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Bränström R, van der Star A, Pachankis JE. Untethered lives: barriers to societal integration as predictors of the sexual orientation disparity in suicidality. Soc Psychiatry Psychiatr Epidemiol 2020; 55:89-99. [PMID: 31300892 DOI: 10.1007/s00127-019-01742-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 06/24/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Despite increasing legal protections and supportive attitudes toward sexual minorities (e.g., those who identify as lesbian, gay, and bisexual [LGB]) in recent decades, suicidality remains more common among this population than among heterosexuals. While barriers to societal integration-or a lack of meaning, purpose, and belonging as derived from societal norms, goals, and attachment-have been widely theorized as determinants of suicidality for the general population, they have not been comprehensively explored to explain the sexual orientation disparity in suicidality. The aim of this study was to examine differences in suicidal ideation and attempts between LGB and heterosexual individuals in a nationally representative sample, and to examine barriers to societal integration as a potential explanation for any observed disparities over-and-above the influence of established contributors to sexual orientation disparity in suicidality. METHODS Data come from the cross-sectional Swedish National Public Health Survey, which collected data from unrestricted random samples of individuals (16-84 years of age) living in Sweden, annually from 2010 to 2015 (n = 57,840 individuals [response rates: 48.1-51.3%]; 1281 (2.2%) self-identified as LGB). Analyses examined sexual orientation differences in suicidality (i.e., past-12-month ideation and attempts), and explored the role of barriers to societal integration (i.e., not living with a partner or children, unemployment, and lack of societal trust) in explaining this disparity over-and-above more commonly explored psychological (e.g., depression, substance use) and interpersonal (e.g., discrimination, victimization, lack of social support) suicidality risk factors. RESULTS Compared to heterosexuals, suicidal ideation and attempts were more common among both gay men/lesbians (adjusted odds ratio [AOR] for suicide ideation: 2.69; 95% confidence intervals [CI]: 2.09, 3.47; AOR for suicide attempts: 5.50; 95% CI: 3.42, 8.83), and bisexuals (AOR for suicide ideation: 3.83; 95% CI: 3.26, 4.51; AOR suicide attempts: 6.78; 95% CI: 4.97, 9.24). Barriers to societal integration mediated the association between sexual orientation and suicidality even in models adjusting for established risk factors for suicidality. CONCLUSION Our results suggest that previously under-examined factors, namely the disproportionate barriers to societal integration that LGB individuals experience, are important contributors to the substantially elevated risk of suicidality among sexual minorities. Preventive interventions should consider innovative ways to foster societal integration within sexual minority populations and to adjust hetero-centric social institutions to better include sexual minority individuals.
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Affiliation(s)
- Richard Bränström
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA. .,Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77, Stockholm, Sweden.
| | - Arjan van der Star
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA.,Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77, Stockholm, Sweden
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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2
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Scheer JR, McConocha E, Behari K, Pachankis JE. Sexual violence as a mediator of sexual orientation disparities in alcohol use, suicidality, and sexual-risk behaviour among female youth. PSYCHOLOGY & SEXUALITY 2019; 12:37-51. [PMID: 33981383 DOI: 10.1080/19419899.2019.1690031] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Sexual violence exposure represents a serious public health issue among female youth given its association with female youths' engagement in health-risk behaviours. Sexual minority female youth are particularly vulnerable to sexual violence exposure, alcohol use, suicidality, and sexual-risk behaviour. Using the population-based 2017 Youth Risk Behaviour Survey, we examined sexual violence as a mediator of sexual orientation disparities in health-risk behaviours among female youth. This study included 7,532 female students in grades 9 through 12 across the US. Participants identified their sexual orientation as heterosexual (73.5%); bisexual (12.2%); and, gay or lesbian (2.2%). Compared to heterosexual female youth, sexual violence exposure, alcohol use, binge drinking, and multiple sex partners were more common among bisexual female youth. The elevated risk of suicidality was most notable among gay or lesbian female youth relative to heterosexual female youth and bisexual female youth relative to heterosexual female youth. Mediation analyses showed that sexual violence exposure partially explained the sexual orientation disparity in these co-occurring health-risk behaviours between bisexual female youth and heterosexual female youth. Our findings highlight the need for clinical attention to be paid to assessing and treating the health effects of sexual violence, especially among bisexual female youth.
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Affiliation(s)
- Jillian R Scheer
- Center for Interdisciplinary Research on AIDS, Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Erin McConocha
- Department of Social & Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Kriti Behari
- Department of Social & Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - John E Pachankis
- Department of Social & Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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3
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Dyar C, Taggart TC, Rodriguez-Seijas C, Thompson RG, Elliott JC, Hasin DS, Eaton NR. Physical Health Disparities Across Dimensions of Sexual Orientation, Race/Ethnicity, and Sex: Evidence for Increased Risk Among Bisexual Adults. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:225-242. [PMID: 29633061 PMCID: PMC6382069 DOI: 10.1007/s10508-018-1169-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 12/16/2017] [Accepted: 01/31/2018] [Indexed: 05/18/2023]
Abstract
Accumulating evidence suggests that sexual minority individuals are at increased risk for physical health conditions compared to heterosexual individuals. However, we know little about physical health disparities affecting bisexual individuals, a population at increased risk for psychiatric and substance use conditions compared to both heterosexual and lesbian/gay populations. Using a large, nationally representative sample, we examined physical health disparities for bisexual individuals. To advance research on sexual minority health disparities, we further: (1) compared prevalence rates of physical health conditions across three dimensions of sexual orientation (i.e., identity, attractions, behavior) and (2) examined whether disparities differed by sex and race/ethnicity. Results indicated that sexual minority individuals were at increased risk for many physical health conditions. Notably, individuals with bisexual identity, attractions, and/or behavior were at increased risk for more physical health conditions than other sexual minority groups. The number and types of physical health disparities affecting bisexually identified individuals and individuals with same- and opposite-sex attractions and/or sexual partners varied across sex and race/ethnicity, with the most consistent disparities emerging for individuals who reported same- and opposite-sex sexual partners. Our findings highlight the substantial physical health disparities affecting sexual minorities and the heightened risk conferred by all facets of bisexuality.
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Affiliation(s)
- Christina Dyar
- Department of Psychology, University of Cincinnati, Cincinnati, OH, 45221, USA.
| | - Tenille C Taggart
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | | | - Ronald G Thompson
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jennifer C Elliott
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Deborah S Hasin
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
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Sabia JJ, Wooden M, Nguyen TT. Sexual identity, same-same relationships, and health dynamics: New evidence from Australia. ECONOMICS AND HUMAN BIOLOGY 2018; 30:24-36. [PMID: 29886348 DOI: 10.1016/j.ehb.2018.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 02/07/2018] [Accepted: 02/08/2018] [Indexed: 06/08/2023]
Abstract
Prior research has found that opposite-sex marital and cohabiting relationships are associated with improvements in health. However, studies examining the health dynamics of same-sex relationships are sparser because few nationally representative longitudinal datasets collect information on adults' sexual identity. Using newly available data on sexual minorities from the Household, Income and Labour Dynamics in Australia (HILDA) Survey, we estimate the effects of Lesbian/Gay/Bisexual (LGB) identification and same-sex relationships on health dynamics. We document two key findings. First, sexual minorities in Australia are more likely to engage in risky health behaviors and report worse health than their heterosexual counterparts. Second, after exploiting the longitudinal nature of the HILDA and accounting for selection into relationships using the dynamic panel approach of Kohn and Averett (2014), we find that while opposite-sex partnerships are associated with a 3 to 7 percentage-point decline in risky health behaviors and improved physical and mental health, the health benefits of same-sex relationships are weaker, particularly for men.
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Affiliation(s)
- Joseph J Sabia
- San Diego State University, University of New Hampshire & IZA, United States.
| | - Mark Wooden
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne & IZA, Australia
| | - Thanh Tam Nguyen
- Department of Economics, University of New Hampshire, United States
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5
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Bränström R, Hatzenbuehler ML, Tinghög P, Pachankis JE. Sexual orientation differences in outpatient psychiatric treatment and antidepressant usage: evidence from a population-based study of siblings. Eur J Epidemiol 2018; 33:591-599. [PMID: 29766438 PMCID: PMC5995973 DOI: 10.1007/s10654-018-0411-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 05/11/2018] [Indexed: 11/05/2022]
Abstract
In the past two decades, population-based health surveys have begun including measures of sexual orientation, permitting estimates of sexual orientation disparities in psychiatric morbidity and differences in treatment utilization. The present study takes advantage of the high-quality, comprehensive nationwide health registry data available in Sweden to examine whether psychiatric outpatient treatment for various diagnoses and antidepressant medication usage are greater in sexual minority individuals compared to their siblings. A longitudinal cohort study design was used with a representative random population-based sample in Stockholm, Sweden. Registry-based health record data on all specialized outpatient health care visits and prescription drug use was linked to a sample of 1154 sexual minority individuals from the Stockholm Public Health Cohort and their siblings. The main outcomes were treatment due to psychiatric diagnoses retrieved from nationwide registry-based health records. In analyses accounting for dependency between siblings, gay men/lesbians had a greater likelihood of being treated for mood disorder [adjusted odds ratio (AOR) 1.77; 99% confidence intervals (CI) 1.00, 3.16] and being prescribed antidepressants (AOR 1.51; 99% CI 1.10, 2.07) compared to their siblings. Further, bisexual individuals had a greater likelihood of any outpatient psychiatric treatment (AOR 1.69; 99% CI 1.17, 2.45) and being prescribed antidepressants (AOR 1.48; 99% CI 1.07, 2.05) as well as a greater likelihood of being treated for a mood disorder (AOR 1.98; 99% CI 1.33, 2.95) compared to their siblings. No difference in anxiety or substance use disorder treatment was found between any sexual minority subgroup and their siblings. The potential role of familial confounding in psychiatric disorder treatment was not supported for more than half of the outcomes that were examined. Results suggest that sexual minority individuals are significantly more likely to be treated for certain psychiatric disorders compared to their siblings. Future research is needed to understand mechanisms other than familial factors that might cause the substantial treatment differences based on sexual orientation reported here.
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Affiliation(s)
- Richard Bränström
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College St., Suite 316, New Haven, CT, 06520, USA. .,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | | | - Petter Tinghög
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health and Medicine, Red Cross University College, Stockholm, Sweden
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College St., Suite 316, New Haven, CT, 06520, USA
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Simpson G, Simons-Coghill M, Bates A, Gan C. What is known about sexual health after pediatric acquired brain injury: A scoping review. NeuroRehabilitation 2018; 41:261-280. [PMID: 28946589 DOI: 10.3233/nre-172197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Positive sexual development is a core task in the transition from childhood/adolescence to adulthood. Little is known about the extent of research addressing this topic after acquired brain injury (ABI). OBJECTIVE To identify publications (1980 to 2016) addressing positive sexual health among children/adolescents with ABI. METHODS A scoping review. RESULTS A search conducted using OVID and PubMed databases yielded 2021 citations with 28 publications meeting the inclusion criteria (six reviews, one expert account, 19 observational and two intervention studies). Teenagers with ABI reported poorer body image, feeling less sexually or physically attractive than sex and age matched non brain-damaged controls. The one study with findings on sexual orientation, reported 15% of adolescents with ABI identified as lesbian, gay or bisexual. Precocious puberty was a rare outcome from ABI, but the most common focus of the publications (14/28). Finally, two case studies (genital touching and classroom masturbation respectively) found that behavioral interventions were an effective means of extinguishing inappropriate sexual behaviour after childhood ABI. CONCLUSIONS Sexual health is a neglected area of research in post-ABI care for children/adolescents. A better understanding of the needs and challenges will help rehabilitation professionals and parents provide more informed and effective supports.
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Affiliation(s)
- Grahame Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, Sydney, NSW, Australia.,John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney School of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Martine Simons-Coghill
- Brain Injury Service, Kids Rehab, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | | | - Caron Gan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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7
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Bränström R, Pachankis JE. Sexual orientation disparities in the co-occurrence of substance use and psychological distress: a national population-based study (2008-2015). Soc Psychiatry Psychiatr Epidemiol 2018; 53:403-412. [PMID: 29450600 PMCID: PMC5862943 DOI: 10.1007/s00127-018-1491-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 01/24/2018] [Indexed: 01/04/2023]
Abstract
PURPOSE Although strong evidence documents the elevated prevalence of both substance use and mental health problems among sexual minorities (i.e., gay, lesbian, and bisexuals), relatively less research has examined whether risk of the co-occurrence of these factors is elevated among sexual minorities compared to heterosexuals. The object of this study was to (1) explore sexual orientation-based differences in substance use, psychological distress, and their co-occurrence in a representative sample in Sweden, and (2) examine if greater exposure to stressors, such as discrimination, victimization/threats, and social isolation, could explain these potential disparities and their co-occurrence. METHODS Data come from the cross-sectional Swedish National Public Health Survey, which collected random samples of individuals (16-84 years of age) annually from 2008 to 2015, with an overall response rate of 49.7% (n = 79,568 individuals; 1673 self-identified as lesbian, gay, or bisexual). Population-level sexual orientation differences in substance use (i.e., alcohol, tobacco, and cannabis) and psychological distress were examined. RESULTS Our findings showed significantly elevated prevalence of high-risk alcohol use, cannabis use, and daily tobacco smoking, among sexual minorities compared to heterosexuals. These substantial disparities in substance use more often co-occurred with psychological distress among sexual minorities than among heterosexuals. The elevated risk of co-occurring psychological distress and substance use was most notable among gay men relative to heterosexual men (adjusted odds ratio [AOR] = 2.65, CI 1.98, 3.55), and bisexual women relative to heterosexual women (AOR = 3.01, CI 2.43, 3.72). Multiple mediation analyses showed that experiences of discrimination, victimization, and social isolation partially explained the sexual orientation disparity in these co-occurring problems. CONCLUSIONS This study adds to a growing body of research showing that sexual minorities experience multiple threats to optimal health and points toward future interventions that address the shared sources of these overlapping health threats in stigma-related stress.
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Affiliation(s)
- Richard Bränström
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA.
- Department of Clinical Neuroscience, Karolinska Institutet, Nobels väg 9, 171 77, Stockholm, Sweden.
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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8
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Camperio Ciani A, Battaglia U, Cesare L, Camperio Ciani G, Capiluppi C. Possible Balancing Selection in Human Female Homosexuality. HUMAN NATURE-AN INTERDISCIPLINARY BIOSOCIAL PERSPECTIVE 2017; 29:14-32. [DOI: 10.1007/s12110-017-9309-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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9
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Howard RM, Perilloux C. Is mating psychology most closely tied to biological sex or preferred partner's sex? PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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10
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Wang J, Yu X, Tessmer HL, Kuniya T, Omori R. Modelling infectious diseases with relapse: a case study of HSV-2. Theor Biol Med Model 2017; 14:13. [PMID: 28716140 PMCID: PMC5512781 DOI: 10.1186/s12976-017-0059-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 06/28/2017] [Indexed: 11/10/2022] Open
Abstract
Background Herpes Simplex Virus Type 2 (HSV-2) is one of the most common sexually transmitted diseases. Although there is still no licensed vaccine for HSV-2, a theoretical investigation of the potential effects of a vaccine is considered important and has recently been conducted by several researchers. Although compartmental mathematical models were considered for each special case in the previous studies, as yet there are few global stability results. Results In this paper, we formulate a multi-group SVIRI epidemic model for HSV-2, which enables us to consider the effects of vaccination, of waning vaccine immunity, and of infection relapse. Since the number of groups is arbitrary, our model can be applied to various structures such as risk, sex, and age group structures. For our model, we define the basic reproduction number ℜ0 and prove that if ℜ0≤1, then the disease-free equilibrium is globally asymptotically stable, whereas if ℜ0>1, then the endemic equilibrium is so. Based on this global stability result, we estimate ℜ0 for HSV-2 by applying our model to the risk group structure and using US data from 2001 to 2014. Through sensitivity analysis, we find that ℜ0 is approximately in the range of 2-3. Moreover, using the estimated parameters, we discuss the optimal vaccination strategy for the eradication of HSV-2. Conclusions Through discussion of the optimal vaccination strategy, we come to the following conclusions. (1) Improving vaccine efficacy is more effective than increasing the number of vaccines. (2) Although the transmission risk in female individuals is higher than that in male individuals, distributing the available vaccines almost equally between female and male individuals is more effective than concentrating them within the female population.
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Affiliation(s)
- Jinliang Wang
- School of Mathematical Science, Heilongjiang University, Harbin, 150080, People's Republic of China
| | - Xiaoqing Yu
- School of Mathematical Science, Heilongjiang University, Harbin, 150080, People's Republic of China
| | - Heidi L Tessmer
- Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, 001-0020, Japan
| | - Toshikazu Kuniya
- Department of Applied Mathematics, Graduate School of System Informatics, Kobe University, 1-1 Rokkodai-cho, Nada-ku, Kobe, 657-8501, Japan.
| | - Ryosuke Omori
- Division of Bioinformatics, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, 001-0020, Japan.,JST, PRESTO, 4-1-8 Honcho, Kawaguchi, Saitama, 332-0012, Japan
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11
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Anderssen N, Malterud K. Oversampling as a methodological strategy for the study of self-reported health among lesbian, gay and bisexual populations. Scand J Public Health 2017; 45:637-646. [PMID: 28675963 DOI: 10.1177/1403494817717407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS Epidemiological research on lesbian, gay and bisexual populations raises concerns regarding self-selection and group sizes. The aim of this research was to present strategies used to overcome these challenges in a national population-based web survey of self-reported sexual orientation and living conditions-exemplified with a case of daily tobacco smoking. METHODS The sample was extracted from pre-established national web panels. Utilizing an oversampling strategy, we established a sample including 315 gay men, 217 bisexual men, 789 heterosexual men, 197 lesbian women, 405 bisexual women and 979 heterosexual women. We compared daily smoking, representing three levels of differentiation of sexual orientation for each gender. RESULTS The aggregation of all non-heterosexuals into one group yielded a higher odds ratio (OR) for non-heterosexuals being a daily smoker. The aggregation of lesbian and bisexual women indicated higher OR between this group and heterosexual women. The full differentiation yielded no differences between groups except for bisexual compared with heterosexual women. CONCLUSIONS The analyses demonstrated the advantage of differentiation of sexual orientation and gender, in this case bisexual women were the main source of group differences. We recommend an oversampling procedure, making it possible to avoid self-recruitment and to increase the transferability of findings.
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Affiliation(s)
- Norman Anderssen
- 1 Research Unit for General Practice, Uni Health Research, Bergen, Norway.,2 Department of Psychosocial Science, University of Bergen, Norway
| | - Kirsti Malterud
- 1 Research Unit for General Practice, Uni Health Research, Bergen, Norway.,3 Department of Global Public Health and Primary Care, University of Bergen, Norway.,4 The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark
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12
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Greaves LM, Barlow FK, Lee CHJ, Matika CM, Wang W, Lindsay CJ, Case CJB, Sengupta NK, Huang Y, Cowie LJ, Stronge S, Storey M, De Souza L, Manuela S, Hammond MD, Milojev P, Townrow CS, Muriwai E, Satherley N, Fraser G, West-Newman T, Houkamau C, Bulbulia J, Osborne D, Wilson MS, Sibley CG. The Diversity and Prevalence of Sexual Orientation Self-Labels in a New Zealand National Sample. ARCHIVES OF SEXUAL BEHAVIOR 2017; 46:1325-1336. [PMID: 27686089 DOI: 10.1007/s10508-016-0857-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 09/03/2016] [Accepted: 09/06/2016] [Indexed: 06/06/2023]
Abstract
In this study, we asked participants to "describe their sexual orientation" in an open-ended measure of self-generated sexual orientation. The question was included as part of the New Zealand Attitudes and Values Study (N = 18,261) 2013/2014 wave, a national probability survey conducted shortly after the first legal same-sex marriages in New Zealand. We present a two-level classification scheme to address questions about the prevalence of, and demographic differences between, sexual orientations. At the most detailed level of the coding scheme, 49 unique categories were generated by participant responses. Of those who responded with the following, significantly more were women: bisexual (2.1 % of women, compared to 1.5 % of men), bicurious (0.7 % of women, 0.4 % of men), and asexual (0.4 % of women and less than 0.1 % of men). However, significantly fewer women than men reported being lesbian or gay (1.8 % of women, compared to 3.5 % of men). Those openly identifying as bicurious, bisexual, or lesbian/gay were significantly younger than those with a heterosexual orientation. This study shows diversity in the terms used in self-generated sexual orientations, and provides up-to-date gender, age, and prevalence estimates for the New Zealand population. Finally, results reveal that a substantial minority of participants may not have understood the question about sexual orientation.
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Affiliation(s)
- Lara M Greaves
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| | - Fiona Kate Barlow
- School of Applied Psychology and Menzies Health Institute, Griffith University, Mount Gravatt, QLD, Australia
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Carol H J Lee
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Correna M Matika
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Weiyu Wang
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Cinnamon-Jo Lindsay
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Claudia J B Case
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Nikhil K Sengupta
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Yanshu Huang
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Lucy J Cowie
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Samantha Stronge
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Mary Storey
- Department of Psychology, California State University, Bakersfield, CA, USA
| | - Lucy De Souza
- Department of Psychology, Wesleyan University, Middletown, CT, USA
| | - Sam Manuela
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Matthew D Hammond
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Petar Milojev
- School of Psychology, Massey University, Auckland, New Zealand
| | - Carly S Townrow
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Emerald Muriwai
- Te Rōpū Whāriki, College of Health, Massey University, Auckland, New Zealand
| | - Nicole Satherley
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Gloria Fraser
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Tim West-Newman
- Ngā Pae o te Māramatanga, University of Auckland, Auckland, New Zealand
| | - Carla Houkamau
- Department of Management and International Business, University of Auckland, Auckland, New Zealand
| | - Joseph Bulbulia
- School of Art History, Classics, and Religious Studies, Victoria University of Wellington, Wellington, New Zealand
| | - Danny Osborne
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Marc S Wilson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Chris G Sibley
- School of Psychology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
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13
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Marrazzo JM, Koutsky LA, Handsfield HH. Characteristics of female sexually transmitted disease clinic clients who report same-sex behaviour. Int J STD AIDS 2017. [DOI: 10.1177/095646240101200108] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Female STD clinic clients were categorized by report of sex partners' gender in the preceding 2 months and characterized with respect to HIV risk and STD diagnosis. Among 18,585 visits, 290 women (1.5%) reported sex exclusively with women, and 841 (4.5%) reported sex with both men and women. Relative to women reporting sex only with men, those reporting sex with both men and women reported more recent partners, sex with partners at high risk for HIV, injection drug and crack cocaine use, and exchange of sex for drugs or money. Women reporting sex exclusively with women more frequently reported prior sex with a bisexual man or an HIV-infected partner. Female STD clinic clients who report sex with both men and women may be at increased HIV risk relative to women reporting sex exclusively with men, and women who report sex only with women may be more likely to have had sex with men at high risk for HIV infection.
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Affiliation(s)
- Jeanne M Marrazzo
- Departments of Medicine, Seattle and King County Seattle, Washington, USA
| | - Laura A Koutsky
- Departments of Epidermiology, Seattle and King County Seattle, Washington, USA
| | - H Hunter Handsfield
- Departments of Public Health, Seattle and King County Seattle, Washington, USA
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14
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David-Barrett T, Kertesz J, Rotkirch A, Ghosh A, Bhattacharya K, Monsivais D, Kaski K. Communication with Family and Friends across the Life Course. PLoS One 2016; 11:e0165687. [PMID: 27893748 PMCID: PMC5156499 DOI: 10.1371/journal.pone.0165687] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 10/03/2016] [Indexed: 11/22/2022] Open
Abstract
Each stage of the human life course is characterised by a distinctive pattern of
social relations. We study how the intensity and importance of the closest
social contacts vary across the life course, using a large database of mobile
communication from a European country. We first determine the most likely social
relationship type from these mobile phone records by relating the age and gender
of the caller and recipient to the frequency, length, and direction of calls. We
then show how communication patterns between parents and children, romantic
partner, and friends vary across the six main stages of the adult family life
course. Young adulthood is dominated by a gradual shift of call activity from
parents to close friends, and then to a romantic partner, culminating in the
period of early family formation during which the focus is on the romantic
partner. During middle adulthood call patterns suggest a high dependence on the
parents of the ego, who, presumably often provide alloparental care, while at
this stage female same-gender friendship also peaks. During post-reproductive
adulthood, individuals and especially women balance close social contacts among
three generations. The age of grandparenthood brings the children entering
adulthood and family formation into the focus, and is associated with a
realignment of close social contacts especially among women, while the old age
is dominated by dependence on their children.
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Affiliation(s)
- Tamas David-Barrett
- Universidad del Desarrollo, Facultad de Gobierno, San Carlos de
Apoquindo, Las Condes, Santiago de Chile, Chile
- Kiel Institute for the World Economy, Kiel, Germany
- Department of Experimental Psychology, University of Oxford, United
Kingdom
- Population Research Institute, Väestöliitto, Helsinki,
Finland
- * E-mail:
| | - Janos Kertesz
- Central European University, Center for Network Science, Budapest,
Hungary
- Department of Computer Science, Aalto University School of Science,
Espoo, Finland
- Department of Theoretical Physics, Budapest University of Technology and
Economics, Budapest, Hungary
| | - Anna Rotkirch
- Population Research Institute, Väestöliitto, Helsinki,
Finland
| | - Asim Ghosh
- Department of Computer Science, Aalto University School of Science,
Espoo, Finland
| | - Kunal Bhattacharya
- Department of Computer Science, Aalto University School of Science,
Espoo, Finland
| | - Daniel Monsivais
- Department of Computer Science, Aalto University School of Science,
Espoo, Finland
| | - Kimmo Kaski
- Department of Computer Science, Aalto University School of Science,
Espoo, Finland
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15
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Chaladze G. Heterosexual Male Carriers Could Explain Persistence of Homosexuality in Men: Individual-Based Simulations of an X-Linked Inheritance Model. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:1705-1711. [PMID: 27067240 DOI: 10.1007/s10508-016-0742-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 09/30/2015] [Accepted: 03/15/2016] [Indexed: 06/05/2023]
Abstract
Homosexuality has been documented throughout history and is found in almost all human cultures. Twin studies suggest that homosexuality is to some extent heritable. However, from an evolutionary perspective, this poses a problem: Male homosexuals tend to have on average five times fewer children than heterosexual males, so how can a phenomenon associated with low reproductive success be maintained at relatively stable frequencies? Recent findings of increased maternal fecundity of male homosexuals suggest that the genes responsible for homosexuality in males increase fecundity in the females who carry them. Can an increase in maternal fecundity compensate for the fecundity reduction in homosexual men and produce a stable polymorphism? In the current study, this problem was addressed with an individual-based modeling (IBM) approach. IBM suggests that male homosexuality can be maintained in a population at low and stable frequencies if roughly more than half of the females and half of the males are carriers of genes that predispose the male to homosexuality.
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Affiliation(s)
- Giorgi Chaladze
- Institute of Ecology, Ilia State University, 3/5 Cholokashvili Ave, 0162, Tbilisi, Georgia.
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16
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Agocha VB, Cooper ML. Risk Perceptions and Safer-Sex Intentions: Does a Partner’s Physical Attractiveness Undermine the Use of Risk-Relevant Information? PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2016. [DOI: 10.1177/0146167299025006009] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An experimental study investigated the combined effects of participant’s gender and an opposite-sex target’s sexual history (SH) and physical attractiveness (PA) on the perceived desirability of that target, participant’s willingness to exchange personal information, intention to have sex, perceived riskiness, and intentions to engage in safer-sex behaviors should intercourse occur with the target. A total of 280 college students (140 men, 140 women) completed self-administered questionnaires immediately after viewing the target’s photograph and biographic information. Results indicated that participants, especially men, overrelied on irrelevant partner characteristics such as PA and underused the more relevant SH information in making judgments about risk and probable future behavior with the target. Supplementary path analyses highlighted the role of desirability of the target as a proximal cause of both lower risk perceptions and weakened intentions to take precautionary actions. The need to more fully address motivational factors in future research and prevention efforts is discussed.
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17
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Filip-Crawford G, Neuberg SL. Homosexuality and Pro-Gay Ideology as Pathogens? Implications of a Disease-Spread Lay Model for Understanding Anti-Gay Behaviors. PERSONALITY AND SOCIAL PSYCHOLOGY REVIEW 2016; 20:332-364. [DOI: 10.1177/1088868315601613] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Negative behaviors targeting gay men and lesbians range from violent physical assault to casting a vote against gay marriage, with very different implications for those targeted. Existing accounts of such actions, however, are unable to differentially predict specific anti-gay behaviors, leaving a large theoretical hole in the literature and hindering the design of effective interventions. We propose (a) that many sexually prejudiced laypersons conceptualize homosexuality and pro-gay ideology as “contaminants” analogous to infectious pathogens and (b) that anti-gay behaviors can thus be viewed as strategic attempts to prevent, contain, treat, or eradicate the “pathogens” of homosexuality and pro-gay ideology. By considering analogues to disease-spread processes (e.g., susceptibility of specific subpopulations, inoculation procedures, prevalence in the local environment, interconnections among community members), we derive novel predictions regarding the incidence and nature of anti-gay behaviors and provide leverage for creating more tailored interventions to reduce such discrimination.
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18
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Hu Y, Xu Y, Tornello SL. Stability of Self-Reported Same-Sex and Both-Sex Attraction from Adolescence to Young Adulthood. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:651-659. [PMID: 26048483 DOI: 10.1007/s10508-015-0541-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 09/15/2014] [Accepted: 02/15/2015] [Indexed: 06/04/2023]
Abstract
This study examined how sexual attraction varied across age, gender of participant, and gender of romantic partner, from adolescence to early adulthood. Comparisons between same-sex and both-sex attracted individuals were of particular interest. Using the National Longitudinal Study of Adolescent Health (AddHealth), we examined the responses of participants who reported experiencing same-sex attractions or both-sex attractions at least once within four waves (n = 1889). Results indicated that same-sex attractions became more stable over time, whereas both-sex attraction remained unstable even into adulthood. Compared with males, females were less stable in same-sex attraction, but more stable in both-sex attraction. The majority of people who reported same-sex attraction did not report having a same-sex romantic partner before they entered adulthood, and those who reported a same-sex romantic partner were more likely to maintain their same-sex attraction than those who did not. As males got older, the gender of their romantic partner tended to become more consistent with their sexual attraction. However, for females, the consistency between the gender of their romantic partner and sexual attraction did not change over time.
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Affiliation(s)
- Yueqin Hu
- Department of Psychology, Texas State University, UAC 253C, 601 University Drive, San Marcos, TX, 78666, USA.
| | - Yishan Xu
- Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Samantha L Tornello
- Department of Psychology, Pennsylvania State University-Altoona, Altoona, PA, USA
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19
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Larsson M, Ross MW, Tumwine G, Agardh A. Determinants of unmet needs for healthcare and sexual health counselling among Ugandan university students with same-sex sexuality experience. Glob Health Action 2016; 9:30790. [PMID: 27032809 PMCID: PMC4816809 DOI: 10.3402/gha.v9.30790] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Research from sub-Saharan Africa has shown that persons with same-sex sexuality experience are at elevated risk for ill health due to sexual risk taking, stigma, and discrimination. However, studies of healthcare seeking among young people in this region with same-sex sexuality experience are limited. OBJECTIVE To identify determinants of unmet healthcare and sexual health counselling needs, respectively, among Ugandan university students with experience of same-sex sexuality. DESIGN In 2010, 1,954 Ugandan university students completed a questionnaire assessing socio-demographic factors, mental health, alcohol usage, sexual behaviours, and healthcare seeking. The study population consisted of those 570 who reported ever being in love with, sexually attracted to, sexually fantasised about, or sexually engaged with someone of the same sex. RESULTS Findings showed that 56% and 30% reported unmet healthcare and sexual health counselling needs, respectively. Unmet healthcare needs were associated with poor mental health and exposure to sexual coercion (OR 3.9, 95% confidence intervals [CI]: 2.7-5.7; OR 2.0, 95% CI: 1.3-3.0, respectively). Unmet sexual health counselling needs were significantly associated with poor mental health (OR 3.2, 95% CI: 2.1-4.8), exposure to sexual coercion (OR 2.6, 95% CI: 1.7-3.9), frequent heavy episodic drinking (OR 3.3, 95% CI: 1.9-5.8), and number of sexual partners (OR 1.9, 95% CI: 1.04-3.3). The associations between poor mental health, sexual coercion, and unmet healthcare needs (AOR 4.2, 95% CI: 2.1-8.5; AOR 2.8, 95% CI: 1.3-5.8) and unmet needs for sexual health counselling (AOR 3.3, 95% CI: 1.6-7.1; AOR 2.7, 95% CI: 1.4-5.4) persisted after adjustment for socio-demographic factors, number of sexual partners, and frequent heavy episodic drinking. CONCLUSIONS These findings indicate that exposure to sexual coercion and poor mental health may influence healthcare seeking behaviours of same-sex sexuality experienced students. Targeted interventions that integrate mental health and trauma response are critical to meet the health needs of this population.
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Affiliation(s)
- Markus Larsson
- Division for Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden;
| | - Michael W Ross
- Program in Human Sexuality, Department of Family Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Gilbert Tumwine
- Department of Obstetrics and Gynaecology, St Francis Hospital Nsambya, Kampala, Uganda
| | - Anette Agardh
- Division for Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
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20
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Agardh A, Ross M, Östergren PO, Larsson M, Tumwine G, Månsson SA, Simpson JA, Patton G. Health Risks in Same-Sex Attracted Ugandan University Students: Evidence from Two Cross-Sectional Studies. PLoS One 2016; 11:e0150627. [PMID: 26982494 PMCID: PMC4794142 DOI: 10.1371/journal.pone.0150627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 02/17/2016] [Indexed: 11/29/2022] Open
Abstract
Widespread discrimination across much of sub-Saharan Africa against persons with same-sex sexuality, including recent attempts in Uganda to extend criminal sanctions against same-sex behavior, are likely to have profound effects on this group’s health, health care access, and well-being. Yet knowledge of the prevalence of same-sex sexuality in this region is scarce. This study aimed to systematically examine prevalence of same-sex sexuality and related health risks in young Ugandan adults. We conducted two cross-sectional survey studies in south-western Uganda targeting student samples (n = 980, n = 1954) representing 80% and 72% of the entire undergraduate classes attending a university in 2005 and 2010, respectively. A questionnaire assessed items concerning same-sex sexuality (same-sex attraction/fantasies, same-sex sexual relations), mental health, substance use, experience of violence, risky sexual behavior, and sexual health counseling needs. Our findings showed that same-sex sexual attraction/fantasies and behavior were common among male and female students, with 10–25% reporting having sexual attraction/fantasies regarding persons of the same-sex, and 6–16% reporting same-sex sexual relations. Experiences of same-sex sexuality were associated with health risks, e.g. poor mental health (2010, AOR = 1.5; 95% CI: 1.0–2.3), sexual coercion (2010, AOR 2.9; CI: 1.9–4.6), and unmet sexual health counseling needs (2010, AOR 2.2; CI: 1.4–3.3). This first study of young adults in Uganda with same-sex sexuality found high levels of health needs but poor access to health care. Effective response is likely to require major shifts in current policy, efforts to reduce stigmatization, and reorientation of health services to better meet the needs of this vulnerable group of young people.
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Affiliation(s)
- Anette Agardh
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
- * E-mail:
| | - Michael Ross
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, United States of America
| | - Per-Olof Östergren
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Markus Larsson
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Gilbert Tumwine
- Department of Obstetrics and Gynaecology, St Francis Hospital, Nsambya, Uganda
| | - Sven-Axel Månsson
- Centre for Sexology and Sexuality Studies, Malmö University, Malmö, Sweden
| | - Julie A. Simpson
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - George Patton
- Centre for Adolescent Health, Royal Children’s Hospital, Murdoch Children’s Research Institute, Department of Paediatrics, University of Melbourne, Victoria, Australia
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21
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Sexual orientation disparities in physical health: age and gender effects in a population-based study. Soc Psychiatry Psychiatr Epidemiol 2016; 51:289-301. [PMID: 26298574 PMCID: PMC4747986 DOI: 10.1007/s00127-015-1116-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 08/16/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Recent studies have identified substantial health disparities between lesbian, gay, and bisexual (LGB) individuals compared to heterosexuals. However, possible variation in sexual orientation health disparities by age and according to gender remains largely unexplored. PURPOSE To examine physical health disparities between LGB and heterosexual individuals in a general population sample in Sweden, to explore potential age and gender differences in these disparities, and to test potential mechanisms underlying any observed disparities. METHOD Between 2008 and 2013, 60,922 individuals (16-84 years of age) responded to nationwide population-based health surveys. In the sample, 430 (0.7%) individuals self-identified as gay/lesbian and 757 (1.3%) self-identified as bisexual. Logistic and negative binomial regression analyses were used to explore health disparities based on sexual orientation. RESULTS Overall, LGB individuals were more likely to report worse self-rated health as well as more physical health symptoms (e.g., pain, insomnia, dermatitis, tinnitus, intestinal problems) and conditions (e.g., diabetes, asthma, high blood pressure) compared to heterosexuals. However, these physical health disparities differed by age. Disparities were largest among adolescents and young adults and generally smallest in older age groups. Health behaviors and elevated reports of exposure to perceived discrimination, victimization, and threats of violence among sexual minorities partially explained the sexual orientation disparities in physical health. CONCLUSIONS Age emerged as an important effect modifier of physical health disparities based on sexual orientation. Gender-specific findings suggest that sexual orientation disparities persist into adulthood for women but are gradually attenuated for older age groups; in contrast, for men, these disparities disappear starting with young adults. These results support a developmental model of minority stress and physical health among LGB individuals.
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22
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Burri A, Spector T, Rahman Q. Common Genetic Factors among Sexual Orientation, Gender Nonconformity, and Number of Sex Partners in Female Twins: Implications for the Evolution of Homosexuality. J Sex Med 2015; 12:1004-11. [DOI: 10.1111/jsm.12847] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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23
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Brody S, Weiss P. Erectile Dysfunction and Premature Ejaculation: Interrelationships and Psychosexual Factors. J Sex Med 2015; 12:398-404. [DOI: 10.1111/jsm.12738] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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24
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Camperio Ciani A, Battaglia U, Zanzotto G. Human homosexuality: a paradigmatic arena for sexually antagonistic selection? Cold Spring Harb Perspect Biol 2015; 7:a017657. [PMID: 25635045 PMCID: PMC4382746 DOI: 10.1101/cshperspect.a017657] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Sexual conflict likely plays a crucial role in the origin and maintenance of homosexuality in our species. Although environmental factors are known to affect human homosexual (HS) preference, sibling concordances and population patterns related to HS indicate that genetic components are also influencing this trait in humans. We argue that multilocus, partially X-linked genetic factors undergoing sexually antagonistic selection that promote maternal female fecundity at the cost of occasional male offspring homosexuality are the best candidates capable of explaining the frequency, familial clustering, and pedigree asymmetries observed in HS male proband families. This establishes male HS as a paradigmatic example of sexual conflict in human biology. HS in females, on the other hand, is currently a more elusive phenomenon from both the empirical and theoretical standpoints because of its fluidity and marked environmental influence. Genetic and epigenetic mechanisms, the latter involving sexually antagonistic components, have been hypothesized for the propagation and maintenance of female HS in the population. However, further data are needed to truly clarify the evolutionary dynamics of this trait.
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Affiliation(s)
- Andrea Camperio Ciani
- Dipartimento di Filosofia, Sociologia, Pedagogia e Psicologia Applicata, Università di Padova, 35100 Padova, Italy
| | - Umberto Battaglia
- Dipartimento di Filosofia, Sociologia, Pedagogia e Psicologia Applicata, Università di Padova, 35100 Padova, Italy
| | - Giovanni Zanzotto
- Dipartimento di Psicologia Generale, Università di Padova, 35100 Padova, Italy
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25
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Olvera-Hernández S, Fernández-Guasti A. Perinatal administration of aromatase inhibitors in rodents as animal models of human male homosexuality: similarities and differences. ADVANCES IN NEUROBIOLOGY 2015; 10:381-406. [PMID: 25287550 DOI: 10.1007/978-1-4939-1372-5_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In this chapter we briefly review the evidence supporting the existence of biological influences on sexual orientation. We focus on basic research studies that have affected the estrogen synthesis during the critical periods of brain sexual differentiation in male rat offspring with the use of aromatase inhibitors, such as 1,4,6-androstatriene-3,17 (ATD) and letrozole. The results after prenatal and/or postnatal treatment with ATD reveal that these animals, when adults, show female sexual responses, such as lordosis or proceptive behaviors, but retain their ability to display male sexual activity with a receptive female. Interestingly, the preference and sexual behavior of these rats vary depending upon the circadian rhythm.Recently, we have established that the treatment with low doses of letrozole during the second half of pregnancy produces male rat offspring, that when adults spend more time in the company of a sexually active male than with a receptive female in a preference test. In addition, they display female sexual behavior when forced to interact with a sexually experienced male and some typical male sexual behavior when faced with a sexually receptive female. Interestingly, these males displayed both sexual behavior patterns spontaneously, i.e., in absence of exogenous steroid hormone treatment. Most of these features correspond with those found in human male homosexuals; however, the "bisexual" behavior shown by the letrozole-treated rats may be related to a particular human population. All these data, taken together, permit to propose letrozole prenatal treatment as a suitable animal model to study human male homosexuality and reinforce the hypothesis that human sexual orientation is underlied by changes in the endocrine milieu during early development.
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Affiliation(s)
- Sandra Olvera-Hernández
- Department of Pharmacobiology, Center for Research and Advanced Studies (CINVESTAV), Calzada de los Tenorios 235 Colonia Granjas Coapa, 14330, México, D.F., Mexico,
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26
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Brown MT, Grossman BR. Same-sex sexual relationships in the national social life, health and aging project: making a case for data collection. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:108-129. [PMID: 24329542 DOI: 10.1080/01634372.2013.865695] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 11/11/2013] [Indexed: 06/03/2023]
Abstract
This study describes the previously unexplored subsample of respondents who reported at least 1 same-sex sexual relationship (SSSR) in the National Social Life, Health, and Aging Project (NSHAP). The NSHAP collected data from 3,005 adults (aged 57-85). Approximately 4% (n = 102) of respondents reported at least one SSSR. These sexual minority elders were younger, more educated, were more likely to be working, had fewer social supports, and better physical health. Results may indicate crisis competence in sexual minority elders. Collecting sexual orientation and gender identity data in larger, US-based probability samples would inform the development of appropriate community-based services and supports.
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Affiliation(s)
- Maria T Brown
- a Aging Studies Institute, Syracuse University , Syracuse , New York , USA
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27
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Wienke C, Whaley RB. Same-gender sexual partnering: a re-analysis of trend data. JOURNAL OF SEX RESEARCH 2013; 52:162-173. [PMID: 24164090 DOI: 10.1080/00224499.2013.819066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Numerous studies have been carried out to estimate the prevalence of same-gender sexual behavior. Among studies conducted in recent years, few confirm the commonly quoted figure of 10%. Yet several studies in the early 2000s indicated that the prevalence of same-gender sex may be increasing, especially among women. This article reexamines the trends identified in previous research by using General Social Survey data from 1988 to 2010 and by focusing on multiple measures of same-gender sex over time. Results indicate that for both women and men the likelihood of having had a same-gender sexual partner since age 18 continued to increase through the 2000s, but that the likelihood of having had a same-gender sexual partner in both the past year and in the past five years leveled off for women and reversed for men. Results also indicate that the percentage of people reporting a pattern of predominantly same-gender sexual behavior has neither increased nor decreased over time. A similar result was found among persons who reported being in a same-gender sexual relationship. Overall, results paint a more complex picture than prior studies in characterizing trends in same-gender sexual behavior.
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Affiliation(s)
- Chris Wienke
- a Department of Sociology , Southern Illinois University Carbondale
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28
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Birger RB, Hallett TB, Sinha A, Grenfell BT, Hodder SL. Modeling the impact of interventions along the HIV continuum of care in Newark, New Jersey. Clin Infect Dis 2013; 58:274-84. [PMID: 24140971 DOI: 10.1093/cid/cit687] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The human immunodeficiency virus (HIV) epidemic in Newark, New Jersey, is among the most severe in the United States. Prevalence ranges up to 3.3% in some groups. The aim of this study is to use a mathematical model of the epidemic in Newark to assess the impact of interventions along the continuum of care, leading to virologic suppression. METHODS A model was constructed of HIV infection including specific care-continuum steps. The model was calibrated to HIV/AIDS cases in Newark among different populations over a 10-year period. Interventions applied to model fits were increasing proportions tested, linked and retained in care, linked and adherent to treatment, and increasing testing frequency, high-risk-group testing, and adherence. Impacts were assessed by measuring incidence and death reductions 10 years postintervention. RESULTS The most effective interventions for reducing incidence were improving treatment adherence and increasing testing frequency and coverage. No single intervention reduced incidence in 2023 by >5%, and the most effective combination of interventions reduced incidence by approximately 16% (2%-24%). The most efficacious interventions for reducing deaths were increasing retention, linkage to care, testing coverage, and adherence. Increasing retention reduced deaths by approximately 27% (24%-29%); the most efficacious combination of interventions reduced deaths in 2023 by approximately 52% (46%-57%). CONCLUSIONS Reducing HIV deaths in Newark over a 10-year period may be a realizable goal, but reducing incidence is less likely. Our results highlight the importance of addressing leaks across the entire continuum of care and reinforcing efforts to prevention new HIV infections with additional interventions.
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Affiliation(s)
- Ruthie B Birger
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey
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29
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Joel D, Tarrasch R, Berman Z, Mukamel M, Ziv E. Queering gender: studying gender identity in ‘normative’ individuals. PSYCHOLOGY & SEXUALITY 2013. [DOI: 10.1080/19419899.2013.830640] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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30
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Apostolou M. Interfamily Conflict, Reproductive Success, and the Evolution of Male Homosexuality. REVIEW OF GENERAL PSYCHOLOGY 2013. [DOI: 10.1037/a0031521] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In a preindustrial context, the mate choices of women are controlled by their parents, who require evidence of wealth and of ability to generate wealth from prospective sons-in-law in order to grant access to their daughters’ reproductive capacity. As a consequence, male siblings have to compete among themselves for controlling family resources required for successful reproduction. This competition increases interfamily conflict, decreasing each of the siblings’ inclusive fitness. Moreover, the sharing of resources among brothers reduces the chances that each one will be able to gain access to a high-quality female and/or to mate polygynously. It is proposed that male homosexuality has evolved to increase the reproductive success of male siblings and to decrease interfamily conflict. That is, by having a homosexual orientation, a younger male sibling increases his inclusive fitness by reducing competition over resources, whereas his older brothers enjoy higher reproductive success by having more resources available for reproduction. Finally, the reproductive costs of this sexual orientation are kept low by the elevated probability that a homosexual man will find himself in an arranged marriage where he is likely to have children.
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Hatzenbuehler ML, Bellatorre A, Lee Y, Finch BK, Muennig P, Fiscella K. Structural stigma and all-cause mortality in sexual minority populations. Soc Sci Med 2013; 103:33-41. [PMID: 23830012 DOI: 10.1016/j.socscimed.2013.06.005] [Citation(s) in RCA: 177] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 04/11/2013] [Accepted: 06/06/2013] [Indexed: 01/19/2023]
Abstract
Stigma operates at multiple levels, including intrapersonal appraisals (e.g., self-stigma), interpersonal events (e.g., hate crimes), and structural conditions (e.g., community norms, institutional policies). Although prior research has indicated that intrapersonal and interpersonal forms of stigma negatively affect the health of the stigmatized, few studies have addressed the health consequences of exposure to structural forms of stigma. To address this gap, we investigated whether structural stigma-operationalized as living in communities with high levels of anti-gay prejudice-increases risk of premature mortality for sexual minorities. We constructed a measure capturing the average level of anti-gay prejudice at the community level, using data from the General Social Survey, which was then prospectively linked to all-cause mortality data via the National Death Index. Sexual minorities living in communities with high levels of anti-gay prejudice experienced a higher hazard of mortality than those living in low-prejudice communities (Hazard Ratio [HR] = 3.03, 95% Confidence Interval [CI] = 1.50, 6.13), controlling for individual and community-level covariates. This result translates into a shorter life expectancy of approximately 12 years (95% C.I.: 4-20 years) for sexual minorities living in high-prejudice communities. Analysis of specific causes of death revealed that suicide, homicide/violence, and cardiovascular diseases were substantially elevated among sexual minorities in high-prejudice communities. Strikingly, there was an 18-year difference in average age of completed suicide between sexual minorities in the high-prejudice (age 37.5) and low-prejudice (age 55.7) communities. These results highlight the importance of examining structural forms of stigma and prejudice as social determinants of health and longevity among minority populations.
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Affiliation(s)
- Mark L Hatzenbuehler
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, Room 549.B, New York, NY 10032, United States.
| | - Anna Bellatorre
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Yeonjin Lee
- Department of Sociology, University of Pennsylvania, Philadelphia, PA, United States
| | | | - Peter Muennig
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Kevin Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, United States
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Pega F, Gray A, Veale JF, Binson D, Sell RL. Toward global comparability of sexual orientation data in official statistics: a conceptual framework of sexual orientation for health data collection in New Zealand's official statistics system. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2013; 2013:473451. [PMID: 23840231 PMCID: PMC3694548 DOI: 10.1155/2013/473451] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 05/14/2013] [Accepted: 05/24/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Effectively addressing health disparities experienced by sexual minority populations requires high-quality official data on sexual orientation. We developed a conceptual framework of sexual orientation to improve the quality of sexual orientation data in New Zealand's Official Statistics System. METHODS We reviewed conceptual and methodological literature, culminating in a draft framework. To improve the framework, we held focus groups and key-informant interviews with sexual minority stakeholders and producers and consumers of official statistics. An advisory board of experts provided additional guidance. RESULTS The framework proposes working definitions of the sexual orientation topic and measurement concepts, describes dimensions of the measurement concepts, discusses variables framing the measurement concepts, and outlines conceptual grey areas. CONCLUSION The framework proposes standard definitions and concepts for the collection of official sexual orientation data in New Zealand. It presents a model for producers of official statistics in other countries, who wish to improve the quality of health data on their citizens.
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Affiliation(s)
- Frank Pega
- Department of Public Health, University of Otago, P.O. Box 7343, Wellington, New Zealand.
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Hatzenbuehler ML, McLaughlin KA, Slopen N. Sexual orientation disparities in cardiovascular biomarkers among young adults. Am J Prev Med 2013; 44:612-21. [PMID: 23683979 PMCID: PMC3659331 DOI: 10.1016/j.amepre.2013.01.027] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 11/05/2012] [Accepted: 01/31/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Emerging evidence from general population studies suggests that lesbian, gay, and bisexual (LGB) adults are more likely to experience adverse cardiovascular outcomes relative to heterosexuals. No studies have examined whether sexual orientation disparities exist in biomarkers of early cardiovascular disease risk. PURPOSE To determine whether sexual orientation disparities in biomarkers of early cardiovascular risk are present among young adults. METHODS Data come from Wave IV (2008-2009) of the National Longitudinal Study for Adolescent Health (N=12,451), a prospective nationally representative study of U.S. adolescents followed into young adulthood (mean age=28.9 years). A total of 520 respondents identified as lesbian, gay, or bisexual. Biomarkers included C-reactive protein, glycosylated hemoglobin, systolic and diastolic blood pressure, and pulse rate. Analyses were conducted in 2012. RESULTS In gender-stratified models adjusted for demographics (age, race/ethnicity); SES (income, education); health behaviors (smoking, regular physical activity, alcohol consumption); and BMI, gay and bisexual men had significant elevations in C-reactive protein, diastolic blood pressure, and pulse rate, compared to heterosexual men. Despite having more risk factors for cardiovascular disease, including smoking, heavy alcohol consumption, and higher BMI, lesbians and bisexual women had lower levels of C-reactive protein than heterosexual women in fully adjusted models. CONCLUSIONS Evidence was found for sexual orientation disparities in biomarkers of cardiovascular risk among young adults, particularly in gay and bisexual men. These findings, if confirmed in other studies, suggest that disruptions in core physiologic processes that ultimately confer risk for cardiovascular disease may occur early in the life course for sexual-minority men.
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Affiliation(s)
- Mark L Hatzenbuehler
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York 10032, USA.
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Hein LC, Scharer KM. Who cares if it is a hate crime? Lesbian, gay, bisexual, and transgender hate crimes--mental health implications and interventions. Perspect Psychiatr Care 2013; 49:84-93. [PMID: 23557451 DOI: 10.1111/j.1744-6163.2012.00354.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Revised: 06/29/2012] [Accepted: 07/23/2012] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The purpose of this paper was to discuss lesbian, gay, bisexual, or transgender-targeted hate crimes and their mental health consequences for the victim and community. CONCLUSIONS Hate crimes are typically more violent than nonhate-motivated crimes and have more deleterious mental health consequences. PRACTICE IMPLICATIONS Thorough assessment coupled with an understanding of the social milieu and the meaning of the experience to the survivor can help the psychiatric nurse partner with the client to select the most appropriate treatment.
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Affiliation(s)
- Laura C Hein
- College of Nursing, University of South Carolina, Columbia, South Carolina, USA.
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Wimpissinger F, Springer C, Stackl W. International online survey: female ejaculation has a positive impact on women's and their partners' sexual lives. BJU Int 2013; 112:E177-85. [DOI: 10.1111/j.1464-410x.2012.11562.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
| | | | - Walter Stackl
- Department of Urology; Rudolfstiftung Hospital Vienna; Vienna; Austria
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Kim HJ, Fredriksen-Goldsen KI. Nonresponse to a question on self-identified sexual orientation in a public health survey and its relationship to race and ethnicity. Am J Public Health 2013; 103:67-9. [PMID: 23153153 PMCID: PMC3518335 DOI: 10.2105/ajph.2012.300835] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2012] [Indexed: 11/04/2022]
Abstract
We examined whether nonresponse to the survey question on self-identified sexual orientation was associated with race and ethnicity, utilizing Washington State Behavioral Risk Factor Surveillance System data. The results of adjusted multinomial logistic regression indicated that the nonresponse rates of Asian Americans, Hispanics, and African Americans are higher than those of non-Hispanic Whites. Innovative ways of measuring sexual orientation to reduce racially and ethnically driven bias need to be developed and integrated into public health surveys.
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Affiliation(s)
- Hyun-Jun Kim
- School of Social Work, University of Washington, Seattle, WA 98105, USA.
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37
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The Prevalence of Gay Men and Lesbians. INTERNATIONAL HANDBOOK ON THE DEMOGRAPHY OF SEXUALITY 2013. [DOI: 10.1007/978-94-007-5512-3_11] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Blashill AJ, O'Cleirigh C, Mayer KH, Goshe BM, Safren SA. Body mass index, depression and sexual transmission risk behaviors among HIV-positive MSM. AIDS Behav 2012; 16:2251-6. [PMID: 21983696 DOI: 10.1007/s10461-011-0056-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Depression has been shown to be a risk factor for serodiscordant unprotected anal intercourse (SDUAI) in some studies, but not others. Body mass index (BMI) has recently been associated with SDUAI; however, to date, no published study has investigated the interactive effect of depression and BMI on SDUAI. The current study assessed the association between depression, BMI, and SDUAI among HIV-positive MSM. Participants were 430 HIV-positive MSM recruited in a Boston community health center where they received primary care. Participants completed audio computer-assisted self interview (ACASI) measures. Objective height and weight and other clinical variables were accessed through participants' electronic medical records. Depression was positively associated with SDUAI. This association was significantly moderated by BMI. Elevated levels of depression were only associated with SDUAI for underweight participants. These findings suggest that underweight, depressed HIV-positive MSM may be particularly likely to engage in SDUAI.
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Affiliation(s)
- Aaron J Blashill
- Massachusettes General Hospital, Harvard Medical School, 1 Bowdoin Sq, 7th Floor, Boston, MA, 02114, USA.
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Morales Knight LF, Hope DA. Correlates of same-sex attractions and behaviors among self-identified heterosexual university students. ARCHIVES OF SEXUAL BEHAVIOR 2012; 41:1199-1208. [PMID: 22476518 DOI: 10.1007/s10508-012-9927-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 09/06/2011] [Accepted: 11/26/2011] [Indexed: 05/31/2023]
Abstract
Few studies have focused on intragroup variations in sexual orientation and fewer on self-identified heterosexuals with same-sex attractions, fantasies, and/or behaviors. Self-identified heterosexual students at a large public midwestern university (N = 263) completed measures of sexuality and gender, attitudes toward lesbian, gay, and bisexual (LGB) people, religious and political beliefs, emotional well-being, and demographics. The sample included 82 individuals (31%; labeled "H+") who endorsed same-sex attraction, fantasy, and/or behavior and 181 (69%; labeled "H") who did not. Women were more likely to be categorized as H+ than men. H+ participants had more positive attitudes toward lesbians and gay and bisexual men and reported more support for LGB-positive public policies than did H participants. H+ participants reported less literalistic beliefs about religious scripture than did H participants. H and H+ groups did not differ significantly on measures of emotional well-being. Results were discussed in the context of recent literature arguing for a more nuanced and gender-differentiated approach toward assessing sexual orientation, as well as literature on the flexibility of sexual orientation and on heterosexual identity development.
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Affiliation(s)
- Luis F Morales Knight
- Department of Psychology, University of Nebraska-Lincoln, 238 Burnett Hall, Lincoln, NE 68588-0308, USA
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40
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Hatzenbuehler ML, McLaughlin KA, Xuan Z. Social networks and risk for depressive symptoms in a national sample of sexual minority youth. Soc Sci Med 2012; 75:1184-91. [PMID: 22771037 PMCID: PMC3407288 DOI: 10.1016/j.socscimed.2012.05.030] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 05/09/2012] [Accepted: 05/29/2012] [Indexed: 10/28/2022]
Abstract
The aim of the study was to examine the social networks of sexual minority youths and to determine the associations between social networks and depressive symptoms. Data were obtained from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative cohort study of American adolescents (N = 14,212). Wave 1 (1994-1995) collected extensive information about the social networks of participants through peer nomination inventories, as well as measures of sexual minority status and depressive symptoms. Using social network data, we examined three characteristics of adolescents' social relationships: (1) social isolation; (2) degree of connectedness; and (3) social status. Sexual minority youths, particularly females, were more isolated, less connected, and had lower social status in peer networks than opposite-sex attracted youths. Among sexual minority male (but not female) youths, greater isolation as well as lower connectedness and status within a network were associated with greater depressive symptoms. Moreover, greater isolation in social networks partially explained the association between sexual minority status and depressive symptoms among males. Finally, a significant 3-way interaction indicated that the association between social isolation and depression was stronger for sexual minority male youths than non-minority youths and sexual minority females. These results suggest that the social networks in which sexual minority male youths are embedded may confer risk for depressive symptoms, underscoring the importance of considering peer networks in both research and interventions targeting sexual minority male adolescents.
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Affiliation(s)
- Mark L Hatzenbuehler
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
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41
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Marshall BDL, Paczkowski MM, Seemann L, Tempalski B, Pouget ER, Galea S, Friedman SR. A complex systems approach to evaluate HIV prevention in metropolitan areas: preliminary implications for combination intervention strategies. PLoS One 2012; 7:e44833. [PMID: 23028637 PMCID: PMC3441492 DOI: 10.1371/journal.pone.0044833] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 08/09/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND HIV transmission among injecting and non-injecting drug users (IDU, NIDU) is a significant public health problem. Continuing propagation in endemic settings and emerging regional outbreaks have indicated the need for comprehensive and coordinated HIV prevention. We describe the development of a conceptual framework and calibration of an agent-based model (ABM) to examine how combinations of interventions may reduce and potentially eliminate HIV transmission among drug-using populations. METHODOLOGY/PRINCIPAL FINDINGS A multidisciplinary team of researchers from epidemiology, sociology, geography, and mathematics developed a conceptual framework based on prior ethnographic and epidemiologic research. An ABM was constructed and calibrated through an iterative design and verification process. In the model, "agents" represent IDU, NIDU, and non-drug users who interact with each other and within risk networks, engaging in sexual and, for IDUs, injection-related risk behavior over time. Agents also interact with simulated HIV prevention interventions (e.g., syringe exchange programs, substance abuse treatment, HIV testing) and initiate antiretroviral treatment (ART) in a stochastic manner. The model was constructed to represent the New York metropolitan statistical area (MSA) population, and calibrated by comparing output trajectories for various outcomes (e.g., IDU/NIDU prevalence, HIV prevalence and incidence) against previously validated MSA-level data. The model closely approximated HIV trajectories in IDU and NIDU observed in New York City between 1992 and 2002, including a linear decrease in HIV prevalence among IDUs. Exploratory results are consistent with empirical studies demonstrating that the effectiveness of a combination of interventions, including syringe exchange expansion and ART provision, dramatically reduced HIV prevalence among IDUs during this time period. CONCLUSIONS/SIGNIFICANCE Complex systems models of adaptive HIV transmission dynamics can be used to identify potential collective benefits of hypothetical combination prevention interventions. Future work will seek to inform novel strategies that may lead to more effective and equitable HIV prevention strategies for drug-using populations.
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Affiliation(s)
- Brandon D L Marshall
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, United States of America.
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42
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Purcell DW, Johnson CH, Lansky A, Prejean J, Stein R, Denning P, Gau1 Z, Weinstock H, Su J, Crepaz N. Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. Open AIDS J 2012; 6:98-107. [PMID: 23049658 PMCID: PMC3462414 DOI: 10.2174/1874613601206010098] [Citation(s) in RCA: 298] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 08/18/2011] [Accepted: 09/20/2011] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND CDC has not previously calculated disease rates for men who have sex with men (MSM) because there is no single comprehensive source of data on population size. To inform prevention planning, CDC developed a national population size estimate for MSM to calculate disease metrics for HIV and syphilis. METHODS We conducted a systematic literature search and identified seven surveys that provided data on same-sex behavior in nationally representative samples. Data were pooled by three recall periods and combined using meta-analytic procedures. We applied the proportion of men reporting same-sex behavior in the past 5 years to U.S. census data to produce a population size estimate. We then calculated three disease metrics using CDC HIV and STD surveillance data and rate ratios comparing MSM to other men and to women. RESULTS Estimates of the proportion of men who engaged in same-sex behavior differed by recall period: past year = 2.9% (95%CI, 2.6-3.2); past five years = 3.9% (3.5-4.4); ever = 6.9% (5.1-8.6). Rates on all 3 disease metrics were much higher among MSM than among either other men or women (38 to 109 times as high). CONCLUSIONS Estimating the population size for MSM allowed us to calculate rates for disease metrics and to develop rate ratios showing dramatically higher rates among MSM than among other men or women. These data greatly improve our understanding of the disproportionate impact of these diseases among MSM in the U.S. and help with prevention planning.
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Affiliation(s)
- David W Purcell
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Center for
Disease Control and Prevention, Atlanta, GA, USA
| | - Christopher H Johnson
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Center for
Disease Control and Prevention, Atlanta, GA, USA
| | - Amy Lansky
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Center for
Disease Control and Prevention, Atlanta, GA, USA
| | - Joseph Prejean
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Center for
Disease Control and Prevention, Atlanta, GA, USA
| | - Renee Stein
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Center for
Disease Control and Prevention, Atlanta, GA, USA
| | - Paul Denning
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Center for
Disease Control and Prevention, Atlanta, GA, USA
| | - Zaneta Gau1
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Center for
Disease Control and Prevention, Atlanta, GA, USA
| | - Hillard Weinstock
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Center for
Disease Control and Prevention, Atlanta, GA, USA
| | - John Su
- Divison of STD Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease
Control and Prevention, Atlanta, GA, USA
| | - Nicole Crepaz
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Center for
Disease Control and Prevention, Atlanta, GA, USA
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Cawich SO, Samuels L, Bambury I, Cherian CJ, Christie L, Kulkarni S. Complete anal sphincter complex disruption from intercourse: A case report and literature review. Int J Surg Case Rep 2012; 3:565-8. [PMID: 22940697 DOI: 10.1016/j.ijscr.2012.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 07/13/2012] [Accepted: 07/31/2012] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Anal sphincter injuries are uncommon injuries outside of obstetric practice - but they may cause disastrous complications. PRESENTATION OF CASE We present a case of complete anal sphincter disruption from anal intercourse in a 25 year old woman. Clinical management is presented and technical details of the repair are discussed. She had an uneventful post-operative course and good continence after 154 days of follow up. DISCUSSION This is one of a handful of reported cases of anal sphincter disruption secondary to anal intercourse. The established risk factors in this case included receptive anal intercourse coupled with alcohol use. We review the pertinent surgical principles that should be observed when repairing these injuries, including anatomically correct repair and appropriate suture choice. There is little evidence to support simultaneous faecal diversion for primary repair of acute perineal lacerations. CONCLUSION Acute post-coital sphincter injuries should be treated operatively on an emergent basis, without diversion because they are low energy injuries with minimal tissue loss and excellent blood supply. Although repair of each injury should be individualized, the majority of these injuries do not require concomitant protective colostomy creation.
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Affiliation(s)
- S O Cawich
- Department of Surgery, University of the West Indies, Mona Campus, Kingston 7, Jamaica
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Yang X, Attané I, Li S, Yang B. Same-Sex Sexual Behaviors Among Male Migrants in a Context of Male “Marriage Squeeze”. Am J Mens Health 2012; 6:485-96. [DOI: 10.1177/1557988312453479] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The male marriage squeeze in China may increase the prevalence of male same-sex sexual behaviors among unmarried male migrants who lack stable female sexual partners. The same-sex sexual behaviors among unmarried male migrants appear to be at high risk of transmission of human immunodeficiency virus (HIV) and sexually transmitted infections (STIs), mainly because of a lack of knowledge of these diseases. Using data from the “Survey on Reproductive Health and Family Life of Migrant Male Bachelors in Urban Areas” conducted in Xi’an City, Shaanxi Province, in December 2009 and January 2010, this study compares same-sex sexual behaviors of unmarried with that of married male migrants (including married but separated men who are migrating without their spouse or partner and cohabitating men who are migrating with their spouse or partner). It is reported that the prevalence of same-sex sexual behaviors among unmarried males reaches 11%, more than twice the 5.1% reported by married but separated men and thrice the 3.8% reported by cohabitating men. It also appears that the same-sex sexual behaviors is significantly associated with men’s attitudes toward same-sex sexual behaviors (odds ratio = 1.59, p < .001), toward life-long bachelorhood (odds ratio = 1.35, p < .01), and with marital status (odds ratio = 0.37, p < .01). The frequency of condom use appears to be higher among unmarried men than among men who are married, whether or not they migrated with their wives, and is significantly associated with scores on knowledge about HIV/AIDS (estimated coefficient = .12, p < .001) and STIs (estimated coefficient = .22, p < .01). It is also associated with the likelihood of same-sex sexual behaviors (estimated coefficients = .83, p < .01) and marital status (estimated coefficients for married but separated = −.50, p < .05; estimated coefficients for cohabitating = −.77, p < .001).
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Affiliation(s)
| | - Isabelle Attané
- INED (French National Institute for Demographic Studies), Paris, France
| | | | - Bo Yang
- Xi’an Jiaotong University, Xi’an, China
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Gender, sexual orientation, and occupational interests: Evidence of their interrelatedness. PERSONALITY AND INDIVIDUAL DIFFERENCES 2012. [DOI: 10.1016/j.paid.2012.02.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Zhou W, Huang M, Wei N, Hu S, Wei E, Xu Y. Application of the capture-recapture method in estimating the size of the active homosexual male population in Hangzhou city of China. Asia Pac J Public Health 2012; 27:NP2423-32. [PMID: 22743853 DOI: 10.1177/1010539512448211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The homosexual population is particularly susceptible to sexually transmitted disease because of various high-risk sexual behaviors among them. The authors explored the application of capture-recapture methods in estimating the size of the sexually active homosexual male population in Hangzhou. Homosexual men at 9 activity sites were investigated in Hangzhou, Zhejiang. The total active homosexual male population of Hangzhou estimated by the capture-recapture method and multiplier method was 2014 (95% confidence interval [CI] = 1899-2129) and 2012.5 (95% CI 1925 to 2101), respectively. This study shows that the capture-recapture method can be used to enumerate and provide accurate and reliable estimates of the active homosexual population in any area, provided that certain conditions are controlled.
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Affiliation(s)
- Weihua Zhou
- Department of Psychiatry, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Manli Huang
- Department of Psychiatry, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ning Wei
- Department of Psychiatry, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shaohua Hu
- Department of Psychiatry, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Erqing Wei
- Department of Psychiatry, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yi Xu
- Department of Psychiatry, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Zietsch BP, Verweij KJH, Heath AC, Madden PAF, Martin NG, Nelson EC, Lynskey MT. Do shared etiological factors contribute to the relationship between sexual orientation and depression? Psychol Med 2012; 42:521-532. [PMID: 21867592 PMCID: PMC3594769 DOI: 10.1017/s0033291711001577] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Gays, lesbians and bisexuals (i.e. non-heterosexuals) have been found to be at much greater risk for many psychiatric symptoms and disorders, including depression. This may be due in part to prejudice and discrimination experienced by non-heterosexuals, but studies controlling for minority stress, or performed in very socially liberal countries, suggest that other mechanisms must also play a role. Here we test the viability of common cause (shared genetic or environmental etiology) explanations of elevated depression rates in non-heterosexuals. METHOD A community-based sample of adult twins (n=9884 individuals) completed surveys investigating the genetics of psychiatric disorder, and were also asked about their sexual orientation. Large subsets of the sample were asked about adverse childhood experiences such as sexual abuse, physical abuse and risky family environment, and also about number of older brothers, paternal and maternal age, and number of close friends. Data were analyzed using the classical twin design. RESULTS Non-heterosexual males and females had higher rates of lifetime depression than their heterosexual counterparts. Genetic factors accounted for 31% and 44% of variation in sexual orientation and depression respectively. Bivariate analysis revealed that genetic factors accounted for a majority (60%) of the correlation between sexual orientation and depression. In addition, childhood sexual abuse and risky family environment were significant predictors of both sexual orientation and depression, further contributing to their correlation. CONCLUSIONS Non-heterosexual men and women had elevated rates of lifetime depression, partly due to shared etiological factors, although causality cannot be definitively resolved.
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Affiliation(s)
- B P Zietsch
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia.
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48
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Abstract
Whether homosexuality should be described as one among many paraphilic sexual interests or an altogether different dimension of sexual interest has long been discussed in terms of its political and social implications. The present article examined the question instead by comparing the major correlates and other features of homosexuality and of the paraphilias, including prevalence, sex ratio, onset and course, fraternal birth order, physical height, handedness, IQ and cognitive neuropsychological profile, and neuroanatomy. Although those literatures remain underdeveloped, the existing findings thus far suggest that homosexuality has a pattern of correlates largely, but not entirely, distinct from that identified among the paraphilias. At least, if homosexuality were deemed a paraphilia, it would be relatively unique among them, taxonometrically speaking.
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Affiliation(s)
- James M Cantor
- Sexual Behaviours Clinic, Law and Mental Health Program, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada.
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Hatzenbuehler ML, O'Cleirigh C, Grasso C, Mayer K, Safren S, Bradford J. Effect of same-sex marriage laws on health care use and expenditures in sexual minority men: a quasi-natural experiment. Am J Public Health 2012; 102:285-91. [PMID: 22390442 PMCID: PMC3484969 DOI: 10.2105/ajph.2011.300382] [Citation(s) in RCA: 148] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2011] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to determine whether health care use and expenditures among gay and bisexual men were reduced following the enactment of same-sex marriage laws in Massachusetts in 2003. METHODS We used quasi-experimental, prospective data from 1211 sexual minority male patients in a community-based health center in Massachusetts. RESULTS In the 12 months after the legalization of same-sex marriage, sexual minority men had a statistically significant decrease in medical care visits (mean = 5.00 vs mean = 4.67; P = .05; Cohen's d = 0.17), mental health care visits (mean = 24.72 vs mean = 22.20; P = .03; Cohen's d = 0.35), and mental health care costs (mean = $2442.28 vs mean = $2137.38; P = .01; Cohen's d = 0.41), compared with the 12 months before the law change. These effects were not modified by partnership status, indicating that the health effect of same-sex marriage laws was similar for partnered and nonpartnered men. CONCLUSIONS Policies that confer protections to same-sex couples may be effective in reducing health care use and costs among sexual minority men.
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Affiliation(s)
- Mark L Hatzenbuehler
- Center for the Study of Social Inequalities in Health, Mailman School of Public Health, Columbia University, 722 W 168 St, New York, NY 10032, USA.
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Dibble SL, Eliason MJ, Crawford B. Correlates of wellbeing among African American lesbians. JOURNAL OF HOMOSEXUALITY 2012; 59:820-838. [PMID: 22853182 DOI: 10.1080/00918369.2012.694763] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although there is a growing body of knowledge about health among African American women in general, there is a dearth of information on African American lesbians. The primary purpose of this study was to investigate the correlates of health-related quality of life among African American lesbians using a cross-sectional anonymous survey with topics and measures developed by members of the African American lesbian community. Surveys were completed by 123 English speaking adult women who identified as African American lesbians and were attending the Zuna Institute's National Black Lesbian Conference. Overall, we found a very high health-related quality of life, in spite of a high frequency of health impairments. The average body mass index (BMI) for this sample was 32.2 (SD = 8.0); 13% were morbidly obese, having a BMI of 40 or more and only 15% of the women were in a healthy weight range; advancing age was associated with poorer physical functioning, decreased physical role functioning, and more pain. Health-related quality of life was associated with depression and spirituality, but not religion. This study highlights the need for subjective measures of health-related quality of life as well as checklists of diseases and disorders.
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Affiliation(s)
- Suzanne L Dibble
- Institute for Health & Aging, University of California, San Francisco, California 94118, USA.
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