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Collins L, Barnes SL, Heffernan K, Lyew D. Knowledge about HIV-Related Services Among Young Blacks with Diverse Sexual Identities: an Intra-racial Analysis. J Racial Ethn Health Disparities 2024; 11:1056-1066. [PMID: 38315291 DOI: 10.1007/s40615-023-01585-7] [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: 11/30/2022] [Revised: 03/23/2023] [Accepted: 03/31/2023] [Indexed: 02/07/2024]
Abstract
Given the disproportionate representation in HIV/AIDS cases among young Black members of the LGBTQIA community, it is important to continue to identify both their ability to assess the knowledge that can foster healthier sexual outcomes as well as dynamics that may foster or undermine their efforts. The goal of this study is to examine whether 236 young Black persons ages 18-30 years old who are members of the LGBTQIA community know where to go locally to locate healthcare services to combat HIV/AIDS and other sexually transmitted health issues. Quantitative findings show the influence of self-identified sexual identity, age, and place of residence on knowledge about HIV-related services. The implications of these results illustrate the possible effects of place and identity development on knowledge about HIV-related services that can affect life chances and quality of life for certain members of this community.
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Affiliation(s)
- Leslie Collins
- Fisk University, 1000 17th Ave N, Nashville, TN, 37208, USA
| | - Sandra L Barnes
- Brown University, Box 1916, Providence, RI, 02912-1916, USA.
| | - Katherine Heffernan
- Department of HOD, Vanderbilt University, 2201 West End Ave, Nashville, TN, 37235, USA
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2
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Dillon FR, Ertl MM, Eklund AC, Westbrook J, Balek G, Algarin A, Martin J, Sánchez FJ, Ebersole R. Sexual Identity Development and Social Ecological Facilitators and Barriers of PrEP Uptake and Adherence Among Latinx Men Who Have Sex with Men. Arch Sex Behav 2024; 53:1197-1211. [PMID: 38212437 DOI: 10.1007/s10508-023-02776-3] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 10/20/2023] [Accepted: 11/30/2023] [Indexed: 01/13/2024]
Abstract
Latinx gay, bisexual, and other men who have sex with men (LMSM) report lower pre-exposure prophylaxis (PrEP) use than their white, non-Latinx counterparts. We hypothesize that this disparity is partially attributable to social ecological factors that can be addressed via prevention interventions. In this retrospective study, we first examined data from 253 LMSM to determine whether theorized associations existed between acquisition of a PrEP prescription (uptake) in relation to several social ecological factors based on a conceptual framework of determinants of access to and uptake of PrEP for LMSM. We also explored relations between frequency of PrEP use (adherence) and social ecological factors with a subsample of 33 LMSM who had initiated PrEP 12 months prior to assessment. In this study, individual-level factors from this framework included age and socioeconomic status. Perceived access to medical care represented both individual- and community-level determinants of PrEP uptake and adherence. Interpersonal-level factors were social support and relationship status. Structural/cultural-level factors were sexual identity development status, the masculinity norm of heterosexual self-presentation, traditional Latinx masculine gender role beliefs of machismo and caballerismo, racial identity, and immigration status. Results indicated that older men and those who endorsed the synthesis/integration status of sexual identity development were more likely to acquire a PrEP prescription during their lifetime in comparison to peers. PrEP adherence was linked with being older, reporting higher socioeconomic status, reporting more appraisal social support, self-identifying as white-Latinx, being U.S.-born, and endorsing less sexual identity uncertainty and more heterosexual self-presentation. Results specify modifiable factors that may inform tailored, community-based prevention efforts to increase PrEP use and decrease existing HIV/AIDS disparities among LMSM.
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Affiliation(s)
- Frank R Dillon
- School of Counseling and Counseling Psychology, Arizona State University, 446 Payne Hall, MC-0811, Tempe, AZ, 85287-0811, USA.
| | - Melissa M Ertl
- HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Austin C Eklund
- Department of Educational & Counseling Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Jaelen Westbrook
- School of Counseling and Counseling Psychology, Arizona State University, 446 Payne Hall, MC-0811, Tempe, AZ, 85287-0811, USA
| | - Gabrielle Balek
- Department of Counseling and Educational Psychology, New Mexico State University, Las Cruces, NM, USA
| | - Angel Algarin
- School of Counseling and Counseling Psychology, Arizona State University, 446 Payne Hall, MC-0811, Tempe, AZ, 85287-0811, USA
| | - Jessica Martin
- Department of Educational & Counseling Psychology, University at Albany, State University of New York, Albany, NY, USA
| | - Francisco J Sánchez
- School of Counseling and Counseling Psychology, Arizona State University, 446 Payne Hall, MC-0811, Tempe, AZ, 85287-0811, USA
| | - Ryan Ebersole
- Department of Educational & Counseling Psychology, University at Albany, State University of New York, Albany, NY, USA
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3
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Gower AL, Eisenberg ME, Brown C, McMorris BJ, Rider GN. Differences in the Prevalence of Adolescent Sexual Identity: Results of Expanding Survey Response Options. J Adolesc Health 2024; 74:625-627. [PMID: 38069925 PMCID: PMC10872779 DOI: 10.1016/j.jadohealth.2023.10.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/25/2023] [Accepted: 10/02/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE To describe the prevalence of sexual identity by grade, racial and ethnic identities, and sex assigned at birth. METHODS Data came from the statewide 2022 Minnesota Student Survey of eighth, ninth, and 11th grade students (N = 99,688). Chi-square tests compared the prevalence of sexual identity across grades, racial/ethnic groups, and sex assigned at birth. RESULTS Over a fifth (22.2%) of students self-reported a minoritized sexual identity. Bisexual and pansexual were most common among Native+ (12.3%, 5.7%, respectively), multiracial (11.6%, 4.4%, respectively), and Latina/x/o (10.4%, 4.1%, respectively) youth. Asexuality was consistently reported across grades, and eighth graders reported gay/lesbian, bisexual, and queer identities less than 11th graders. Youth assigned female at birth were more likely to report gay/lesbian, bisexual, asexual, pansexual, queer, and questioning than youth assigned male at birth. DISCUSSION Results support the continued use of further expanded sexual identities in epidemiologic surveys.
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Affiliation(s)
- Amy L Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota.
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Camille Brown
- School of Nursing, University of Minnesota, Weaver-Densford Hall, Minneapolis, Minnesota
| | - Barbara J McMorris
- School of Nursing, University of Minnesota, Weaver-Densford Hall, Minneapolis, Minnesota
| | - G Nic Rider
- Insitute for Sexual and Gender Health, Department of Family Medicine and Community Health University of Minnesota Medical School, Minneapolis, Minnesota
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4
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Zhang ZM, Smith-Johnson M, Gorman BK. Who Cares? Unpaid Caregiving by Sexual Identity, Gender, and Partnership Status Among U.S. Adults. Demography 2024; 61:115-140. [PMID: 38206071 DOI: 10.1215/00703370-11145841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Recent scholarship indicates that sexual minority adults have higher caregiving rates than heterosexuals and that women are more likely to be caregivers than men. However, little research has addressed how gender and sexuality intersect in shaping caregiving status. This study uses data from the Behavioral Risk Factor Surveillance System and aggregates a probability-based sample of adults living in 36 U.S. states between 2015 and 2021. We examine who provides care among adult heterosexual, lesbian, gay, and bisexual men and women. Results reveal that women are more likely to be caregivers than men, but only among heterosexuals. We find little variation in caregiving by sexuality among women, but bisexual men are more likely than heterosexual men to be caregivers; the latter result appears to be driven by unpartnered, bisexual men. Lastly, we contextualize caregivers' experiences and reveal selected descriptive differences in patterns of care recipient-caregiver relationships across gender and sexual identity groups. Our findings advance understanding of caregiving and changing family ties in an era of population aging and increasing diversity in sexual identities.
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Affiliation(s)
- Zhe Meredith Zhang
- Department of Sociology, California State University, Los Angeles, CA, USA
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Julian CA, Manning WD, Westrick-Payne KK. Responses to Sexual and Gender Identity Measures in Population-Level Data by Birth Cohort: A Research Note. Demography 2024; 61:15-30. [PMID: 38258548 DOI: 10.1215/00703370-11164985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
The measurement of sexual and gender identity in the United States has been evolving to generate more precise demographic estimates of the population and a better understanding of health and well-being. Younger cohorts of sexual- and gender-diverse adults are endorsing identities outside of the lesbian, gay, bisexual, and transgender (LGBT) labels. Current population-level surveys often include a category such as "something else" without providing further details, and doing so inadequately captures these diverse identities. In this research note, our analysis of the most recent federal data source to incorporate sexual and gender identity measures-the Household Pulse Survey-reveals that younger birth cohorts are more likely to select "something else" for their sexual identity and "none of these" for their gender identity. The observed sexual and gender identity response patterns across birth cohorts underscore the importance of developing and applying new strategies to directly measure sexual- and gender-diverse adults who identify with identities outside of those explicitly captured on surveys. The integration of sexual and gender identity measures in population-level surveys carries broader implications for civil rights and for addressing health inequities and therefore must be responsive to cohort differences in identification.
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Affiliation(s)
- Christopher A Julian
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH, USA
| | - Wendy D Manning
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH, USA
| | - Krista K Westrick-Payne
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH, USA
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Marquez J, Humphrey N, Black L, Cutts M, Khanna D. Gender and sexual identity-based inequalities in adolescent wellbeing: findings from the #BeeWell Study. BMC Public Health 2023; 23:2211. [PMID: 37946184 PMCID: PMC10636841 DOI: 10.1186/s12889-023-16992-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 10/13/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Gender and sexual minority adolescents experience greater symptoms of psychological distress than their peers, but little is known about broader aspects of their wellbeing. This study examines wellbeing inequalities relating to gender and sexual identity among adolescents from Greater Manchester in the United Kingdom. METHOD 37,978 adolescents (aged 12-15, attending 165 secondary schools) completed surveys of life satisfaction, positive and negative affect (hedonic framework); autonomy, self-esteem, optimism, and positive relationships (eudaimonic framework); and, symptoms of distress and mental wellbeing (complete state framework). Structural correlated factors models were used to assess gender and sexual identity wellbeing inequalities. RESULTS The magnitude of wellbeing inequalities pertaining to gender and sexual identity were routinely substantially greater than those concerning other characteristics (e.g., socio-economic disadvantage). Gender identity wellbeing inequalities followed a consistent pattern, with the largest disparities evident between gender diverse adolescents and boys. Sexual identity wellbeing inequalities also followed a consistent pattern, with the largest disparities evident between sexual minority youth (both gay/lesbian and bi/pansexual) and their heterosexual peers. Finally, variation was evident across wellbeing domains. For example, observed gender identity (boys vs. girls) and sexual identity (heterosexual vs. sexual minority) disparities were substantially greater for symptoms of distress than for mental wellbeing in the complete state model. CONCLUSIONS LGBTQ + adolescents experience lower wellbeing than their peers, and this is evident across a range of wellbeing domains. Accordingly, there is an urgent need for the prioritisation of improved prevention and intervention efforts that can better meet the needs of gender diverse and sexual minority youth, and future research should be conducted to improve understanding of the mechanisms underpinning the wellbeing inequalities observed.
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Affiliation(s)
- Jose Marquez
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK.
| | - Neil Humphrey
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
| | - Louise Black
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
| | - Megan Cutts
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
| | - Devi Khanna
- Manchester Institute of Education, University of Manchester, Manchester, M13 9PL, UK
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Rubini K, Al-Bakri T, Bridel W, Clapperton A, Greaves M, Hill NE, Labrecque M, MacDonagh R, Miguel G, Orvis S, Osbourne-Sorrell W, Randall T, Reid M, Rosser A, Presseau J, Vesnaver E. Engaging community members to ensure culturally specific language is used in research: should I use gay, queer, MSM, or this other new acronym? Res Involv Engagem 2023; 9:75. [PMID: 37667325 PMCID: PMC10478417 DOI: 10.1186/s40900-023-00463-0] [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] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/05/2023] [Indexed: 09/06/2023]
Abstract
Researchers often use terminology to define their participant groups that is rooted in a clinical understanding of the group's shared identity(ies). Such naming often ignores the ways that the individuals who comprise these populations identify themselves. One oft-cited benefit of patient-oriented or community-engaged research is that language is local and relevant to impacted communities. This paper aims to contribute to the literature on how this local and relevant language can best be established. We ask how researchers can identify and implement accurate terminology, even when divergent perspectives exist within the communities involved. We draw from our experience with the Expanding Plasma Donation in Canada study, a community-engaged research study, which explored the views of people impacted by the "men who have sex with men" (MSM) blood donation policies in Canada. We describe the collaborative process through which we came to a consensual naming of this population, the challenges we faced, and a set of guiding principles we used to address them. We did not find an all-encompassing term or acronym that worked for all stages of research. Instead, we offer a set of guiding principles that can aid researchers engaging in a similar process: harm reduction, consent and transparency, collaboration and community involvement, recognition of missing voices, and resisting and/or restructuring oppressive standards.
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Affiliation(s)
- Kyle Rubini
- Local Advisory Group, Toronto Metropolitan University, Toronto, Canada
| | | | - William Bridel
- Local Advisory Group, University of Calgary, Calgary, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | | | | | | | | | | | | | | | | | | | | | | | - Justin Presseau
- School of Psychology, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
- School of Epidemiology and Public Health, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Elisabeth Vesnaver
- School of Epidemiology and Public Health, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada.
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8
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Kelly LM, Shepherd BF, Brochu PM, Zajac K. Co-occurring suicidal ideation and alcohol-related problems: An intersectional analysis of Native American and White adults with minoritized sexual identities. Addict Behav 2023; 142:107674. [PMID: 36905898 DOI: 10.1016/j.addbeh.2023.107674] [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] [Received: 06/16/2022] [Revised: 02/11/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND Disparities in suicidal ideation (SI) and alcohol use disorder (AUD) are evident in both Native American and minoritized sexual identity groups, relative to non-Hispanic White and heterosexual groups. However, Native Americans report lower drinking and binge drinking rates than White adults. Persons with intersecting identities, specifically Native Americans with minoritized sexual identities, may be at greater risk for SI and drinking, binge drinking, and AUD than White and Native American heterosexual adults. METHODS Five years (2015-2019) of National Survey of Drug Use and Health data were combined (N = 130,157). Multinomial logistic regressions tested racial (Native American vs White) and sexual identity (lesbian/gay/bisexual vs heterosexual) differences in odds of SI, drinking, and co-occurring SI + drinking, versus neither SI/drinking. Subsequent analyses examined SI + binge drinking, and SI + AUD. RESULTS Compared to White heterosexual adults, Native American heterosexual adults reported lower co-occurring SI + drinking odds, whereas Native American sexual minoritized adults reported higher odds. Native American sexual minoritized groups showed greater co-occurring SI + binge drinking odds and greater co-occurring SI + AUD odds compared to White heterosexual adults. Native American sexual minoritized adults showed greater SI only compared to White sexual minoritized adults. Sexual minoritized Native Americans showed higher odds of co-occurring SI + drinking, binge drinking, and AUD than White heterosexual adults. CONCLUSIONS Native American sexual minoritized groups showed higher likelihood of co-occurring SI + drinking, binge drinking, and AUD relative to both White and Native American heterosexual adults. Disparities warrant outreach for suicide and AUD prevention for Native American sexual minoritized adults.
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Affiliation(s)
- Lourah M Kelly
- University of Connecticut, School of Medicine, United States
| | - Benjamin F Shepherd
- Nova Southeastern University, Department of Clinical and School Psychology, United States
| | - Paula M Brochu
- Nova Southeastern University, Department of Clinical and School Psychology, United States
| | - Kristyn Zajac
- University of Connecticut, School of Medicine, United States.
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9
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Azagba S, Ebling T, Shan L. Is socioeconomic status related to youth e-cigarette use? Examining family affluence and sexual identity. Addict Behav 2023; 141:107636. [PMID: 36821881 DOI: 10.1016/j.addbeh.2023.107636] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/08/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023]
Abstract
There is limited evidence about the relationship between socioeconomic status (SES) and youth electronic cigarette use, particularly among sexual minorities. This study investigates whether family affluence is significantly associated with e-cigarette use among youth, including sexual minority youth. Data came from the 2021 National Youth Tobacco Survey (N = 10,515). The prevalence of e-cigarette use for all participants and sexual minority youth (N = 1376) by SES was calculated and ranked according to the Family Affluence Scale. A propensity score weighting method was used to address the imbalance in characteristics among SES groups. The associations of SES with current e-cigarette use and current flavored e-cigarette use were estimated using univariate survey logistic regression for all participants and self-identified sexual minority students. The prevalence of e-cigarette use was similar among socioeconomic groups for all participants and sexual minorities. The propensity score weighting analysis showed no significant association between SES and current e-cigarette use for all participants and sexual minority students. Equally, there was no significant association between SES and current flavored e-cigarette use. Findings suggest that other protective and risk factors might explain youth e-cigarette use more than SES (family affluence scale).
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Affiliation(s)
- Sunday Azagba
- College of Nursing, The Pennsylvania State University, University Park, PA, United States.
| | - Todd Ebling
- College of Nursing, The Pennsylvania State University, University Park, PA, United States
| | - Lingpeng Shan
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, United States
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10
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Evans-Polce RJ, Veliz P, Kcomt L, Boyd CJ, Esteban McCabe S. Examining sexual identity stability and change over time and associations with tobacco use in a nationally representative US sample. Addict Behav 2023; 141:107661. [PMID: 36821882 PMCID: PMC10570932 DOI: 10.1016/j.addbeh.2023.107661] [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: 08/26/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Epidemiologic research has found sexual minority identifying individuals are disproportionately burdened by tobacco use and tobacco use disorder (TUD). However, these studies often conceptualize sexual identity as time-invariant. This study examined sexual identity over time and whether a transition to a sexual minority identity was associated with tobacco outcomes. METHODS This study used data from Waves 1-4 of the Population Assessment of Tobacco and Health (2013/14-2016/18) study (adolescents and adults aged ≥ 14 years; n = 26,553). We examined associations of sexual identity stability and change with changes in the number of tobacco products used and TUD symptoms. RESULTS Males and females who experienced two or more changes in sexual identity and females who changed from a heterosexual to a sexual minority identity were more likely to have an increase in two or more tobacco products and increase TUD symptoms compared to heterosexual-stable males and females. Gay-stable males were less likely to increase TUD symptoms compared to heterosexual-stable males. CONCLUSIONS Experiencing a change in sexual identity may be a particularly vulnerable period for increases in tobacco products used and TUD. It may be important to provide tobacco use intervention and support resources to individuals coming out as a sexual minority and those fluid in their sexual identity.
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Affiliation(s)
- Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing University of Michigan, Ann Arbor, MI, United States.
| | - Philip Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing University of Michigan, Ann Arbor, MI, United States; Institute for Social Research University of Michigan, Ann Arbor, MI, United States
| | - Luisa Kcomt
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing University of Michigan, Ann Arbor, MI, United States; School of Social Work, Wayne State University, Detroit, MI, United States
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing University of Michigan, Ann Arbor, MI, United States; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, United States; Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States; Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, United States
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing University of Michigan, Ann Arbor, MI, United States; Institute for Social Research University of Michigan, Ann Arbor, MI, United States; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, United States; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, United States; Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, United States
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11
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Doremus CF, Jones MC, Angelone DJ. Understanding Attraction, Behavior, and Identity in the Asexual Community. Arch Sex Behav 2023; 52:1255-1270. [PMID: 36417056 DOI: 10.1007/s10508-022-02477-3] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 05/11/2023]
Abstract
Models of sexuality have evolved substantially in the past several decades through the inclusion of new aspects which were previously overlooked. Components such as romantic attraction and behavior have also traditionally been included in models of sexuality. However, romantic and sexual orientations do not coincide for all individuals. A population for which this is true and one that has developed a robust language for discussing romantic orientation is the asexual community. The current study aimed to explore romantic and sexual orientation through patterns found within the factors of attraction, behavior, and identity in the asexual community. The current sample composed of individuals who identified as asexual (N = 306, Mage = 27.1) was 61% female, 13% non-binary, and 10% self-described or used multiple labels. Within this sample, aspects of sexual and romantic orientations and experiences were measured, including fluidity, the quantity and type of self-identified labels, desire for romance or sex, and the role of contextual influences on these experiences. These aspects were used as the primary characteristics to construct participant profiles, both complete profiles and factor specific (attraction, behavior, identity). t-distributed stochastic neighbor embedding (tSNE) was used to find patterns of similarity between individual participant profiles. Overall, it appeared that attraction was the factor most closely associated with overall experiences; however, substantial variability existed between participants. These findings provide a mechanism for better understanding of some nuances of romantic and sexual orientation and may be a useful first step toward future inquiry and hypothesis generation.
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Affiliation(s)
| | - Meredith C Jones
- Department of Psychology, Rowan University, Glassboro, NJ, 08028, USA.
| | - D J Angelone
- Department of Psychology, Rowan University, Glassboro, NJ, 08028, USA
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12
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Drotning KJ, Doan L, Sayer LC, Fish JN, Rinderknecht RG. Not All Homes Are Safe: Family Violence Following the Onset of the Covid-19 Pandemic. J Fam Violence 2023; 38:189-201. [PMID: 35221467 PMCID: PMC8860732 DOI: 10.1007/s10896-022-00372-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 05/07/2023]
Abstract
Evidence from victim service providers suggests the COVID-19 pandemic led to an increase in family violence. However, empirical evidence has been limited. This study uses novel survey data to investigate the occurrence of family violence during the early months of the COVID-19 pandemic in the United States. Data come from the second wave of the Assessing the Social Consequences of COVID-19 study, an online non-probability sample collected in April and May 2020. Family violence is measured using four variables: any violence, physical violence, verbal abuse, and restricted access. The authors use logistic regression and KHB decomposition to examine the prevalence of family violence during the COVID-19 pandemic. We find that sexual minorities, in particular bisexual people, experienced higher rates of family violence than heterosexual respondents. Women were the only group to report an increase in the frequency of family violence. Household income loss is associated with the incidence of verbal violence. Our findings demonstrate the importance of expanding victim services to address the additional barriers victims face within the pandemic context and beyond, including broad contexts of social isolation and financial precarity experienced by individuals at risk of family violence.
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Affiliation(s)
- Kelsey J. Drotning
- Department of Sociology, Univeristy of Maryland, 2112 Parren Mitchell Art-Sociology Building, 3834 Campus Dr., College Park, MD 20742 USA
| | - Long Doan
- Department of Sociology, Univeristy of Maryland, 2112 Parren Mitchell Art-Sociology Building, 3834 Campus Dr., College Park, MD 20742 USA
| | - Liana C. Sayer
- Department of Sociology, Univeristy of Maryland, 2112 Parren Mitchell Art-Sociology Building, 3834 Campus Dr., College Park, MD 20742 USA
| | - Jessica N. Fish
- School of Public Health, University of Maryland, College Park, MD USA
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13
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Savin-Williams RC. Sexual and romantic spectrums: Mostly straights and mostly gays/lesbians. Curr Opin Psychol 2022; 48:101503. [PMID: 36427401 DOI: 10.1016/j.copsyc.2022.101503] [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] [Received: 08/02/2022] [Revised: 09/29/2022] [Accepted: 10/20/2022] [Indexed: 01/28/2023]
Abstract
Sexual and romantic orientations and identities exist along a spectrum with varying degrees of compliance to traditional concepts of sex and romance. Recent investigations have focused on individuals who are not exclusive in their sexual and romantic lives-mostly straights and mostly gays/lesbians. Multi-disciplinary research reveals the diversity of individuals' internal and external sexual and romantic feelings and expressions. One corrective strategy is to scrap categorically based assessment tools and replace them with continuum measures that capture the multiplicity of individuals' sexual and romantic lives. Here I suggest several new measures that are more responsive to a spectrum approach.
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14
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Döring N, Bhana D, Albury K. Digital sexual identities: Between empowerment and disempowerment. Curr Opin Psychol 2022; 48:101466. [PMID: 36242854 DOI: 10.1016/j.copsyc.2022.101466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/25/2022] [Accepted: 09/08/2022] [Indexed: 01/28/2023]
Abstract
In the digital age, people increasingly explore and express their sexual identities online. The management and development of digital sexual identities can provide opportunities of empowerment on the individual, interpersonal, and societal level. At the same time, social media users are confronted with risks of sexual disempowerment in terms of identity de-validation, social exclusion, discrimination or even criminalization. The review article summarizes the current state of research on six selected sexual identities: (1) heterosexual, (2) LGBTIQ+, (3) asexual, (4) kink and fetish, (5) polyamory, and (6) sex worker identities in digital contexts. Covering a variety of social media platforms and cultural backgrounds, the review demonstrates that digital sexual identities are best understood as multifaceted socio-technical phenomena with ambivalent outcomes.
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Affiliation(s)
- Nicola Döring
- Technische Universität Ilmenau, IfMK, Ehrenbergstraße 29, 98693, Ilmenau, Germany.
| | - Deevia Bhana
- University of KwaZulu-Natal, Private Bag X03, Ashwood, Durban, South Africa
| | - Kath Albury
- Swinburne University of Technology, John Street, Hawthorn, Victoria, Australia. 3122
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15
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Chen M, Tian N, Chang Q. Adverse childhood experiences, sexual orientation, and depressive symptoms among Chinese college students: An ecological framework analysis. Child Abuse Negl 2022; 134:105881. [PMID: 36152533 DOI: 10.1016/j.chiabu.2022.105881] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 06/06/2022] [Revised: 08/29/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Extensive evidence has demonstrated that adverse childhood experiences (ACEs) predict a high risk of negative health and behavioral outcomes in later life. However, the influence of individuals' psychosocial characteristics and environmental stressors have been mostly omitted in previous research. OBJECTIVE This study aimed to examine the prevalence of ACEs among LGB (lesbian, gay, and bisexual) and heterosexual emerging adults, and the associations between different patterns of ACE exposure and depressive symptoms after adjusting for factors at different levels. PARTICIPANTS AND SETTING A representative sample of 928 college students in Xiamen city, China was recruited. METHODS Latent class analysis was applied to identify the patterns of ACEs. A series of regression analyses were conducted to examine the associations between ACEs and depression and whether ACEs interacted with sexual identity to influence depression, after controlling for individual characteristics, family, school, and society-level factors. RESULTS Over 35 % of the participants reported they had experienced at least one type of moderate to extreme childhood maltreatment, and those who identified as LGB reported a higher level of ACE exposure. Higher levels of ACE exposure based on score and clustering approaches were associated with higher risks of depression among Chinese emerging adults. However, the associations between ACEs and depression were not significantly moderated by sexual identity. CONCLUSIONS The findings highlighted the importance of early screening for ACEs particularly among sexual minorities and of delivering tailored interventions based on ecological backgrounds. Both the traditional scoring approach and a data-driven approach can be effective in detecting the cumulative effect of ACEs.
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Affiliation(s)
- Mengtong Chen
- Department of Social Work, The Chinese University of Hong Kong, Shatin, NT, Hong Kong.
| | - Naiqi Tian
- School of Sociology and Anthropology, Xiamen University, 422 Siming South Road, Siming District, Xiamen, Fujian, China
| | - Qingsong Chang
- School of Sociology and Anthropology, Xiamen University, 422 Siming South Road, Siming District, Xiamen, Fujian, China; Institute of Artificial Intelligence, Xiamen University, 422 Siming South Road, Siming District, Xiamen, Fujian, China.
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16
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Krueger EA, Repati ML, Harlow AF, Unger JB, Lee JO, Pedersen ER, Conn BM, Wong C, Young LE, Barrington-Trimis JL, Leventhal AM. Changes in sexual identity and substance use during young adulthood. Drug Alcohol Depend 2022; 241:109674. [PMID: 36332590 DOI: 10.1016/j.drugalcdep.2022.109674] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sexual identity is dynamic, and changes in identity (e.g., from heterosexual to lesbian, gay, bisexual, or queer [LGBQ+]) are common during young adulthood. It is not well-understood how sexual identity changes may be associated with substance use risk. METHODS Two waves of data (baseline: October, 2018-October, 2019; follow-up: May-October, 2020) were used from a prospective cohort of young adults (N = 1896; mean age=21.2). Frequency of past 30-day use and new initiation of five substance use outcomes (alcohol, any tobacco, e-cigarettes, cannabis, illicit drugs) were compared across four groups: consistently heterosexual (N = 1567), consistently LGBQ+ (N = 244), heterosexual to LGBQ+ (N = 65), and LGBQ+ to heterosexual (N = 20). RESULTS Consistently LGBQ+ (vs. consistently heterosexual) participants reported greater frequency of past 30-day use of alcohol (aOR=1.34, 95% CI=1.04-1.72), any tobacco products (aOR=1.88, CI=1.34-2.63), e-cigarettes (aOR=1.49, CI=1.01-2.19), cannabis (aOR=1.36, CI=1.01-1.84), and illicit drugs (aOR=2.84, CI=1.77-4.56). Heterosexual to LGBQ+ (vs. consistently heterosexual) participants reported greater frequency of past 30-day use of any tobacco products (aOR=1.87, CI=1.06-3.33) and illicit drugs (aOR=2.48, CI=1.10-5.62), and had greater risk of initiating alcohol (aRR=1.82, CI=1.02-3.25) and cannabis use (aRR=2.90, CI=1.81-4.64). LGBQ+ to heterosexual (vs. consistently LGBQ+) participants reported lower frequency of past 30-day use of alcohol (aOR=0.35, CI=0.14-0.88) and any tobacco products (aOR=0.15, CI=0.03-0.80). CONCLUSIONS Identifying as LGBQ+ was associated with increased risk for frequent substance use, and newly adopting an LGBQ+ identity was associated with increased risk for new substance use initiation. Prevention and treatment interventions may need to tailor messaging to young people who have newly adopted an LGBQ+ identity.
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17
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Wolf JK, Platt LF. Religion and sexual identities. Curr Opin Psychol 2022; 48:101495. [PMID: 36423507 DOI: 10.1016/j.copsyc.2022.101495] [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] [Received: 08/01/2022] [Revised: 09/19/2022] [Accepted: 10/18/2022] [Indexed: 01/28/2023]
Abstract
Religion and sexuality have a complex, deep-rooted relationship. Religions often teach how aspects of sexuality should be conducted, typically promoting heterosexuality. Such discourse is at odds with a growing population using sexual minority identities. The tension between one's homonegative faith or religious environment and their sexual minority orientation can lead to poor health outcomes like psychological distress and suicidal ideation. Attempts to change sexual orientation to match religious expectations are futile and frequently harmful. However, sexual minority individuals can find health benefits if they are able to reconcile their religious and sexual identities or find accepting religious/spiritual communities. The COVID-19 pandemic and religious influence on US politics have also shaped the safety of environments for disclosing a sexual minority identity.
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Affiliation(s)
- Julia Kay Wolf
- One UTSA Circle, College for Health, Community and Policy, The University of Texas at San Antonio, San Antonio, TX, USA.
| | - Lisa F Platt
- 504 Allen Hall, Counseling Psychology, West Virginia University, Morgantown, WV, USA.
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18
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Traeen B, Fischer N, Grøndahl P. Norwegian Data on Prevalence, Sexual Risk Behaviors, Sexual Problems, and Sexual Satisfaction in Men Who Have Sex Exclusively with Women, Men Who Have Sex Exclusively with Men, and Men Who Have Sex with Men and Women. Int J Sex Health 2022; 34:702-715. [PMID: 38596394 PMCID: PMC10903632 DOI: 10.1080/19317611.2022.2126056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 06/10/2022] [Accepted: 06/26/2022] [Indexed: 04/11/2024]
Abstract
Objective: This study investigates how men who have sex exclusively with women (MSEW) differ from men who have sex exclusively with men (MSEM), and men who have sex with men and women (MSMW) on selected variables. Methods: A probability-based web sample of 2,181 men was recruited. Results: Most MSEM considered their sexual identity as gay, and most MSMW as heterosexual. The MSEM were the most frequent condom users, while MSMW were the least frequent users and had the highest number of sexual partners. The MSEM and MSMW had a lower likelihood of premature ejaculation than MSEW. Conclusions: MSMW should be targeted in health campaigns.
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Affiliation(s)
- Bente Traeen
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Nantje Fischer
- Department of Psychology, University of Oslo, Oslo, Norway
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19
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López R Jr, Gonçalves SF, Poon JA, Ansell EB, Esposito-Smythers C, Chaplin TM. Sexual Identity and its Association with Trajectories of Depressive Symptoms and Emotion Regulation Difficulties from Early to Middle Adolescence. Child Psychiatry Hum Dev 2022; 53:1062-74. [PMID: 34021440 DOI: 10.1007/s10578-021-01188-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
Few studies have examined how changes in sexual identity impact trajectories of depressive symptoms and emotion regulation difficulties. The current study addresses this gap in the literature by examining these associations over a three-year period in a community sample of adolescents (N = 177; Mage = 12.56; SD = 0.60; nmale = 95). Multilevel modeling revealed that youth who consistently held sexual minority identities from early to middle adolescence-but not youth with inconsistent sexual identity-demonstrated increases in depressive symptoms and emotion regulation difficulties relative to their heterosexual peers. Findings suggest that treatments that bolster emotion regulation abilities and address depressive symptoms may be of particular benefit to youth with consistent sexual minority identities from early to middle adolescence.
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20
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Adzrago D, Obekpa EO, Suragh TA, John ER, Yeh PG, Gallardo KR, Wilkerson JM. Kratom use categories and their associations with co-occurring substance use and mental health disorder symptoms during the COVID-19 pandemic. Drug Alcohol Depend 2022; 239:109605. [PMID: 36027671 DOI: 10.1016/j.drugalcdep.2022.109605] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/14/2022] [Accepted: 08/16/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Kratom, a psychoactive substance, use is an evolving research area that needs more studies to augment the limited literature. Our study examines the association between kratom use categories and mental health and substance use disorders in the U.S. METHODS We used the 2020 National Survey on Drug Use and Health data (N = 32,893), a cross-sectional survey data, on the U.S. population aged 12 years or older. We used STATA/SE version 16 to perform a multinomial logistic regression analysis to assess our study aims. RESULTS Bisexuals, compared to heterosexuals, had higher risks of kratom use within the past 30 days (relative risk ratio [RRR]= 2.47, 95% CI= 1.07, 5.71). Major depressive episode was positively associated with kratom use more than 30 days ago (RRR= 2.04, 95% CI= 1.24, 3.34). This association was also observed for mild (RRR= 2.04, 95% CI= 1.38, 3.02), moderate (RRR= 2.25, 95% CI= 1.13, 4.51), or severe alcohol use disorder (RRR= 1.88, 95% CI= 1.05, 3.36); and mild (RRR= 1.98, 95% CI= 1.27, 3.11), moderate (RRR= 2.38, 95% CI= 1.27, 4.45), or severe marijuana use disorder (RRR= 2.13, 95% CI= 1.02, 4.47). Illicit drug other than marijuana use disorder was associated positively with kratom use more than 30 days ago (RRR= 2.81, 95% CI= 1.85, 4.26) and kratom use within the past 30 days (RRR= 5.48, 95% CI= 1.50, 20.02). CONCLUSIONS Our findings suggested that identifying as bisexual, experiencing depression, alcohol use disorder, or illicit drug use disorder increased the risks of kratom use. There is a need to consider mental health and substance use disorders and sexual identity in kratom use interventions and policies geared toward reducing or preventing kratom use.
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Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, CDC Prevention Research Center, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
| | - Elizabeth O Obekpa
- Center for Health Promotion and Prevention Research, CDC Prevention Research Center, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Tiffany A Suragh
- Center for Health Promotion and Prevention Research, CDC Prevention Research Center, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Evit R John
- Department of Biostatistics & Data Science, UTHealth, Houston, TX, USA
| | - Paul G Yeh
- School of Public Health, UTHealth, Houston, TX, USA
| | - Kathryn R Gallardo
- Center for Health Promotion and Prevention Research, CDC Prevention Research Center, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - J Michael Wilkerson
- Center for Health Promotion and Prevention Research, CDC Prevention Research Center, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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21
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Diamond LM, Alley J. Rethinking minority stress: A social safety perspective on the health effects of stigma in sexually-diverse and gender-diverse populations. Neurosci Biobehav Rev 2022; 138:104720. [PMID: 35662651 DOI: 10.1016/j.neubiorev.2022.104720] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/25/2022] [Accepted: 05/30/2022] [Indexed: 12/13/2022]
Abstract
For over two decades, the minority stress model has guided research on the health of sexually-diverse individuals (those who are not exclusively heterosexual) and gender-diverse individuals (those whose gender identity/expression differs from their birth-assigned sex/gender). According to this model, the cumulative stress caused by stigma and social marginalization fosters stress-related health problems. Yet studies linking minority stress to physical health outcomes have yielded mixed results, suggesting that something is missing from our understanding of stigma and health. Social safety may be the missing piece. Social safety refers to reliable social connection, inclusion, and protection, which are core human needs that are imperiled by stigma. The absence of social safety is just as health-consequential for stigmatized individuals as the presence of minority stress, because the chronic threat-vigilance fostered by insufficient safety has negative long-term effects on cognitive, emotional, and immunological functioning, even when exposure to minority stress is low. We argue that insufficient social safety is a primary cause of stigma-related health disparities and a key target for intervention.
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Affiliation(s)
- Lisa M Diamond
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.
| | - Jenna Alley
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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22
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Abstract
INTRODUCTION This study traced sexuality differences in Black Lives Matter (BLM) approval before using theories of "political distinctiveness" to explain why sexuality differences occurred. METHODS A random sample of 3489 US adults completed the 2016 wave of the American National Election Survey (ANES) Time Series project. Ordinary least squares (OLS) regressions assessed differences in BLM support by reported sexual identity when adjusting for possibly relevant covariates. RESULTS Lesbians, gays, and bisexuals (LGB) backed BLM more than heterosexuals. Increased LGB support of BLM was driven by sexuality differences in racial backgrounds, marital statuses, perceptions of police biases, approval of Black empowerment, authoritarianism, and emotional bonds to people of color. CONCLUSIONS Sexual identities shape reactions to antiracist social movements. LGB alignment with BLM is partly due to sexual discrepancies in demographic qualities, group memberships, and the way sexual identities alter an awareness of social biases. POLICY IMPLICATIONS Greater LGB liberalism, plus the queer friendly nature of BLM, offers greater prospects in the creation and maintenance of intersectional social justice movements that seek to improve the lives of racial and sexual minorities.
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Affiliation(s)
- Eric Swank
- Social and Cultural Analysis, Arizona State University, 4701 West Thunderbird Avenue, Glendale, AZ 85306 USA
| | - Breanne Fahs
- Women and Gender Studies, Arizona State University, 4701 West Thunderbird Avenue, Glendale, AZ 85306 USA
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23
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Xavier Hall CD, Feinstein BA, Rusie L, Phillips Ii G, Beach LB. Race and Sexual Identity Differences in PrEP Continuum Outcomes Among Latino Men in a Large Chicago Area Healthcare Network. AIDS Behav 2022; 26:1943-1955. [PMID: 34993667 PMCID: PMC8736294 DOI: 10.1007/s10461-021-03544-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 01/08/2023]
Abstract
U.S. HIV incidence is threefold higher among Latino individuals than non-Latino Whites. Pre-exposure prophylaxis (PrEP) uptake remains low among Latino men. Most HIV studies view Latino communities as a monolithic group, ignoring racial and sexual diversity. This analysis examines PrEP-related outcomes including eligibility, first prescription, and second prescription across race and sexual identity in a sample of Latino cisgender men (n = 8271) who sought services from a healthcare network in Chicago in 2012-2019. Logistic regression was used to calculate adjusted odds ratios. Latino-only participants had lower odds of PrEP eligibility and first prescription compared to White-Latino participants. No other significant differences by race were detected. While bisexual participants had equivalent odds of PrEP eligibility, they had lower odds of first PrEP prescription compared to gay participants. Heterosexual participants also had lower odds of PrEP eligibility and initiation. Future research should address unique factors shaping PrEP-related outcomes among diverse Latino populations.
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Affiliation(s)
- Casey D Xavier Hall
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL, 60611, USA.
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA.
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | | | - Gregory Phillips Ii
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
| | - Lauren B Beach
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
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Silva T. Heterosexual Identification and Same-Sex Partnering: Prevalence and Attitudinal Characteristics in the USA. Arch Sex Behav 2022; 51:2231-2239. [PMID: 35505221 DOI: 10.1007/s10508-022-02293-9] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 01/03/2022] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Abstract
This paper used the 2011-2017 National Survey of Family Growth to estimate population sizes and attitudinal characteristics of heterosexual-identified men who have sex with men (MSM) and women who have sex with women (WSW) aged 15-44 years. Analyses estimated population sizes in stages: after excluding respondents who reported only one lifetime same-sex partner, which happened before the age of 15; after excluding males who reported nonconsensual male-male sex; after excluding respondents who reported only one lifetime same-sex partner, regardless of the age at which that experience occurred; after excluding respondents who reported only two lifetime same-sex partners, the first of which occurred before age 15; and after excluding males who reported male-male sex work. The broadest criteria included many individuals with limited same-sex sexual histories or those who experienced nonconsensual sex or potentially coerced sex in youth. After excluding those respondents, analyses showed that heterosexual-identified MSM and WSW had a diversity of attitudes about gender and LGB rights; only a distinct minority were overtly homophobic and conservative. Researchers should carefully consider whether to include respondents who report unwanted sexual contact or sex at very young ages when they analyze sexual identity-behavior discordance or define sexual minority populations on the basis of behavior.
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Affiliation(s)
- Tony Silva
- Department of Sociology, University of British Columbia, 6303 NW Marine Drive, Vancouver, BC, V6T 1Z1, Canada.
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25
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Olmstead SB, Anders KM. Are the Developmental Features of Emerging Adulthood Associated with Willingness to Engage in Consensually Nonmonogamous Relationships? Arch Sex Behav 2022; 51:1813-1822. [PMID: 35212888 DOI: 10.1007/s10508-021-02258-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 06/14/2023]
Abstract
The purpose of this study was to examine whether the developmental features of emerging adulthood were associated with willingness to engage in consensually nonmonogamous (CNM) relationships. All participants (N = 792) were English speaking emerging adults (ages 18-25) residing in the USA. About half were attending college, whereas the other half had no college experience. After controlling for a number of variables (i.e., college status, sex/gender, sexual orientation, sexual identity exploration, sexual identity commitment, and casual sex attitudes), greater perceptions of emerging adulthood as a time of identity exploration and feeling in between were negatively associated with willingness to engage in CNM relationships. Also, greater perceptions of emerging adulthood as a time of experimentation/possibilities was positively associated with willingness to engage in CNM. Although our final model explained 33.5% of the variance in willingness to engage in CNM relationships, perceptions of the developmental features of emerging adulthood accounted for just 4.2% of the variance explained. Future research on CNM relationships and relationship education for emerging adults are discussed.
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Affiliation(s)
- Spencer B Olmstead
- Department of Child and Family Studies, College of Education, Health, and Human Sciences, The University of Tennessee, 115 Jessie W. Harris Building, 1215 W. Cumberland Avenue, Knoxville, TN, 37996, USA.
| | - Kristin M Anders
- Department of Applied Human Sciences, College of Health and Human Sciences, Kansas State University, Manhattan, KS, USA
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26
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Caba AE, Mallory AB, Simon KA, Rathus T, Watson RJ. Complex Outness Patterns Among Sexual Minority Youth: A Latent Class Analysis. J Youth Adolesc 2022; 51:746-765. [PMID: 35150376 DOI: 10.1007/s10964-022-01580-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/21/2022] [Indexed: 11/29/2022]
Abstract
Prior scholarship has documented health-relevant consequences of sexual minority youth (SMY) sexual identity disclosure (i.e., "outness"), yet most of the extant work focuses on one social context at a time and/or measures outness as dichotomous: out or not out. However, SMY are out in some contexts (e.g., family, friends) and not in others, and to varying degrees (e.g., to some friends, but not to all). Using a national sample of 8884 SMY ages 13-17 (45% cisgender female, 67% White, 38% gay/lesbian and 34% bisexual, and 36% from the U.S. South), this study used latent class analysis to identify complex patterns of outness among SMY, as well differences in class membership by demographics, depression, family rejection, and bullying. The results indicated six distinct classes: out to all but teachers (n = 1033), out to siblings and peers (n = 1808), out to siblings and LGBTQ peers (n = 1707), out to LGBTQ peers (n = 1376), mostly not out (n = 1653), and very much not out (n = 1307). The findings reveal significant differences in class membership by age, sexual identity, gender identity, race and ethnicity, geography, and well-being outcomes. Moreover, these findings underscore the complex role of outness across social contexts in shaping health and well-being.
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Affiliation(s)
- Antonia E Caba
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA.
| | - Allen B Mallory
- College of Education & Human Ecology Department of Human Sciences Program of Human Development & Family Sciences Campbell Hall 130C, 1787 Neil Ave, Columbus, OH, 43210, USA
| | - Kay A Simon
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
| | - Taylor Rathus
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
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27
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Brown SL, Seymour NE, Mitchell SM, Moscardini EH, Roush JF, Tucker RP, Cukrowicz KC. Interpersonal Risk Factors, Sexual and Gender Minority Status, and Suicidal Ideation: Is BDSM Disclosure Protective? Arch Sex Behav 2022; 51:1091-1101. [PMID: 35044597 PMCID: PMC8891054 DOI: 10.1007/s10508-021-02186-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 01/06/2020] [Revised: 10/08/2021] [Accepted: 10/09/2021] [Indexed: 06/14/2023]
Abstract
Suicidal ideation is elevated among individuals who engage in BDSM practices and those with sexual and gender minority (SGM) identities. There is limited research on the intersectionality of these identities and how they relate to suicidal ideation, especially within a theoretical framework of suicide risk, such as the interpersonal theory of suicide. Thus, we tested the indirect relation between BDSM disclosure and suicidal ideation through thwarted belongingness and perceived burdensomeness, as well as the moderating role of SGM identity on these indirect associations. Participants were 125 (Mage = 28.27 years; 64% cisgender men) individuals recruited via online BDSM-related forums who endorsed BDSM involvement and recent suicidal ideation. Results indicated significant moderated mediation, such that BDSM disclosure was indirectly negatively related to suicidal ideation through lower thwarted belongingness, but not perceived burdensomeness, among SGM individuals. This was due to the significant relation between BDSM disclosure and thwarted belongingness. There were no significant moderated mediation or indirect effects related to perceived burdensomeness. We also provide supplemental analyses with positive ideation (i.e., positive thoughts toward life) as the criterion variable. In conclusion, BDSM disclosure appears to be protective against suicidal ideation through thwarted belongingness but only for SGM individuals. This work furthers our understanding of the impact of intersecting marginalized identities on suicide risk and resilience. Implications, limitations, and future directions are further discussed.
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Affiliation(s)
- Sarah L Brown
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychological Sciences, Texas Tech University, Mail Stop 2051, Lubbock, TX, 79409-2051, USA
| | - Nicole E Seymour
- Department of Psychological Sciences, Texas Tech University, Mail Stop 2051, Lubbock, TX, 79409-2051, USA
| | - Sean M Mitchell
- Department of Psychological Sciences, Texas Tech University, Mail Stop 2051, Lubbock, TX, 79409-2051, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Emma H Moscardini
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Jared F Roush
- VA Long Beach Healthcare System, Long Beach, CA, USA
| | - Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Kelly C Cukrowicz
- Department of Psychological Sciences, Texas Tech University, Mail Stop 2051, Lubbock, TX, 79409-2051, USA.
- School of Veterinary Medicine, Texas Tech University, Texas Tech University, Amarillo, TX, USA.
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Mauro PM, Philbin MM, Greene ER, Askari MS, Martins SS. Medical and Non-Medical Opioid Use at the Intersection of Gender and Sexual Identity: Associations with State Medical Cannabis Law Status in a U.S. National Sample of Adults. Arch Sex Behav 2021; 50:3551-3561. [PMID: 34751862 PMCID: PMC8729119 DOI: 10.1007/s10508-021-02128-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 08/05/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
At the structural level, medical cannabis laws (MCLs) have been negatively associated with opioid prescribing practices, and sexual minority adults report disproportionately high non-medical prescription opioid use. We examined medical/non-medical prescription opioid use by intersecting sexual identity and gender and explored associations with MCLs using the 2015-2017 National Survey on Drug Use and Health, which captured sexual identity and MCL state residence for adults 18 + years (N = 126,463). Survey-weighted gender-stratified multinomial logistic models estimated adjusted relative risk ratios (aRRR) of medical vs. no prescription opioid use, and any non-medical vs. no prescription opioid use, by sexual identity and MCL, and tested moderation by MCL. Past-year medical prescription opioid use was higher among women than men across sexual identities (e.g., bisexual: 38.5% women vs. 30.2% men). Non-medical prescription opioid use was lower among women than men, except for bisexual adults (12.4% women vs. 7.6% men). MCL was associated with lower medical prescription opioid vs. no use among heterosexual women (aRRR = 0.86, 95% confidence interval [CI] = 0.81-0.91), bisexual women (aRRR = 0.74, 95% CI = 0.62-0.89), and heterosexual men (aRRR = 0.91, 95% CI = 0.85-0.97). Living in an MCL state was associated with lower non-medical vs. no use among heterosexual and bisexual women, but not among men or lesbian/gay women. MCL status did not moderate associations between sexual identity and prescription opioid outcomes. Future studies should assess whether implementing MCLs could particularly affect bisexual women who reported the highest prescription opioid use and may need targeted services.
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Affiliation(s)
- Pia M Mauro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th Street, New York, NY, 10032, USA.
| | - Morgan M Philbin
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Emily R Greene
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th Street, New York, NY, 10032, USA
| | - Melanie S Askari
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th Street, New York, NY, 10032, USA
| | - Silvia S Martins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W 168th Street, New York, NY, 10032, USA
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Ronis ST, Byers ES, Brotto LA, Nichols S. Beyond the Label: A sexual Identity Among Individuals on the High-Functioning Autism Spectrum. Arch Sex Behav 2021; 50:3831-3842. [PMID: 34661809 DOI: 10.1007/s10508-021-01969-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 06/13/2023]
Abstract
Researchers have suggested that asexuality, which has been conceptualized traditionally as a persistent lack of sexual attraction to others, may be more common among individuals with autism spectrum disorder than in the neurotypical population. However, no studies to date have considered how these individuals understand and conceptualize their sexual identity. The aim of this study was to provide a more nuanced understanding of asexuality among individuals with high-functioning autism spectrum disorder (HF-ASD) than has been done in the past. Individuals with ASD, 21-72 years old (M = 34.04 years, SD = 10.53), were recruited from online communities that serve adults with ASD and Amazon's Mechanical Turk to complete an online survey of sexual and gender identity. Overall, 17 (5.1%) participants who met study criteria (N = 332) self-identified as asexual. However, 9 of the 17 people identifying as asexual expressed at least some sexual attraction to others. In addition, based on open-ended responses, some participants linked their asexual identity more with a lack of desire or perceived skill to engage in interpersonal relations than a lack of sexual attraction. Results suggest that researchers should be cautious in attributing higher rates of asexuality among individuals with ASD than in the general population to a narrow explanation and that both researchers and professionals working with individuals with ASD should consider multiple questions or approaches to accurately assess sexual identity.
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Affiliation(s)
- Scott T Ronis
- Department of Psychology, University of New Brunswick, 38 Dineen Drive, Keirstead Hall, Fredericton, NB, E3B 5A3, Canada.
| | - E Sandra Byers
- Department of Psychology, University of New Brunswick, 38 Dineen Drive, Keirstead Hall, Fredericton, NB, E3B 5A3, Canada
| | - Lori A Brotto
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Shana Nichols
- ASPIRE Center for Learning and Development, Huntington, NY, USA
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30
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Levine SB. Reflections on the Clinician's Role with Individuals Who Self-identify as Transgender. Arch Sex Behav 2021; 50:3527-3536. [PMID: 34528149 PMCID: PMC8604856 DOI: 10.1007/s10508-021-02142-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 06/13/2023]
Abstract
The fact that modern patterns of the treatment of trans individuals are not based on controlled or long-term comprehensive follow-up studies has allowed many ethical tensions to persist. These have been intensifying as the numbers of adolescent girls declare themselves to be trans, have gender dysphoria, or are "boys." This essay aims to assist clinicians in their initial approach to trans patients of any age. Gender identity is only one aspect of an individual's multifaceted identity. The contributions to the passionate positions in the trans culture debate are discussed along with the controversy over the official, not falsifiable, position that all gender identities are inherently normal. The essay posits that it is relevant and ethical to investigate the forces that may have propelled an individual to create and announce a new identity. Some of these biological, social, and psychological forces are enumerated. Using the adolescent patient as an example, a model for a comprehensive evaluation process and its goals are provided. The essay is framed within a developmental perspective.
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Affiliation(s)
- Stephen B Levine
- Department of Psychiatry, Case Western Reserve University, 23425 Commerce Park, #104, Beachwood, OH, 44122, USA.
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31
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Azagba S, Shan L. Disparities in the frequency of tobacco products use by sexual identity status. Addict Behav 2021; 122:107032. [PMID: 34229134 DOI: 10.1016/j.addbeh.2021.107032] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Largely absent from the literature are studies examining differences in tobacco use frequency among sexual minority populations versus heterosexuals. The current study examined the frequency of tobacco product use (i.e., cigarette, e-cigarettes and cigars, smokeless tobacco, hookah, and heated tobacco products) among sexual minority students versus heterosexuals (straight). METHODS Data from the 2020 National Youth Tobacco Survey (n = 14,531) were analyzed to examine the association between sexual identity (lesbian or gay, bisexual, not sure, and heterosexual or straight) and tobacco use frequency. Negative binomial regression and zero-inflated negative binomial models were used to assess the association between sexual identity and each tobacco use frequency among current and ever users. RESULTS Current e-cigarettes users who identified as gay or lesbian used e-cigarette more frequently than heterosexual students. Multivariable count regression analysis showed that the e-cigarette use frequency in the past 30 days was significantly higher for gays or lesbians (IRR 1.45, 95% CI, 1.19-1.76) compared to heterosexuals. Similarly, gay or lesbian students who were current hookah users on average reported 81% more days of hookah use (IRR, 1.81, 95% CI, 1.08-3.03). The frequency of cigarette smoking was also significantly higher among bisexual cigarette smokers. No significant differences were found in other tobacco product use frequencies between sexual minority and heterosexual youths. CONCLUSION Sexual identity was associated with tobacco use frequency, especially for e-cigarettes and hookah. Elevated tobacco use among sexual minority groups deserves special consideration among a population group that is highly vulnerable to marketing and advertisement targeting.
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Affiliation(s)
- Sunday Azagba
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States.
| | - Lingpeng Shan
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States
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32
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Perales F, Campbell AK, Everett BG, McNair R, Hughes TL. Prevalence and Sociodemographic Correlates of Identifying as Mainly Heterosexual: Stability and Change across Three Cohorts of Australian Women. Arch Sex Behav 2021; 50:3459-3477. [PMID: 34008060 DOI: 10.1007/s10508-021-02000-0] [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: 06/29/2020] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 06/12/2023]
Abstract
In recent decades, the ways in which sexual minorities identify have changed dramatically. In response, social and health surveys have begun offering a greater range of response options within sexual orientation questions-for example, intermediate categories for "mainly heterosexual" and "mainly lesbian/gay" alongside the more common response options of "heterosexual," "bisexual," and "lesbian/gay." Recent studies indicate that women who identify as "mainly heterosexual" report poorer health, greater health-risk behaviors, and higher rates of victimization than women identifying as "exclusively heterosexual." However, we know very little about the demographic profile of women who choose the "mainly heterosexual" identity label compared to the adjacent "exclusively heterosexual" or "bisexual" labels or about changes over time in the prevalence and correlates of "mainly heterosexual" identification. This study addressed these knowledge gaps by modeling unique, high-quality survey data from three national cohorts of Australian women (Australian Longitudinal Study on Women's Health, 2000-2017, n = 76,930 observations). Consistent with the facilitative environments model, we document stark cross-cohort increases in the percentage of Australian women identifying as "mainly heterosexual"-from ∼1% of those born in 1946-1951 to ∼26% of those born in 1989-1995, coinciding with comparable declines in the percentage of women identifying as "exclusively heterosexual." We also found evidence of cohort differences in the associations between key sociodemographic factors-such as age, education, and socioeconomic status-and the likelihood of women identifying as "mainly heterosexual." Finally, our results indicate that same-sex sexual attractions were more strongly associated with "mainly heterosexual" identification than was same-sex sexual behavior.
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Affiliation(s)
- Francisco Perales
- School of Social Science, University of Queensland, Michie Building (#9), St Lucia Campus, St Lucia, Brisbane, QLD, 4072, Australia.
| | - Alice K Campbell
- Institute for Social Science Research, University of Queensland, Brisbane, QLD, Australia
| | | | - Ruth McNair
- Department of General Practice, University of Melbourne, Melbourne, VIC, Australia
| | - Tonda L Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York City, NY, USA
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Brewster KL, Tillman KH, Holway GV. Timing of First Sexual Experience with a Same-Sex Partner: A Life Course Approach. Arch Sex Behav 2021; 50:3587-3599. [PMID: 34697690 DOI: 10.1007/s10508-021-02043-3] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 06/13/2023]
Abstract
Theories of sexual identity development recognize the initiation of sexual experience with same-sex partners (SESSP) to be a significant event in the coming-out process, yet the research literature lacks a population-based description of its timing and variation across population subgroups. Using data from the 2011-2017 National Survey of Family Growth and guided by the life course paradigm, we explored the timing and correlates of first SESSP among individuals (1425 women; 545 men) who identified as lesbian (n = 307), gay (n = 285), or bisexual (n = 1378) (LGB). Descriptive findings revealed that the median age at first SESSP was about 19 years for lesbian women and gay men and one to two years later for bisexual women and men. Notably, initiation of SESSP occurred over a wide age range, particularly among bisexual men. Multivariable results indicated that the probability of first SESSP did not vary by demographic characteristics or family background among men. Among women, nativity status, family stability, and independent living were associated with probability of first SESSP. Coital experience predicted timing among both women and men. Tests for statistical interactions suggested that age at first SESSP was contingent on mother's education (women), sexual identity (men), family stability (men), and birth cohort (women and men). Our findings highlight the complicated nature of LGB sexual experiences, and we end with a call for greater effort to ensure that LGB individuals are represented in national surveys designed to provide data on sexual and reproductive health.
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Affiliation(s)
- Karin L Brewster
- Department of Sociology and Center for Demography and Population Health, Florida State University, 601 Bellamy Bldg, 113 Collegiate Loop, Tallahassee, FL, 32306-2240, USA.
| | - Kathryn Harker Tillman
- Department of Sociology and Center for Demography and Population Health, Florida State University, 601 Bellamy Bldg, 113 Collegiate Loop, Tallahassee, FL, 32306-2240, USA
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34
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Evans-Polce RJ, Smith DM, Veliz P, Boyd CJ, McCabe SE. Sexual identity differences in biomarkers of tobacco exposure among women in a national sample. Cancer Epidemiol 2021; 74:101980. [PMID: 34247064 PMCID: PMC8455424 DOI: 10.1016/j.canep.2021.101980] [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: 04/08/2021] [Revised: 06/29/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Sexual minority women are consistently at increased risk for tobacco use compared to heterosexual women. Neither biomarkers of nicotine exposure nor biomarkers of tobacco toxicant exposure have been examined by sexual identity. METHODS This study used interview and biomarker data from women in the biomarker core sample of Wave 1 of the Population Assessment of Tobacco and Health (PATH) study (2013-2014; n = 4930). We examined associations of sexual identity with nicotine exposure (measured with urinary cotinine and TNE-2) and with tobacco-specific nitrosamines (measured with urinary NNAL). Multivariable regression modeling was used to examine these associations among the full biomarker core sample, among past 30-day tobacco users, and among exclusive established cigarette users before and after controlling for tobacco use quantity and intensity. RESULTS In the full biomarker sample of women, prior to adjusting for tobacco use quantity and intensity, bisexual women had significantly higher cotinine, TNE-2, and NNAL levels compared to heterosexual women. Among exclusive established cigarette users, gay/lesbian women had significantly higher NNAL compared to heterosexual women prior to adjusting for tobacco quantity and intensity. No differences by sexual identity were found after adjusting for tobacco use quantity and intensity. CONCLUSIONS This is the first study to demonstrate differences in biological markers of tobacco exposure by sexual identity among women in the U.S. This has important public health implications as greater exposure to both nicotine and to tobacco-specific nitrosamines are strongly linked to cancer risk.
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Affiliation(s)
- Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA.
| | - Danielle M Smith
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Philip Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA; Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA; Institute for Research on Women and Gender, University of Michigan, Ann Arbor, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA; Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Timmins L, Schneider JA, Chen YT, Goedel WC, Brewer R, Callander D, Knox J, Eavou R, Hanson H, Duncan DT. Sexual Identity, Sexual Behavior and Pre-exposure Prophylaxis in Black Cisgender Sexual Minority Men: The N2 Cohort Study in Chicago. AIDS Behav 2021; 25:3327-3336. [PMID: 33852095 PMCID: PMC8419005 DOI: 10.1007/s10461-021-03246-4] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 01/04/2023]
Abstract
This study investigated sexual identity and behavior and their potential associations with PrEP use and attitudes in cisgender Black gay and bisexual men. A total of N = 173 (mean age 25.2) participants from the Neighborhoods and Networks (N2) Study in Chicago were included. Of these, 104 were gay-identified and reported sex with men only (GSMO), 26 were gay-identified and reported sex with men and women (GSMW), 8 were bisexual-identified and reported sex with men only (BSMO), and 35 were bisexual-identified and reported sex with men and women (BSMW). Reporting sex with men and women in the past 6 months, RR = 0.39, 95% CI [0.17, 0.89], identifying as bisexual, RR = 0.52, 95% CI [0.29, 0.92], and the combination of the two, RR = 0.24, 95% CI [0.07, 0.76] were significantly associated with lower rates of current oral PrEP use. Black bisexual-identifying men who reported sex with men and women were significantly more likely to have discontinued oral PrEP, RR = 2.50, 95% CI [1.14, 5.50], than Black gay-identified men who reported sex with men only. Participants who had not used oral PrEP before reported lower levels of interest in long-acting injectable PrEP than those who were currently using oral PrEP, RR = 0.56, 95% CI [0.40, 0.79]. No other significant differences were found. Overlooking the combination of sexual identity and behavior may mischaracterize PrEP rates and miss uniquely vulnerable subgroups. Black gay and bisexual men who had not used oral PrEP may be particularly disinterested in long-acting injectable PrEP.
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Affiliation(s)
- Liadh Timmins
- Columbia Spatial Epidemiology Lab, Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 729, New York, NY, 10032, USA.
| | - John A Schneider
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago School of Medicine, Chicago, IL, USA
| | - Yen-Tyng Chen
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Public Health, William Paterson University of New Jersey, Wayne, NJ, USA
| | - William C Goedel
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Russell Brewer
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago School of Medicine, Chicago, IL, USA
| | - Denton Callander
- Columbia Spatial Epidemiology Lab, Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 729, New York, NY, 10032, USA
| | - Justin Knox
- Columbia Spatial Epidemiology Lab, Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 729, New York, NY, 10032, USA
| | - Rebecca Eavou
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - Hillary Hanson
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - Dustin T Duncan
- Columbia Spatial Epidemiology Lab, Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, Room 729, New York, NY, 10032, USA
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Skeen SJ, Starks TJ, Jimenez RH, Rendina HJ, Cain D. Heterosexual Cisgender Men Partnered with Transgender Women Exhibit Higher HIV/STI Sexual Risk than Their Gay, Bisexual, and Queer Counterparts: Findings from a U.S.-Based Convenience Sample Recruited Online. AIDS Behav 2021; 25:3279-3291. [PMID: 34050403 PMCID: PMC10062375 DOI: 10.1007/s10461-021-03314-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 01/15/2023]
Abstract
Cisgender men are frequently vectors for HIV transmission among transgender women. Despite this, the correlates of sexual risk among these men remain under-examined. The purpose of the present study was to explore potential differences in relationship characteristics, sexual risk-taking, and risk-reduction strategies among cisgender men partnered with transgender women. The study utilized secondary screening data provided by adult cis men who reported being in a primary relationship with a trans woman (N = 710). Gay men (18%) were comparatively older, and most likely to report both HIV seropositivity and committed pairings. Heterosexual men (14%) were more likely to report exchange sex, briefer relationships, extra-dyadic sex, lesser serostatus awareness or PrEP uptake. Queer men (7%) were youngest, and most likely to access PrEP. Heterosexual cis men with trans women partners may be subject to unique socio-cultural drivers of sexual risk, such as heteronormative pressures and relationship stigma.
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Affiliation(s)
- Simone J Skeen
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA.
- School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, LA, 70112, USA.
| | - Tyrel J Starks
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Science PhD Program, The Graduate Center, CUNY, New York, NY, USA
| | - Ruben H Jimenez
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
| | - H Jonathon Rendina
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
- Health Psychology and Clinical Science PhD Program, The Graduate Center, CUNY, New York, NY, USA
| | - Demetria Cain
- Department of Psychology, Hunter College, City University of New York (CUNY), New York, NY, USA
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Long JE, Montaño M, Sanchez H, Huerta L, Calderón Garcia D, Lama JR, Andrasik M, Duerr A. Self-Identity, Beliefs, and Behavior Among Men Who Have Sex with Transgender Women: Implications for HIV Research and Interventions. Arch Sex Behav 2021; 50:3287-3295. [PMID: 34617189 PMCID: PMC8784120 DOI: 10.1007/s10508-021-02019-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 05/13/2023]
Abstract
While transgender women have been identified as a global priority population for HIV prevention and treatment, little is known about the cisgender male partners of transgender women, including their sexual behavior and HIV prevalence. Previous research has suggested that these male partners have varied identities and sexual behavior, which make identifying and engaging them in research difficult. This paper describes interviews conducted with fifteen cisgender men who reported recent sexual activity with transgender women in Lima, Peru. The purpose of this research was to explore how these men reported their identities and sexual behavior, to better understand how they would interact with HIV outreach, research, and care. The major themes were sexual orientation and identity; view of transgender partners; social ties to transgender women and other men with transgender women partners; disclosure of relationships; HIV knowledge and risk perception; and attitudes toward interventions. We found that language used to assess sexual orientation was problematic in this population, due to lack of consistency between orientation and reported behavior, and unfamiliarity with terms used to describe sexual orientation. In addition, stigma, lack of knowledge of HIV prevention methods, and fear of disclosure of sexual behavior were identified as barriers that could impact engagement in HIV research, prevention, and care. However, participants reported social relationships with both transgender women and other men who have transgender partners, presenting possible avenues for recruitment into HIV research and healthcare services.
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Affiliation(s)
- Jessica E Long
- Department of Epidemiology, University of Washington, Box 351619, Seattle, WA, 98195, USA.
| | - Michalina Montaño
- Department of Epidemiology, University of Washington, Box 351619, Seattle, WA, 98195, USA
| | | | | | | | - Javier R Lama
- Asociación Civil Impacta Salud y Educación, Lima, Peru
| | | | - Ann Duerr
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Kelly LM, Shepherd BF, Becker SJ. Elevated risk of substance use disorder and suicidal ideation among Black and Hispanic lesbian, gay, and bisexual adults. Drug Alcohol Depend 2021; 226:108848. [PMID: 34214885 PMCID: PMC8431829 DOI: 10.1016/j.drugalcdep.2021.108848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/04/2021] [Accepted: 05/13/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Black and Hispanic persons who identify as lesbian, gay, or bisexual (LGB) experience health disparities relative to non-Hispanic White and heterosexual groups respectively, including higher rates of suicidal ideation (SI) and substance use disorder (SUD). To elucidate intersectional risk, we used a large national sample to examine rates of SI, SUD, and their co-occurrence (SI + SUD) at the intersection of sexual identity and race/ethnicity. METHOD Data were from five years (2015-2019) of the National Survey of Drug Use and Heath (unweighted N = 189,127). Multinomial logistic regressions with persons without SI and SUD as references were stratified by gender and controlled for survey year, age, education, marital status, and income. RESULTS Compared to same-race and same-gender heterosexual adults, White, Black, and Hispanic LGB men and women showed higher odds of SI (AOR = 2.86-4.45), SUD (AOR = 1.23-3.01), and SI + SUD (AOR = 2.72-6.85). Compared to same-gender White heterosexual adults, Black and Latinx heterosexual men and women showed lower odds of SI (AORs = .54-.65), SUD (AORs = .52-.78) and SI + SUD (AORs = .41-.57). Compared to same-gender White LGB adults, Black and Hispanic women, but not men, showed lower SI odds (AORs = .58-.72). Compared to same-gender White heterosexual adults, Black and Hispanic LGB men and women showed higher odds of SI (AORs = 1.71-2.51) and SI + SUD (AORs = 1.91-2.97). CONCLUSIONS Consistent with research showing effects of multiple minority stress on behavioral health, adults with intersecting racial/ethnic and sexual minority identities showed increased odds of SI, SUD, and SI + SUD relative to Non-Hispanic White heterosexual peers. Black, Hispanic, and White LGB adults may benefit from screening and intervention for SI and SUD.
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Affiliation(s)
- Lourah M Kelly
- University of Connecticut School of Medicine, United States.
| | | | - Sara J Becker
- Brown University School of Public Health, United States; Warren Alpert Medical School of Brown University, United States
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Krasnova A, Diaz JE, Philbin MM, Mauro PM. Disparities in substance use disorder treatment use and perceived need by sexual identity and gender among adults in the United States. Drug Alcohol Depend 2021; 226:108828. [PMID: 34325282 PMCID: PMC8477369 DOI: 10.1016/j.drugalcdep.2021.108828] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/30/2021] [Accepted: 05/10/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Substance use disorder (SUD) treatment use is low in the United States. We assessed differences in treatment use and perceived need by sexual identity (i.e., lesbian, gay, bisexual, heterosexual) and gender among adults with a past-year SUD. METHODS We pooled data from the 2015-2019 National Survey on Drug Use and Health for adults (18+) who met past-year DSM-IV SUD criteria and self-reported sexual identity (n = 21,926). Weighted multivariable logistic regressions estimated odds of past-year: 1) any SUD treatment; 2) specialty SUD treatment; 3) perceived SUD treatment need by sexual identity, stratified by gender and adjusted for socio-demographics. RESULTS Any past-year SUD treatment use was low among adult men (heterosexual [10.4 %], gay [15.5 %], and bisexual [7.1 %]) and women (heterosexual [9.9 %], gay/lesbian [11.9 %], and bisexual [13.2 %]). Patterns were similar for specialty SUD treatment and perceived treatment need. Adjusted odds of any SUD treatment use were higher among gay men (aOR = 1.65 [95 % Confidence Interval 1.10-2.46]) and bisexual women (aOR = 1.31 [1.01-1.69]) than their heterosexual peers. Compared to their heterosexual counterparts, adjusted odds of perceived SUD treatment need were higher among bisexual women (aOR = 1.65 [1.22-2.25]), gay men (aOR = 1.76 [1.09-2.84]), and bisexual men (aOR = 2.39 [1.35-4.24]). CONCLUSIONS Most adults with SUD did not receive treatment. Gay men and bisexual women were more likely to receive treatment and reported higher perceived SUD treatment need than heterosexual peers. Facilitating treatment access and engagement is needed to reduce unmet needs among marginalized people who perceive SUD treatment need.
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Affiliation(s)
- Anna Krasnova
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States.
| | - José E Diaz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Morgan M Philbin
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Pia M Mauro
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
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Curry CW, Felt D, Kan K, Ruprecht M, Wang X, Phillips G, Beach LB. Asthma Remission Disparities Among US Youth by Sexual Identity and Race/Ethnicity, 2009-2017. J Allergy Clin Immunol Pract 2021; 9:3396-3406. [PMID: 33964511 PMCID: PMC8434969 DOI: 10.1016/j.jaip.2021.04.046] [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] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/13/2021] [Accepted: 04/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sexual minority and racial/ethnic minority youth experience a higher burden of asthma. The frameworks of minority stress theory and intersectionality suggest that sexual minority and racial/ethnic minority youth may experience disparities in nonremitting asthma. OBJECTIVE To examine adjusted odds of nonremitting asthma by sexual identity, race/ethnicity, and their intersections, along with their relationship with traditional nonremitting asthma risk factors (weight status and smoking) and victimization (bullying, cyberbullying, and forced sex). METHODS We used data from the Youth Risk Behavior Survey pooled across 41 jurisdiction-years (biennially, 2009-2017), resulting in a sample of 21,789 US youth. The prevalence of nonremitting asthma was examined by sexual identity, race/ethnicity, and their intersections, stratified by sex. Bivariate associations and backward logistic regression models, stratified by sex, were built to examine nonremitting asthma disparities and the effects of selected traditional correlates and victimization variables. RESULTS At the intersections, 8 sexual minority and racial/ethnic minority subpopulations were significantly more likely to have nonremitting asthma compared with White heterosexual sex-matched peers. White gay males and Black lesbian females had the highest odds of nonremitting asthma. Traditional risks of nonremitting asthma and victimization were associated with attenuated odds of nonremitting asthma. CONCLUSIONS Many sexual minority and racial/ethnic youth subpopulations are more likely to have nonremitting asthma. Evidence suggests that traditional nonremitting asthma risk factors and victimization may partly explain disparities in nonremitting asthma. Asthma management guidelines should be updated to include population health disparities of sexual and racial/ethnic minorities.
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Affiliation(s)
- Caleb W. Curry
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
- College of Arts and Sciences, Case Western Reserve University, Cleveland, OH
| | - Dylan Felt
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Kristin Kan
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL
| | - Megan Ruprecht
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Xinzi Wang
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Gregory Phillips
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lauren B. Beach
- Evaluation, Data Integration, and Technical Assistance (EDIT) Research Program, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
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Anderson A, Dierkhising J, Rush G, Carleton M, Rosendale N, Bove R. Experiences of sexual and gender minority people living with multiple sclerosis in Northern California: An exploratory study. Mult Scler Relat Disord 2021; 55:103214. [PMID: 34428637 DOI: 10.1016/j.msard.2021.103214] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/20/2021] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Sexual and gender minority (SGM) individuals may face unique challenges in accessing quality medical care due to structural disparities, social discrimination, and lack of culturally competent healthcare. Multiple sclerosis (MS) requires complex care. Little research has been carried out at the intersection between SGM identity and MS care. OBJECTIVE To identify unmet clinical and social needs in our clinical population of SGM patients with MS. METHODS Patients with MS who self-identified as SGM were recruited through the UCSF MS Center and a National MS Society web post to complete a 45-minute web-based (Qualtrics) survey. The mixed qualitative and quantitative survey covered experiences with different domains of MS care, drug/alcohol use, relationship status, social support, and participation in MS and SGM communities. RESULTS Among the 26 survey respondents, mean age was 50.2 (SD 10.6) years; gender identity was women (46%) men (38%) and genderqueer, transgender, or other (15%); sexual orientation was gay/lesbian/bisexual (35%), pansexual/queer (27%), questioning (23%), or other identity (15%). Over two thirds (69%) of respondents were partnered. Overall satisfaction with MS care was high: 79.2% participants scored ≥4/5 (somewhat or extremely satisfied); participants dissatisfied with their care cited feeling dismissed. While 87.5% felt that their SGM identities did not affect their MS care, still 30% did report feeling uncomfortable discussing their SGM identities with their clinician. Participants rated low impact of having MS on participation in SGM communities (mean 2.4/5 on Likert scale); those participants reporting higher impact cited fatigue, immobility and stigmatization of disease as primary factors. Similarly, SGM status had low effect on participation in the MS community (mean 1.4/5); higher impact was related to apprehension around identity disclosure to new groups. Identified resources that might improve MS care included more representation, inclusivity and openness from clinicians, and SGM-focused MS support groups. DISCUSSION In this exploratory survey of the needs of SGM people living with MS in Northern California, most participants reported that they were unlikely to participate in activities in the SGM community due to MS status or symptoms, however most felt that their SGM status did not affect their MS care. Given the center's location in a hub for SGM community and activism, surveying individuals in other settings would provide greater insights into the role of community, clinical support and the experience of SGM people living with MS.
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Affiliation(s)
- Annika Anderson
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA.
| | - Jason Dierkhising
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Gillian Rush
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Mia Carleton
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA
| | - Nicole Rosendale
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Department of Neurology, School of Medicine, University of California, San Francisco, CA, USA.
| | - Riley Bove
- UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Department of Neurology, School of Medicine, University of California, San Francisco, CA, USA.
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Gratz KL, Mann AJD, Tull MT. Suicidal ideation among university students during the COVID-19 pandemic: Identifying at-risk subgroups. Psychiatry Res 2021; 302:114034. [PMID: 34098158 DOI: 10.1016/j.psychres.2021.114034] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/23/2021] [Indexed: 10/21/2022]
Abstract
Given concerns of increased suicide risk among university students during the COVID-19 pandemic, this study examined rates of lifetime and past-year suicidal ideation (SI) among university students in Fall 2020 (vs. two earlier semesters), overall and across gender, racial/ethnic background, and sexual identity. Participants included 1700 university students enrolled in a general education psychology course in Fall 2020, Fall 2014, or Fall 2013. Rates of SI were not significantly higher in Fall 2020 versus the earlier semesters and did not differ across racial/ethnic background. However, rates of SI in Fall 2020 were significantly higher among sexual minority than heterosexual students.
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West-Livingston LN, Dittman JM, Park JA, Pascarella L. Sexual orientation, gender identity, and gender expression: From current state to solutions for the support of lesbian, gay, bisexual, transgender, and queer/questioning patients and colleagues. J Vasc Surg 2021; 74:64S-75S. [PMID: 34303461 DOI: 10.1016/j.jvs.2021.03.057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 03/23/2021] [Indexed: 01/16/2023]
Abstract
Many of the systemic practices in medicine that have alienated lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) individuals persist today, undermining the optimal care for these patients and isolating LGBTQ medical providers from their colleagues. The 2020 Task Force on Diversity, Equity, and Inclusion Report recently published by the Society for Vascular Surgery marked the first publication advocating for the inclusion of sexual orientation and sexual identity in the development of initiatives promoting and protecting diversity across vascular surgery. Vascular providers should be aware that it is crucial to cultivate an environment that is inclusive for LGBTQ patients because a large proportion of these patients have reported not self-disclosing their status to medical providers, either out of concern over potential personal repercussions or failing to recognize the potential relevance of LGBTQ status to their medical care. Safe Zone training has provided a standard resource for providers and staff that can be integrated into onboarding and routine training. Clarifying the current terminology for sexual orientation and identity will ensure that vascular providers will recognize patients who could benefit from screening for additional vascular risk factors relevant to this population related to sexual health, social behavior, physical health, and medical therapies. The adoption of gender neutral language on intake forms and general correspondence with colleagues is key to reducing the unintended exclusion of those with LGBTQ identities in both inpatient and outpatient environments. In many locales across the United States, the professional and personal repercussions for openly reporting LGBTQ status persist, complicating efforts toward quantifying, recognizing, and supporting these patients, practitioners, and trainees. Contributing to an inclusive environment for patients and peers and acting as a professional ally are congruent with the ethos in vascular surgery to treat all patients and colleagues with respect and optimize the healthcare of every vascular patient.
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Affiliation(s)
| | - James M Dittman
- Virginia Commonwealth University School of Medicine, Richmond, Va
| | - Jason A Park
- Boston University School of Medicine, Boston, Mass
| | - Luigi Pascarella
- Division of Vascular Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC.
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Bradfield OM. Sexual identity or religious freedom: could conversion therapy ever be morally permissible in limited urgent situations? Monash Bioeth Rev 2021; 39:51-59. [PMID: 34283383 PMCID: PMC8321984 DOI: 10.1007/s40592-021-00132-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/03/2022]
Abstract
Conversion therapy refers to a range of unscientific, discredited and harmful heterosexist practices that attempt to re-align an individual's sexual orientation, usually from non-heterosexual to heterosexual. In Australia, the state of Victoria recently joined Queensland and the Australian Capital Territory in criminalising conversion therapy. Although many other jurisdictions have also introduced legislation banning conversion therapy, it persists in over 60 countries. Children are particularly vulnerable to the harmful effects of conversion therapy, which can include coercion, rejection, isolation and blame. However, if new biotechnologies create safe and effective conversion therapies, the question posed here is whether it would ever be morally permissible to use them. In addressing this question, we need to closely examine the individual's circumstances and the prevailing social context in which conversion therapy is employed. I argue that, even in a sexually unjust world, conversion therapy may be morally permissible if it were the only safe and effective means of relieving intense anguish and dysphoria for the individual. The person providing the conversion therapy must be qualified, sufficiently independent from any religious organisation and must provide conversion therapy in a way that is positively affirming of the individual and their existing sexuality.
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Affiliation(s)
- Owen M Bradfield
- Law & Public Health Unit, Centre for Health Policy, Melbourne School of Population & Global Health, University of Melbourne, Parkville, Australia. .,University of Oxford, Oxford, UK.
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Cusack CE, Christian C, Drake JE, Levinson CA. A network analysis of eating disorder symptoms and co-occurring alcohol misuse among heterosexual and sexual minority college women. Addict Behav 2021; 118:106867. [PMID: 33639368 DOI: 10.1016/j.addbeh.2021.106867] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
Eating disorders and alcohol misuse are common problems among college women. Individually, both have high prevalence rates and are associated with a significant economic burden. Yet eating disorders and alcohol misuse also frequently present simultaneously, which may increase symptom severity and related impairment. These associations are especially important to test in sexual minority populations, as symptoms may present differently, and the prevalence and personal cost of these disorders may be even higher for this group. The present study (N = 1072 undergraduate college women) used network analysis to identify pathways, central symptoms, and bridge symptoms across alcohol misuse and eating disorder symptoms. A network comparison test was used to determine if the network structure differed between heterosexual women (n = 923) and sexual minority women (n = 149). For the overall network, cognitive restraint, excessive exercise, and frequency of binge drinking, were the most central symptoms. Bridge symptoms included drinking in the morning, purging, alcohol-related guilt, and muscle building. Heterosexual and sexual minority women did not differ significantly in network structure or global strength. Regardless of sexual orientation, prevention efforts for eating disorders and alcohol misuse among college women should target central and bridge symptoms.
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Rostad WL, Clayton HB, Estefan LF, Johns MM. Substance Use and Disparities in Teen Dating Violence Victimization by Sexual Identity Among High School Students. Prev Sci 2021; 21:398-407. [PMID: 31485923 DOI: 10.1007/s11121-019-01049-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 02/06/2023]
Abstract
Sexual minority youth (SMY) report more substance use and experience more physical and sexual dating violence victimization than heterosexual youth; however, few studies have explored the relationship between substance use and disparities in teen dating violence and victimization (TDVV) using national-level estimates, and examined if these relationships vary by sexual minority subgroups. Data from the nationally representative 2015 and 2017 national Youth Risk Behavior Surveys were used to examine differences in TDVV and substance use by sexual identity, and to determine if substance use was associated with TDVV disparities between SMY and heterosexual high school students who dated 12 months prior to the survey (n = 18,704). Sex-stratified logistic regression models generated prevalence ratios adjusted for demographic characteristics and substance use behaviors to determine if substance use mediated the relationship between sexual identity and TDVV. Compared with their heterosexual peers, SMY experienced higher rates of TDVV and were more likely to report using most types of substances, although differences were more pronounced among female students compared with male students. Disparities in TDVV were reduced for male gay and bisexual students as well as for female bisexual students once substance use was entered into the model, suggesting that there is a relationship between substance use and some of gay and bisexual students' risk for experiences of TDVV. Comprehensive efforts for violence prevention among sexual minority students may benefit from incorporating substance use prevention, given its relationship to disparities in TDVV.
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Affiliation(s)
- Whitney L Rostad
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA. .,, Seattle, USA.
| | - Heather B Clayton
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lianne Fuino Estefan
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michelle M Johns
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Rentería R, Benjet C, Gutiérrez-García RA, Abrego-Ramírez A, Albor Y, Borges G, Covarrubias Díaz-Couder MA, Durán MDS, González-González R, Guzmán Saldaña R, E Hermosillo De la Torre A, Martínez-Jerez AM, Martinez Martinez KI, Medina-Mora ME, Martínez Ruiz S, Paz Pérez MA, Pérez Tarango G, Zavala Berbena MA, Méndez E, Auerbach RP, Mortier P. Prevalence of 12-month mental and substance use disorders in sexual minority college students in Mexico. Soc Psychiatry Psychiatr Epidemiol 2021; 56:247-257. [PMID: 32886133 DOI: 10.1007/s00127-020-01943-4] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 08/07/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Mental health disparities have been documented among sexual minority college students, but there is a dearth of evidence from developing countries. The aim is to estimate the prevalence of 12-month mental and substance use disorders across a range of sexual identities among first-year college students in Mexican universities, and test whether there is an association between sexual identity and disorders and whether the association is moderated by gender. METHOD The University Project for Healthy Students, a web-based survey conducted as part of the World Health Organization's World Mental Health International College Student initiative, recruited 7874 students from nine Mexican universities in 2016 and 2017. Logistic regressions estimated the association of sexual identity with 12-month major depressive episode, generalized anxiety disorder, panic disorder, alcohol abuse/dependence, and drug abuse/dependence, with interaction terms for gender. RESULTS Compared to heterosexual students reporting no same-sex attraction (SSA), heterosexual students with SSA (AORs range 1.77-3.67) and lesbian/gay and bisexual students (AORs range 2.22-5.32) were at a higher risk for several disorders. Asexual students were at higher risk for drug abuse/dependence (AOR = 3.64). Students unsure of their sexual identity were at a higher risk for major depressive episode, panic disorder, and drug abuse/dependence (AORs range 2.25-3.82). Gender differences varied across sexual identity and disorder. CONCLUSION These findings are the first empirical report of sexual minority psychiatric disparities among a college student population from a developing nation and underscore the importance of clinical interventions that address mental health needs among sexual minority college students.
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Affiliation(s)
- Roberto Rentería
- Counseling & Counseling Psychology, Arizona State University, Tempe, Arizona, USA
| | - Corina Benjet
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico.
| | - Raúl A Gutiérrez-García
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Adrián Abrego-Ramírez
- Dirección de Investigación, Universidad Politécnica de Aguascalientes, Aguascalientes, Aguascalientes, Mexico.,Dirección de Educación a Distancia, Universidad Cuauhtémoc, Plantel Aguascalientes, Aguascalientes, Mexico
| | - Yesica Albor
- Departamento de Salud Púbica, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad De México, Mexico
| | - Guilherme Borges
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | | | - María Del Socorro Durán
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, Mexico
| | - Rogaciano González-González
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Rebeca Guzmán Saldaña
- Instituto de Ciencias de la Salud y Coordinación de Investigación, Universidad Autónoma del Estado de Hidalgo, Pachuca, Hidalgo, Mexico
| | | | - Ana María Martínez-Jerez
- Unidad Académica de Ciencias Jurídicas y Sociales, Universidad Autónoma de Tamaulipas, Ciudad Victoria, Tamaulipas, Mexico
| | - Kalina I Martinez Martinez
- Departamento de Psicología, Universidad Autónoma de Aguascalientes, Aguascalientes, Aguascalientes, Mexico
| | - María Elena Medina-Mora
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | | | - María Abigail Paz Pérez
- Facultad de Ciencias Sociales y Humanidades, Universidad De La Salle Bajío, Campus Salamanca, Salamanca, Guanajuato, Mexico
| | - Gustavo Pérez Tarango
- Dirección de Orientación y Desarrollo Educativo, Universidad De La Salle Bajío, Campus Campestre, León, Guanajuato, Mexico
| | | | - Enrique Méndez
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad De México, Mexico
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York City, NY, USA
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Houghton M, Tasker F. Exploring Lesbian and Bisexual Catholic Women's Narratives of Religious and Sexual Identity Formation and Integration. J Homosex 2021; 68:47-69. [PMID: 31188720 DOI: 10.1080/00918369.2019.1624455] [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: 06/09/2023]
Abstract
Many LGBT people with a Christian upbringing experience conflict between their religious and sexual identities. Many resolve this conflict by leaving Christianity, others by moving to affirming churches. Some research has examined the experiences of LGBT people who choose to attend conservative churches; however, there has been very little research on the experiences of non-heterosexual women in the Catholic Church. Narrative and thematic analyses of data collected through qualitative interviews with six non-heterosexual Catholic women revealed several ways participants had integrated their faith and sexuality: acceptance from other Catholics, distinguishing between the Church and God, meeting other LGBT Christians, and developing a personal relationship with God. These reflect strategies adopted by gay Catholic men and LGBT Christians attending Protestant churches. Nonetheless, participants reported that their experiences varied from those of gay Catholic men due to gay men being more visible and more subject to prejudice within the Church.
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Affiliation(s)
- Marie Houghton
- Department of Psychological Sciences, Birkbeck University of London , Bloomsbury, London, UK
| | - Fiona Tasker
- Department of Psychological Sciences, Birkbeck University of London , Bloomsbury, London, UK
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Hsieh SH, Perri PF. Estimating the proportion of non-heterosexuals in Taiwan using Christofides' randomized response model: A comparison of different estimation methods. Soc Sci Res 2021; 93:102475. [PMID: 33308680 DOI: 10.1016/j.ssresearch.2020.102475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 08/22/2020] [Accepted: 09/13/2020] [Indexed: 06/12/2023]
Abstract
In social research, investigating sensitive, highly personal or embarrassing issues by means of standard survey techniques based on direct questioning leads to refusals to answer or false responses which, generally, flaw the validity of the analyses and produce incorrect inferences. To correct biases induced by nonresponse or underreporting of sensitive matters, Warner (1965) introduced an indirect questioning approach, known as the randomized response technique, which allows researchers to estimate the proportion of individuals with sensitive attributes or behaviors, while ensuring respondents' privacy protection. In this article, we consider the randomized response model proposed by Christofides (2003) and, through a simulation and an empirical study, compare different estimation methods for the prevalence of a sensitive attribute. Specifically, we discuss how the model has been implemented in a pilot study to collect data and derive maximum likelihood and Bayesian estimates for the proportion of non-heterosexuals aged 20 years or older for the Taiwanese population and for some subgroups of it by sex and age. Our analysis, and in particular the Bayesian approach, seems to meet the expectation of social researchers and experts of sexual behaviors. In fact, the produced estimates are higher than official findings in Taiwan obtained by direct questioning in face-to-face interviews and provide a more reliable picture of sexual identity in the country. Moreover, Bayesian estimates appear more accurate than those produced by the method of moment and the maximum likelihood method.
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Affiliation(s)
- Shu-Hui Hsieh
- Center for Survey Research, Research Center for Humanities and Social Sciences, Academia Sinica, Taiwan, ROC.
| | - Pier Francesco Perri
- Department of Economics, Statistics and Finance "Giovanni Anania", University of Calabria, Italy.
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Abstract
The 2019–2020 Supreme Court session was an extraordinary session. One major ruling involved insanity defense and whether the two prongs of cognitive capacity and moral capacity were required. Sexual identity was ruled to be covered by the Civil Rights Act in relation to employment. Unanimous criminal jury decisions were ruled a required condition for conviction. The rescindment of DACA was overturned on procedural grounds. Other decisions related to conditions of abortion, habitual residence in international custody cases, police immunity from civil liability, guns, HIV, and capital punishment. Thirty-five percent of cases were unanimous (down from the recent average), and 22% were decided by a 5–4 vote (slightly above the recent average).
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