Examining the Influence of Pre-HAART Experiences on Older, Self-Identifying Gay Men's Contemporary Constructions of Quality of Life (QOL)

Some older gay men (50+) experience diminished quality of life (QOL) due to historical and ongoing discrimination in addition to living through a collective trauma-the pre-HAART era of the HIV/AIDS epidemic-characterized by the absence of treatment and rampant discrimination targeting gay men. A growing body of literature, however, illustrates that older gay men demonstrate remarkable resilience but little is known about how QOL is conceptualized and how these conceptualizations are potentially shaped by pre-HAART experiences. The current study drew on constructivist grounded theory methods to examine how QOL is conceptualized in light of the sociohistorical relevance of pre-HAART. Twenty Canadian based gay men aged 50+ participated in semi-structured interviews via Zoom. Ultimately, QOL is understood as experiencing contentment, which is made possible by the development and implementation of three key processes: (1) developing and cultivating meaningful connections, (2) growing into and embracing identity, and (3) appreciating the capacity to do what brings joy. QOL for this group is greatly informed by a context of disadvantage, and the demonstrated resilience warrants further investigation to meaningfully support the overall well-being of older gay men.

Scoping Literature Review: Experiences of Sexual and Gender Minority Older Adults, With Diagnoses of Dementia, Who Use Residential Long-Term Services and Supports

The number of sexual and gender minority (SGM) older adults utilizing residential long-term supports and services (LTSS) will increase in the forthcoming decades. Paradoxically, while requiring more LTSS services than their non-SGM counterparts, SGM older adults are less likely to access these services, partly due to fears of discrimination. Furthermore, SGM older adults living with Alzheimer's disease and related dementias (AD/ADRD) present unique challenges and opportunities for LTSS facilities. This article provides a scoping review on the intersection between experiences of SGM older adults with AD/ADRD who use residential LTSS. This review identified three themes: (1) the experiences of discrimination among SGM residents in LTSS facilities, (2) the need for comprehensive staff training in residential LTSS to ensure proper care of SGM populations, and (3) the crucial role of inclusive facility policies. As the number of SGM older adults is expected to increase, further research is necessary.

Exploring discrimination, social acceptance, and its impact on the psychological well-being of older men who have sex with men: A cross-sectional study

BACKGROUND

The exploration of discrimination, social acceptance, and their impact on the psychological well-being of older men who have sex with men (MSM) is a critical area of study within the broader field of LGBTQ+ research. This demographic, comprising individuals who identify as both male and homosexual and are aged in the older spectrum of the population, faces unique challenges that intersect age, sexual orientation, and societal attitudes. Objectives This study aimed to explore the relationship between social acceptance and isolation with discrimination and the impact on the psychological well-being of older MSM.

METHODS

A cross-sectional survey was administered among older MSM residing in three distinct regions: the People's Republic of China (PRC), Hong Kong, and Taiwan, with a total sample size of N = 453 participants, evenly distributed with N = 151 individuals from each region. The survey included the General Health Questionnaire-12 (GHQ-12), the Discrimination and Self-Stigma Evaluation Scale (DSSES), and the Perceived Acceptance Scale (PAS) which measures the perceived social acceptance from friends, mother, father, and family. The data were analyzed using descriptive statistics, ANOVA, and regression analysis.

RESULTS

The mean scores of the GHQ-12 indicated that the participants had a moderate level of psychological distress, with a mean score of 6.38 (SD = 2.55). The DSSES mean score was 27.78 (SD = 8.73), indicating that participants experienced discrimination in their everyday lives. The PAS mean score was 3.08 (SD = 0.48), indicating that participants had a moderate level of perceived social acceptance. These results suggest that discrimination and social acceptance differ among older MSM in different areas in PRC, Hong Kong, and Taiwan.

CONCLUSIONS

The study highlights the impact of discrimination and social acceptance on the psychological well-being of older MSM. The findings suggest that interventions aimed at reducing discrimination and promoting social acceptance may improve the psychological well-being of older MSM. These results have important implications for healthcare providers and policymakers in developing strategies to promote social acceptance and reduce discrimination towards older MSM.

Older, self-identifying gay men's conceptualisations of psychological well-being (PWB): A Canadian perspective

Many older gay men experience diminished psychological well-being (PWB) due to unique circumstances including discrimination, living with HIV, and aging through the HIV/AIDS crisis. However, there remains ambiguity as to how older gay men define and understand PWB. Our team interviewed and analyzed the accounts of 26 older (50+) self-identifying English-speaking men living in southwestern British Columbia, Canada. We drew on tenets of constructivist grounded theory and intersectionality to account for unique contextual considerations and power relations. Semi-structured Zoom interviews were conducted from August-October 2022. Interview transcripts were compared to generate high-order conceptual findings underpinned by processes understood as central to PWB. Three PWB temporal processes highlighted interlocking social and contextual circumstances intersecting with power and maturation: (1) being emotionally balanced, (2) living gratitude (3) and fully embracing self-acceptance. Being emotionally balanced supported the affective and sustainable state of contentment, living gratitude drew from the wisdom of accrued experiences to cultivate a positive affective state inclusive to recognising social location privileges, whilst fully embracing self-acceptance redressed the harms of anti-gay discourses that men endured throughout their lives. The knowledge is relevant to service and resource development to deliver tailored PWB supports to older gay men.

The impacts of sexual stigma on the mental health of older sexual minority men

OBJECTIVES

The purpose of this study was to explore the impacts of sexual stigma experiences on the mental health of older gay and bisexual men in Portugal.

METHODS

Self-identified older gay and bisexual men (n = 210) between 50 and 80 years old (mean age = 60.03; SD = 6.33) participated in this study. Measurement instruments included a sociodemographic questionnaire, the Brief Symptom Inventory-18, measures of suicidal ideation and intention, and the Sexual Stigma Scale.

RESULTS

Older gay and bisexual men with higher levels of sexual stigma presented significantly higher anxiety, depression, somatization, and suicidal ideation scores. Correlational analyses showed significant correlations among mental health variables and sexual stigma variables. Regression analyses showed that sexual stigma explained 11% of anxiety symptoms, 10% of depression symptoms, and 9% of somatization symptoms.

DISCUSSION

Sexual stigma has a negative impact on older gay and bisexual men's mental health. Mental health professionals should be aware of how sexual stigma affects sexual minority men's quality of life and work toward the reduction/elimination of sexual stigma in society.

Loneliness Perceptions in Older Portuguese Gay and Bisexual Men

The purpose of this study was to explore the perceptions of loneliness among gay and bisexual men in Portugal over 60 years old. Despite the growth of the older population in Portugal, the social isolation and loneliness experiences in older gay and bisexual men is only beginning to be understood. A structured electronic inquiry with 35 gay and bisexual men over 60 years of age from Portugal (mean age was 66.45 years (SD = 4.45) was used, ranging from 60 to 77 years). Data were analyzed using thematic analysis, comparing self-perceived loneliness levels by sexual orientation and by levels of loneliness. The recurrent themes in the narratives of loneliness perception of the participants in the study were as follows: Mental Health, Support System, Dating and Relationships, Discrimination, Coping, Personal Characteristics, and Coming-out issues. Differences between sexual orientation and levels of loneliness were also found.

The Importance of Social Support, Positive Identity, and Resilience in the Successful Aging of Older Sexual Minority Men

The aim of this study was to assess the relationship between social support, positive identity, and resilience and the successful aging of older sexual minority men. The study involved having 210 self-identified gay and bisexual men aged between 50 and 80 years complete a cross-sectional online survey comprised of sociodemographic information; the Portuguese version of the Multidimensional Scale of Perceived Social Support; the Lesbian, Gay, and multifactor Bisexual Positive Identity Measure; the Connor–Davidson Resilience Scale 10; and the Successful Aging Perceptions Scale. The results showed that self-identified gay participants showed higher levels of positive identity, while bisexual participants scored higher for resilience, mental health, and successful aging. Higher levels of social support, resilience, and positive identity were significant predictors of mental health (28%), physical health (18%), and successful aging (10%) in our sample. These results offer similarities with the growing body of literature on the positive factors of successful aging in the gay and bisexual men communities, which is an important step in the development of aging and health preventive initiatives among this population.

Psychosocial Impacts of COVID-19 Pandemic on Lesbian, Gay, and Bisexual People Living in Portugal and Brazil—A Qualitative Study

Introduction:

Not many studies have been reported from Portugal or Brazil to date, regarding the psychosocial impacts of COVID-19 on lesbian, gay, and bisexual (LGB) people, especially from a qualitative perspective.

Materials and Methods:

A convenience sample of 65 self-identified LGB individuals from Portugal and Brazil participated in this study. Thirty-two participants were from Portugal and 33 from Brazil. The average age was 34.48 years (standard deviation = 11.66), ranging from 19 to 67. We used an online interview approach in an asynchronous format. All study respondents completed a structured inquiry consisting of a short section of sociodemographic questions and a single open-ended question: “As a lesbian, gay, bisexual (or other) self-identified person, please elaborate on how the COVID-19 pandemic has impacted your life.”

Results:

The thematic analysis of participants’ responses revealed 9 recurring themes, encompassing 18 subcategories to occur: mental health (depression, anxiety, fear, anger, and loneliness), isolation (social distancing and leisure impediments), relationships (family and friends), work-related problems, education-related problems, financial problems, changes (behavioral changes and opportunity to grow), coping (seeking support, accessing information and physical activities), and LGBTQI (lesbian, gay, bisexual, transgender, queer and intersex) topics (health barriers, going back into the closet, pride celebration events, and online dating).

Conclusions:

Our results provide voice to LGB Portuguese and Brazilian people during the COVID-19 pandemic demonstrating specific challenges exacerbated by stigma and sexual discrimination amplified by preexistent social inequalities.

The Impact of COVID-19 on Depressive Symptoms through the Lens of Sexual Orientation

This research seeks to explore the impact of COVID-19 on depressive symptoms, analyzing discrepancies of sexual orientation in a Portuguese-speaking sample. 1590 individuals participated, of which 63% were women, and 88% self-identified as straight. Participants responded to the depression sub-scale of the Beck Symptoms Iventory-18, the fear of COVID-19 scale and the COVID-19 negative impact scale. Depressive symptoms observed were higher than expected, and several significant differences were obtained: women and self-identified bisexual participants had higher levels of depressive symptoms compared to male and straight and gay or lesbian participants. Depressive symptoms negatively correlated with age and positively correlated with COVID-19 aggravated responses, fear of COVID-19, and negative impact of COVID-19. Hierarchical linear regression analysis showed that age, gender and sexual orientation explained 6% of the variance of depressive symptoms, and when fear and the negative impact of COVID-19 was added, the model explained 23% of results. This study provides an important contribution to the understanding of factors arising from the pandemic that may have an impact on the mental health of sexual minorities.

Intimate Dynamics and Relationship Satisfaction among LGB Adolescents: The Role of Sexual Minority Oppression

Adolescent lesbian, gay, and bisexual (LGB) romantic partners face the challenge of developing satisfactory relationships while managing stressors associated with being members of a stigmatized minority group due to their sexual minority status. The aims of this study were to explore and describe relationship dynamics among LGB adolescents that are in committed same-sex relationships in Portugal, to assess levels of satisfaction with their relationships, and to assess whether LGB oppression was associated with the likelihood of anticipating and experiencing problems within the relationship. A sample of 182 self-identified LGB adolescents (mean age = 17.89 years; SD = 1.99), completed an online survey consisting of various sociodemographic measures, a relationship dynamics questionnaire, a self-assessment of relationship satisfaction, and an adapted version of the Gay and Lesbian Oppressive Situations Inventory. Results show that participants were highly satisfied with their relationships, except those who were non-monogamous and less committed to their relationships. Participants showed moderate levels of LGB oppression situations, and, as demonstrated by the hierarchical multiple regression analysis, age (being older), having lower levels of commitment, and being exposed to higher levels of exclusion, rejection, and separation were strong predictors of lower levels of relationship satisfaction.

Health Status and Quality of Life of Middle-Aged and Older Taiwanese Sexual and Gender Minorities

PURPOSE

To examine the health status and quality of life of middle-aged and older sexual and gender minority adults in Taiwan.

RESEARCH DESIGN AND METHODS

A cross-sectional online survey was conducted between May and December 2019. A total of 535 self-identified lesbian, gay, bisexual, and transgender (LGBT) men and women ≥40 years of age were included in the final sample. An online questionnaire, which included the following three sections, was used to collect data in this study: (a) demographics, (b) the World Health Organization Quality of Life-Brief Taiwan version, and (c) physical and psychological health status.

RESULTS

Middle-aged and older Taiwanese LGBT adults who were single, were unemployed, and earned monthly incomes of <20,000 New Taiwan Dollars reported poorer quality of life. Participants with one or more physical or psychological health problems also reported poorer quality of life than those who had no health problems. In addition, singlehood, unemployment, and poor quality of life and health were positively associated with mental health issues.

CONCLUSIONS

It is important to attenuate health disparities and mitigate discrimination within Taiwanese society to enhance the quality of life and mental health of middle-aged and older Taiwanese LGBT adults.

CLINICAL RELEVANCE

Healthcare providers should be attuned to and knowledgeable about the health issues and specific healthcare needs of middle-aged and older LGBT adults, and they should also provide culturally competent care to reduce health disparities of the LGBT adults.