Exploring Individual and Contextual Factors Associated With Sexual Risk and Substance Use Among Underserved GBQMSM and Transgender and Nonbinary Persons in South Central Appalachia

Gay, bisexual, queer, and other men who have sex with men (GBQMSM) and transgender and nonbinary persons are at elevated risk for HIV, sexually transmitted infections (STIs), and hepatitis C (HCV); in Appalachia, these communities experience more disease burden. However, little is known about the factors influencing risk. Sixteen semistructured in-depth interviews were conducted examining factors influencing prevention and care. Data were analyzed using constant comparison methodology. Fifteen themes emerged within four domains: social environment (e.g., microaggressions across gender, sexual orientation, and racial identities), substance use (e.g., high prevalence, use as coping mechanism), sexual health (e.g., misinformation and denial of risk for HIV and STIs), and access to health care (e.g., cost and transportation barriers, lack of local respectful care). Findings highlighted salient barriers and assets influencing prevention and care and suggest that multilevel interventions are needed to improve access to and use of HIV, STI, and HCV prevention and care services.

Measuring anti-transgender stigma in low-income and middle-income countries: a scoping review protocol

INTRODUCTION

Globally, transgender and other gender diverse (trans) people face pervasive stigma, which contributes to health inequities across multiple health outcomes. Stigma is a fundamental cause of health inequities because it simultaneously limits access to resources, contributes to systemic vulnerability and generates chronic stress. Anti-trans stigma occurs across multiple socioecological levels, resulting in multiple possible definitions and measurements of trans stigma. Understanding how trans stigma has been measured in low-income and middle-income countries (LMICs) is critical to health promotion efforts for trans communities. Accordingly, this scoping review will identify and examine how anti-trans stigma has been measured in existing LMIC-specific research to inform best practices for measurement of anti-trans stigma that includes consideration of local context.

METHODS AND ANALYSIS

This is the protocol for a scoping review of anti-trans stigma in LMICs. We will search (from January 2001 to December 2021) PubMed, WHO Global Medicus and EBSCO. Study selection will conform to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist. Original studies in English, Spanish, Arabic or Russian will be included. Reviewers will independently screen all citations, full-text articles and abstract data. Data analysis will involve quantitative and qualitative methods. A narrative summary of findings will be conducted.

ETHICS AND DISSEMINATION

As a scoping review (no direct interaction with participants), this study is exempt from human subjects oversight. Understanding context-specific ways to measure anti-trans stigma is urgently needed to support trans health globally. The planned scoping review will help to address this gap. Results of the review will be disseminated in a peer-reviewed journal and likely in other media such as conferences, seminars and symposia. PROTOCOL REGISTRATION NUMBER: osf.io/qcs2v.

The Role of Health Policies in Faith-based Institutions in Promoting Health and Changing Food Practices: The Philadelphia Ujima Experience

BACKGROUND

The Philadelphia Ujima Health Collaborative uses a community-based participatory research framework to address nutrition in underserved communities. Participation in individual-level focused health promotion activities motivated two faith-based partners to develop wellness policies to better inform their health promoting practices, specifically around food served at church events.

OBJECTIVES

This study investigated the effectiveness of church-based policies in influencing 1) organizational practices regarding food and beverages served and sold and 2) individual attitudes and practices toward healthy eating.

METHODS

Congregants completed questionnaires assessing their knowledge and awareness of the policy as well as observed changes in institutional and personal practices. Additionally key informant interviews were conducted with ministry leaders and members.

RESULTS

As a result of the wellness policies developed, sites increased consumption of fruits, vegetables, and water at events. Institutional barriers and lessons learned were identified.

CONCLUSIONS

Effective community-academic partnerships using community participatory approaches with a health in all policies focus can improve health behaviors in diverse and underserved communities and engage them to play an active role in health promotion.