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Sullivan P, Trapido E, Acquavella J, Gillum RF, Kirby RS, Kramer MR, Carmichael SL, Frankenfeld CL, Yeung E, Woodyatt C, Baral S. Editorial priorities and timeliness of editorial assessment and peer review during the COVID-19 pandemic. Ann Epidemiol 2022; 69:24-26. [PMID: 35149226 PMCID: PMC8824164 DOI: 10.1016/j.annepidem.2022.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/25/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Patrick Sullivan
- Emory University Rollins School of Public Health, 1518 Clifton Road NE, 4th Floor GCR, 30322, Atlanta, GA, United States.
| | - Ed Trapido
- Emory University Rollins School of Public Health, 1518 Clifton Road NE, 4th Floor GCR, 30322, Atlanta, GA, United States
| | - John Acquavella
- Emory University Rollins School of Public Health, 1518 Clifton Road NE, 4th Floor GCR, 30322, Atlanta, GA, United States
| | - Richard F Gillum
- Emory University Rollins School of Public Health, 1518 Clifton Road NE, 4th Floor GCR, 30322, Atlanta, GA, United States
| | - Russell S Kirby
- Emory University Rollins School of Public Health, 1518 Clifton Road NE, 4th Floor GCR, 30322, Atlanta, GA, United States
| | - Michael R Kramer
- Emory University Rollins School of Public Health, 1518 Clifton Road NE, 4th Floor GCR, 30322, Atlanta, GA, United States
| | - Suzan L Carmichael
- Emory University Rollins School of Public Health, 1518 Clifton Road NE, 4th Floor GCR, 30322, Atlanta, GA, United States
| | - Cara L Frankenfeld
- Emory University Rollins School of Public Health, 1518 Clifton Road NE, 4th Floor GCR, 30322, Atlanta, GA, United States
| | - Edwina Yeung
- Emory University Rollins School of Public Health, 1518 Clifton Road NE, 4th Floor GCR, 30322, Atlanta, GA, United States
| | - Cory Woodyatt
- Emory University Rollins School of Public Health, 1518 Clifton Road NE, 4th Floor GCR, 30322, Atlanta, GA, United States
| | - Stefan Baral
- Emory University Rollins School of Public Health, 1518 Clifton Road NE, 4th Floor GCR, 30322, Atlanta, GA, United States
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Sullivan PS, Woodyatt C, Koski C, Pembleton E, McGuinness P, Taussig J, Ricca A, Luisi N, Mokotoff E, Benbow N, Castel AD, Do AN, Valdiserri RO, Bradley H, Jaggi C, O'Farrell D, Filipowicz R, Siegler AJ, Curran J, Sanchez TH. A Data Visualization and Dissemination Resource to Support HIV Prevention and Care at the Local Level: Analysis and Uses of the AIDSVu Public Data Resource. J Med Internet Res 2020; 22:e23173. [PMID: 33095177 PMCID: PMC7654504 DOI: 10.2196/23173] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/25/2020] [Accepted: 09/13/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AIDSVu is a public resource for visualizing HIV surveillance data and other population-based information relevant to HIV prevention, care, policy, and impact assessment. OBJECTIVE The site, AIDSVu.org, aims to make data about the US HIV epidemic widely available, easily accessible, and locally relevant to inform public health decision making. METHODS AIDSVu develops visualizations, maps, and downloadable datasets using results from HIV surveillance systems, other population-based sources of information (eg, US Census and national probability surveys), and other data developed specifically for display and dissemination through the website (eg, pre-exposure prophylaxis [PrEP] prescriptions). Other types of content are developed to translate surveillance data into summarized content for diverse audiences using infographic panels, interactive maps, local and state fact sheets, and narrative blog posts. RESULTS Over 10 years, AIDSVu.org has used an expanded number of data sources and has progressively provided HIV surveillance and related data at finer geographic levels, with current data resources providing HIV prevalence data down to the census tract level in many of the largest US cities. Data are available at the county level in 48 US states and at the ZIP Code level in more than 50 US cities. In 2019, over 500,000 unique users consumed AIDSVu data and resources, and HIV-related data and insights were disseminated through nearly 4,000,000 social media posts. Since AIDSVu's inception, at least 249 peer-reviewed publications have used AIDSVu data for analyses or referenced AIDSVu resources. Data uses have included targeting of HIV testing programs, identifying areas with inequitable PrEP uptake, including maps and data in academic and community grant applications, and strategically selecting locations for new HIV treatment and care facilities to serve high-need areas. CONCLUSIONS Surveillance data should be actively used to guide and evaluate public health programs; AIDSVu translates high-quality, population-based data about the US HIV epidemic and makes that information available in formats that are not consistently available in surveillance reports. Bringing public health surveillance data to an online resource is a democratization of data, and presenting information about the HIV epidemic in more visual formats allows diverse stakeholders to engage with, understand, and use these important public health data to inform public health decision making.
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Affiliation(s)
- Patrick Sean Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Cory Woodyatt
- Oregon Health & Science University, Portland, OR, United States
| | | | - Elizabeth Pembleton
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Jennifer Taussig
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Alexandra Ricca
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Nicole Luisi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Nanette Benbow
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Amanda D Castel
- Department of Epidemiology, Milken Institute for Public Health, George Washington University, Washington, DC, United States
| | - Ann N Do
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Ronald O Valdiserri
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Heather Bradley
- Department of Epidemiology, School of Public Health, Georgia State University, Atlanta, GA, United States
| | - Chandni Jaggi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Rebecca Filipowicz
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Aaron J Siegler
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - James Curran
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Travis H Sanchez
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
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Owen-Smith AA, Gerth J, Sineath RC, Barzilay J, Becerra-Culqui TA, Getahun D, Giammattei S, Hunkeler E, Lash TL, Millman A, Nash R, Quinn VP, Robinson B, Roblin D, Sanchez T, Silverberg MJ, Tangpricha V, Valentine C, Winter S, Woodyatt C, Song Y, Goodman M. Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction, and Mental Health in a Cohort of Transgender Individuals. J Sex Med 2018; 15:591-600. [PMID: 29463478 DOI: 10.1016/j.jsxm.2018.01.017] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Transgender individuals sometimes seek gender confirmation treatments (GCT), including hormone therapy (HT) and/or surgical change of the chest and genitalia ("top" and "bottom" gender confirmation surgeries). These treatments may ameliorate distress resulting from the incongruence between one's physical appearance and gender identity. AIM The aim was to examine the degree to which individuals' body-gender congruence, body image satisfaction, depression, and anxiety differed by GCT groups in cohorts of transmasculine (TM) and transfeminine (TF) individuals. METHODS The Study of Transition, Outcomes, and Gender is a cohort study of transgender individuals recruited from 3 health plans located in Georgia, Northern California, and Southern California; cohort members were recruited to complete a survey between 2015-2017. Participants were asked about: history of GCT; body-gender congruence; body image satisfaction; depression; and anxiety. Participants were categorized as having received: (1) no GCT to date; (2) HT only; (3) top surgery; (4) partial bottom surgery; and (5) definitive bottom surgery. OUTCOMES Outcomes of interest included body-gender congruence, body image satisfaction, depression, and anxiety. RESULTS Of the 2,136 individuals invited to participate, 697 subjects (33%) completed the survey, including 347 TM and 350 TF individuals. The proportion of participants with low body-gender congruence scores was significantly higher in the "no treatment" group (prevalence ratio [PR] = 3.96, 95% CI 2.72-5.75) compared to the definitive bottom surgery group. The PR for depression comparing participants who reported no treatment relative to those who had definitive surgery was 1.94 (95% CI 1.42-2.66); the corresponding PR for anxiety was 4.33 (95% CI 1.83-10.54). CLINICAL TRANSLATION Withholding or delaying GCT until depression or anxiety have been treated may not be the optimal treatment course given the benefits of reduced levels of distress after undergoing these interventions. CONCLUSIONS Strengths include the well-defined sampling frame, which allowed correcting for non-response, a sample with approximately equal numbers of TF and TM participants, and the ability to combine data on HT and gender confirmation surgeries. Limitations include the cross-sectional design and the fact that participants may not be representative of the transgender population in the United States. Body-gender congruence and body image satisfaction were higher, and depression and anxiety were lower among individuals who had more extensive GCT compared to those who received less treatment or no treatment at all. Owen-Smith AA, Gerth J, Sineath RC, et al. Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction and Mental Health in a Cohort Of Transgender Individuals. J Sex Med 2018;15:591-600.
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Affiliation(s)
- Ashli A Owen-Smith
- Department of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA; Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA.
| | - Joseph Gerth
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Joshua Barzilay
- Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA
| | - Tracy A Becerra-Culqui
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Darios Getahun
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Shawn Giammattei
- Rockway Institute, Alliant International University, San Francisco, CA
| | - Enid Hunkeler
- Emeritus, Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Andrea Millman
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Rebecca Nash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Virginia P Quinn
- Emeritus, Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Brandi Robinson
- Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA
| | - Douglas Roblin
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, MD
| | - Travis Sanchez
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Vin Tangpricha
- School of Medicine, Emory University, Atlanta, GA; Atlanta US Department of Veterans Affairs Medical Center, Atlanta, GA
| | - Cadence Valentine
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA
| | - Savannah Winter
- Center for Clinical and Outcomes Research, Kaiser Permanente Georgia, Atlanta, GA
| | - Cory Woodyatt
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Yongjia Song
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Michael Goodman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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Frost DM, LeBlanc AJ, de Vries B, Alston-Stepnitz E, Stephenson R, Woodyatt C. Couple-level Minority Stress: An Examination of Same-sex Couples' Unique Experiences. J Health Soc Behav 2017; 58:455-472. [PMID: 29172770 PMCID: PMC6625756 DOI: 10.1177/0022146517736754] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [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: 05/11/2023]
Abstract
Social stress resulting from stigma, prejudice, and discrimination-"minority stress"-negatively impacts sexual minority individuals' health and relational well-being. The present study examined how being in a same-sex couple can result in exposure to unique minority stressors not accounted for at the individual level. Relationship timeline interviews were conducted with 120 same-sex couples equally distributed across two study sites (Atlanta and San Francisco), gender (male and female), and relationship duration (at least six months but less than three years, at least three years but less than seven years, and seven or more years). Directed content analyses identified 17 unique couple-level minority stressors experienced within nine distinct social contexts. Analyses also revealed experiences of dyadic minority stress processes (stress discrepancies and stress contagion). These findings can be useful in future efforts to better understand and address the cumulative impact of minority stress on relational well-being and individual health.
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Affiliation(s)
- David M. Frost
- University of Surrey, Guildford, Surrey, UK
- University College London, London, UK
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de Vries B, LeBlanc AJ, Frost DM, Alston-Stepnitz E, Stephenson R, Woodyatt C. The Relationship Timeline: A Method for the Study of Shared Lived Experiences in Relational Contexts. Adv Life Course Res 2017; 32:55-64. [PMID: 28584522 PMCID: PMC5454772 DOI: 10.1016/j.alcr.2016.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 05/11/2023]
Abstract
Lifeline methods-graphic illustrations of the pathways of lived experience traveled by individuals from birth to anticipated death-have been useful in the study of lived experience. Existing lifeline methods and research focus on the individual experience; absent from this literature are the collective experiences of those in intimate relationships. In this paper, based on our research with 120 same-sex couples, we present a method to allow for the joint creation of relationship timelines, which serve as the basis for eliciting dyadic data in multiple forms: graphic representations of relationship development through couples' creation of a timeline of key events and periods; qualitative narratives of couples' shared experiences; and quantitative ratings of significant events and periods in their lives together. Lessons learned from the application of this Relationship Timeline Method are discussed, as are implications for future study of the shared lived experience.
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Mitchell JW, Lee JY, Woodyatt C, Bauermeister J, Sullivan P, Stephenson R. Decisions About Testing for HIV While in a Relationship: Perspectives From an Urban, Convenience Sample of HIV-Negative Male Couples Who Have a Sexual Agreement. Arch Sex Behav 2017; 46:1069-1077. [PMID: 27511208 PMCID: PMC5572095 DOI: 10.1007/s10508-016-0807-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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] [Received: 03/01/2016] [Revised: 06/17/2016] [Accepted: 07/01/2016] [Indexed: 05/30/2023]
Abstract
Many HIV-negative male couples establish a sexual agreement to help manage their HIV risk; however, less is known about their decisions about testing in this context. The present study examined whether male couples discussed HIV testing and explored their decisions about testing in the context of their sexual agreement at the individual- and couple-levels. Qualitative dyadic interview data were collected from 29 HIV-negative male couples with a sexual agreement who resided in Atlanta or Detroit; the sample was stratified by agreement type. Content analysis revealed male couples' decisions about HIV testing as routine, self-assurance, reliance and assumption on partner, beginning of relationship testers, and/or trust; decisions varied between partners and by agreement type. Findings suggest prevention efforts should help male couples integrate HIV testing into their sexual agreement that matches their agreement type and associated HIV-related risk behavior, and help shift their one-sided decisions about testing to a couple's mutually shared decision.
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Affiliation(s)
- Jason W Mitchell
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
| | - Ji-Young Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Cory Woodyatt
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - José Bauermeister
- Department of Health Behavior and Health Education, School of Public Health and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Patrick Sullivan
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rob Stephenson
- Department of Health Behavior and Biological Sciences, School of Nursing and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
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Owen-Smith AA, Woodyatt C, Sineath RC, Hunkeler EM, Barnwell LT, Graham A, Stephenson R, Goodman M. Perceptions of Barriers to and Facilitators of Participation in Health Research Among Transgender People. Transgend Health 2016; 1:187-196. [PMID: 28861532 PMCID: PMC5549538 DOI: 10.1089/trgh.2016.0023] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Although transgender people may be at increased risk for a range of health problems, they have been the subject of relatively little health research. An important step toward expanding the evidence base is to understand and address the reasons for nonparticipation and dropout. The aim of this study was to explore the perceptions of barriers to and facilitators of participation in health research among a sample of transgender people in San Francisco, CA, and Atlanta, GA. Methods: Twelve in-person focus groups (FGs) were conducted; six (three with transwomen, three with transmen) were conducted in San Francisco and six FGs were conducted in Atlanta (three with transwomen and three with transmen). FGs were audiorecorded, transcribed, and uploaded to MaxQDA software for analysis. A codebook was used to code transcripts; new codes were added iteratively as they arose. All transcripts were coded by at least 2 of the 4 researchers and, after each transcript was coded, the researchers met to discuss any discrepancies, which were resolved by consensus. Results: Among 67 FG participants, 37 (55%) identified as transmen and 30 (45%) identified as transwomen. The average age of participants was ∼41 years (range 18-67) and the majority (61%) were non-Hispanic Whites. Several barriers that can hinder participation in health research were identified, including logistical concerns, issues related to mistrust, a lack of awareness about participation opportunities, and psychosocial/emotional concerns related to being "outed." A broad range of facilitators were also identified, including the opportunity to gain knowledge, access medical services, and contribute to the transgender community. Conclusion: These findings provide insights about the perceived barriers to and facilitators of research participation and offer some guidance for researchers in our ongoing effort to engage the transgender community in health research.
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Affiliation(s)
- Ashli A Owen-Smith
- Department of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, Georgia
| | - Cory Woodyatt
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - R Craig Sineath
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Enid M Hunkeler
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - La Tasha Barnwell
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ashley Graham
- Department of Anthropology, University of Connecticut, Storrs, Connecticut
| | - Rob Stephenson
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Michael Goodman
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Owen-Smith AA, Sineath C, Sanchez T, Dea R, Giammattei S, Gillespie T, Helms MF, Hunkeler EM, Quinn VP, Roblin D, Slovis J, Stephenson R, Sullivan PS, Tangpricha V, Woodyatt C, Goodman M. Perception of Community Tolerance and Prevalence of Depression among Transgender Persons. J Gay Lesbian Ment Health 2016; 21:64-76. [PMID: 29170689 DOI: 10.1080/19359705.2016.1228553] [Citation(s) in RCA: 16] [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: 10/21/2022]
Abstract
Purpose The goal of the study was to examine the association between depression and perceived community tolerance after controlling for various demographic and personal characteristics, treatment receipt, and past experiences with abuse or discrimination. Methods An on-line survey assessed depressive symptoms among transgender and gender non-conforming individuals. Depression was assessed using the 7-item Beck Depression Inventory for Primary Care (BDI-PC) and the 10-item Center for Epidemiologic Studies Depression (CESD-10) scale. Results The prevalence ratios (95% confidence intervals) comparing depression in persons who did and did not perceive their area as tolerant were 0.33 (0.20-0.54) for BD-PC and 0.66 (0.49-0.89) for CESD-10. Other factors associated with depression were experience with abuse or discrimination, lower education, and unfulfilled desire to receive hormonal therapy. Conclusion Depression was common in this sample of transgender and gender non-conforming individuals and was strongly and consistently associated with participants' perceptions of community tolerance, even after adjusting for possible confounding. The association between desire to receive hormonal therapy and depression is a finding that warrants further exploration. Future research should also assess depression and changes in perception of community tolerance in transgender individuals before and after initiation of gender confirmation treatment.
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Affiliation(s)
- Ashli A Owen-Smith
- Georgia State University, School of Public Health, Department of Health Management and Policy, Atlanta GA
| | - Craig Sineath
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta GA
| | - Travis Sanchez
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta GA
| | - Robin Dea
- The Permanente Medical Group (Retired), Redwood City, CA
| | - Shawn Giammattei
- The Rockway Institute, Alliant International University, San Francisco, CA
| | - Theresa Gillespie
- Emory University, School of Medicine, Department of Surgery, Atlanta, GA
| | - Monica F Helms
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta GA
| | - Enid M Hunkeler
- Kaiser Permanente Northern California, Division of Research, Oakland, CA
| | | | - Douglas Roblin
- Georgia State University, School of Public Health, Department of Health Management and Policy, Atlanta GA
| | - Jennifer Slovis
- Kaiser Permanente Northern California, Division of Research, Oakland, CA
| | - Robert Stephenson
- University of Michigan, School of Nursing, Department of Health Behavior and Biological Sciences, Ann Arbor, MI
| | - Patrick S Sullivan
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta GA
| | - Vin Tangpricha
- Emory University, School of Medicine, Department of Endocrinology, Atlanta, GA
| | - Cory Woodyatt
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta GA
| | - Michael Goodman
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta GA
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Owen-Smith AA, Woodyatt C, Sineath RC, Hunkeler E, Barnwell LT, Graham A, Goodman M. A Qualitative Exploration of Perceived Health Issues Among Transgender Individuals in Atlanta and San Francisco. J Patient Cent Res Rev 2016. [DOI: 10.17294/2330-0698.1335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Owen-Smith AA, Woodyatt C, Sineath RC, Hunkeler E, Barnwell LT, Graham A, Goodman M. Perceptions of Barriers to and Facilitators of Participation in Transgender Health Research. J Patient Cent Res Rev 2016. [DOI: 10.17294/2330-0698.1336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mitchell JW, Lee JY, Woodyatt C, Bauermeister J, Sullivan P, Stephenson R. Perceived Challenges and Rewards of Forming a Sexual Agreement Among HIV-Negative Male Couples. Arch Sex Behav 2016; 45:1525-34. [PMID: 26964794 PMCID: PMC4945420 DOI: 10.1007/s10508-016-0701-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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] [Received: 10/22/2015] [Revised: 01/07/2016] [Accepted: 01/19/2016] [Indexed: 05/11/2023]
Abstract
Sexual agreements, explicit mutual understandings made between two partners about which sexual and related behaviors they agree to engage in within and/or outside of their relationship, are common among male couples. However, little is known about the perceived rewards and challenges partnered men face in the process of forming a sexual agreement. Such knowledge may be useful for the development of future HIV preventive and sexual health programs that encourage male couples to establish a sexual agreement in their relationship. By using qualitative dyadic data from a sample of 29 self-reported concordant HIV-negative male couples who had a sexual agreement, the present qualitative study sought to assess partnered men's perceived rewards and challenges of forming a sexual agreement in their relationship and examine whether both men in the couple concurred about their perceived rewards and challenges of forming a sexual agreement. Themes for perceived rewards were (1) being honest, (2) improving communication, (3) increasing understanding about expectations and permitted behaviors, (4) enhancing intimacy and relational bond, and (5) building trust. Themes for perceived challenges were: (1) stigma about having an open agreement; (2) awkwardness about the topic and talking about it; (3) jealousy; and (4) no perceived challenges. Few couples had both partners concur about their perceived rewards or challenges toward establishing a sexual agreement. The variety of perceived rewards and challenges highlight the need for tailoring given that a variety of factors may influence partnered men's establishment of a sexual agreement in their relationship.
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Affiliation(s)
- Jason W Mitchell
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
| | - Ji-Young Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136, USA
| | - Cory Woodyatt
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - José Bauermeister
- Department of Health Behavior and Health Education, School of Public Health, and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Patrick Sullivan
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rob Stephenson
- Department of Health Behavior and Biological Sciences, School of Nursing, and The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
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Sineath RC, Woodyatt C, Sanchez T, Giammattei S, Gillespie T, Hunkeler E, Owen-Smith A, Quinn VP, Roblin D, Stephenson R, Sullivan PS, Tangpricha V, Goodman M. Determinants of and Barriers to Hormonal and Surgical Treatment Receipt Among Transgender People. Transgend Health 2016; 1:129-136. [PMID: 27689139 PMCID: PMC5012371 DOI: 10.1089/trgh.2016.0013] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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] [Indexed: 02/01/2023] Open
Abstract
Purpose: Medical gender confirmation therapy (GCT) plays an important role in transgender health; however, its prevalence and determinants constitute an area of uncertainty. Methods: Data for this cross-sectional study were obtained from an online survey distributed from October 2012 through the end of 2013 among persons who visited the social media sites of a transgender education and social networking meeting. Eligible respondents (n=280) were persons whose gender identity was different from their sex assigned at birth and who responded to questions about previously received or planned hormonal therapy (HT), chest reconstruction, or genital surgery. Multivariable logistic regression models examined how receipt and plans to receive different GCT types were associated with participants' characteristics and gender identity. Results: The respective percentages of ever and current HT were 58% and 47% for transwomen and 63% and 57% for transmen. Genital surgery was reported by 11 participants; all transwomen. Relative to transmen, transwomen were thrice more likely to report plans to undergo genital surgery. By contrast, transmen were more than 10 times as likely as transwomen to have had or planned chest surgery. Older participants and those who were in a committed relationship were less likely to plan future GCT. Having health insurance was not associated with GCT receipt. Treatment cost was named as the main problem by 23% of transwomen and 29% of transmen. Accessing a qualified healthcare provider for transgender-related care was listed as the primary reason for not receiving surgery by 41% of transmen and 2% of transwomen. Conclusions: Prevalence of GCT differed across subgroups of participants and was lower than corresponding estimates reported elsewhere. The variability of results may reflect differences in recruitment procedures and response rates; however, it is also possible that it may be driven by geographic, socioeconomic, and health-related heterogeneity of the transgender population.
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Affiliation(s)
- R Craig Sineath
- Rollins School of Public Health, Emory University, Atlanta, Georgia.; School of Medicine, Emory University, Atlanta, Georgia
| | - Cory Woodyatt
- Rollins School of Public Health, Emory University , Atlanta, Georgia
| | - Travis Sanchez
- Rollins School of Public Health, Emory University , Atlanta, Georgia
| | - Shawn Giammattei
- The Rockway Institute, Alliant International University , San Francisco, California
| | - Theresa Gillespie
- School of Medicine, Emory University, Atlanta, Georgia.; Atlanta VA Medical Center, Decatur, Georgia
| | - Enid Hunkeler
- Division of Research, Kaiser Permanente, Oakland, California
| | - Ashli Owen-Smith
- School of Public Health, Georgia State University , Atlanta, Georgia
| | | | - Douglas Roblin
- School of Public Health, Georgia State University , Atlanta, Georgia
| | | | | | - Vin Tangpricha
- School of Medicine, Emory University, Atlanta, Georgia.; Atlanta VA Medical Center, Decatur, Georgia
| | - Michael Goodman
- Rollins School of Public Health, Emory University , Atlanta, Georgia
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Mitchell JW, Lee JY, Woodyatt C, Bauermeister J, Sullivan P, Stephenson R. Illuminating the Context and Circumstances of Male Couples Establishing a Sexual Agreement in Their Relationship. Am J Mens Health 2016; 11:600-609. [PMID: 27334670 DOI: 10.1177/1557988316655528] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 11/15/2022] Open
Abstract
A sexual agreement is an explicit mutual understanding made between two partners about which sexual and relational behaviors they agree to engage in within and/or outside of their relationship. Factors that prompt male couples to form a sexual agreement and under what circumstances remain underinvestigated, yet are important considerations for development of couples-based sexual health and HIV prevention interventions. By using thematic analysis with qualitative dyadic data from a convenience sample of 29 HIV-negative male couples, the present study sought to describe the timing and investigate the context and circumstances that led male couples to establish a sexual agreement in their relationship at both the individual and couple levels, and by agreement type. Themes identified for when a sexual agreement was formed included within the first 6 months, and after 6 months in the relationship. Themes related to context and circumstances of couples' sexual agreement formation were as follows: (a) desire for sexual exploration, (b) arisen circumstances or events with other men, (c) influences from past relationship(s) and/or other couples (i.e., peers), (d) to protect against HIV, and (e) purposeful conversations versus understood. Findings suggest HIV prevention efforts should include skill-building exercises to help improve communication and promote sex positivity within male couples' relationships.
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Mitchell JW, Lee JY, Woodyatt C, Bauermeister J, Sullivan P, Stephenson R. HIV-negative male couples' attitudes about pre-exposure prophylaxis (PrEP) and using PrEP with a sexual agreement. AIDS Care 2016; 28:994-9. [PMID: 27055001 DOI: 10.1080/09540121.2016.1168911] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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: 10/22/2022]
Abstract
One efficacious strategy to help prevent HIV is oral pre-exposure prophylaxis (PrEP), a daily regimen of antiretroviral treatment taken by HIV-negative individuals. Two of the recommendations of Centers for Disease Control and Prevention (CDC) guidelines for PrEP pertain to being in a relationship (i.e., male couples). Despite the recognition of how primary partners in male couples' relationships shape HIV risk and CDC's PrEP guidelines, there is a paucity of data that examine HIV-negative male couples' attitudes toward PrEP use and using PrEP with a sexual agreement. A sexual agreement is an explicit agreement made between two individuals about what sex and other related behaviors may occur within and outside of their relationship. In this qualitative study, we examine HIV-negative male couples' attitudes toward PrEP use and whether they thought PrEP could be integrated into a sexual agreement. Data for this study are drawn from couple-level interviews conducted in 2014 with 29 HIV-negative male couples who had a sexual agreement and were from Atlanta or Detroit. Both passive (e.g., flyers) and active (e.g., targeted Facebook advertisements) recruitment methods were used; the sample was stratified by agreement type. Thematic analysis was applied to identify the following themes regarding HIV-negative male couples' attitudes toward PrEP use: (1) PrEP and condom use; (2) concerns about PrEP (e.g., effectiveness, side effects, and promoting sexually risky behavior); and (3) accessibility of PrEP. Some thought PrEP could be a part of couples' agreement because it could help reduce sexual anxiety and sexual risk, and would help keep the couple safe. Others described PrEP use with an agreement as something for "others". Some were also concerned that incorporating PrEP could usurp the need for a sexual agreement in a couples' relationship. These themes highlight the need to improve informational messaging and promotion efforts about PrEP among HIV-negative male couples who may benefit from using it.
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Affiliation(s)
- Jason W Mitchell
- a Department of Public Health Sciences , University of Miami Miller School of Medicine , Miami , FL , USA
| | - Ji-Young Lee
- a Department of Public Health Sciences , University of Miami Miller School of Medicine , Miami , FL , USA
| | - Cory Woodyatt
- b Department of Epidemiology, Rollins School of Public Health , Emory University , Atlanta , GA , USA
| | - José Bauermeister
- c Department of Health Behavior and Health Education, School of Public Health, and The Center for Sexuality and Health Disparities , University of Michigan , Ann Arbor , MI , USA
| | - Patrick Sullivan
- b Department of Epidemiology, Rollins School of Public Health , Emory University , Atlanta , GA , USA
| | - Rob Stephenson
- d Department of Health Behavior and Biological Sciences, School of Nursing, and The Center for Sexuality and Health Disparities , University of Michigan , Ann Arbor , MI , USA
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O'Byrne P, Bryan A, Woodyatt C. Nondisclosure prosecutions and HIV prevention: results from an Ottawa-based gay men's sex survey. J Assoc Nurses AIDS Care 2012; 24:81-7. [PMID: 22554814 DOI: 10.1016/j.jana.2012.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 01/16/2012] [Indexed: 10/28/2022]
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