C, Mustanski B. Patterns of polyvictimization predict stimulant use, alcohol and marijuana problems in a large cohort of sexual minority and gender minority youth assigned male at birth. Psychol Addict Behav 2022; 36:186-196. [PMID: 34081488 PMCID: PMC8639824 DOI: 10.1037/adb0000751] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Men who have sex with men (MSM) and gender minorities (GM) are more likely to have substance problems and experience various forms of victimization compared to their heterosexual and cisgender counterparts. Polyvictimization allows for the assessment of the combined impact of multiple forms of victimization on health. This study examines the effects of polyvictimization patterns on stimulant use, alcohol and marijuana problems among a large cohort study. METHOD The sample was collected between 2015 and 2019 (n = 1,202). Mean age was 22. The sample was racially diverse (34.4% Black, 29.0% Hispanic/Latinx, 25.8% white, 5.9% other racial identity), 92.4% of the sample were MSM and 7.6% of the sample were GM. Using latent class analysis five qualitatively different polyvictimization classes were identified. Associations between these classes and stimulant use, alcohol and marijuana problems were examined using negative binomial and logistic regressions. RESULTS Polyvictimization class significantly predicted alcohol problems and cannabis problems, at baseline as well as methamphetamine, and cocaine use at both time points. The polyvictimization profiles that were characterized by intimate partner violence (IPV), childhood sexual abuse (CSA), and high victimization across types were associated with substance outcomes at baseline. The polyvictimization class that was characterized by report of IPV was associated with cocaine use at 6 month follow-up. The polyvictimization class that was characterized by CSA was associated with methamphetamine use at 6 month follow-up. CONCLUSIONS Researchers should examine the effects of victimization experiences more holistically and develop substance interventions that take multiple forms of victimization experiences into account. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Casey D. Xavier Hall
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL,Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
| | - Michael E. Newcomb
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL,Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
| | - Christina Dyar
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL,Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL,Corresponding author: Brian Mustanski, 625 N Michigan Ave, Suite 14-061; Chicago, IL 60611; ; (312) 503-6509
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16
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Manders OC, Xavier Hall CD, Vertamatti MAF, Evans DP, Campbell JC. We need to use words that we'd use in Brazil, right? A Community-Based Content Validation of a Translated Femicide Risk Assessment Instrument. Violence Against Women 2021; 28:2889-2908. [PMID: 34860627 DOI: 10.1177/10778012211051397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Danger Assessment (DA) is a widely-used risk assessment instrument designed to help women understand their risk of femicide. Currently, no validated tool exists in Brazilian Portuguese. The purpose of this study was to conduct a cross-cultural adaptation of the DA for use in the Brazilian context as a precursor to validation and broader testing among women in Brazil. This study describes a community participatory approach for translation and cultural adaptation of the DA from European to Brazilian Portuguese that engages the target population in the process. Using a three-step process, a final version of the DA-Brazil instrument was developed.
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Affiliation(s)
- Olivia C Manders
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA
| | - Casey D Xavier Hall
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA
| | | | - Dabney P Evans
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, USA
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17
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Xavier Hall CD, Morgan E, Bundy C, Foran JE, Janulis P, Newcomb ME, Mustanski B. Substance Use Predicts Sustained Viral Suppression in a Community Cohort of Sexual and Gender Minority Youth Living with HIV. AIDS Behav 2021; 25:3303-3315. [PMID: 33582890 DOI: 10.1007/s10461-021-03179-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2021] [Indexed: 12/23/2022]
Abstract
Retention in care and sustained viral suppression are integral outcomes in the care continuum for people living with HIV (PLWH) and HIV prevention; however, less is known about how substance use predicts sustained viral suppression over time. This study seeks to examine the predictive effects of substance use on sustained viral suppression in a sample of cisgender sexual minority men and gender minority PLWH (n = 163) drawn from a longitudinal sample in the Chicago area collected 2015-2019. Using data from 3 visits separated by 6 months, participants were coded persistently detectable, inconsistently virally suppressed, and consistently virally suppressed (< 40 copies/mL at all visits). Multinomial logistic regressions were utilized. About 40% of participants had sustained viral suppression. In multinomial logistic regressions, CUDIT-R predicted persistent detectable status and stimulant use was associated with inconsistent viral suppression. Substance use may create challenges in achieving sustained viral suppression, which has important implications for care and prevention.
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Affiliation(s)
- Casey D Xavier Hall
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Ethan Morgan
- Infectious Disease Institute, College of Nursing, Ohio State University, Columbus, OH, USA
| | - Camille Bundy
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - James E Foran
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Patrick Janulis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA.
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18
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Burns PA, Hall CDX, Poteat T, Mena LA, Wong FY. Living While Black, Gay, and Poor: The Association of Race, Neighborhood Structural Disadvantage, and PrEP Utilization Among a Sample of Black Men Who Have Sex With Men in the Deep South. AIDS Educ Prev 2021; 33:395-410. [PMID: 34596429 PMCID: PMC10134438 DOI: 10.1521/aeap.2021.33.5.395] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Utilizing the Andersen Healthcare Utilization Model, we examined the role of neighborhood context on pre-exposure prophylaxis (PrEP) utilization among a sample of Black men who have sex with men (MSM) residing in a medium-sized city in the Deep South. Data were derived from a sample of 142 Black MSM aged 18-64 years who were eligible for PrEP from a community-based study known as "ACCELERATE!" We used multilevel structural equation modeling to assess PrEP use. Social support, sexual risk, and health care access were predictive of PrEP use. Notably, residing in a neighborhood with concentrated poverty was associated with decreased PrEP use. Our findings reveal neighborhood structural disadvantage is associated with decreased PrEP use among Black MSM, after adjusting of individual-level sociodemographic characteristics. There is an urgent need to develop HIV prevention interventions and programs that explicitly address structural-level factors to eliminate racial/ethnic differences in HIV.
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Affiliation(s)
- Paul A. Burns
- University of Mississippi Medical Center. John D. Bower School of Population Health | Center for HIV/AIDS Research, Education and Policy, 2500 North State Street, TR202-09, Jackson, MS 39216 USA
| | - Casey D. Xavier Hall
- Northwestern University, Department of Medical Social Sciences at Feinberg School of Medicine | Institute for Sexual and Gender Minority Health and Wellbeing, 625 N Michigan Ave, Suite 1400, Chicago, IL 60611
| | - Tonia Poteat
- University of North Carolina-Chapel Hill, School of Medicine | Department of Social Medicine and Center for Health Equity Research 321 S. Columbia Street, Chapel Hill, NC 27599
| | - Leandro A. Mena
- University of Mississippi Medical Center. John D. Bower School of Population Health | Center for HIV/AIDS Research, Education and Policy, 2500 North State Street, TR202-09, Jackson, MS 39216 USA
- Univerisity of Mississippi Medical Center, School of Medicine, Department of Infectious Diseases, 2500 North State Street, Jackson, MS 39216 USA
| | - Frank Y. Wong
- University of Mississippi Medical Center. John D. Bower School of Population Health | Center for HIV/AIDS Research, Education and Policy, 2500 North State Street, TR202-09, Jackson, MS 39216 USA
- Florida State University, College of Nursing | Center for Population Sciences and Health Equity, 2010 Levy Avenue, Building B, Suite 3600, Tallahassee, FL 32310
- University of Hawaiì at Mānoa, Department of Psychology, Sakamaki C 400, 2530 Dole St C 400, Honolulu, HI 96822
- Fudan University, School of Public Health-Epidemiology, Shanghai, China
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Morgan E, Meites E, Markowitz LE, Xavier Hall CD, Querec TD, Unger ER, Crosby RA, Newcomb ME, Mustanski B. Sexual Positioning Practices and Anal Human Papillomavirus Infection Among Young Men Who Have Sex with Men and Transgender Women-Chicago, Illinois, 2016-2018. Sex Transm Dis 2021; 48:709-713. [PMID: 34110734 PMCID: PMC8459672 DOI: 10.1097/olq.0000000000001433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States; men who have sex with men (MSM) have higher prevalence of infection and related disease compared with other men. We assessed whether differences in HPV acquisition exist among MSM according to their sexual positioning practices, as well as self-reported receipt of HPV vaccination. METHODS We enrolled young MSM and transgender women aged 18 to 26 years in Chicago, IL (N = 666). Participants self-reported their history of HPV vaccination and submitted self-collected anal swab specimens for type-specific HPV detection using an L1-consensus PCR assay. Multivariable logistic regression analyses were used to assess relationships between sexual positioning practices and detection of any HPV or quadrivalent HPV vaccine (4vHPV) types by vaccination status, defined as self-reported receipt of ≥1 HPV vaccine dose versus none. RESULTS Among 666 participants, 400 (60.1%) had any anal HPV, and 146 (21.9%) had a 4vHPV type. Among vaccinated participants, 18, 36, and 177 reported exclusively insertive, exclusively receptive, or both sexual positioning practices, respectively. Compared with participants reporting exclusively insertive anal sex, odds of any HPV were significantly higher among participants engaging exclusively in receptive anal sex (adjusted odds ratio [aOR], 5.90; 95% confidence interval [CI], 2.52-13.78), as well as those engaging in both (aOR, 3.32; 95% CI, 1.71-6.44). Vaccinated participants, compared with unvaccinated participants, had lower odds of 4vHPV-type HPV regardless of sexual positioning practices (aOR, 0.56; 95% CI, 0.34-0.92). CONCLUSIONS Adult men and transgender women who practice anal receptive sex have high prevalence of infection with any HPV. Routine vaccination of all adolescents is expected to reduce HPV-related disease incidence among adult MSM and transgender women as vaccinated cohorts age.
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Affiliation(s)
- Ethan Morgan
- Infectious Disease Institute and College of Nursing, The Ohio State University, Columbus, OH
| | - Elissa Meites
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lauri E. Markowitz
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | - Troy D. Querec
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | - Elizabeth R. Unger
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Michael E. Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University, Chicago, IL
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Evans DP, Xavier Hall CD, da Rocha RWG, Prado SM, Signorelli MC. "These Questions Have Everything That Happens to me": Analysis of a Femicide Risk Assessment Tool for Abused Women in Brazil. J Fam Violence 2021; 37:547-557. [PMID: 34493898 PMCID: PMC8414033 DOI: 10.1007/s10896-021-00313-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 05/26/2023]
Abstract
PURPOSE The purpose of this mixed-methods triangulation study was to assess the face validity and comprehension of a femicide risk assessment tool, the Danger Assessment-Brazil (DA-Brazil) among women seeking care in a one stop center for abused women in Curitiba, Brazil. Our secondary aim was to assess professionals' perceptions of feasibility for using the DA-Brazil in the same setting. METHOD Fifty-five women experiencing relationship violence completed the instrument and participated in cognitive interviews about their experience; professionals attending survivors were also interviewed. RESULTS The vast majority of women described the DA-Brazil instrument as being easy to comprehend (n = 41, 73.2%). Nearly half of participants (n = 26, 46.4%) had some kind of question regarding the DA-Brazil calendar, a tool to visualize abuse frequency and severity. Queries aligned with five categories: recollection of dates, scale, relationship status, terminology, and discomfort. Professionals reported that the DA-Brazil instrument would support referral decision-making. CONCLUSION The overall face validity and comprehension of the DA-Brazil appears to be high. The majority of challenges were around the calendar activity. Professional perceptions of the DA-Brazil suggest a high degree of feasibility for its use in Brazilian healthcare settings. In order for the DA-Brazil to effectively be administered with facilitated support there is a need for training on the best use of the instrument. Accurate assessment of femicide risk is critical in a country like Brazil with high rates of femicide. The DA-Brazil provides a valid assessment of femicide risk and has the potential to trigger early intervention for those at risk. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10896-021-00313-1.
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Affiliation(s)
- Dabney P. Evans
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, Atlanta, GA 30322 USA
| | - Casey D. Xavier Hall
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University Chicago, Chicago, IL USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL USA
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Hahm HC, Xavier Hall CD, Garcia KT, Cavallino A, Ha Y, Cozier YC, Liu C. Experiences of COVID-19-related anti-Asian discrimination and affective reactions in a multiple race sample of U.S. young adults. BMC Public Health 2021; 21:1563. [PMID: 34407792 PMCID: PMC8371291 DOI: 10.1186/s12889-021-11559-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 07/27/2021] [Indexed: 12/02/2022] Open
Abstract
Background Little remains known about both Asian and Asian American (A/AA) and non-Asian young adults’ experiences and affective reactions regarding COVID-19 anti-Asian discrimination. To our knowledge, this is the first study that explores the nature and impact of COVID-19 anti-Asian discrimination within a multi-racial sample. Methods This study uses qualitative open-ended responses from a sub-sample of Wave I of the COVID-19 Adult Resilience Experiences Study (CARES) data collected between March to September 2020. Thematic analysis was used to explore two open-ended questions: “Are there experiences we missed in the survey so far that you wish to describe?” and “What are your thoughts about the current social climate?” The data analysis for this study focused on 113 discrimination or racism-related comments. Results A total of 1331 young adults completed an online survey of which 611 provided comments; a multi-racial sample of 95 individuals (65.3% non-Asians, 24.7% A/AA) contributed 113 COVID-19 anti-Asian discrimination or racism-related comments. Two overarching themes were: types of discrimination (societal, interpersonal, intrapersonal) and affective reactions to discrimination (fear, anxiety/distress, hopelessness/depression, and avoidance). Not only did both A/AA and non-Asian participants report witnessing or hearing reports of anti-Asian discrimination, but both groups described having negative affective reactions to anti-Asian discrimination. Conclusion Anti-Asian discrimination in the face of COVID may be more widespread than initial reports indicate. Our finding suggests that anti-Asian discrimination is a societal illness that impacts all populations in the U.S. This calls for cross-racial coalitions and solidarity in the fight against discrimination and racism. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11559-1.
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Affiliation(s)
- Hyeouk Chris Hahm
- Boston University School of Social Work, 264 Bay State Road, Boston, MA, 02215, USA.
| | - Casey D Xavier Hall
- Northwestern University's Institute for Sexual and Gender Minority Health and Wellbeing, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA
| | | | - Anna Cavallino
- Boston University School of Social Work, 264 Bay State Road, Boston, MA, 02215, USA
| | - Yoonsook Ha
- Boston University School of Social Work, 264 Bay State Road, Boston, MA, 02215, USA
| | - Yvette C Cozier
- Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA
| | - Cindy Liu
- Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
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22
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Jefferson K, Stanhope KK, Jones-Harrell C, Vester A, Tyano E, Hall CDX. A scoping review of recommendations in the English language on conducting research with trauma-exposed populations since publication of the Belmont report; thematic review of existing recommendations on research with trauma-exposed populations. PLoS One 2021; 16:e0254003. [PMID: 34324528 PMCID: PMC8321367 DOI: 10.1371/journal.pone.0254003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 06/17/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To identify recommendations for conducting public health research with trauma-exposed populations. METHODS Researchers searched Embase, PubMed, Scopus, Web of Science, Open Grey, and Google Scholar for recommendations. Trauma that causes psychological impact was our exposure of interest and we excluded clinical articles on treating physical trauma. We reviewed titles and abstracts of 8,070 articles and full text of 300 articles. We analyzed recommendations with thematic analysis, generated questions from the existing pool of recommendations, and then summarized select gaps. RESULTS We abstracted recommendations from 145 articles in five categories: community benefit, participant benefit, safety, researcher well-being, and recommendations for conduct of trauma research. CONCLUSIONS Gold standards to guide the conduct of trauma-informed public health research do not yet exist. The literature suggests participation in trauma research is not inherently harmful, and current recommendations concern using research to benefit communities and participants, protecting participants and researchers from harm, and improving professional practice. As public health researchers increasingly analyze trauma as a determinant of health, gold standards for the conduct of trauma-informed public health research would be appropriate and timely.
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Affiliation(s)
- Kevin Jefferson
- Independent Researcher, Atlanta, Georgia, United States of America
| | - Kaitlyn K. Stanhope
- Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Carla Jones-Harrell
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Aimée Vester
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Emma Tyano
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, United States of America
| | - Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Well-being, Northwestern University, Evanston, Illinois, United States of America
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois, United States of America
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23
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Hall CDX, Moran K, Newcomb ME, Mustanski B. Age of Occurrence and Severity of Childhood Sexual Abuse: Impacts on Health Outcomes in Men Who Have Sex with Men and Transgender Women. J Sex Res 2021; 58:763-774. [PMID: 33215945 PMCID: PMC8134626 DOI: 10.1080/00224499.2020.1840497] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Childhood sexual abuse (CSA) is associated with a wide range of health outcomes and is more prevalent among men who have sex with men (MSM) compared to men who have sex with women exclusively and among transgender women (TW) compared to cisgender peers; however, there is a lack of consensus regarding an explanatory theoretical model. This analysis examined these models across health outcomes using baseline data from a longitudinal study of MSM and TW in Chicago (n = 1,035) collected from 2015 to 2019. Severity of CSA was measured for two age ranges (prior to 13 and 13-17). Logistic regression and negative binomial regressions were estimated. Teenage experiences of CSA were associated with alcohol problems, cannabis problems, suicide ideation/attempt, depression, condomless anal sex partners, rectal STI, and HIV. Pre-teenage CSA was associated with alcohol use and depressive symptoms. Significant interactions across age of experience of CSA were found for alcohol problems, cannabis problems, and condomless anal sex partners. Consistent with previous literature, this analysis found CSA to be a significant influence on various health outcomes. No single explanatory framework emerged; however, adolescent exposures may be more closely linked to health outcomes and risk behaviors than pre-teenage or cumulative exposures.
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Affiliation(s)
- Casey D. Xavier Hall
- Department of Medical Social Sciences, Northwestern
University Feinberg School of Medicine, Chicago, IL
- Northwestern University Institute for Sexual and Gender
Minority Health and Wellbeing, Chicago, IL
| | - Kevin Moran
- Northwestern University Institute for Sexual and Gender
Minority Health and Wellbeing, Chicago, IL
| | - Michael E. Newcomb
- Department of Medical Social Sciences, Northwestern
University Feinberg School of Medicine, Chicago, IL
- Northwestern University Institute for Sexual and Gender
Minority Health and Wellbeing, Chicago, IL
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern
University Feinberg School of Medicine, Chicago, IL
- Northwestern University Institute for Sexual and Gender
Minority Health and Wellbeing, Chicago, IL
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24
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Hall CDX, Luu M, Nehl EJ, He N, Zheng T, Haardörfer R, Wong FY. Do the same socio-demographic variables predict testing uptake and sero-status? HIV and syphilis among an observational sample of Chinese men who have sex with men in Shanghai, China. Int J STD AIDS 2021; 31:939-949. [PMID: 32772687 DOI: 10.1177/0956462420909733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
HIV and syphilis are pronounced among men who have sex with men (MSM) in China and often occur as co-infections, while testing remains low. Few studies examine common predictors across these outcomes. This observational venue-based sample of 546 MSM in Shanghai, China used a common set of psychosocial predictors to construct logistic models for the outcomes (HIV non-testing, syphilis non-testing, HIV sero-status, and syphilis sero-status). Fifty-seven (10.7%) participants tested positive for HIV, 126 (23.5%) for syphilis, and 33% of HIV-positive participants had a co-infection. Non-sex working MSM had consistently higher odds of HIV and syphilis non-testing (OR= 2.2, 95% CI 1.4-3.5, p < 0.001; OR = 2.4, 95, 95% CI 1.5-3.8, p < 0.001, respectively) compared to 'money boy' sex workers. Participants with a 0 score on HIV knowledge had 4.1 times (95% CI 1.4-12.5, p = 0.01) the odds of reporting HIV non-testing, 6.0 (95% CI 1.96-18.5, p < 0.01) times the odds of reporting non-testing for syphilis, and 8.44 times (95% CI 1.19-59.7, p = 0.03) the odds of testing positive for HIV, compared to a score of 8. The results highlighted the importance of integrating HIV/syphilis education and promoting testing for both HIV and syphilis among all sub-groups of MSM in China.
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Affiliation(s)
- Casey D Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Minh Luu
- Department of Behavioral Sciences and Health Education, Emory University's Rollins School of Public Health, Atlanta, GA, USA
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Emory University's Rollins School of Public Health, Atlanta, GA, USA
| | - Na He
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Tony Zheng
- Shanghai Piaoxue Multicultural Medua, Ltd, Shanghai, China
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory University's Rollins School of Public Health, Atlanta, GA, USA
| | - Frank Y Wong
- Department of Behavioral Sciences and Health Education, Emory University's Rollins School of Public Health, Atlanta, GA, USA.,Center for Indigenous Nursing Research for Health Equity, Florida State University, Tallahassee, FL, USA.,Department of Psychology, University of Hawai'i, Mānoa, Honolulu, HI, USA
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25
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Hall CDX, Smith JC, Driggers RA, Stoller B, Khan Z, Li J, Ignatius E, Siegler AJ. PrEParing for long-acting injectable PrEP in the South: perspectives from healthcare providers in Georgia. AIDS Care 2021; 33:706-711. [PMID: 32838546 PMCID: PMC8152107 DOI: 10.1080/09540121.2020.1810616] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
New modalities of Pre-exposure Prophylaxis (PrEP) such as long-acting injectable PrEP (LAI-PrEP) promise increased prevention of HIV transmission; however, similar biomedical interventions have not been met with universal adoption by healthcare providers or populations most affected by HIV. This qualitative study explores healthcare provider considerations for the rollout of LAI-PrEP. Eleven key-informant in-depth interviews were conducted with clinicians who prescribe daily oral PrEP. Participants reviewed a currently proposed LAI regimen and were asked to reflect on its implications for their clinical practice. Interviews were transcribed verbatim and thematically coded, with results organized using the Consolidated Framework for Implementation Research (CFIR). All participants expressed interest in prescribing LAI-PrEP and anticipated that at least some patients would be interested. Participants identified characteristics of the intervention, inner intervention setting, and outer intervention setting that will be influential in bringing LAI-PrEP to scale. Clinicians in the South have unique insights into the challenges of and opportunities for successful rollout of future PrEP regimens. Bringing these insights into a CFIR framework highlights the nuances surrounding LAI-PrEP, including structural concerns such as cost barriers and access to in-person healthcare services. It is critical to address these challenges to ensure successful implementation of new PrEP formulations.
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Affiliation(s)
- Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Justin C. Smith
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, GA,Positive Impact Health Centers, Atlanta, GA
| | - Robert A. Driggers
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Bethany Stoller
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Zara Khan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jingjing Li
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Elisa Ignatius
- Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Aaron J. Siegler
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, GA,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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26
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Hall CDX, Feinstein BA, Sales JM, Girod C, Yount KM. Outness, discrimination, and depressive symptoms among bi+ women: The roles of partner gender and sexual identity. J Bisex 2021; 21:24-41. [PMID: 34504396 PMCID: PMC8425272 DOI: 10.1080/15299716.2021.1886219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Bisexual and other non-monosexual (bi+) women are at higher risk than monosexual women for mental health problems. While being in a relationship is typically associated with better health outcomes, research suggests an inverse association for bisexual women. Despite emerging evidence of differences in bisexual women's experiences based on the gender of their partner, few studies have considered partner sexual identity. To address this gap, the current study examined influences of partner gender and sexual identity on outness, discrimination, and depressive symptoms in a cross-sectional study of 608 bi+ cisgender women. Adjusting for other demographics, being in a relationship with a bisexual cisgender woman, a lesbian cisgender woman, or a bisexual cisgender man was positively associated with outness and discrimination compared to being in a relationship with a heterosexual cisgender man. Findings highlight the importance of accounting for partner gender and sexual identity in order to understand bi+ women's experiences.
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Affiliation(s)
- Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Brian A. Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - Jessica M. Sales
- Department of Behavioral, Social, & Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Kathryn M. Yount
- Department of Behavioral, Social, & Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
- Department of Sociology, Emory University, Atlanta, GA
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27
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Abstract
Bisexual people comprise over half of all adults who identify as sexual minorities within the United States. Increasingly, population level health research has revealed that bisexual people face striking and broad-ranging health disparities compared not only to heterosexual people, but also often compared to their gay and lesbian peers. Despite the fact that bisexual people comprise an 'invisible majority' of LGBTQ people and are disproportionately impacted by poor health, the vast majority of funding dedicated to LGBTQ community organizing and to sexual and gender minority health research does not address the needs of bisexual people. Within this three-part article, we first describe how manifestations of systematic biphobia have led to the current situation where bisexual community organizations and bisexual health researchers are not granted adequate resources to address the health and health promotion of bisexual populations. In the second section, we articulate foundational ethical guiding principles and propose Bi Us, For Us, a new model to inform the design, evaluation, and implementation of intersectional bisexual community engaged research to inform the development of structural bisexual-specific health equity interventions. In the last section of this paper, we present the Chicago Bisexual Health Task Force as a case study of the model in action to illustrate a real-life approach that community engaged research and advocacy initiatives can take to promote bisexual health equity. We view this article as an invitation for dialogue about how to develop best practices to advance bisexual health equity and hope that it inspires additional bisexual people, organizers, and researchers to join in these pursuits.
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Affiliation(s)
- Lauren B. Beach
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Casey D. Xavier Hall
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
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28
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Evans DP, Hall CDX, DeSousa N, Wilkins JD, Chiang EDDO, Vertamatti MAF. "Women fear the law more than abusers": a study of public trust in health and legal response to violence against women in Santo André, São Paulo State, Brazil. CAD SAUDE PUBLICA 2020; 36:e00114019. [PMID: 33146264 DOI: 10.1590/0102-311x00114019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 04/02/2020] [Indexed: 11/22/2022] Open
Abstract
Little is known about how perceptions of government affects women's views of violence against women. This qualitative study examines women's perceptions of violence against women laws and trust in the health and legal sector response in São Paulo State, Brazil. Thirty interviews with female residents of Santo André, 18 years and older, were audio recorded, transcribed, coded, and analyzed for themes using MAXQDA12 software. All women were familiar with at least one federal violence against women law. They expressed widespread lack of trust in the government. They viewed the legal sector as ineffective and felt violence against women laws have little impact, or exacerbate violence. Disdain for the health sector was less prominent than for the legal sector. A generalized lack of trust in government manifests as a lack of confidence in these laws for women seeking support through legal and health sectors. Adoption of legal protections for women is a significant accomplishment. However, health and legal sector violence against women response needs to consider perceptions of government, how violence against women laws are operationalized, and the role of each sector in ensuring women's safety. Violence against women response efforts should include standardized intersectoral procedures including referral to accessible resources and means of screening women who may be at high risk for femicide.
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Affiliation(s)
- Dabney P Evans
- Rollins School of Public Health, Emory University, Atlanta, U.S.A
| | | | - Nancy DeSousa
- Rollins School of Public Health, Emory University, Atlanta, U.S.A
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29
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Xavier Hall CD, Evans DP. Social comorbidities? A qualitative study mapping syndemic theory onto gender-based violence and co-occurring social phenomena among Brazilian women. BMC Public Health 2020; 20:1260. [PMID: 32811465 PMCID: PMC7437066 DOI: 10.1186/s12889-020-09352-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 08/05/2020] [Indexed: 12/05/2022] Open
Abstract
Background Gender-based violence is a globally recognized social problem impacting women and girls worldwide. Intimate partner violence (IPV) represents the most common form of gender-based violence. Among the countries grappling with gender-based violence is Brazil, which has identified high rates of IPV along with co-occurring social conditions such as adverse childhood experiences, community violence, and substance use. While the syndemic framework has incorporated IPV into understandings of HIV and other diseases, none have explicitly applied syndemic framework to understand IPV and co-occurring social conditions -- referred to here as “social comorbidities” -- in the absence of a biological outcome. This study aims to: (1) Examine perspectives on violence and relevant social comorbidities (substance use, community violence, and childhood abuse) among women living in Santo André, São Paulo State, Brazil; and (2) Apply the syndemic framework to a set of social comorbidities among women living in Santo André, São Paulo State, Brazil. Methods This thematic analysis applies a syndemic framework to 28 in-depth interviews with women in Santo André, Brazil. Interviews were recorded and transcribed verbatim in Portuguese. Our analysis examined themes relating to IPV, community violence, substance use, and other individual experiences and community issues using syndemics as an organizing framework (e.g. diseases, adverse interactions, disparity conditions, and enhanced disease transmission). Results Most participants described experiencing multiple social comorbidities including IPV, adverse childhood experiences, community violence, family violence, and substance use. Adverse interactions included increased financial conflicts, a sense of isolation, and increased severity of violence due to substance use. Long term enhanced “disease” progression included injury, increased mental health symptoms, femicide, and death. Conclusions Our results suggest that using a syndemic framework to understand IPV in the context of social comorbidities could be useful for understanding how these social phenomena may mutually reinforce each other and cause adverse interactions. Similar applications across other social phenomena may also be possible.
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Affiliation(s)
- Casey D Xavier Hall
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. .,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Suite 1400, Chicago, IL, 60611, USA.
| | - Dabney P Evans
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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30
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Feinstein BA, Xavier Hall CD, Dyar C, Davila J. Motivations for sexual identity concealment and their associations with mental health among bisexual, pansexual, queer, and fluid (bi+) individuals. J Bisex 2020; 20:324-341. [PMID: 33727893 PMCID: PMC7958702 DOI: 10.1080/15299716.2020.1743402] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Bisexual and other non-monosexual (bi+) people are at increased risk for depression and anxiety compared to both heterosexual and gay/lesbian people. Bi+ people are also more likely to conceal their sexual orientation than gay/lesbian people are, and concealment is generally associated with negative mental health outcomes. Despite evidence that concealment is a particularly salient stressor for bi+ people, there has been a lack of attention to their motivations for concealment. As such, the goal of the current study was to examine the associations among concealment, motivations for concealment, and depression and generalized anxiety symptoms in a sample of 715 bi+ people who completed an online survey. Nearly half of participants endorsed purposely trying to conceal their bi+ identity in their day-to-day life, and concealment was significantly associated with higher levels of depression and generalized anxiety. Using exploratory factor analysis, we identified two motivations for concealment: intrapersonal motivations (e.g., one's bi+ identity not being a central part of one's overall identity, not being comfortable with being bi+) and interpersonal motivations (e.g., concern about being judged or treated negatively, concern about putting oneself at risk of physical harm). Interpersonal motivations were significantly associated with higher levels of depression and generalized anxiety, whereas intrapersonal motivations were not. In sum, while concealment may generally be associated with negative mental health outcomes, this may only be the case for those who conceal out of concern for discrimination and victimization. These findings highlight the importance of examining bi+ people's motivations for concealing their sexual orientation in order to understand the extent to which they experience negative mental health outcomes.
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Affiliation(s)
- Brian A. Feinstein
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Christina Dyar
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
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