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Sexual minority men of color report intimate partner violence (IPV) and substance use at elevated rates compared to heterosexual peers, but little is known about how types (physical/sexual, controlling, monitoring, emotional) of perpetration and victimization are connected to types of substance use. Associations between past-6-month IPV experiences and substance use (tobacco, alcohol, cannabis, poppers, cocaine) were examined among sexual minority men (N = 414; 18-27 years). IPV victimization and perpetration were reported by 22% and 14% of the sample. Any victimization and controlling victimization were positively correlated with tobacco use, physical victimization was positively correlated with cocaine and poppers use, and monitoring victimization was negatively correlated with cannabis and poppers use. Any perpetration was positively correlated with tobacco use and binge drinking, and emotional perpetration was positively correlated with binge drinking. Understanding and addressing IPV victimization and perpetration experiences are critical for understanding risk conferred by IPV in this population.
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Violencia de Pareja , Minorías Sexuales y de Género , Trastornos Relacionados con Sustancias , Humanos , Masculino , Violencia de Pareja/estadística & datos numéricos , Violencia de Pareja/psicología , Adolescente , Minorías Sexuales y de Género/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Adulto Joven , Víctimas de Crimen/estadística & datos numéricos , Víctimas de Crimen/psicología , Población Urbana/estadística & datos numéricosRESUMEN
This study examined differences in alcohol use by sexual and gender identities during the COVID-19 pandemic, and assessed whether variation between groups was explained by pandemic-related stressors and minority stress. Data from 2,429 partnered adults in the National Couples' Health and Time Use Study (n = 3,593) collected from September 2020 to April 2021 were used to model drinking patterns (frequency, amount, and drinking to cope) by sexual and gender identities, COVID-19 stress and disruption, microaggressions, and supportive climate. Regression models indicated differences in drinking by gender and sexual identities, even controlling for demographic and socioeconomic factors. Gay, lesbian, and bisexual people had higher odds of drinking to cope with the pandemic than did heterosexual people, and cisgender men had higher odds than did cisgender women. Gay and lesbian people drank more regularly than did heterosexual people, as did cisgender men in relation to cisgender women. Exclusively bisexual people drank significantly more drinks than exclusively heterosexual people, and cisgender men drank significantly more drinks than did cisgender women and those who identified as trans/another gender identity. COVID-19 stress and minority stress were associated with greater alcohol consumption, but they did not account for these differentials. Moving forward, researchers will need to continuously assess these associations, as sources of discrimination and stress will persist beyond the pandemic. Although LGBTQ+ people have disproportionate sources of stress, they varied in how they used alcohol to cope. Potential sources of resilience among sexual and gender diverse individuals should be explored.
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Consumo de Bebidas Alcohólicas , COVID-19 , Identidad de Género , Pandemias , Minorías Sexuales y de Género , Humanos , COVID-19/epidemiología , COVID-19/psicología , Masculino , Femenino , Consumo de Bebidas Alcohólicas/epidemiología , Adulto , Minorías Sexuales y de Género/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Persona de Mediana Edad , SARS-CoV-2 , Adulto Joven , Estrés Psicológico/epidemiologíaRESUMEN
LGBTQIA+ youth are disproportionately affected by mental health issues including suicidal ideation and suicide attempts. Minoritized youth have numerous social and structural factors influencing their health, including a lack of access to care and resources. However, these youth and their caregivers also have many unique and individual cultural strengths. Awareness of special considerations and work toward dismantling structural drivers is essential in improving the health of these youth. Additionally, it is important to support minoritized youth and their caregivers through tailored evidence-based treatments in addressing social and structural drivers to influence individual, community, educational, institutional, and policy levels and prevent suicide in achieving mental health equity.
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Minorías Sexuales y de Género , Humanos , Adolescente , Minorías Sexuales y de Género/psicología , Intento de Suicidio , Ideación Suicida , Prevención del Suicidio , Suicidio/psicologíaRESUMEN
Introduction: Food insecurity is defined as inconsistent access to enough food to meet nutritional needs. Discrimination is associated with food insecurity and poor health, especially among racial and ethnic minoritized and sexual or gender minoritized groups. We examined the demographic associations of perceived everyday discrimination and food pantry discrimination in Massachusetts. Methods: From December 2021 through February 2022, The Greater Boston Food Bank conducted a cross-sectional, statewide survey of Massachusetts adults. Of the 3,085 respondents, 702 were food pantry clients for whom complete data on food security were available; we analyzed data from this subset of respondents. We used the validated 10-item Everyday Discrimination Scale to measure perceived everyday discrimination and a 10-item modified version of the Everyday Discrimination Scale to measure perceived discrimination at food pantries. Logistic regression adjusted for race and ethnicity, age, gender identity, sexual orientation, having children in the household, annual household income, and household size assessed demographic associations of perceived everyday discrimination and discrimination at food pantries. Results: Food pantry clients identifying as LGBTQ+ were more likely than those identifying as non-LGBTQ+ to report perceived everyday discrimination (adjusted odds ratio [AOR] = 2.44; 95% CI, 1.24-4.79). Clients identifying as Hispanic (AOR = 1.83, 95% CI, 1.13-2.96) were more likely than clients identifying as non-Hispanic White to report perceived discrimination at food pantries. Conclusion: To equitably reach and serve households with food insecurity, food banks and pantries need to understand experiences of discrimination and unconscious bias to develop programs, policies, and practices to address discrimination and create more inclusive interventions for food assistance.
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Asistencia Alimentaria , Inseguridad Alimentaria , Humanos , Massachusetts , Femenino , Masculino , Estudios Transversales , Adulto , Asistencia Alimentaria/estadística & datos numéricos , Persona de Mediana Edad , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Adulto Joven , Discriminación Social/psicología , Abastecimiento de Alimentos/estadística & datos numéricos , Adolescente , AncianoRESUMEN
Research comparing monogamous and non-monogamous relationships on well-being indicators across diverse populations have yielded inconsistent findings. The present study investigates sociodemographic characteristics, as well as personal and relational outcomes, across different relationship configurations. Data were drawn from an online community-based sample of 1,528 LGBTQ+ persons aged 18 years and older in Quebec, Canada. A latent class analysis was performed based on legal relationship status, relationship agreement, cohabitation status, and the seeking of extradyadic sexual and romantic partners on the internet. Class differences on sociodemographic characteristics and well-being and relationship quality indicators were examined. A five-class solution best fit the data, highlighting five distinct relationship configurations: Formalized monogamy (59%), Free monogamy (20%), Formalized open relationship (11%), Monogamous considering alternatives (7%) and Free consensual non-monogamies (3%). Cisgender women were more likely to engage in monogamous relationships than cisgender men, who were overrepresented in open relationships. Lower levels of perceived partner support were observed in both free monogamous and consensually non-monogamous relationships, the latter of which also showed lower levels of well-being. Consensual non-monogamy researchers exploring relationship outcomes should examine relationship facets that go beyond relationship structure or agreement. Variations in monogamies and non-monogamies, both consensual and non-consensual, may be present within each broad relationship configuration, as reflected in different personal and relational needs, which can then translate to better or poorer outcomes.
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Análisis de Clases Latentes , Parejas Sexuales , Minorías Sexuales y de Género , Humanos , Masculino , Femenino , Adulto , Minorías Sexuales y de Género/psicología , Parejas Sexuales/psicología , Persona de Mediana Edad , Quebec , Adolescente , Adulto Joven , Conducta Sexual/psicología , Relaciones InterpersonalesRESUMEN
BACKGROUND: Research has linked stigma surrounding preexposure prophylaxis (PrEP) to poor HIV prevention outcomes, including PrEP adherence. However, there remains a limited understanding of the mechanisms through which PrEP stigma affects PrEP adherence, specifically among sexual and gender minority (SGM) youth. In this study, we aimed to investigate the indirect effect of PrEP stigma on PrEP adherence through PrEP confidence and the moderating role of anticipated HIV stigma. METHODS: Participants included 235 SGM youth, assigned male sex at birth, aged 16-24, and self-reported HIV-negative, with an active PrEP prescription from the Prepared, Protected, emPowered randomized controlled trial. Participants were recruited from 9 clinics in the United States between 2019 and 2021. Using baseline data, we tested cross-sectional indirect and conditional indirect effects using the Statistical Package for the Social Sciences Process with confidence intervals and 2000 resamples. RESULTS: We found significant indirect effects, suggesting that PrEP stigma was negatively associated with PrEP confidence, which in turn resulted in both monthly and weekly optimal PrEP adherence (Indirect effects: B = -0.11, Standard Error [SE] = 0.05, CI: [-0.244 to -0.032]; B = -0.09, SE = 0.04, CI: [-0.191 to -0.014], respectively). Anticipated HIV stigma moderated these indirect effects (B = -0.11, SE = 0.08, CI: [-0.315 to -0.001]; B = -0.09, SE = 0.06, CI: [-0.245 to -0.001], respectively), suggesting that the conditional indirect effects were significant at high but not low levels of anticipated HIV stigma. CONCLUSION: Results suggest that SGM youth who are on PrEP anticipating HIV stigma experience a compounding effect of PrEP stigma on PrEP confidence, consequently leading to suboptimal adherence. Interventions addressing the intersectionality of PrEP and HIV stigmas and enhancing confidence could improve PrEP adherence, particularly among SGM youth.
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Fármacos Anti-VIH , Infecciones por VIH , Cumplimiento de la Medicación , Profilaxis Pre-Exposición , Estigma Social , Humanos , Masculino , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Adolescente , Cumplimiento de la Medicación/psicología , Adulto Joven , Fármacos Anti-VIH/uso terapéutico , Estudios Transversales , Femenino , Minorías Sexuales y de Género/psicología , Estados UnidosRESUMEN
There is a long history of institutional and interpersonal stigma, violence, and oppression of sexual and gender minority (SGM) individuals in the United States and around the world. Structural and sociocultural factors have served to promote and justify criminalization, discrimination, and violence targeting SGM groups. This commentary provides a brief chronological summary of laws and policies that served to pathologize, oppress, and justify violence and discrimination; the evolution of academic study and understanding; activism aimed at changing laws, questioning pathologizing assumptions and practices, and protecting human rights; current challenges; and recommendations for policy, research, and practice. This commentary pays particular attention to the roles the Global Alliance for Behavioral Health and Social Justice and its journal, American Journal of Orthopsychiatry, have played to advocate for full recognition of the human rights of SGM individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Derechos Humanos , Minorías Sexuales y de Género , Humanos , Minorías Sexuales y de Género/psicología , Estados Unidos , Violencia/prevención & control , Estigma SocialRESUMEN
BACKGROUND: There is evidence youth in foster care may be vulnerable to commercial and sexual exploitation of children (CSEC) in the U.S. Youth in care may show vulnerabilities such as running away, identifying as sexual/gender minorities, or exhibiting complex behavioral and mental health needs. However, the nature and nuances of the relationship between CSEC and foster care placements has been largely unexamined. OBJECTIVES: This review explores the literature on trafficking among foster care youth to establish what is known about risk factors, vulnerable populations, and leverage points for prevention and intervention. METHODS: This scoping review was conducted using PRISMA-ScR guidelines. Eight databases were searched, and the screening process resulted in 16 final articles in the analysis. RESULTS: Sixteen articles were screened into the current study. In reviewing the content, a few distinct themes emerged. First, the articles focused on three different populations of CSEC youth. Second, there was variability in the definitions of CSEC used by scholars. Third, there was a range of terms used to describe youth who were trafficked. Finally, there were broad differences in study methodology. This included the data sources used and the array of outcomes explored (e.g. substance use, mental health diagnoses, housing stability). CONCLUSIONS: It is important for scholars to use common language and definitions when studying the sex trafficking of minors. Developing national databases and improving state and federal data sharing is needed to inform prevalence estimates and explore various pathways to youth experiencing CSEC.
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Abuso Sexual Infantil , Cuidados en el Hogar de Adopción , Trata de Personas , Humanos , Cuidados en el Hogar de Adopción/psicología , Adolescente , Estados Unidos/epidemiología , Niño , Trata de Personas/psicología , Trata de Personas/estadística & datos numéricos , Abuso Sexual Infantil/psicología , Abuso Sexual Infantil/estadística & datos numéricos , Poblaciones Vulnerables/psicología , Femenino , Factores de Riesgo , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Trabajo Sexual/psicología , Trabajo Sexual/estadística & datos numéricos , MasculinoRESUMEN
INTRODUCTION: Researchers predict long-term increases in suicide deaths following the COVID-19 pandemic. Little is known about risk factors for suicidal ideation (SI) and suicidal attempts (SA) or treatment barriers and promoters during the pandemic. We examine these factors in a young adult sample. METHODS: Analyses used a 2022 cross-sectional survey dataset (N = 1,956). Logistic regression identified factors associated with pandemic suicidality (i.e., SI, SA). Non-treatment seekers reported barriers to seeking treatment. Logistic regression identified promotive factors associated with treatment-seeking. RESULTS: 28.6 % of our sample developed suicidality during the pandemic, of whom 49.6 % did not seek treatment. Asian race and sexual minority status were strongly associated with increased odds of pandemic suicidality. Among SI non-treatment-seekers, barriers were primarily attitudinal (e.g., "symptoms are not serious enough for treatment"); among non-treatment-seekers with SA, barriers were mostly structural (e.g., insufficient funds). Previous depression treatment was strongly associated with increased odds of treatment-seeking. CONCLUSION: Asian American individuals were at increased risk for pandemic suicidality, which may reflect interpersonal risks related to COVID-19-related anti-Asian racism. Our findings point to a "foot-in-the-door" effect: past treatment-seeking was positively associated with future treatment-seeking. To promote this effect and decrease barriers, we suggest integrated mental health screening and referrals in primary care.
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COVID-19 , Aceptación de la Atención de Salud , Ideación Suicida , Intento de Suicidio , Humanos , COVID-19/psicología , COVID-19/epidemiología , Masculino , Femenino , Adulto Joven , Aceptación de la Atención de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud/psicología , Factores de Riesgo , Intento de Suicidio/estadística & datos numéricos , Intento de Suicidio/psicología , Estudios Transversales , Adulto , Adolescente , Asiático/psicología , Asiático/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricosRESUMEN
BACKGROUND: The study aimed to investigate the potential link between a history of childhood sexual abuse (CSA) and the experience of technology-facilitated sexual violence on dating apps (TFSV), considering distinct motivations for app usage among CSA survivors. OBJECTIVE: To explore the association between CSA and TFSV on dating apps, while also examining the potential moderating role of motivations for app usage and differences based on sexual orientation. PARTICIPANTS AND SETTING: The study utilized an online survey among 534 dating app users in Israel. METHODS: Participants completed an online survey assessing history of CSA, experiences of TFSV on dating apps, and motivations for app usage. RESULTS: The study found that individuals with a history of CSA experienced more TFSV on dating apps. Survivors of CSA showed lower motivation for love and higher motivation for self-worth validation, ease of communication, and thrill of excitement. Differences between heterosexual and LGBTQ+ participants were observed, with LGBTQ+ individuals reporting higher levels of CSA prevalence and TFSV on dating apps. Motivations for app usage and sexual orientation were found to moderate the association between CSA history and TFSV on dating apps. Among LGBTQ+ participants, those who experienced CSA had a higher likelihood of encountering TFSV on dating apps, regardless of their motivations. Heterosexual individuals with a history of CSA were more prone to TFSV on dating apps if they had a strong motivation for love. CONCLUSIONS: This study shed light on unique vulnerabilities among individuals with a history of CSA, including increased susceptibility to TFSV on dating apps.
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Aplicaciones Móviles , Motivación , Humanos , Femenino , Masculino , Adulto , Israel , Adulto Joven , Abuso Sexual Infantil/psicología , Niño , Encuestas y Cuestionarios , Adolescente , Adultos Sobrevivientes del Maltrato a los Niños/psicología , Persona de Mediana Edad , Delitos Sexuales/psicología , Minorías Sexuales y de Género/psicologíaRESUMEN
BACKGROUND: Pre-exposure prophylaxis (PrEP) to prevent HIV is severely underutilized among sexually minoritized men (SMM). Inequitable access to PrEP-prescribing facilities and providers is a critical barrier to PrEP uptake among SMM. Integrating HIV prevention services, such as PrEP screening, into pharmacy-based settings is a viable solution to addressing HIV inequities in the US. We aimed to examine willingness to obtain PrEP screening in a pharmacy and its associated correlates, leveraging Andersen's Healthcare Utilization Model (AHUM), among a national sample of SMM in the U.S. METHODS: Data from the 2020 American Men's Internet Survey, an annual online survey among SMM, were analyzed. Drawing on AHUM-related constructs, we used a modified stepwise Poisson regression with robust variance estimates to examine differences in willingness to screen for PrEP in a pharmacy. Estimated prevalence ratios (PR) were calculated with 95% confidence intervals (CI95%). RESULTS: Out of 10,816 men, most (76%) were willing to screen for PrEP in a pharmacy. Participants were more willing to screen for PrEP in a pharmacy if they (1) had a general willingness to use PrEP (PR = 1.52; CI95% =1.45, 1.59); (2) felt comfortable speaking with pharmacy staff about PrEP (PR = 2.71; CI95% =2.47, 2.98); and (3) had HIV-related concerns (PR = 1.04; CI95% =1.02, 1.06). There were no observed differences in men's willingness to screen for PrEP in a pharmacy by race/ethnicity, education level, annual household income, nor insurance status. CONCLUSIONS: Strategically offering PrEP screening in pharmacies could mitigate access-related barriers to HIV prevention services among SMM, particularly across various sociodemographic domains. Importantly, this approach has vitally important implications for addressing broader inequities in HIV prevention. Future studies should examine strategies to successfully integrate PrEP screenings in pharmacies among diverse populations, especially among those at elevated risk for HIV.
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Infecciones por VIH , Aceptación de la Atención de Salud , Profilaxis Pre-Exposición , Humanos , Masculino , Adulto , Profilaxis Pre-Exposición/estadística & datos numéricos , Infecciones por VIH/prevención & control , Infecciones por VIH/diagnóstico , Estados Unidos , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto Joven , Persona de Mediana Edad , Adolescente , Encuestas y Cuestionarios , Minorías Sexuales y de Género/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Tamizaje Masivo/estadística & datos numéricos , Farmacias/estadística & datos numéricosRESUMEN
Culture is a central theme across various theories and disciplines, influencing behavior and self-perception through interactions within social groups, families, and legal systems. This influence extends to the general population and particularly impacts sexual and gender minorities (SGMs), resulting in minority stress that contributes to mental health issues and the development of Early Maladaptive Schemas (EMSs). Adolescents within these groups face typical developmental stressors-such as hormonal changes and societal pressures-compounded by prejudice, increasing their vulnerability to depression, anxiety, stress, substance abuse, and eating disorders. Despite these challenges, Schema Therapy (ST) lacks comprehensive studies on the sociocultural aspects influencing EMS acquisition in SGM adolescents. This theoretical review aims to fill this gap by exploring the impact of society and culture on EMS development within SGM adolescents. We recognize the broad spectrum of cultural influences and emphasize the importance of cultural sensitivity and diversity. This review specifically addresses how societal and cultural dynamics impact SGM individuals, acknowledging that while ethnic or other cultural factors are not the focus of this paper, they merit future research. This manuscript will discuss central topics and their impact on LGBTQIA+ youth, including (1) the background (definition of culture, lack of studies on ST focusing on culture, and studies on adverse psychological outcomes), (2) minority stress theory and prejudice against sexual and gender diversity (distal and proximal stressors and sociocultural aspects), (3) EMSs and unmet emotional needs, (4) ST affirmative strategies (working with schema modes, imagery rescripting, chair work, and photo techniques), and (5) final considerations (limitations and research agenda).
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Minorías Sexuales y de Género , Humanos , Minorías Sexuales y de Género/psicología , Adolescente , Femenino , Masculino , Cultura , Estrés Psicológico/psicología , Adaptación PsicológicaRESUMEN
Queer young adults report significantly higher levels of anxiety and depression than their heterosexual counterparts, which is linked to sexual minority stress. Therefore, it is important to understand the coping strategies employed by this population to navigate minority stress and how coping strategies may impact mental health outcomes. Drawing from a U.S. national diverse sample of 387 queer young adults (ages 18-39 years), we analyzed descriptive results of 11 behavioral strategies to cope with minority stress and used ordered logistic and linear regression to examine the following objectives: the frequency of the use of each coping strategy, and the associations between each strategy and demographic characteristics as well as depression and anxiety. Results revealed that avoidance and talking with friends were the most frequently utilized coping strategies, while prayer/religious activities and counseling/psychotherapy/support groups were infrequently used. We examined utilization preferences of coping strategies across demographic factors (e.g., assigned sex at birth and sexual orientation). The use of counseling/psychotherapy/support group was positively associated with mental health symptoms, while exercise and mindfulness/mediation were associated with lower mental health symptoms. Our findings provide insights for mental health researchers and professionals in selecting appropriate coping strategies for queer young adults in prevention and intervention efforts.
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Adaptación Psicológica , Salud Mental , Minorías Sexuales y de Género , Estrés Psicológico , Humanos , Adulto Joven , Adulto , Masculino , Femenino , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Adolescente , Estrés Psicológico/psicología , Depresión/psicología , Depresión/epidemiología , Ansiedad/psicología , Ansiedad/epidemiología , Estados UnidosRESUMEN
Our study assessed the association between methamphetamine (i.e., crystal meth, CM) use and awareness and interest in event-driven (ED) PrEP among HIV-negative and those with unknown serostatus cisgender males and transgender people. We performed log-binomial regression analysis to predict awareness (i.e., having heard of ED PrEP) and being interested in ED PrEP. We found that participants who recently used CM were less likely to know of ED PrEP (aPR = 0.83, 95% CI [0.69, 0.99]) but more interested in ED PrEP (aPR = 1.12, 95% CI [1.01, 1.30]), after accounting for demographic and HIV-related behaviors. Opportunities to expand PrEP uptake and improve adherence among individuals who report CM use are essential to impact the HIV epidemic significantly. Continued research on the needs and best practices to work with this community is needed to ensure a successful rollout and implementation of ED PrEP.
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Infecciones por VIH , Conocimientos, Actitudes y Práctica en Salud , Metanfetamina , Profilaxis Pre-Exposición , Minorías Sexuales y de Género , Humanos , Masculino , Metanfetamina/administración & dosificación , Infecciones por VIH/prevención & control , Adulto , Minorías Sexuales y de Género/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Profilaxis Pre-Exposición/métodos , Fármacos Anti-VIH , Persona de Mediana Edad , Trastornos Relacionados con Anfetaminas/epidemiología , Trastornos Relacionados con Anfetaminas/psicología , Adulto Joven , Homosexualidad Masculina/estadística & datos numéricos , Homosexualidad Masculina/psicología , Aceptación de la Atención de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud/psicología , Personas Transgénero/estadística & datos numéricos , Personas Transgénero/psicología , AdolescenteRESUMEN
BACKGROUND: Sexual minority student-athletes (SMSAs) face discrimination and identity conflicts in intercollegiate sport, impacting their participation and mental health. This study explores the perceptions of Chinese SMSAs regarding their sexual minority identities, aiming to fill the current gap in research related to non-Western countries. METHODS: A qualitative methodology was adopted, utilising the Interpretive Phenomenological Analysis (IPA) approach with self-categorization theory as the theoretical framework. Participants were recruited through purposive and snowball sampling, and data were collected via semi-structured interviews, documents, and field notes. Sixteen former and current Chinese SMSAs participated in this study. RESULTS: The study reveals four themes: hidden truths, prioritisation of athlete identity, self-stereotyping, and attempt. The results revealed that while SMSAs were common in intercollegiate sport, their identities were often concealed and not openly discussed. The predominant focus on athlete identity in sport overshadowed their sexual minority identities. Additionally, SMSAs developed self-stereotypes that influenced their thoughts and behaviours. The non-heterosexual team atmosphere in women's teams led to the development of intimate relationships among teammates. CONCLUSIONS: The findings from this study could be incorporated into existing sport policies to ensure the safe participation of SMSAs in Chinese intercollegiate sports. This research offers valuable insights for the development and implementation of inclusive policies. Future research in China could investigate the attitudes of coaches and heterosexual student-athletes toward sexual minority identities to inform targeted interventions.
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Atletas , Investigación Cualitativa , Minorías Sexuales y de Género , Deportes , Estudiantes , Humanos , China , Femenino , Minorías Sexuales y de Género/psicología , Masculino , Atletas/psicología , Adulto Joven , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Deportes/psicología , Adulto , Adolescente , EstereotipoRESUMEN
BACKGROUND: The mpox outbreak resulted in 32,063 cases and 58 deaths in the United States and 95,912 cases worldwide from May 2022 to March 2024 according to the US Centers for Disease Control and Prevention (CDC). Like other disease outbreaks (eg, HIV) with perceived community associations, mpox can create the risk of stigma, exacerbate homophobia, and potentially hinder health care access and social equity. However, the existing literature on mpox has limited representation of the perspective of sexual minority men and gender-diverse (SMMGD) individuals. OBJECTIVE: To fill this gap, this study aimed to synthesize themes of discussions among SMMGD individuals and listen to SMMGD voices for identifying problems in current public health communication surrounding mpox to improve inclusivity, equity, and justice. METHODS: We analyzed mpox-related posts (N=8688) posted between October 2020 and September 2022 by 2326 users who self-identified on Twitter/X as SMMGD and were geolocated in the United States. We applied BERTopic (a topic-modeling technique) on the tweets, validated the machine-generated topics through human labeling and annotations, and conducted content analysis of the tweets in each topic. Geographic analysis was performed on the size of the most prominent topic across US states in relation to the University of California, Los Angeles (UCLA) lesbian, gay, and bisexual (LGB) social climate index. RESULTS: BERTopic identified 11 topics, which annotators labeled as mpox health activism (n=2590, 29.81%), mpox vaccination (n=2242, 25.81%), and adverse events (n=85, 0.98%); sarcasm, jokes, and emotional expressions (n=1220, 14.04%); COVID-19 and mpox (n=636, 7.32%); government or public health response (n=532, 6.12%); mpox symptoms (n=238, 2.74%); case reports (n=192, 2.21%); puns on the naming of the virus (ie, mpox; n=75, 0.86%); media publicity (n=59, 0.68%); and mpox in children (n=58, 0.67%). Spearman rank correlation indicated significant negative correlation (ρ=-0.322, P=.03) between the topic size of health activism and the UCLA LGB social climate index at the US state level. CONCLUSIONS: Discussions among SMMGD individuals on mpox encompass both utilitarian (eg, vaccine access, case reports, and mpox symptoms) and emotionally charged (ie, promoting awareness, advocating against homophobia, misinformation/disinformation, and health stigma) themes. Mpox health activism is more prevalent in US states with lower LGB social acceptance, suggesting a resilient communicative pattern among SMMGD individuals in the face of public health oppression. Our method for social listening could facilitate future public health efforts, providing a cost-effective way to capture the perspective of impacted populations. This study illuminates SMMGD engagement with the mpox discourse, underscoring the need for more inclusive public health programming. Findings also highlight the social impact of mpox: health stigma. Our findings could inform interventions to optimize the delivery of informational and tangible health resources leveraging computational mixed-method analyses (eg, BERTopic) and big data.
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Minorías Sexuales y de Género , Medios de Comunicación Sociales , Humanos , Masculino , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Medios de Comunicación Sociales/estadística & datos numéricos , Estados Unidos/epidemiología , FemeninoRESUMEN
Objectives. To explore the extent to which structural stigma (sociocultural and institutional constraining factors) is associated with sexual orientation disparities in long-term health conditions. Methods. We measured structural stigma using the regional percentage of votes against same-sex marriage from Australia's 2017 Marriage Equality Survey and mapped this to the 2021 Census survey of 10 093 399 and 136 988 individuals in different-sex and same-sex relationships, respectively. Controlling for individual and area-level confounders, we used logistic regression analyses to examine the association between quartiles of structural stigma and sexual orientation disparities in long-term health conditions (e.g., any, mental health, asthma, cardiovascular). Results. In the lowest stigma quartile, individuals in same-sex relationships had 56% higher odds of reporting any long-term health condition (odds ratio [OR] = 1.56; 95% confidence interval [CI] = 1.53, 1.59) and this increased to 63% in the highest stigma quartile (OR = 1.63; 95% CI = 1.58, 1.68). Effects were particularly pronounced for cardiovascular, respiratory, and mental health conditions as well as for men, younger populations, and those living in socioeconomically deprived regions. Conclusions. Living in stigmatizing environments may have deleterious health effects for sexual minorities in Australia. Policy action and enhanced protections for sexual minorities are urgently required. (Am J Public Health. 2024;114(10):1110-1122. https://doi.org/10.2105/AJPH.2024.307759).
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Disparidades en el Estado de Salud , Estigma Social , Humanos , Australia , Masculino , Femenino , Adulto , Persona de Mediana Edad , Censos , Anciano , Adolescente , Adulto Joven , Homosexualidad/estadística & datos numéricos , Homosexualidad/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Factores Socioeconómicos , Pueblos de AustralasiaRESUMEN
BACKGROUND: Sexual and gender minority (SGM) young people are disproportionately affected by HIV in the United States, and substance use is a major driver of new infections. People who use web-based venues to meet sex partners are more likely to report substance use, sexual risk behaviors, and sexually transmitted infections. To our knowledge, no machine learning (ML) interventions have been developed that use web-based and digital technologies to inform and personalize HIV and substance use prevention efforts for SGM young people. OBJECTIVE: This study aims to test the acceptability, appropriateness, and feasibility of the uTECH intervention, a SMS text messaging intervention using an ML algorithm to promote HIV prevention and substance use harm reduction among SGM people aged 18 to 29 years who have sex with men. This intervention will be compared to the Young Men's Health Project (YMHP) alone, an existing Centers for Disease Control and Prevention best evidence intervention for young SGM people, which consists of 4 motivational interviewing-based counseling sessions. The YMHP condition will receive YMHP sessions and will be compared to the uTECH+YMHP condition, which includes YMHP sessions as well as uTECH SMS text messages. METHODS: In a study funded by the National Institutes of Health, we will recruit and enroll SGM participants (aged 18-29 years) in the United States (N=330) to participate in a 12-month, 2-arm randomized comparison trial. All participants will receive 4 counseling sessions conducted over Zoom (Zoom Video Communications, Inc) with a master's-level social worker. Participants in the uTECH+YMHP condition will receive curated SMS text messages informed by an ML algorithm that seek to promote HIV and substance use risk reduction strategies as well as undergoing YMHP counseling. We hypothesize that the uTECH+YMHP intervention will be considered acceptable, appropriate, and feasible to most participants. We also hypothesize that participants in the combined condition will experience enhanced and more durable reductions in substance use and sexual risk behaviors compared to participants receiving YMHP alone. Appropriate statistical methods, models, and procedures will be selected to evaluate primary hypotheses and behavioral health outcomes in both intervention conditions using an α<.05 significance level, including comparison tests, tests of fixed effects, and growth curve modeling. RESULTS: This study was funded in August 2019. As of June 2024, all participants have been enrolled. Data analysis has commenced, and expected results will be published in the fall of 2025. CONCLUSIONS: This study aims to develop and test the acceptability, appropriateness, and feasibility of uTECH, a novel approach to reduce HIV risk and substance use among SGM young adults. TRIAL REGISTRATION: ClinicalTrials.gov NCT04710901; https://clinicaltrials.gov/study/NCT04710901. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58448.
Asunto(s)
Infecciones por VIH , Homosexualidad Masculina , Aprendizaje Automático , Minorías Sexuales y de Género , Humanos , Masculino , Infecciones por VIH/prevención & control , Infecciones por VIH/epidemiología , Minorías Sexuales y de Género/psicología , Adulto Joven , Adolescente , Homosexualidad Masculina/psicología , Adulto , Envío de Mensajes de Texto , Femenino , Estados Unidos/epidemiologíaRESUMEN
Although parents of sexual and gender minority (SGM) adolescents play a critical role in communicating about sexual health to their children, most parents have reported that they are unknowledgeable and uncomfortable talking about sexual health to their SGM adolescent. Because of the limited availability of sex education programs for parents of SGM adolescents, the study aimed to (1) describe the attitudes toward using and willingness to use a hypothetical online sex communication intervention for parents of SGM adolescents and (2) examine factors associated with willingness to use such an intervention. Parents of SGM adolescents from across the United States (N = 385) completed an online survey from March 10-16, 2023. Most participants were open to participating in a hypothetical online sex communication program and had positive attitudes toward it. Logistic regression results showed that participants who overall agreed a hypothetical online parent-based sex education intervention would be helpful and of interest had higher odds of being overall willing to participate in such a hypothetical intervention. Additionally, participants with higher income levels were also more likely to be willing to participate in a hypothetical program. Results from this exploratory study suggest that most parents of SGM adolescents have positive attitudes toward a hypothetical online parent-based sex education program and are willing to participate in it, highlighting a need to develop sex education programs tailored to the needs and preferences of parents of SGM adolescents. Additionally, equitable access to such programs is necessary especially regarding income level.
Asunto(s)
Padres , Educación Sexual , Minorías Sexuales y de Género , Humanos , Masculino , Femenino , Minorías Sexuales y de Género/psicología , Adolescente , Educación Sexual/métodos , Padres/psicología , Adulto , Comunicación , Encuestas y Cuestionarios , Estados Unidos , Persona de Mediana Edad , Relaciones Padres-Hijo , Internet , Conducta Sexual/psicologíaRESUMEN
BACKGROUND: Ecological momentary assessment (EMA) studies have begun to establish links between sexual minority enacted stigma and anxious/depressed affect at the daily level. However, few of these studies have examined the effects of the unique stigma experienced by transgender and gender diverse (TGD) people. Further, the potential moderating roles of emotion regulation strategies (i.e., strategies used to up- or down-regulate emotions) and coping self-efficacy (i.e., individuals' perceptions of their ability to cope effectively with stressors) have been neglected in EMA research on enacted stigma. METHODS: The current study aimed to extend this literature by examining the moderating roles of six emotion regulation strategies (i.e., reflection, reappraisal, rumination, expressive suppression, distraction, social sharing) and coping self-efficacy on concurrent and prospective associations between TGD enacted stigma and affect using EMA data from 115 sexual minority gender diverse individuals assigned female at birth. RESULTS: Results indicated that coping self-efficacy buffered prospective associations between TGD enacted stigma and anxious/depressed affect, while rumination exacerbated these effects. Some unexpected buffering effects were identified in concurrent associations between enacted stigma and negative affect, with suppression and distraction temporarily tempering this association. However, suppression also prospectively predicted increases in negative affect, suggesting that any benefit of this emotion regulation strategy is temporary. CONCLUSIONS: Findings highlight emotion regulation strategies that may be effective in reducing negative affect, identify coping self-efficacy as a promising buffer of effects of enacted stigma, and confirm emotion regulation strategies that may exacerbate effects of enacted stigma.