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Phillips GL, Curtis MG, Kelsey SW, Floresca YB, Davoudpour S, Quiballo K, Beach LB. Changes to Sexual Identity Response Options in the Youth Risk Behavior Survey. JAMA Pediatr 2024; 178:506-508. [PMID: 38436940 PMCID: PMC10912997 DOI: 10.1001/jamapediatrics.2024.0024] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/05/2023] [Indexed: 03/05/2024]
Abstract
This survey study discusses changes in the proportion of youths who selected “not sure” among other response options to questions about their sexual identity in the National Youth Risk Behavior Survey between 2019 and 2021 and recommends measures to inclusively reflect sexual identities.
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Affiliation(s)
- Gregory L. Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Michael G. Curtis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Scar Winter Kelsey
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ysabel Beatrice Floresca
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Shahin Davoudpour
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Kagen Quiballo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Lauren B. Beach
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Xu J, Narla SS, Davoudpour S, Ruprecht MM, Curtis MG, Phillips Ii G. COVID-19 testing and vaccination uptake among youth and young adults: Disparities by age, race/ethnicity, sexual orientation, and gender identity. Am J Infect Control 2024; 52:312-319. [PMID: 37741292 PMCID: PMC10925914 DOI: 10.1016/j.ajic.2023.09.010] [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: 06/29/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND The COVID-19 pandemic disproportionately impacts youth and young adults (YYA) and YYA with multiple marginalized identities, yet little is known about differences in uptake, testing access, and vaccine concerns among YYA by diverse demographic identities. METHODS Between 2/2021 and 2/2022, we conducted a national, cross-sectional online survey focused on diverse YYA ages 14 to 24 (n = 983). We explored the prevalence of COVID-19 testing and vaccination among YYA by age, race/ethnicity, and sexual and gender identities. Bivariate and multivariable logistic regression models were developed to estimate associations between individual variables and COVID-19 testing and vaccination. RESULTS The overall COVID-19 testing and vaccination rates in our sample were high (75.99% and 69.07%, respectively). No differences in testing by demographics were found. Compared to individuals aged 14 to 17 years, those aged 18 to 21 years and 22 to 24 years were over 2 times and 4 times as likely to report receiving a vaccine, respectively. All race/ethnicity groups except for Asian individuals were more likely to report being vaccinated compared to their white peers. CONCLUSIONS Our findings showed critical disparities in COVID-19 vaccination among YYA with marginalized identities and emphasized the urgency for data collection and research on pandemic prevention for vulnerable YYA populations.
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Affiliation(s)
- Jiayi Xu
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Shreya S Narla
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Shahin Davoudpour
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Megan M Ruprecht
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Michael G Curtis
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Gregory Phillips Ii
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
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Curtis MG, Davoudpour S, Felt D, French AL, Hosek SG, Phillips G, Serrano PA. Monkeypox-Induced Secondary Traumatic Stress: An Exploratory Analysis of Young Sexual and Gender Minority Adults Living in Illinois. Eur J Trauma Dissociation 2023; 7:100349. [PMID: 37810174 PMCID: PMC10552682 DOI: 10.1016/j.ejtd.2023.100349] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Objective Prior epidemic literature suggests that the rapid proliferation of Monkeypox (Mpox) within the United States may trigger severe stress reactions that increase the risk of developing secondary traumatic stress among young adults most at risk of exposure. The present exploratory study aimed to investigate the degree to which proximity to Mpox (i.e. knowing people who acquired Mpox), was associated with symptoms of secondary traumatization. Method An online survey was administered to 253 participants enrolled in Keeping it LITE, a prospective U.S. cohort study of ethnically diverse, sexually active, sexual and gender minority persons ages 19-39 in September 2022. A multiple linear regression was used to examine the association between proximity to Mpox and secondary traumatic stress (STS) symptoms. Results Study findings demonstrated that Mpox morbidity was low (1%); however, 37% of participants reported knowing at least one person diagnosed with Mpox. For most individuals, this person was a friend (28%). 16% of participants were found to have at least one indicator of Mpox-related STS. Results of our multiple linear regression demonstrated a positive association between an individual's indirect exposure to Mpox via their interpersonal relationships and STS symptoms. Conclusions Findings suggest that the more adults' interpersonal relationships are saturated with people who have acquired Mpox, the more likely they are to develop symptoms of secondary traumatization. These findings provide tentative initial evidence that secondary exposure to Mpox via one's social network may undermine adults' mental health even after the conclusion of the outbreak.
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Curtis MG, Floresca YB, Davoudpour S, Xu J, Phillips G. Patterns of COVID-19 related lifestyle disruptions and their associations with mental health outcomes among youth and young adults. J Mood Anxiety Disord 2023; 4:100029. [PMID: 38125785 PMCID: PMC10732581 DOI: 10.1016/j.xjmad.2023.100029] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
The COVID-19 pandemic is a socionatural disaster that has disrupted the lives of individuals, families, and communities. Youth and young adults (YYA) were uniquely vulnerable to the proximal mental health effects of the pandemic; however, few studies have examined the long-term mental health effects of the pandemic. In the present study, we sought to (a) identity distinctive profiles of COVID-related lifestyle disruptions experienced by YYA, (b) investigate sociodemographic characteristics correlates of profile membership, and (c) examine the extent to which profile membership was prospectively associated with changes in depressive and anxiety symptoms. Hypothesis were tested using latent profile analysis with data from 1055 YYA collected across two time-points, 6-months apart. Results produced a three-class model: low- (11%), moderate- (61%), and high-levels of (28%) disruption. Members of the high levels of disruption group were more likely to identify as Black or Latinx American, bisexual/pansexual, or as transgender or gender diverse in comparison to the low levels of disruption group. Inclusion in the high levels of disruption group was associated with increases in depressive and anxiety symptoms from T1 to T2. YYA from multiple marginalize communities (i. e. those who identified as both racial/ethnic and sexual/gender minorities) experienced the greatest levels of lifestyle disruption related to COVID-19. Consequently, disruptive effects of the COVID-19 pandemic prospectively eroded their mental health. YYA are in urgent need of developmentally appropriate resources to effectively recovery from the pandemic.
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Affiliation(s)
- Michael G. Curtis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, USA
| | - Ysabel Beatrice Floresca
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, USA
| | - Shahin Davoudpour
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, USA
| | - Jiayi Xu
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, USA
| | - Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, USA
- Division of Public Health Practice, Department of Preventive Medicine, Feinberg School of Medicine Northwestern University, USA
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Phillips G, Curtis MG, Felt D, Davoudpour S, Rodriguez-Ortiz AE, Cortez A, French AL, Hosek SG, Serrano PA. Changes in Sexual Behaviors Due to Mpox: a Cross-Sectional Study of Sexual and Gender Minority Individuals in Illinois. Prev Sci 2023:10.1007/s11121-023-01604-3. [PMID: 37906357 DOI: 10.1007/s11121-023-01604-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
The spread of the monkeypox virus (mpox) in 2022 primarily within the sexual networks of men who have sex with men (MSM) triggered a potentially stigmatizing public health response in the USA. Despite mpox being primarily spread through skin-to-skin contact, most messaging has promoted abstinence and/or reduction in sexual risk behaviors. More research is needed on decreases in sexual risk behaviors among sexual and gender minority (SGM) youth and young adults (YYA) related to the most recent mpox epidemic and whether there are factors associated with these decreases in sexual risk behavior. Participants within an ongoing cohort study of SGM YYA who reside in Illinois were offered the opportunity to participate in an mpox survey between September 10th and September 20th, 2022. Analyses looked at demographic factors associated with sexual activity since the start of the outbreak, as well as associations with two sexual risk reduction factors. Survey participation was 68.7% (322/469). Three-quarters of participants (82.6%) reported sexual activity since June 1st. Most sexually active participants (83.5%) adopted at least one sexual risk reduction behavior due to mpox. Black and Latinx individuals were less likely to be sexually active but more likely to report risk reduction behaviors (31.3% and 22.6%, respectively). Participants who received the mpox vaccine were more likely to report sexual activity. SGM YYA in Illinois reported that their sexual behaviors were impacted by the mpox outbreak. However, associations between vaccination and sexual behavior demonstrate that those who are vaccinated do adopt protective methods despite not decreasing sexual activity. Therefore, sex-positive communications and harm reduction messaging may be more appropriate as opposed to abstinence-only prevention, which can further stigmatize an already marginalized group.
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Affiliation(s)
- Gregory Phillips
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA.
| | - Michael G Curtis
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA
| | - Dylan Felt
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA
| | - Shahin Davoudpour
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA
| | - Anthony E Rodriguez-Ortiz
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA
| | - Alfred Cortez
- Department of Medical Social Sciences, Northwestern University, 625 N. Michigan Ave, Chicago, IL, 60611, USA
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Davoudpour S. Don't Be My Neighbor: Exploring Social and Value Predictors of Sexual Prejudice Expressed by Those Who Fully Accept Sexual Minorities. Arch Sex Behav 2023; 52:2337-2353. [PMID: 36877321 DOI: 10.1007/s10508-023-02567-w] [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] [Received: 10/02/2021] [Revised: 02/14/2023] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
It is without a doubt that acceptance of sexual minorities is growing across the globe. Two major narratives are commonly assumed to be true about this increased acceptance. First, this acceptance is increased by proximity to the stigmatized. Second, this acceptance is enduring. These might not be entirely true as multiple attitudinal datasets frequently show a diversity among the accepting population, especially for those who express full acceptance of the stigmatized while refusing neighboring proximity to them. This inconsistency in acceptance is the main focus of this study. Using rejection of neighboring proximity to sexual minorities as a case for stigma and data from the Integrated Values Surveys (n = 52,796; 48.15% male), this study explores the similarities and differences between those who fully accept sexual minorities and those who express heightened sexual prejudice when rejecting neighboring proximity to sexual minorities. Logistic regression models show those in the accepting population who reject neighboring proximity to sexual minorities are more likely to be men, lower educated, highly religious, hold a traditional gender-related belief, and are attracted to right-wing political ideologies. While those with extreme sexual prejudice share sex, age, and traditional gender-related beliefs in rejecting neighboring proximity to sexual minorities, no effects for educational attainment and political ideology were discovered. Theoretical and practical implications are discussed.
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Affiliation(s)
- Shahin Davoudpour
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., 14th floor, Chicago, IL, 60611, USA.
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Curtis MG, Davoudpour S, Rodriguez-Ortiz AE, Felt D, French AL, Hosek SG, Phillips G, Serrano PA. Predictors of Mpox vaccine uptake among sexual and gender minority young adults living in Illinois: Unvaccinated vs. double vs. single dose vaccine recipients. Vaccine 2023; 41:4002-4008. [PMID: 37236817 PMCID: PMC10206605 DOI: 10.1016/j.vaccine.2023.05.043] [Citation(s) in RCA: 2] [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] [Received: 02/03/2023] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
INTRODUCTION The 2022 global outbreak of Monkeypox virus (Mpox), which has primarily spread through the sexual networks of sexual and gender minority (SGM) individuals, has introduced new public health challenges. While an efficacious Mpox vaccine is in active circulation, few Mpox vaccine studies have examined its uptake among SGM groups. The aims of this study were to investigate (a) the prevalence of Mpox vaccine uptake among SGM and (b) the contextual, Mpox-disease specific, and Mpox-vaccine specific factors associated with Mpox vaccine among SGM. METHODS We conducted a cross-sectional survey in Illinois, USA in September 2022; 320 young SGM completed self-administered questionnaires. Multinomial logistic regression was used to assess the contextual, Mpox-disease specific, and Mpox-vaccine specific factors associated with Mpox vaccine uptake. Adjusted Odds Ratios (aORs) and 95 % Confidence Intervals (CI) are reported. RESULTS Approximately 50 % of the SGM participants included in this study had received at least their first dose of the Mpox vaccine. Multinomial regression analysis showed that individuals who had recently experienced food insecurity, had higher degrees of fear of social rejection due to Mpox acquisition, and were more Mpox-vaccine hesitant were more likely to be unvaccinated. Conversely, knowing people who have contracted Mpox, having higher formal educational attainment, having higher degrees of Mpox-related internalized heterosexism, and being more concerned about one's safety regarding Mpox morbidity were more likely to be double-dosers. CONCLUSION Approximately 50 % of the SGMs included in this study received at least their first dose of the Mpox vaccine; however, only one-quarter of participants completed the recommended 2-dose Mpox regimen. Our findings indicate that socioeconomic stability, fear of social rejection due to disease acquisition, and Mpox-specific vaccine hesitancy may be important structural targets to consider when developing vaccine-uptake prevention and intervention strategies tailored to the needs of sexual and gender minorities.
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Affiliation(s)
- Michael G Curtis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States.
| | - Shahin Davoudpour
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States
| | - Anthony E Rodriguez-Ortiz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States
| | - Dylan Felt
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States
| | - Audrey L French
- Division of Infectious Disease, Department of Medicine, John H. Stroger Hospital, Jr., of Cook County Health, Chicago, IL, United States
| | - Sybil G Hosek
- Division of Infectious Disease, Department of Medicine, John H. Stroger Hospital, Jr., of Cook County Health, Chicago, IL, United States; Department of Psychiatry, John H. Stroger Hospital, Jr., of Cook County Health, Chicago, IL, United States
| | - Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Evanston, IL, United States; Division of Public Health Practice, Department of Preventive Medicine, Feinberg School of Medicine Northwestern University, Chicago, IL, United States
| | - Pedro A Serrano
- Division of Public Health Practice, Department of Preventive Medicine, Feinberg School of Medicine Northwestern University, Chicago, IL, United States; Department of Research, CORE Center of Cook County Health, Chicago, IL, United States
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Phillips G, Davoudpour S, Floresca YB, Felt D, Curry CW, Wang X, Choi J, Kelsey SW, Beach LB. Disparities in HIV Testing, Condom Use, and HIV Education Between Transgender and Not Transgender High School-Aged Youth: Findings From the 2019 Youth Risk Behavior Survey. Health Educ Behav 2023; 50:29-40. [PMID: 36540958 DOI: 10.1177/10901981221142238] [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: 12/24/2022]
Abstract
Transgender individuals are disproportionately affected by HIV in the United States. Given increased risk of HIV among youth, there is a need to understand HIV risk and protective factors among transgender individuals who are 18 years and younger. Patterns of HIV testing, HIV education, and condom use have known associations with HIV outcomes among youth in general, but are understudied among transgender youth. This study assessed these outcomes by developing a series of sex-stratified multivariable logistic regression models using pooled Youth Risk Behavior Survey data. Results indicate female and male transgender youth as well as males who were not sure they were transgender were more likely have tested for HIV compared with their not transgender peers. Male transgender youth were significantly less likely to have received HIV education compared with not transgender males. Females not sure if they were transgender and male transgender youth were significantly less likely to have used condoms compared with, respectively, not transgender female and not transgender male counterparts. In sum, condom use and HIV education both remain lower among transgender individuals relative to their not-transgender peers. This highlights the need for the promotion of culturally appropriate HIV education and HIV prevention supports among transgender youth.
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Affiliation(s)
| | | | | | - Dylan Felt
- Northwestern University, Chicago IL, USA
| | - Caleb W Curry
- Northwestern University, Chicago IL, USA.,Case Western Reserve University, Cleveland, OH, USA
| | - Xinzi Wang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Davoudpour S, Davis JK. Life Extension and Overpopulation: Demography, Morals, and the Malthusian Objection. HEC Forum 2022:10.1007/s10730-022-09504-9. [PMID: 36571631 DOI: 10.1007/s10730-022-09504-9] [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] [Accepted: 12/13/2022] [Indexed: 12/27/2022]
Abstract
One of the main objections to life extension is that life extension will cause severe overpopulation. This objection presents both moral and demographic issues. To explore the demographic issue, we present an updated and improved version of the formula in chapter six of New Methuselahs for projecting the demographic impact of life extension. The new version includes additional demographical factors such as non-aging related causes of death. According to projections generated with this revised formula, moderate life extension (a life expectancy of 120 years) will not significantly increase population at the fertility rates current in the developed world, but radical life expectancy (halting aging completely, leading to an average life expectancy of 1000 years) can lead to severe overpopulation even at very low fertility rates. This formula also enables us to ascertain what fertility rate and birth spacing will prevent life extension from causing severe overpopulation. The moral issues arise if radical life extension causes overpopulation severe enough to outweigh the benefits it brings. New Methuselahs proposed a reproductive policy for avoiding severe overpopulation by limiting reproduction for those who use life extension. We then consider a moral objection to this policy that was not discussed in New Methuselahs: it is not likely that society will succeed in imposing limits to reproduction, therefore, it is likely that radical life extension is morally wrong. We respond to this objection and defend our response against two further objections.
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Affiliation(s)
- Shahin Davoudpour
- Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA.
| | - John K Davis
- Department of Philosophy, California State University, Fullerton, Fullerton, CA, 92831, USA
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