Sexual orientation and differences in HIV cognitions

Medical avoidance among marginalized groups: the impact of the COVID-19 pandemic

Medical avoidance is common among U.S. adults, and may be emphasized among members of marginalized communities due to discrimination concerns. In the current study, we investigated whether this disparity in avoidance was maintained or exacerbated during the onset of the COVID-19 pandemic. We assessed the likelihood of avoiding medical care due to general-, discrimination-, and COVID-19-related concerns in an online sample (N = 471). As hypothesized, marginalized groups (i.e., non-White race, Latinx/e ethnicity, non-heterosexual sexual orientation, high BMI) endorsed more general- and discrimination-related medical avoidance than majoritized groups. However, marginalized groups were equally likely to seek COVID-19 treatment as majoritized groups. Implications for reducing medical avoidance among marginalized groups are discussed.

How Can I Get COVID?: Understanding Differences in American Heterosexual and Sexual Minority Men’s Risk Perception

Men are more vulnerable to COVID-19 infections compared to women, but their risk perceptions around COVID-19 are persistently lower. Further, men often engage in less health promotion behavior because self-care in this capacity is seen as weak or less masculine. This combination has consequences for mortality; thus, a better understanding of men’s COVID-19 cognitions and individual difference factors is critical. In a web-based survey conducted during the beginning stages of the pandemic in the U.S., we collected risk perceptions of various sexual and non-sexual behaviors from heterosexual (n = 137) and gay/bisexual men (n = 108). There were no significant sexual orientation differences for perceptions of COVID-19 risk from routine activities or in overall risk estimates. However, gay/bisexual men did report engaging in more precautionary behavior while socializing (i.e., masking, social distancing) and reported higher risk perceptions than did heterosexual men for nearly all intimate and sexual activities. A more nuanced understanding of cognitions around COVID-19 is needed to better understand motivation for—and especially motivation against—pursuing vaccinations and continuing precautionary behavior.

Gendered Experiences of Living with HIV in Australia

Globally, women represent more than half the people living with HIV. This proportion varies by country, with an over-representation of HIV among men who have sex with men (MSM) in some regions. For example, in Australia, MSM account for over 60% of transmissions, with heterosexual sex accounting for almost a quarter of transmissions. Irrespective of geographic region, there is evidence that women can have a different lived experience of HIV due to their unequal social and economic status in society, while MSM can have a different lived experience depending on the laws and customs of their geographic location. Gender differences related to risk factors, stigma, access to services, mental health, health-related quality of life and economic consequences have been consistently reported globally. This paper explores the subjective lived experience of gender and sexuality disparities among three individuals living with HIV in Australia: a male who identified as gay, and a male and female who each identified as heterosexual. Analysis of themes from these three case reports indicated discernible differences by gender and sexuality in four areas: access to medical services, social support, stigma and mental health. It is argued that knowledge and understanding of potential gender and sexuality disparities must be factored into supportive interventions for people living with HIV in Australia.

Sexual orientation and quality of life of people living with HIV/AIDS in China: evidence from an institutional-based cross-sectional study

BACKGROUND

At the end of 2019, there were approximately one million people known to be living with HIV/AIDS (PLWHA) in China. Different sexual orientation groups were observed within the people living with HIV in general, and studies have found that socially marginalized groups exist among this population, such as men who have sex with men (MSM) and bisexual individuals. Correspondingly, sexual orientation may pose challenges to the emotional and psychological development of PLWHA. Under this background, we aim to analyze whether sexual orientation affects the health-related quality of life (HRQOL) of PLWHA in order to provide evidence and suggestions for how wellbeing can be enhanced for sexual minorities living with HIV/AIDS.

METHOD

An institutional-based cross-sectional study design was used to collect data from PLWHA in Yunnan province and Beijing municipality in China. In our study, sexual orientation was classified as heterosexual, homosexual and bisexual, and HRQOL was measured using the Chinese WHOQOL-HIV-BREF scale. Logistic regression model was used to analyze the relationships of participants' sexual orientation and HRQOL. In addition, multivariable stepwise liner regression model was used to analyze the factors influencing HRQOL of PLWHA.

RESULTS

In total, 2610 PLWHA were included in the study, 36.5% of the participants identified as homosexual and most were males, 13.8% were bisexuals and 49.7% were heterosexuals. For the overall HRQOL, the homosexual PLWHA group scored highest (81.53 ± 12.45) with a high HRQOL score signifying a better health-related quality of life, followed by bisexuals (79.72 ± 12.81) and heterosexuals (78.02 ± 13.06). However, the bisexual group showed a markedly higher level of spiritual health. In addition, there was no statistical difference in the total HRQOL scores and domains by sex roles among the homosexual group (p > 0.01). However, sexual orientation was statistically associated with the physical and spiritual domains of HRQOL (p < 0.05).

CONCLUSION

In terms of sexual orientation for those living with HIV/AIDS, a better quality of life was found for homosexual individuals, whilst being a heterosexual individual saw a negative impact on quality of life, especially in the physical and spiritual domains. Strengthening the individualized and comprehensive care for heterosexual group as well as other sexual minority populations is imperative. Moreover, heterosexual PLWHA are more likely to be ignored and require more support and care to improve their HRQOL than do those in sexual minorities.