The Impact of Parental Reaction to Sexual Orientation on Depressive Symptoms and Sexual Risk Behavior Among Hispanic Men Who Have Sex with Men

Effects of Racist Microaggressions and Sexual and Gender Minority Stress on Mental Health Among Latinx Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning + Young Adults

This study examines the effects of racist microaggressions and lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ)-related minority stressors (i.e., identity concealment, family rejection, internalized LGBTQ-phobia, victimization, and racialized heterosexism/cisgenderism) on psychological distress among Latinx LGBTQ+ young people, specifically college students. Participants are a Latinx subset (n = 80) from a national online nonprobability cross-sectional survey of LGBTQ+ college students. The study aim was examined using linear/logistic regression. Findings indicated that racist microaggressions and family rejection were associated with psychological distress. In addition, racist microaggressions were the only stressor associated with clinically significant psychological distress that may warrant psychiatric/psychological treatment. Therefore, racist microaggressions and family rejection are unique stressors that may saliently affect mental health among Latinx LGBTQ+ students. There is a great need to integrate minority stress theory with other critically-oriented theories, such as intersectionality, in research and intervention to eliminate mental health inequities faced by Latinx LGBTQ+ young people.

Mental health impact of multiple sexually minoritized and gender expansive stressors among LGBTQ+ young adults: a latent class analysis

AIMS

In the United States, lesbian, gay, bisexual, transgender, queer, intersex, asexual and other sexually minoritized and gender expansive (LGBTQ+) young adults are at increased risk for experiencing mental health inequities, including anxiety, depression and psychological distress-related challenges associated with their sexual and gender identities. LGBTQ+ young adults may have unique experiences of sexual and gender minority-related vulnerability because of LGBTQ+-related minority stress and stressors, such as heterosexism, family rejection, identity concealment and internalized homophobia. Identifying and understanding specific LGBTQ+-related minority stress experiences and their complex roles in contributing to mental health burden among LGBTQ+ young adults could inform public health efforts to eliminate mental health inequities experienced by LGBTQ+ young adults. Therefore, this study sought to form empirically based risk profiles (i.e., latent classes) of LGBTQ+ young adults based on their experiences with familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment, and then identify associations of derived classes with psychological distress.

METHODS

We recruited and enrolled participants using nonprobability, cross-sectional online survey data collected between May and August 2020 (N = 482). We used a three-step latent class analysis (LCA) approach to identify unique classes of response patterns to LGBTQ+-related minority stressor subscale items (i.e., familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment), and multinomial logistic regression to characterize the associations between the derived classes and psychological distress.

RESULTS

Five distinct latent classes emerged from the LCA: (1) low minority stress, (2) LGBTQ+ identity concealment, (3) family rejection, (4) moderate minority stress and (5) high minority stress. Participants who were classified in the high and moderate minority stress classes were more likely to suffer from moderate and severe psychological distress compared to those classified in the low minority stress class. Additionally, relative to those in the low minority stress class, participants who were classified in the LGBTQ+ identity concealment group were more likely to suffer from severe psychological distress.

CONCLUSION

Familial heterosexist experiences, LGBTQ+-related family rejection, internalized LGBTQ+-phobia and LGBTQ+ identity concealment are four constructs that have been extensively examined as predictors for mental health outcomes among LGBTQ+ persons, and our study is among the first to reveal nuanced gradients of these stressors. Additionally, we found that more severe endorsement of minority stress was associated with greater psychological distress. Given our study results and the previously established negative mental health impacts of minority stressors among LGBTQ+ young adults, findings from our study can inform research, practice, and policy reform and development that could prevent and reduce mental health inequities among LGBTQ+ young adults.

Definitions and Measurement Tools for Assessing Parental Reactions to LGB People Coming Out: A Critical Review

Parental responses to young people's coming out as lesbian, gay or bisexual (LGB) are a crucial experience in identity formation and subsequent mental health outcomes. However, how parents react to coming out varies and remains relatively imprecise in the literature. The aim of the present critical review was to explore and discuss the different definitions and measurement tools used in studies assessing perceived parental reactions to the coming out of LGB people aged 18 years and over. Following PRISMA guidelines, a review of 14 selected articles was carried out to examine the different tools used. Then, based on this selection of articles, a review of the different proposed definitions of parental reactions was carried out. Analysis revealed that the Perceived Parental Reactions Scale emerged as the most widely used and most appropriate international scale for capturing the diversity of perceived parental reactions. Then, parental responses were often addressed in a dichotomous manner, focusing primarily on acceptance or rejection. Future studies will need to consider a more nuanced approach to understanding parental reactions to coming out.

Sexual Orientation-Based Victimization and Internalized Homonegativity Among Latinx Sexual Minority Youth: The Moderating Effects of Social Support and School Level

Latinx sexual minority adolescents and young adults experience sexual orientation-based victimization at school and may internalize these heterosexist experiences. However, social support may buffer the deleterious contributions of sexual orientation-based victimization. The current study explored associations between sexual orientation-based victimization and internalized homonegativity in different social contexts (family, peer, school adult) and across development (high school versus college) among 238 Latinx sexual minority adolescents and young adults (M = 19.03, SD = 2.28). Results indicated that sexual orientation-based victimization was positively associated with internalized homonegativity among Latinx sexual minority adolescents and young adults. Such associations were moderated by family support and the school level in the family context, such that in high school, family support exacerbated the association between sexual orientation-based victimization and internalized homonegativity. Yet, in college, family support mitigated that association. Findings also indicated that peer support exacerbated the association between sexual orientation-based victimization and internalized homonegativity in high school and college. No moderation of school adult support emerged in the context of school adults. Findings support the application of the minority stress model in Latinx sexual minority adolescents and young adults and highlight the complex moderating effect of social support across social contexts and development.

Drug Use, Family Support, and Depressive Symptoms Among Latinx Sexual Minority Men: A Longitudinal Analysis

Family rejection has negative health consequences for Latinx sexual minority men (LSMM). However, LSMM often reconcile with their families, a phenomenon cross-sectional studies miss. We analyzed longitudinal data from the Healthy Young Men's Study in Los Angeles. We used individual fixed-effects Poisson regression to model changes over time in the associations among family support, drug use, and depressive symptoms. We found that (1) the initiation of drug use was associated with a 7.2% (Ratio=1.072, 95% CI 1.006 - 1.142, p = 0.03) increase in family support among LSMM who reported high depressive symptoms (depression subscale T-score ≥ 63) in at least one data wave; (2) a 1-unit increase in family support was associated with a 4.7% (RR = ;0.953, 95% CI 0.931 - 0.976, p < 0.001) decrease in the probability of high depressive symptoms; and (3) no significant association between a change in drug use and a change in high depressive symptoms. Over time, LSMM appear to benefit from the health effects of family support associated with Latinx family structures.

Impact of Racist Microaggressions and LGBTQ-Related Minority Stressors: Effects on Psychological Distress Among LGBTQ+ Young People of Color

BACKGROUND

College students situated at the nexus of racial and sexual and gender minority (SGM) identities may experience multiple identity-related oppressions. We assessed whether racist microaggressions and lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ)-related minority stressors (ie, family rejection, identity concealment, racialized heterosexism and/or cisgenderism, internalized LGBTQ-phobia, and victimization) are associated with greater psychological distress among SGM college students of color (SOC) (students who identified as Hispanic/Latinx and/or any nonwhite race).

METHODS

Participants were a subset of SOC (n = 200) from a larger nonprobability cross-sectional study of SGM college students. Participants were recruited by using online social media platforms and university email listserves from May through August 2020. Participants completed an online Qualtrics survey using previously validated measures of minority stress, racist microaggressions, and psychological distress. Simple and covariate-adjusted multiple linear regression models were used to examine the associations between racist microaggressions and LGBTQ-related minority stressors with psychological distress.

RESULTS

In simple linear regression models, racist microaggressions and all LGBTQ-related stressors (ie, family rejection, identity concealment, racialized heterosexism and/or cisgenderism, internalized LGBTQ-phobia, and victimization) were significantly and positively associated with greater psychological distress. In covariate-adjusted multiple linear regression, racist microaggressions, internalized LGBTQ-phobia, and LGBTQ-related family rejection (but not identity concealment, racialized heterosexism and/or cisgenderism, and victimization) were independently and significantly associated with greater psychological distress.

CONCLUSION

Study findings reveal that racist microaggressions, along with LGBTQ-related family rejection and internalized LGBTQ-phobia, have a significant impact on psychological distress among SGM SOC. Public health leaders have an important opportunity for policy and program development and reform to address the identity-related mental health needs of SGM SOC.

Childhood Sexual Abuse and Associated Suicidal Ideation and Attempts Among Gay and Bisexual Men in China: A Moderated Mediation Model

Childhood sexual abuse (CSA) is a critical risk factor for suicidal ideation and attempts, especially among gay and bisexual men who experience living as a minority. However, whether internalized homophobia (IH) underlies suicide risk and the role of outness to one's family in this association warrants investigation to inform preventive interventions. Using a cross-sectional survey of 570 gay and bisexual men in China, we examined the relationship between CSA and suicidality in the Chinese context and tested a moderated mediation model in this relationship. Nearly 65.6% of the participants had experienced suicidal ideation and 36.8% had attempted suicide. Participants with a history of CSA had higher suicidal ideation (r = 0.33, p < .01) and attempts (r = 0.48, p < .01). Our bootstrapped mediation analysis showed that IH partially mediated the relationship between CSA and suicidal ideation and attempts. Moreover, outness to one's family (parents and other family members) strengthened the direct association of CSA and IH, and the indirect relationship between CSA and suicidal ideation and attempts. These findings highlight the significance of identifying risk factors and mechanisms for suicidality among Chinese gay and bisexual men, suggesting the importance of early intervention, especially for those who have experienced CSA, to eliminate their IH and to improve family support for coming out to prevent the onset of suicidal ideation and attempts.

Violence, Suffering and Subversion: Notes From a Qualitative Study About Schooling Trajectories of Brazilian Young Homosexuals

The objective of this article was to analyze the schooling trajectories of young homosexuals, as well as to verify situations that caused psychological distress in formal education environments. Three men who self-identified as homosexual participated in the research. Semi-structured, reflexive and group interviews were used as data collection methods and data were analyzed through Thematic Analysis. The participants' accounts revealed four key themes. 1) It was evident that the participants experienced multiple forms of violence and discrimination and that they suffered psychological distress in educational environments. As a result, 2) participants tended to hide their sexual identities in the school environment, reinforcing psychological distress. A key explanatory theme in the young people's accounts was 3) institutional neglect that centered on omissions and silences in the school context, thus reinscribing their invisibility. However, despite the detrimental environment and psychological distress, homosexual young men also 4) find ways to subvert and destabilize heteronormativity.

Determinants of public health and interventions to address HIV infection among men who have sex with men in Miami-Dade County, Florida, USA

Human immunodeficiency virus (HIV) among men who have sex with men (MSM) has been recognized as a public health problem in Miami-Dade County, Florida, USA. This was found to be a significant problem in our need assessment as evidenced by the HIV incidence rate of 28.4 per 100,000 population, which is higher than the average incidence reported for the state of Florida. MSM account for the mostly affected group, reaching 59% of all the new cases. A review of the HIV determinants was conducted using an ecological framework. At the individual level, sexual abuse, alcohol, and drug consumption were identified as determinants of HIV infection in this population. Family rejection was recognized as a determinant at the interpersonal level. Connection to the gay community can function as a protective factor but it can also be possible predictor of HIV infection. Among structural factors, poverty was found to be positively associated with HIV prevalence. Additionally, we highlighted the importance of sexual health education and especially pre-exposure prophylaxis (PrEP) as protective factors. By using systems thinking tools, we designed a causal loop diagram that illustrates visually the recognized determinants of public health. Finally, we presented several studies that evaluate evidence-based interventions to improve the uptake and retention in care of PrEP in MSM. We also described existing interventions implemented in Miami-Dade County, and reported studies that may contribute to the development of new HIV preventive strategies in the future.

Family Matters: The Impact of Traditional and Egalitarian Gender Role Messages on Sexual and Gender Minority Latinx Adults' Alcohol Use and Sexual Risk

Latinx sexual and gender minority individuals are at increased risk for engaging in risky sexual behavior given the intersection of their sexual orientation and ethnic identities. Many studies have found that sexual and gender minority Latinx folks experience nonacceptance and discrimination from within their families due to their identity. However, none have explored how underlying familial beliefs, such as traditional and egalitarian gender roles, influence sexual and gender minority Latinx adults' risky sexual behavior. Within a sample of 168 Latinx sexual and gender minority individuals, the present study examined the indirect effect of receiving traditional and egalitarian parental gender role messages on risky sexual behavior through alcohol use and internalized stigma related to their sexual and gender minority identity. Results showed that traditional gender role messages were indirectly associated with increased risky sexual behavior through increased alcohol use, whereas no such indirect effect was found through internalized stigma. Receiving egalitarian gender role messages was not associated with risky sexual behaviors. Findings from this paper can be used to tailor community outreach programs that aim to reduce sexual risk behaviors and alcohol use in the Latinx sexual and gender minority community as a result of traditional parental gender role messages.

Psychological Issues among Spanish Adolescents and Young People when Coming out of the Closet to Their Families

Some social settings may make the process of 'coming out' more difficult for gay males and lesbian females, and the decision to do so may be even more problematic for adolescents and young people. As a result, some may choose to hide their sexual orientation, leading to emotional suffering. This study aims to analyse the differences in perceived stress, life satisfaction, happiness, and psychological distress experienced by both coming out and closeted young people and teens. The sample included a total of 228 Spanish young people aged 16-23 years old (M = 19.69, S.D. = 1.81) who identified themselves as gay or lesbian (73.2% women). The results of this study show that people in the closet show greater psychological distress (anxiety and depressive symptomatology) and perceived stress. Although perceived stress is positively related to psychological distress in both groups, the correlation is higher in the closeted group. This suggests that perceived stress has more serious consequences on the mental health of the closeted group than of the 'coming out' group. To sum up, the results show the importance of family support for gay and lesbian young people.

Associations Between Fathers' Masculinity Orientation and Anticipated Reaction Toward Their Child's Coming Out

The present study examined associations between fathers' masculinity orientation and their anticipated reaction toward their child's coming out as lesbian or gay (LG). Participants were 134 German fathers (28 to 60years) of a minor child. They were asked how they would personally react if, one day, their child disclosed their LG identity to them. As hypothesized, fathers with a stronger masculinity orientation (i.e., adherence to traditional male gender norms, such as independence, assertiveness, and physical strength) reported that they would be more likely to reject their LG child. This association was serially mediated by two factors: fathers' general anti-LG attitudes (i.e., level of homophobia) and their emotional distress due to their child's coming out (e.g., feelings of anger, shame, or sadness). The result pattern was independent of the child's gender or age. The discussion centers on the problematic role of traditional masculinity when it comes to fathers' acceptance of their non-heterosexual child.

Understanding the Lived Experiences of Hispanic Sexual Minority Youth and their Parents

Disclosure of sexual identity and/or gender orientation is difficult for youth and is associated with elevated adverse health risks, particularly when there is parental rejection. There are limited studies conducted with Hispanic sexual minority youth (HSMY) and their families to understand the disclosure process, how the family unit changes and adapts following disclosure, and the implications for preventive interventions for HSMY and their families. This paper explores the lived experiences of youth and parents throughout the disclosure process. A phenomenological approach was used to interview 15 parent-youth dyads (N = 30) to understand what it means for Hispanic youth to disclose their sexual identity and/or gender orientation. Three themes that best described the experience emerged from the participant interviews; the experience of disclosing included intrapersonal challenges, navigating disclosure, and conceptualizing acceptance. The authors highlight implications for preventive interventions that can help these families undergoing the unique process of disclosure.

The interplay of familial warmth and LGBTQ+ specific family rejection on LGBTQ+ adolescents' self-esteem

INTRODUCTION

Our study sought to assess the interplay of family dynamics, namely familial warmth and LGBTQ+ specific rejection, and its association to self-esteem in a non-probabilistic sample of LGBTQ+ adolescents in the United States.

METHODS

Stratified by (1) cisgender and (2) transgender and non-binary LGBTQ+ adolescents (N = 8774), we tested multivariable regression analyses to assess the association between familial warmth and LGBTQ+ specific family rejection, adjusted for sociodemographic characteristics. We then conducted a sub-analysis with LGBTQ+ adolescents who reported being out to any family member about their LGBTQ+ identity; specifically, we tested a series of multivariable regression models to assess whether levels of LGBTQ+ specific family rejection attenuated the association between familial warmth and self-esteem.

RESULTS

Full sample models indicated a positive association between familial warmth and self-esteem. Findings from our sub-analysis indicated that familial warmth remained positively linked to self-esteem and family rejection was negatively associated with self-esteem. Family rejection was a statistically significant moderator, attenuating the association between familial warmth and self-esteem. With respect to being out about one's sexual orientation, these findings were robust across gender stratification groups.

CONCLUSIONS

Families of origin serve as sources of stress and resilience for LGBTQ+ adolescents. Our findings contribute support to arguments that familial warmth and LGBTQ+ specific rejection are not mutually-exclusive experiences among LGBTQ+ adolescents. We provide recommendations for multilevel interventions to leverage activities that support positive family dynamics and self-esteem among LGBTQ+ adolescents.

The Effect of Early Traumatic Experiences on Attachment Styles in Sexual Gender Minority Individuals

PURPOSE

This study was carried out to specify the attachment characteristics of sexual gender minority individuals and to determine the effects of childhood traumatic experiences on attachment styles.

DESIGN AND METHODS

A descriptive cross-sectional study was conducted on 141 sexual gender minority individuals from 2016 to 2017.

FINDINGS

The number of childhood physical and sexual trauma episodes was found to be high in sexual minorities; in particular, the traumatized narratives were found to be associated with an avoidant attachment style (p > 0.05).

PRACTICE IMPLICATIONS

The study results may contribute to healthcare professionals' understanding of childhood trauma as it relates to sexual identity development and attachment disorders sexual identity development and attachment disorders.

Being Simultaneously Curious and Stressed, Precipitants to Methamphetamine Initiation Among Chinese Men Who Have Sex With Men: Findings From a Qualitative Study

ABSTRACT

The cultural context and precipitants for initiating methamphetamine (MA) using among Chinese men who have sex with men (MSM) are unclear. This qualitative descriptive study, which explores the specific precipitants of MA initiation within a cultural context among MSM in China, was conducted with data from semistructured, face-to-face interviews with 24 MA-using MSM (8 HIV positive). Two themes were identified, internal precipitants included the following: (a) curiosity, (b) desire for maximum sexual pleasure, (c) experience with other drugs, and (d) strong sense of self-control capacity. External precipitants included (a) Xiao (filial piety), (b) peer pressure, (c) negative life events, (d) parental emotional neglect, and (e) experiences of homophobia. Internal precipitants to MA initiation for Chinese MSM are consistent with past research. External precipitants were more culture specific. This exacerbates the vulnerability of MSM to MA initiation and keeps it hidden among this population. Future drug use prevention interventions for MSM should address external precipitants and integrate culture-specific strategies.

Same-Sex Attraction Disclosure and Sexual Communication Topics within Families

Few studies compare family communication about sex and relationships for sexual minority youth versus hetero-sexual teenagers. Further, existing studies often focus on mothers, overlooking fathers and extended family. Our survey of 952 adolescents aged 14-21 included 115 adolescents disclosing non-heterosexual attraction. Mothers offered more sexual protection methods messages to their non-SM teens, whereas fathers talked less with SM teens about risks of sex and relational sex. Most participants identified mothers, sisters, and female cousins, with male SMs having the highest number of disclosures to family members, whereas female and non-binary SMs confided in fewer family members or no one.

Immigrant Status and Sexual Orientation Disclosure: Implications for HIV/STD Prevention Among Men Who Have Sex with Men in Seattle, Washington

Men who have sex with men (MSM) are disproportionately affected by HIV and may avoid disclosing their sexual preferences to others. With heightened attention on immigrant status in the United States, foreign-born MSM may be particularly concerned about disclosing their sexual orientation. We sought to examine how immigrant status is associated with sexual orientation disclosure among MSM and to assess the impact of disclosure on HIV/STD prevention outcomes stratified by nativity. We analyzed data from the 2014 and 2017 Seattle-area surveys of MSM from the National HIV Behavioral Surveillance (NHBS) system. Foreign-born MSM were less likely than U.S.-born MSM to have disclosed their sexuality to friends who are not gay, lesbian, or bisexual (85.0% vs. 95.5%; p < .001) or to family members (80.5% vs. 91.3%; p < .001). Further, disclosure to one's health care provider significantly increased the likelihood of having tested for HIV in the past 12 months among foreign-born and U.S.-born MSM. Findings highlight the need to better understand the risks and benefits of disclosure among foreign-born MSM. Future research may explore how responses and reactions to disclosure among foreign-born MSM shape pathways to HIV risk and prevention.

Internalizing Symptoms and Externalizing Behaviors in Latinx Adolescents with Same Sex Behaviors in Miami

Sexual minorities report poorer mental health relative to heterosexual counterparts, but this is underexplored in Latinx youth. This study compares internalizing symptoms and externalizing behaviors in Latinx adolescents with Same Sex Behaviors (LASSB) to their Latinx adolescent peers who did not report same sex behaviors (non-LASSB). It also explores the moderating role of biculturalism on the relationship between internalizing symptoms and externalizing behaviors, and same-sex behaviors. Individual-level baseline data (Total N=1,634; LASSB n=195) from five trials of a preventive intervention for Latinx adolescents were synthesized. Normal and clinical levels of internalizing symptoms and externalizing behaviors were determined, and logistic regression models were conducted to determine the odds of LASSB reporting these behaviors relative to non-LASSB. Additional adjusted models tested for the moderating effect of biculturalism. LASSB reported significantly higher odds of normal levels of all externalizing behaviors and clinical levels of anxious/depressed compared to non-LASSB. Biculturalism significantly moderated the association between same-sex behavior and clinical levels of internalizing behaviors; however, in subgroup analyses among LASSB, biculturalism did not significantly predict any of these behaviors. Latinx adolescents exhibited mental health disparities by same-sex behavior. Biculturalism may be an important indicator for describing these disparities in LASSB and should be further explored.

Lack of virologic suppression is associated with lower HIV-related disclosure stigma in people living with HIV

Stigma remains a leading barrier to HIV care. To determine the influence of disclosure stigma (DS), fear of disclosing one's serostatus, on virologic suppression, a cross-sectional study was performed at the largest publicly-funded HIV clinic in South Texas. A survey was administered to participants who were: ≥18 years old, living with HIV, and receiving antiretroviral therapy. Surveys included demographics, adherence questionnaire, and a validated HIV-stigma scale with DS as the sum of 10 items ranked 0-3, with score of 30 indicating highest stigma. The primary outcome was lack of virologic suppression (LOVS): most recent HIV-1 RNA > 20 copies/ml. A bivariate analyses examined predictors of DS, dichotomized at the median. Depression score, perceived stress, and lack of friend/family support were associated with DS. Logistic regression models examined the relationship between DS, as a continuous variable, and LOVS. For 275 participants (69% Hispanic), median DS score was 18.5. DS was significantly inversely associated with LOVS (aOR 0.94 per 1 scale point; CI 0.89, 0.99) after adjustment for age, gender/sexual orientation, race/ethnicity, and drug use. The unanticipated inverse association between DS and LOVS highlights the complexity of this relationship. However, the balance of data in this cohort demonstrate an overall negative impact of DS.

Intersectionality and Health Behaviors Among US High School Students: Examining Race/Ethnicity, Sexual Identity, and Sex

BACKGROUND

Little research exists examining the impact of multiple minority identities, particularly sexual orientation, race/ethnicity, and sex on health-risk behaviors like mental health, substance use, violence, and sexual risk among high school students in the United States. In this study, we use a nationally representative dataset to examine differences between non-Hispanic white heterosexuals (HSs) and non-Hispanic white sexual minority, black HS, black sexual minority, Hispanic HS, and Hispanic sexual minority students.

METHODS

Data from the 2015 wave of the Youth Risk Behavioral Surveillance System were used in this study. Chi-square and hierarchical logistic regression models examined differences between the groups on outcomes including: (1) mental health and suicide, (2) alcohol, tobacco, and illicit substances, (3) sexual risk and protective factors, and (4) school and physical and/or sexual violence.

RESULTS

Whereas sexual minority youth (SMY) generally demonstrate poorer health outcomes compared to HSs, SMY who are also racial/ethnic minorities often have even poorer health outcomes, particularly relating to substance use, sexual risk behaviors, physical/sexual violence, and suicide.

CONCLUSIONS

The need for culturally tailored education and school-based interventions that consider intersections between race/ethnicity, sexual identity, and biological sex are warranted to address health disparities related to mental health and suicide, substance use, sexual risk, and violence.

Social Support and Other Factors Associated with HIV Testing by Hispanic/Latino Gay, Bisexual, and Other Men Who Have Sex with Men in the U.S. South

Cognitive-psychosocial and other factors may affect participation in HIV testing, particularly by Hispanic/Latino gay, bisexual, and other men who have sex with men (MSM) in the U.S. South, a region hard-hit by HIV. We used univariate and multivariable logistic regression analyses to examine the association between social support and other cognitive-psychosocial factors; sociodemographic characteristics; risk behaviors; and self-reported HIV testing in a sample of 304 Hispanic/Latino MSM in North Carolina. In the multivariable logistic regression analysis, general and HIV-related social support and HIV-related knowledge were associated with greater odds of testing; speaking only Spanish was associated with reduced odds of testing. Social support and aspects of social connectedness may constitute community-based resources for use in HIV prevention efforts with Hispanic/Latino MSM. However, harnessing these resources for HIV prevention will require a better understanding of how social support relationships and processes shape HIV risks and protective actions by these vulnerable MSM.

The Correlation between Stigma and Family Acceptance with Religiosity of PLWH MSM in Medan, Indonesia

There are several factors related to religiosity of PLWH MSM in Medan. This study aimed to identify the correlation between stigma and family acceptance with religiosity of PLWH MSM in Medan. This cross-sectional study applied purposive sampling technique and involved 175 samples from H. Adam Malik Public Central Hospital, Medan Pirngadi Hospital, Padang Bulan and Teladan Public Health Centers. The data was analyzed using the multiple logistic regression technique. Bivariate analysis showed a significant correlation between stigma along with family acceptance with religiosity of PLWH MSM in Medan (p = 0.005; α = 0.005).

Correlation of family acceptance and peer support group toward sexual behavior risk on MSM with HIV/AIDS in Medan, Indonesia

OBJECTIVES

This research aims to determine the relationship of family acceptance and peer group support toward sexual behavior risk and the sociodemographic factors that influence it.

METHOD

The study uses cross-sectional design, which involves 180 MSM (men who have sex with men) with HIV/AIDS as respondents, using a consecutive sampling technique.

RESULTS

The results show that most respondents have high family acceptance (52.8%) and good peer support (56.1%); 56.7% of respondents have high sexual behavior risk. The chi-squared test determined a significant relationship between family acceptance and peer support with sexual behavior risk (p<0.001 and p<0.001; α=0.05).

CONCLUSION

Nursing interventions that encourage family members to always accept the condition of patients-specifically MSM-with HIV/AIDS are necessary to prevent sexual behavior risk.

Interpersonal Sensitivity and Loneliness among Chinese Gay Men: A Cross-Sectional Survey

To understand the current status of, and factors related to interpersonal sensitivity (IS) and loneliness among Chinese gay men. The Chinese version SCL-90-R was used to evaluate the status of IS, and the short-form UCLA Loneliness scale (ULS-8) was used for assessing loneliness level. Associations between demographics and IS were examined by chi-square tests and multivariable logistic regress analysis. Linear regression was used to assess the correlations between demographic factors and IS and loneliness. Dating practices and venues were summarized by multiple responses. Gay men who screened positive IS was identified in 36%. Age (OR_25-29 = 8.731, 95% CI 2.296 to 33.139), education level (OR_college = 0.037, 95% CI 0.046 to 0.911), being the only-child at home (OR_yes = 4.733, 95% CI 2.293 to 9.733), monthly income (OR_>7000 = 0.228, 95% CI 0.055 to 0.944), numbers of current sexual partners (OR₁ = 0.285, 95% CI 0.129 to 0.629; OR₂ = 0.109 95% CI 0.027 to 0.431) were related to IS. IS was also associated with a higher score of ULS-8 (β = 6.903, p < 0.001). Other variables associated with the score of ULS-8 included: living in a non-nuclear family (β = 0.998, p = 0.020), being a college student (β = -1.556, p = 0.044), having a higher monthly income (β for 3000-5000 yuan = -1.177, p = 0.045; β for over 7000 yuan = -2.207, p = 0.002), having sexual partners (all β < 1, p < 0.001), being the only-child (β = 1.393, p = 0.005). Nearly half of the sample (46.78%) reported that they looked for dating partners on the Internet or dating apps. IS and loneliness are positively correlated. Our study suggests that more humanistic care and social support should be given to Chinese gay men.

Hispanic Parental Experiences of Learning a Child Identifies as a Sexual Minority

Sexual minority youth (SMY) who do not feel loved and supported by their families face greater challenges and often experience various health disparities. The coming-out process is often difficult for all SMY and their families. While there is limited research on the impact of sexual orientation disclosure on families, there is even less that focuses exclusively on Hispanic families. This qualitative study explores the impact on a sample of Hispanic parents of having a child come out as lesbian, gay, or bisexual. The results demonstrate that while coming out is often challenging for SMY and their families, these challenges may be exacerbated for Hispanics due to cultural factors that contribute to children living at home longer and negative reactions to being gay. Parental reactions, impacts of disclosure on the family, and the impact of cultural factors are discussed. This study helps illuminate how cultural factors influence the coming out experience of Hispanic parents. These findings are important for understanding the experiences of these families in order to provide culturally appropriate resources for families navigating the coming out process.