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Pingel ES. Seeing Inside: How Stigma and Recognition Shape Community Health Worker Home Visits in São Paulo, Brazil. Community Health Equity Res Policy 2024; 44:303-313. [PMID: 36322964 DOI: 10.1177/2752535x221137384] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Community Health Worker (CHW) home visits are central to primary care provision in São Paulo, Brazil. Yet CHWs receive little training prior to conducting these visits. In the neighborhood where I conducted ethnographic fieldwork, nearly half of patients were immigrants to Brazil, adding a layer of sociocultural and linguistic difference. I thus investigated how interactions between CHWs and patients unfolded and were shaped by cultural processes. Analyzing fieldnotes and interview data, I found that CHWs cherished relationships with older adult Portuguese-speaking patients, while expressing exasperation and even disgust with more recent immigrants and patients living with stigmatized health conditions. The cultural processes of recognition and stigma shaped CHWs' perceptions of and interactions with patients. I ground these analyses in the history of state-sponsored discourse linking immigrants with poor hygiene, concluding that home visits deserve greater scrutiny as a public health tool that may increase access to care at the expense of health equity.
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Affiliation(s)
- Emily S Pingel
- Department of Sociology, Emory University, Atlanta, GA, USA
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2
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Abstract
Decreased engagement in preventive services, including vaccination, during the COVID-19 pandemic represents a grave threat to global health. We use the case of the Bom Retiro Public Health Clinic in São Paulo, Brazil, to underscore how continuity of care is not only feasible, but a crucial part of health as a human right. The long-standing relationship between the clinic and neighborhood residents has facilitated ongoing management of physical and mental health conditions. Furthermore, we demonstrate how the clinic's history of confronting infectious diseases has equipped it to adapt preventive services to meet patients' needs during the pandemic. Our academic-community partnership used a multidisciplinary approach, relying on analysis of historical data, ethnographic data, and direct clinical experience. We identify specific prevention strategies alongside areas for improvement. We conclude that the clinic serves as a model for continuity of care in urban settings during a pandemic.
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Affiliation(s)
- Emily S. Pingel
- Emory University, Atlanta, GA, USA,Emily S. Pingel, Department of Sociology, Emory University, Tarbutton Hall Room 225, 1555 Dickey Drive, Atlanta, GA 30030, USA.
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3
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Sirdenis TK, Harper GW, Carrillo MD, Jadwin-Cakmak L, Loveluck J, Pingel ES, Benton A, Peterson A, Pollard R, Bauermeister JA. Toward Sexual Health Equity for Gay, Bisexual, and Transgender Youth: An Intergenerational, Collaborative, Multisector Partnerships Approach to Structural Change. Health Educ Behav 2020; 46:88S-99S. [PMID: 31549560 DOI: 10.1177/1090198119853607] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Gay, bisexual, and transgender youth (GBTY) experience sexual health inequities and contend with intersectional oppression. The Michigan Forward in Enhancing Research and Community Equity (MFierce) Coalition formed as an intergenerational, collaborative, multisector partnership with a focus on implementing community-identified policy, systems, and environmental (PSE) change strategies to address inequities and injustices. Aims. We describe MFierce coalition development and structural change activities organized within Collaborating for Equity and Justice (CEJ) principles and provide empirical data supporting the utility of such principles. Method. We prioritized leadership by GBTY and created personal and professional capacity-building activities to support GBTY in being change agents. Our work was grounded in community-engaged scholarship and used a shared-power community development process. Our PSE change intervention, the Health Access Initiative (HAI), was a structural change program for health facilities aimed at improving the quality of and access to sexual health care for GBTY. Results. We evaluated coalition functioning and activities through multimethod assessments and evaluated PSE changes through HAI participant surveys. Data demonstrated positive and steady coalition dynamics, multiple benefits of participation for GBTY, and strategies for collaborative multigenerational community work. HAI outcome data revealed significant increases in PSE changes. Discussion. Centering life experiences of GBTY in collaborative partnerships and building opportunities for professional and personal development can support sustainable community change. We offer recommendations for developing future intergenerational, collaborative, multisector partnerships that prioritize youth leadership. Conclusion. Collaborative methods and careful consideration of adult-youth dynamics can inform future transformative efforts focused on health equity and justice for GBTY.
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Affiliation(s)
| | | | | | | | | | | | | | - Amy Peterson
- Michigan Department of Health and Human Services, Lansing, MI, USA
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4
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Sewell AA, Pingel ES. The dual contingencies of ethnoraciality: Status-context disparities in health information sources among sexual minorities. Soc Sci Res 2020; 87:102395. [PMID: 32279856 DOI: 10.1016/j.ssresearch.2019.102395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 10/28/2019] [Accepted: 11/20/2019] [Indexed: 06/11/2023]
Abstract
Researchers often explore health (care) beliefs as a function of individual characteristics; yet, few consider the role of context in shaping both beliefs and the behaviors that are informed by them. As a sociopolitical construct, ethnoraciality provides a concerning source of bias in studies of health (care) beliefs because it inhabits both individual and contextual forms. This study examines whether the ethnoracial context of the residential area where sexual minorities live is associated with a particular health (care) belief - sources of trustworthy health information - and considers how ethnoracial group membership status differentiates these ecological associations drawing on mediation and moderation models. Using data from the 2010 Social Justice Sexuality Project, our analysis shows that sexual minorities who live with high concentrations of Latinos and Whites are less likely to rely exclusively on medical professionals for trustworthy health information than those who live with high concentrations of Blacks. Moreover, exclusive reliance on medical professionals for health information among Black and Latino sexual minorities is stronger in co-ethnic communities (predominately Black and Latino areas, respectively). The analysis also documents status and contextual differentials and status-context contingencies of reliance on the Internet, social networks, and multiple agents ("triangulation") as sources of health information. Findings suggest that place-based co-ethnic networks may facilitate disease prevention among Black and Latino sexual minorities by improving the quality of their relationships with sick role gatekeepers and breaking down the silos of the medical complex. The study concludes by considering the value of a place-based approach to alleviating health disparities among sexual minorities vis-à-vis the health care system.
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Sullivan SP, Pingel ES, Stephenson R, Bauermeister JA. "It Was Supposed To Be a Onetime Thing": Experiences of Romantic and Sexual Relationship Typologies Among Young Gay, Bisexual, and Other Men Who Have Sex with Men. Arch Sex Behav 2018; 47:1221-1230. [PMID: 28875247 PMCID: PMC5837906 DOI: 10.1007/s10508-017-1058-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 12/19/2016] [Revised: 07/26/2017] [Accepted: 08/09/2017] [Indexed: 06/03/2023]
Abstract
Young gay, bisexual, and other men who have sex with men (MSM) are at elevated risk for HIV infection, highlighting the need to understand the elements of prevention and risk associated with their relationships. We employed a phenomenological approach to explore how young MSM become involved in different romantic and sexual experiences. We analyzed 28 semi-structured interviews conducted with young MSM living in Michigan. Using a phenomenological approach, we analyzed the data using an inductive coding strategy and thematic analysis. Participants defined their romantic and sexual interactions with a limited set of partner classifications (e.g., dating, hooking up, friends-with-benefits), but recognized how these classifications were shifting, sometimes unexpectedly so (e.g., a date turning into a hook up and vice versa). Young MSM described relationships in transition that at times defied available typologies or hybridized elements of multiple partner types at once. Based on our analyses, we underscore the need to acknowledge the fluctuating and contextual nature of young MSM's romantic and sexual experiences. We discuss the relevance of our findings in terms of the developmental period of young adulthood and the implications our findings have HIV prevention efforts among young MSM.
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Affiliation(s)
- Stephen P Sullivan
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, 48109, USA.
| | - Emily S Pingel
- Department of Sociology, Emory University, Atlanta, GA, USA
| | - Rob Stephenson
- Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, 48109, USA
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Pingel ES, Bauermeister JA. 'Church hurt can be the worst hurt': community stakeholder perceptions of the role of Black churches in HIV prevention among young Black gay and bisexual men. Cult Health Sex 2018; 20:218-231. [PMID: 28662610 DOI: 10.1080/13691058.2017.1338756] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Black gay and bisexual men aged 15-29 are disproportionately represented among new cases of HIV in the USA. Researchers have argued that community-based prevention cannot succeed without the participation of faith-based organisations, particularly given the salience of religion and spirituality in the lives of young Black gay and bisexual men. Yet some Black churches may be hesitant to engage in HIV prevention efforts given their beliefs about same-sex behaviour. It is less clear, however, whether and how public health practitioners in the field of HIV prevention have approached church inclusion. We therefore explored how community stakeholders describe the involvement of Black churches with the HIV continuum of care. We draw on a qualitative dataset of 50 in-depth semi-structured interviews conducted in Detroit, USA. Participants offered multiple perspectives on the response of Black churches to the HIV epidemic, from overt stigma to gradual acceptance and action. Nevertheless, participants agreed that when stigma was present in the pews and the pulpit, young Black gay and bisexual men were at potential risk of social isolation. Furthermore, tensions may exist between Black churches and secular community-based organisations that are attributable to histories of mistrust. These findings have important implications for future community-based intervention strategies among young Black gay and bisexual men.
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Affiliation(s)
- Emily S Pingel
- a Department of Health Behavior & Health Education, School of Public Health , University of Michigan , Ann Arbor , USA
- b Department of Sociology , Emory University , Atlanta , USA
| | - José A Bauermeister
- a Department of Health Behavior & Health Education, School of Public Health , University of Michigan , Ann Arbor , USA
- c Department of Family and Community Health , University of Pennsylvania , Philadelphia , USA
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Abstract
Sexual minority women (SMW; i.e., women who identify their sexuality as lesbian, bisexual, or something other than heterosexual) report greater smoking behaviors than their heterosexual counterparts across all ages. We conducted a multivariable regression to examine the correlates of prior smoking cessation attempts and smoking cessation intentions in a sample of young SMW who smoke (N = 338; aged 18-24 years). Covariates included sociodemographic characteristics (i.e., race/ethnicity, sexual identity, age, urbanity), general (i.e., perceived stress), and sexuality-specific (i.e., internalized homophobia) stressors, as well as smoking attitudes and subjective norms. Bisexual women (OR = 1.92, 95% CI: 1.11, 3.31) were more likely than lesbian counterparts to report a prior smoking cessation attempt. Prior cessation attempts were associated with less internalized homophobia (OR = 0.44, 95% CI: 0.27, 0.69) and positive attitudes toward smoking (OR = 2.17, 95% CI: 1.27, 3.70). Smoking cessation intentions in the next month were negatively associated with being a daily smoker (β = -0.14) and attitudes toward smoking (β = -0.19). Based on these findings, we underscore the need to address the risk correlates associated with SMW's quit attempts and include these in cessation interventions.
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Affiliation(s)
- Jose A. Bauermeister
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Emily J. Youatt
- Center for Sexuality & Health Disparities, University of Michigan, Ann Arbor, MI
| | | | - Jorge H. Soler
- Center for Sexuality & Health Disparities, University of Michigan, Ann Arbor, MI
| | - Michelle M. Johns
- Center for Sexuality & Health Disparities, University of Michigan, Ann Arbor, MI
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Bauermeister JA, Pingel ES, Sirdenis TK, Andrzejewski J, Gillard G, Harper GW. Ensuring Community Participation During Program Planning: Lessons Learned During the Development of a HIV/STI Program for Young Sexual and Gender Minorities. Am J Community Psychol 2017; 60:215-228. [PMID: 28685871 PMCID: PMC5625131 DOI: 10.1002/ajcp.12147] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 05/23/2023]
Abstract
HIV/STI incidence has shifted to a younger demographic, comprised disproportionately of gay and bisexual men, transgender women, and people of color. Recognizing the importance of community organizing and participatory engagement during the intervention planning process, we describe the steps taken to engage diverse constituents (e.g., youth and practitioners) during the development of a structural-level HIV/STI prevention and care initiative for young sexual and gender minorities in Southeast Michigan. Our multi-sector coalition (MFierce; Michigan Forward in Enhancing Research and Community Equity) utilized a series of community dialogues to identify, refine, and select programmatic strategies with the greatest potential. Evaluation data (N = 173) from the community dialogues highlighted constituents' overall satisfaction with our elicitation process. Using a case study format, we describe our community dialogue approach, illustrate how these dialogues strengthened our program development, and provide recommendations that may be used in future community-based program planning efforts.
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Meanley S, Pingel ES, Bauermeister JA. Psychological well-being among religious and spiritual-identified young gay and bisexual men. Sex Res Social Policy 2016; 13:35-45. [PMID: 28163799 PMCID: PMC5289650 DOI: 10.1007/s13178-015-0199-4] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Religiosity and spirituality are often integral facets of human development. Young gay and bisexual men (YGBM), however, may find themselves at odds when attempting to reconcile potentially conflicting identities like religion and their sexual orientation. We sought to explore how different components of religiosity (participation, commitment, spiritual coping) are linked to different markers of psychological well-being (life purpose, self-esteem, and internalized homophobia). Using data collected in Metro Detroit (N = 351 ages 18-29 years; 47% African American, 29% Non-Latino White, 8% Latino, 16% Other Race), we examined how components of religiosity/spirituality were associated with psychological well-being among religious/spiritual-identified participants. An overwhelming majority (79.5%) identified as religious/spiritual, with most YGBM (91.0%) reporting spirituality as a coping source. Over three quarters of our religious/spiritual sample (77.7%) reported attending a religious service in the past year. Religious participation and commitment were negatively associated with psychological well-being. Conversely, spiritual coping was positively associated with YGBM's psychological well-being. Programs assisting YGBM navigate multiple/conflicting identities through sexuality-affirming resources may aid improve of their psychological well-being. We discuss the public health potential of increasing sensitivity to the religious/spiritual needs of YGBM across social service organizations.
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Affiliation(s)
- Steven Meanley
- The Center for Sexuality & Health Disparities,
University of Michigan School of Public Health, Ann Arbor, MI
| | - Emily S. Pingel
- The Center for Sexuality & Health Disparities,
University of Michigan School of Public Health, Ann Arbor, MI
| | - José A. Bauermeister
- The Center for Sexuality & Health Disparities,
University of Michigan School of Public Health, Ann Arbor, MI
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Bauermeister JA, Eaton L, Andrzejewski J, Loveluck J, VanHemert W, Pingel ES. Where You Live Matters: Structural Correlates of HIV Risk Behavior Among Young Men Who Have Sex with Men in Metro Detroit. AIDS Behav 2015; 19:2358-69. [PMID: 26334445 DOI: 10.1007/s10461-015-1180-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [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: 12/27/2022]
Abstract
Structural characteristics are linked to HIV/STI risks, yet few studies have examined the mechanisms through which structural characteristics influence the HIV/STI risk of young men who have sex with men (YMSM). Using data from a cross-sectional survey of YMSM (ages 18-29) living in Detroit Metro (N = 328; 9 % HIV-positive; 49 % Black, 27 % White, 15 % Latino, 9 % Other race), we used multilevel modeling to examine the association between community-level characteristics (e.g., socioeconomic disadvantage; distance to LGBT-affirming institutions) and YMSM's HIV testing behavior and likelihood of engaging in unprotected anal intercourse with serodiscordant partner(s). We accounted for individual-level factors (race/ethnicity, poverty, homelessness, alcohol and marijuana use) and contextual factors (community acceptance and stigma regarding same-sex sexuality). YMSM in neighborhoods with greater disadvantage and nearer to an AIDS Service Organization were more likely to have tested for HIV and less likely to report serodiscordant partners. Community acceptance was associated with having tested for HIV. Efforts to address YMSM's exposure to structural barriers in Detroit Metro are needed to inform HIV prevention strategies from a socioecological perspective.
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Affiliation(s)
- José A Bauermeister
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA.
| | - Lisa Eaton
- University of Connecticut, Storrs, CT, USA
| | - Jack Andrzejewski
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | | | | | - Emily S Pingel
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
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Bauermeister JA, Eaton L, Meanley S, Pingel ES. Transactional Sex With Regular and Casual Partners Among Young Men Who Have Sex With Men in the Detroit Metro Area. Am J Mens Health 2015; 11:498-507. [PMID: 26438470 DOI: 10.1177/1557988315609110] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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] Open
Abstract
Transactional sex refers to the commodification of the body in exchange for shelter, food, and other goods and needs. Transactional sex has been associated with negative health outcomes including HIV infection, psychological distress, and substance use and abuse. Compared with the body of research examining transactional sex among women, less is known about the prevalence and correlates of transactional sex among men. Using data from a cross-sectional survey of young men who have sex with men (ages 18-29) living in the Detroit Metro Area ( N = 357; 9% HIV infected; 49% Black, 26% White, 16% Latino, 9% Other race), multivariate logistic regression analyses examined the association between transactional sex with regular and casual partners and key psychosocial factors (e.g., race/ethnicity, education, poverty, relationship status, HIV status, prior sexually transmitted infections [STIs], mental health, substance use, and residential instability) previously identified in the transactional sex literature. Forty-four percent of the current sample reported engaging in transactional sex. Transactional sex was associated with age, employment status, relationship status, and anxiety symptoms. When stratified, transactional sex with a regular partner was associated with age, educational attainment, employment status, relationship status, anxiety, and alcohol use. Transactional sex with a casual partner was associated with homelessness, race/ethnicity, employment status, and hard drug use. The implications of these findings for HIV/STI prevention are discussed, including the notion that efforts to address HIV/STIs among young men who have sex with men may require interventions to consider experiences of transactional sex and the psychosocial contexts that may increase its likelihood.
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Affiliation(s)
| | - Lisa Eaton
- 2 University of Connecticut, West Hartford, CT, USA
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Bauermeister JA, Pingel ES, Jadwin-Cakmak L, Harper GW, Horvath K, Weiss G, Dittus P. Acceptability and preliminary efficacy of a tailored online HIV/STI testing intervention for young men who have sex with men: the Get Connected! program. AIDS Behav 2015; 19:1860-74. [PMID: 25638038 DOI: 10.1007/s10461-015-1009-y] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [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: 01/30/2023]
Abstract
Southeast Michigan accounts for over 70 % of all HIV/STI cases in the state, with young men who have sex with men (YMSM) between the ages of 13 and 24 encumbering the largest burden in HIV/STI incidence. Using community-based participatory research principles, we developed and pilot tested a web-based, randomized control trial seeking to promote HIV/STI testing ("Get Connected!") among YMSM (N = 130; ages 15-24). Randomized participants completed a baseline assessment and shown a test-locator condition (control) or a tailored, personalized site (treatment). At 30-day follow-up, we found high acceptability among YMSM in both conditions, yet higher credibility of intervention content among YMSM in the treatment group (d = .55). Furthermore, 30 participants reported testing by following, with the majority of these participants (73.3 %; n = 22) completing the treatment condition, a clinically meaningful effect (d = .34) suggesting preliminary efficacy for the intervention. These results demonstrate the potential of the intervention, and suggest that a larger efficacy trial may be warranted.
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Affiliation(s)
- José A Bauermeister
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA.
| | - Emily S Pingel
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | - Laura Jadwin-Cakmak
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | - Gary W Harper
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | | | - Gretchen Weiss
- National Association of County and City Health Officials (NACCHO), Washington, DC, USA
| | - Patricia Dittus
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Bauermeister JA, Pingel ES, Jadwin-Cakmak L, Harper GW, Horvath K, Weiss G, Dittus P. Acceptability and preliminary efficacy of a tailored online HIV/STI testing intervention for young men who have sex with men: the Get Connected! program. AIDS Behav 2015. [PMID: 25638038 DOI: 10.1007/sl0461-015-1009-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Southeast Michigan accounts for over 70 % of all HIV/STI cases in the state, with young men who have sex with men (YMSM) between the ages of 13 and 24 encumbering the largest burden in HIV/STI incidence. Using community-based participatory research principles, we developed and pilot tested a web-based, randomized control trial seeking to promote HIV/STI testing ("Get Connected!") among YMSM (N = 130; ages 15-24). Randomized participants completed a baseline assessment and shown a test-locator condition (control) or a tailored, personalized site (treatment). At 30-day follow-up, we found high acceptability among YMSM in both conditions, yet higher credibility of intervention content among YMSM in the treatment group (d = .55). Furthermore, 30 participants reported testing by following, with the majority of these participants (73.3 %; n = 22) completing the treatment condition, a clinically meaningful effect (d = .34) suggesting preliminary efficacy for the intervention. These results demonstrate the potential of the intervention, and suggest that a larger efficacy trial may be warranted.
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Affiliation(s)
- José A Bauermeister
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA.
| | - Emily S Pingel
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | - Laura Jadwin-Cakmak
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | - Gary W Harper
- Center for Sexuality and Health Disparities, Department of Health Behavior & Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, SPH I Room 3822, Ann Arbor, MI, 48109-2029, USA
| | | | - Gretchen Weiss
- National Association of County and City Health Officials (NACCHO), Washington, DC, USA
| | - Patricia Dittus
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Youatt EJ, Johns MM, Pingel ES, Soler JH, Bauermeister JA. Exploring young adult sexual minority women's perspectives on LGBTQ smoking. J LGBT Youth 2015; 12:323-342. [PMID: 26508993 PMCID: PMC4617757 DOI: 10.1080/19361653.2015.1022242] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Smoking rates are higher among lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals than among heterosexuals. These disparities are exacerbated during the transition from youth to young adulthood. The current study uses in-depth qualitative interviews to understand perceptions of LGBTQ smoking among LBQ-identified women (N=30, ages 18-24). Major themes identified include the belief that smoking was a way of overcoming stressors faced by heterosexual and LGBTQ young adults alike, a mechanism to relieve sexuality-related stressors, and an ingrained part of LGBTQ culture. Results suggest unique stressors influence LGBTQ smokers. Implications for smoking cessation interventions for LGBTQ youth are discussed.
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Affiliation(s)
- Emily J Youatt
- The Center for Sexuality and Health Disparities, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Michelle M Johns
- The Center for Sexuality and Health Disparities, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Emily S Pingel
- The Center for Sexuality and Health Disparities, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Jorge H Soler
- The Center for Sexuality and Health Disparities, School of Public Health, University of Michigan, Ann Arbor, MI
| | - José A Bauermeister
- The Center for Sexuality and Health Disparities, School of Public Health, University of Michigan, Ann Arbor, MI
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Jadwin-Cakmak LA, Pingel ES, Harper GW, Bauermeister JA. Coming Out to Dad: Young Gay and Bisexual Men's Experiences Disclosing Same-Sex Attraction to Their Fathers. Am J Mens Health 2014; 9:274-88. [PMID: 24989422 DOI: 10.1177/1557988314539993] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [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: 11/15/2022] Open
Abstract
Few studies have examined the relationship between young gay and bisexual men (YGBM) and their fathers. Based on a phenomenological framework, this study investigated the role of fathers in YGBM's coming-out experience, focusing on how fathers responded to disclosure of same-sex attraction, how fathers' responses compared with sons' expectations, and what sons perceived as having influenced their fathers' responses. Semistructured in-depth interviews with 30 gay and bisexual men aged 18 to 24 years were conducted as part of a larger study; topics explored in the interview included experiences coming out to family and others. Nineteen participants' narratives included discussion about their fathers and were included in the current analyses. The YGBM who were interviewed perceived a complex range of responses upon coming out to their fathers, ranging from enthusiastic acceptance to physical violence. Participants spoke of fathers who were accepting in different manners and who often held contradictory attitudes about same-sex attraction. Fathers' responses commonly differed from sons' expectations, which were informed by homophobic talk and gendered expectations. Sons spoke about what informed their expectations as well as what they perceived as influencing their fathers' responses, including gender norms, beliefs regarding the cause of same-sex attraction, religious and sociopolitical views, and concerns about HIV/AIDS. Particularly striking was the pervasive influence of hegemonic masculinity throughout the YGBM's stories. The implications of these findings for future research and intervention development are discussed, as well as study strengths and limitations.
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Affiliation(s)
| | - Emily S Pingel
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Gary W Harper
- University of Michigan School of Public Health, Ann Arbor, MI, USA
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Meanley S, Hickok A, Johns MM, Pingel ES, Bauermeister JA. Body mass index, body esteem, and unprotected receptive anal intercourse among young men who have sex with men who seek partners online. Arch Sex Behav 2014; 43:735-744. [PMID: 23979783 PMCID: PMC3933482 DOI: 10.1007/s10508-013-0159-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 02/01/2013] [Accepted: 05/16/2013] [Indexed: 06/02/2023]
Abstract
Research examining the relationship between body mass index (BMI) and sexual risk outcomes among men who have sex with men (MSM) has yielded inconsistent results. Using a web-based survey, single-identified (e.g., not in a relationship) young MSM (N = 431) between the ages of 18 and 24 years who sought romantic partners online were asked to respond to items regarding their BMI, body image (e.g., attribution, dissatisfaction, and pride), and sexual risk behaviors. We used Poisson regressions to examine the relationships between BMI, body image, and the number of unprotected receptive anal intercourse (URAI) occasions and partners in the past 2 months. We found a curvilinear relationship between BMI and URAI occasions, and a linear relationship between BMI and URAI partners. These relationships persisted after accounting for body image. Further, we found that body attribution served as a protective factor whereas body pride served as a risk factor. We discuss the implications of our findings for sexual health education and HIV prevention.
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Johns MM, Pingel ES, Youatt EJ, Soler JH, McClelland SI, Bauermeister JA. LGBT community, social network characteristics, and smoking behaviors in young sexual minority women. Am J Community Psychol 2013; 52:141-54. [PMID: 23783884 DOI: 10.1007/s10464-013-9584-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Smoking rates among young sexual minority women (YSMW) are disproportionately high as compared to heterosexual populations. While this disparity has commonly been attributed to the sexual minority stress process, little empirical work has explored what may protect YSMW from high rates of smoking. Using data (N = 471) from a cross-sectional study designed to investigate YSMW's (age 18-24) smoking behaviors and correlates; we explore the relationship of LGBT community connections, YSMW's social network characteristics, and stress to smoking behaviors (i.e., status, frequency, amount). Through this analysis, we find support for LGBT community connection as well as friendships with other sexual minorities as protective in relation to YSMW's smoking behaviors. We discuss the implications of our results, highlighting the need for future longitudinal research and interventions designed to bolster YSMW's connections to the LGBT community and their social networks.
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Affiliation(s)
- Michelle Marie Johns
- Center for Sexuality and Health Disparities, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
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Pingel ES, Bauermeister JA, Johns MM, Eisenberg A, Leslie-Santana M. "A safe way to explore": Reframing risk on the Internet amidst young gay men's search for identity. J Adolesc Res 2013; 28:453-478. [PMID: 25525293 DOI: 10.1177/0743558412470985] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Internet use provides a vital opportunity for sexual minority youth to learn about sexual desires and pursue partnerships otherwise publically stigmatized. Researchers, however, have portrayed the Internet as an inherently risky venue for HIV/STI transmission among young gay men (YGM). We therefore investigated how YGM use the Internet during adolescence and emerging adulthood. In the course of 34 in-depth, semi-structured interviews with a sample of self-identified YGM, 18-24 years of age, we inquired about initial experiences of online dating. We found that YGM benefit online through exploration of their sexual identities, while simultaneously encountering and negotiating sources of risk. In examining YGM's perceptions of risk, we hope to reach a greater understanding of the opportunities for HIV prevention and health promotion among YGM.
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Affiliation(s)
- Emily S Pingel
- The managing director of the Sexuality and Health Research Laboratory at the University of Michigan School of Public Health. She specializes in qualitative research, with her most recent endeavors exploring LGBT youth development and identity. She holds a BA in Anthropology and French from Tufts University and a Master's degree in Public Health from the University of Michigan
| | - Jose A Bauermeister
- Assistant Professor in the Department of Health Behavior and Health Education in the University of Michigan School of Public Health. Originally from San Juan, Puerto Rico, Dr. Bauermeister completed his MPH and PhD in Public Health from the University of Michigan. His primary research interests focus on sexuality and health, and interpersonal prevention and health promotion strategies for high-risk adolescents and young adults
| | - Michelle M Johns
- Second year PhD student in the Department of Health Behavior and Health Education at the University of Michigan. A native of the deserts of Arizona, she holds a BA in Psychology and Gender Studies from Whitman College and a Master of Public Health degree from the University of Michigan School of Public Health. Her research focuses on issues of health and well-being among women and LGBT people
| | - Anna Eisenberg
- Research coordinator at the University of Michigan. She received her Master of Public Health degree from the University of Michigan School of Public Health in Health Behavior and Health Education in 2010. She has worked at the University of California at San Francisco on international studies exploring female-controlled STI prevention methods. Her research interests include issues related to communication regarding sexuality and STI prevention
| | - Matthew Leslie-Santana
- Graduate of the University of Michigan School of Music, Theatre, and Dance with a major in Violin Performance and a minor in Latin American and Caribbean Studies. Additionally, he interned at the YES Institute in Miami, a not-for-profit organization focusing on suicide prevention among LGBT and all youth through community-based education on gender and orientation. He recently completed a Master's in Music at the Cleveland Institute of Music
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Pingel ES, Bauermeister JA, Elkington KS, Fergus S, Caldwell CH, Zimmerman MA. Condom Use Trajectories in Adolescence and the Transition to Adulthood: The Role of Mother and Father Support. J Res Adolesc 2012; 22:350-366. [PMID: 22639524 PMCID: PMC3358796 DOI: 10.1111/j.1532-7795.2011.00775.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Few studies have investigated how mother and father support differ on predicting youths' sexual risk behavior. We therefore examined the influence of parental support on condom use trajectories and its correlates in a predominantly African American sample [(N=627; 53% female; M = 14.86 years (SD=. 64)] from adolescence to young adulthood. We used hierarchical growth curve modeling to examine the relationship between condom use, substance use, psychological distress and parental support prospectively. We found that consistent condom use decreased over time and was associated negatively with psychological distress and substance use. Furthermore, both maternal and paternal support were associated with more condom use over time. We discuss the implications of our findings for HIV prevention programs.
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Affiliation(s)
- Emily S. Pingel
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - José A. Bauermeister
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Katherine S. Elkington
- HIV Center for Clinical and Behavioral Studies, Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Stevenson Fergus
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - Cleopatra H. Caldwell
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Marc A. Zimmerman
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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