1
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Starks TJ, Robles G, Dellucci TV, Cain D, D Kyre K, Outlaw AY, Lovejoy TI, Naar S, Ewing SWF. Optimizing Individual HIV Testing and Counseling for Emerging Adult Sexual Minority Men (Aged 18 to 24) in Relationships: A Pilot Randomized Controlled Trial of Adjunct Communication Components. AIDS Behav 2024; 28:2730-2745. [PMID: 38801503 DOI: 10.1007/s10461-024-04371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 05/29/2024]
Abstract
The majority of new HIV infections in the US occur among sexual minority men (SMM) with older adolescent and emerging adult SMM at the highest risk. Those in relationships face unique HIV prevention challenges. Existing sexual HIV transmission risk interventions for male couples often encounter implementation challenges and engaging younger SMM early in relationships may be particularly difficult. This pilot randomized controlled trial evaluated the acceptibility and feasibility of We Test HIV testing - a behavioral health intervention tailored for younger SMM in realtionships - and generated preliminary estimates of effect size. The intervention comprises two adjunct moduls - video-based communication skills training as well as communication goal setting and planning - delivered in conjunction with routine HIV testing and counseling in individual or dyadic formats. A sample of 69 SMM aged 17 to 24 were recruited online. Following baseline assessment, youth were randomized to receive either the experimental, We Test, intervention or routine HIV testing (the control condition). Follow-up assessments were completed 3 and 6 months post-baseline. Results suggested the study was feasible and the individually delivered format was acceptible. We Test HIV testing was associated with significant improvements in communication skills. In addition, youth who remained in a relationship experienced an increase in communal coping to reduce HIV infection risk and relationship power. While groups did not differ with respect to condomless anal sex with casual partners, these psycho-social constructs (communication, communal coping with HIV prevention, and relationship power) may serve as mediators of intervention effects on sexual risk reduction in a larger study.
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Affiliation(s)
- Tyrel J Starks
- Department of Psychology, Hunter College, City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA.
- Graduate Program in Health Psychology and Clinical Practice, Graduate Center, City University of New York, New York, NY, USA.
| | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | - Trey V Dellucci
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Demetria Cain
- Department of Psychology, Hunter College, City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - Kory D Kyre
- Department of Psychology, Hunter College, City University of New York, 695 Park Ave. 611 Hunter North, New York, NY, 10065, USA
| | - Angulique Y Outlaw
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Travis I Lovejoy
- Division of Clinical Psychology, School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Sylvie Naar
- Center for Translational Behavioral Sciences, Florida State University College of Medicine, Tallahassee, FL, USA
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2
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Petrizzo K, Moxie J. Past experiences and preferences for LGBTQ + sex education among LGBTQ + college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-11. [PMID: 38442354 DOI: 10.1080/07448481.2024.2317173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/30/2024] [Indexed: 03/07/2024]
Abstract
Background: Lesbian, gay, bisexual, transgender, queer, and others (LGBTQ+) students experience more negative sexual health outcomes than their cisgender, heterosexual peers and do not have access to relevant sex education. This denial necessitates comprehensive sex education in college for LGBTQ + students. Objective: Given the rise of online learning and that LGBTQ + students are already drawn to online spaces, this research seeks to determine preferences in virtual LGBTQ + sexuality education content and delivery LGBTQ + college students. Methods: We conducted a survey with US college students who identified as LGBTQ+ (N = 91) to identify past experiences with sex education, desires for future sex education, and preferences for online learning. Results: Past sex education, resources used, consequences, preferences for LGBTQ + sexuality and online education are discussed. Conclusions: Overall, we find high comfort with online learning, heteronormative and cisnormative past sex education courses created negative physical and mental health outcomes, and desires for tailored sex education.
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Affiliation(s)
- Kristen Petrizzo
- Department of Sociology, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Jessamyn Moxie
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
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3
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Exploring the psychological and physiological impacts of digital microaggressions and hostile online climates on LGBTQ + youth. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04435-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
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4
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Siegel M, Randall AK, Lannutti PJ, Fischer MS, Gandhi Y, Lukas R, Meuwly N, Rosta-Filep O, van Stein K, Ditzen B, Martos T, Schneckenreiter C, Totenhagen CJ, Zemp M. Intimate Pride: a Tri-Nation Study on Associations between Positive Minority Identity Aspects and Relationship Quality in Sexual Minorities from German-Speaking Countries. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2022; 8:1-29. [PMID: 35936990 PMCID: PMC9344453 DOI: 10.1007/s41042-022-00070-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/01/2022] [Indexed: 11/29/2022]
Abstract
Investigations into the intimate relationships of sexual minorities are proliferating, but often adopt a deficit-oriented and US-centered perspective. In this tri-nation online study with sexual minority participants from Austria, Germany, and Switzerland (N = 571), we (i) assessed the construct validity of the German version of a well-known measure for positive minority identity aspects (the Lesbian, Gay, Bisexual Positive Identity Measure; LGB-PIM), and (ii) explored associations between these aspects (self-awareness, authenticity, community, capacity for intimacy, and social justice) and self-reported relationship quality. Model fit of the German version of the LGB-PIM was deemed acceptable. Higher levels of positive minority identity aspects showed small to moderate associations with higher levels of relationship quality in bivariate analyses, but only capacity for intimacy was linked to relationship quality in higher-order models (controlling for country, age, sexual orientation, gender identity, relationship length, and psychological distress). Results remained robust in several sensitivity analyses. Our results highlight the differential role of positive identity aspects for relationship functioning, with capacity for intimacy as a fruitful leverage point for therapeutic work.
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Affiliation(s)
- Magdalena Siegel
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Ashley K. Randall
- Counseling and Counseling Psychology, Arizona State University, Tempe, USA
| | | | - Melanie S. Fischer
- Institute of Medical Psychology, Heidelberg University Hospital & Heidelberg University, Heidelberg, Germany
| | - Yuvamathi Gandhi
- Counseling and Counseling Psychology, Arizona State University, Tempe, USA
| | - Raphaela Lukas
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
| | - Nathalie Meuwly
- Department of Psychology, Institute for Family Research and Counseling, University of Fribourg, Fribourg, Switzerland
| | | | - Katharina van Stein
- Institute of Medical Psychology, Heidelberg University Hospital & Heidelberg University, Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Heidelberg University Hospital & Heidelberg University, Heidelberg, Germany
| | - Tamás Martos
- Department of Personality, Clinical and Health Psychology, University of Szeged, Szeged, Hungary
| | | | - Casey J. Totenhagen
- Human Development and Family Studies, University of Alabama, Tuscaloosa, USA AL
| | - Martina Zemp
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
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5
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Kuhlemeier A. Effects of Friendship among Same-Sex Attracted Youth on Sexual Minority Identity Development in Young Adulthood. JOURNAL OF HOMOSEXUALITY 2022; 69:1372-1397. [PMID: 33861688 PMCID: PMC8521548 DOI: 10.1080/00918369.2021.1913918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Using data from Waves 1 and 3 of the National Longitudinal Study of Adolescent to Adult Health, this study investigated the interactive impact of adolescent friendship network characteristics and same-sex attraction (SSA) on the development of sexual minority (SM) identity in young adulthood. Results indicate that SSA youth who identified a best friend that also identified them as their best friend were 5.3 times more likely to identify as a SM compared to those who did not experience reciprocity. For each additional classmate who listed them as a friend, SSA youth were 1.2 times more likely to identify as a SM. Increased centrality in friendship network increased the likelihood that SSA youth would identify as a SM by 1.8 times. Sex-stratified results reveal that particular network characteristics impact boys and girls differently. These findings point to the importance of further investigating relationships between friendship characteristics and identity formation among adolescents.
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Affiliation(s)
- Alena Kuhlemeier
- Department of Sociology, University of New Mexico, MSC05 3080, 1915 Roma NE Ste. 1103, Albuquerque, NM, 87131, USA
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6
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Ding X, Chaillon A, Pan X, Zhang J, Zhong P, He L, Chen W, Fan Q, Jiang J, Luo M, Xia Y, Guo Z, Smith DM. Characterizing genetic transmission networks among newly diagnosed HIV-1 infected individuals in eastern China: 2012-2016. PLoS One 2022; 17:e0269973. [PMID: 35709166 PMCID: PMC9202869 DOI: 10.1371/journal.pone.0269973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/01/2022] [Indexed: 11/19/2022] Open
Abstract
We aimed to elucidate the characteristics of HIV molecular epidemiology and identify transmission hubs in eastern China using genetic transmission network and lineage analyses. HIV-TRACE was used to infer putative relationships. Across the range of epidemiologically-plausible genetic distance (GD) thresholds (0.1-2.0%), a sensitivity analysis was performed to determine the optimal threshold, generating the maximum number of transmission clusters and providing reliable resolution without merging different small clusters into a single large cluster. Characteristics of genetically linked individuals were analyzed using logistic regression. Assortativity (shared characteristics) analysis was performed to infer shared attributes between putative partners. 1,993 persons living with HIV-1 were enrolled. The determined GD thresholds within subtypes CRF07_BC, CRF01_AE, and B were 0.5%, 1.2%, and 1.7%, respectively, and 826 of 1,993 (41.4%) sequences were linked with at least one other sequence, forming 188 transmission clusters of 2-80 sequences. Clustering rates for the main subtypes CRF01_AE, CRF07_BC, and B were 50.9% (523/1027), 34.2% (256/749), and 32.1% (25/78), respectively. Median cluster sizes of these subtypes were 2 (2-52, n = 523), 2 (2-80, n = 256), and 3 (2-6, n = 25), respectively. Subtypes in individuals diagnosed and residing in Hangzhou city (OR = 1.423, 95% CI: 1.168-1.734) and men who have sex with men (MSM) were more likely to cluster. Assortativity analysis revealed individuals were more likely to be genetically linked to individuals from the same age group (AIage = 0.090, P<0.001) and the same area of residency in Zhejiang (AIcity = 0.078, P<0.001). Additionally, students living with HIV were more likely to be linked with students than show a random distribution (AI student = 0.740, P<0.01). These results highlight the importance of Hangzhou City in the regional epidemic and show that MSM comprise the population rapidly transmitting HIV in Zhejiang Province. We also provide a molecular epidemiology framework for improving our understanding of HIV transmission dynamics in eastern China.
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Affiliation(s)
- Xiaobei Ding
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Antoine Chaillon
- Department of Medicine, University of California, San Diego, California, United States of America
| | - Xiaohong Pan
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Jiafeng Zhang
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Ping Zhong
- Department of AIDS and STD Control and Prevention, Shanghai Municipal Centers for Disease Control and Prevention, Shanghai, China
| | - Lin He
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Wanjun Chen
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Qin Fan
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Jun Jiang
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Mingyu Luo
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Yan Xia
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Zhihong Guo
- Department of AIDS and STD Control and Prevention, Zhejiang Provincial Centers for Disease Control and Prevention, Hangzhou, China
| | - Davey M. Smith
- Department of Medicine, University of California, San Diego, California, United States of America
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7
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Lozano A, Fernández A, Tapia MI, Estrada Y, Juan Martinuzzi L, Prado G. Understanding the Lived Experiences of Hispanic Sexual Minority Youth and their Parents. FAMILY PROCESS 2021; 60:1488-1506. [PMID: 33438248 DOI: 10.1111/famp.12629] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Alyssa Lozano
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Alejandra Fernández
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Maria I Tapia
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | - Yannine Estrada
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | | | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
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8
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Macapagal K, Moran K, Newcomb ME, Moskowitz DA, Owens C, Mustanski B. Patterns of Online and Offline Partnering, Partnership Characteristics, and Condomless Sex Among Adolescent Sexual Minority Males in the USA. AIDS Behav 2021; 25:2033-2045. [PMID: 33385277 PMCID: PMC9355016 DOI: 10.1007/s10461-020-03133-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 01/25/2023]
Abstract
Online partner-seeking among adolescent sexual minority males (ASMM) has been associated with condomless anal sex. Two hypotheses may explain this association: that online venues facilitate HIV transmission risk behavior more than offline venues (accentuation), or that individuals who tend to engage in these behaviors are more likely to seek partners online (self-selection). We examined these hypotheses in 700 13-18 year-old ASMM who completed the baseline survey of an effectiveness trial of an HIV prevention program in 2018-2020. The survey assessed demographic, sexual, and venue characteristics of male anal sex partnerships in the past 3 months. Many participants (83%) reported ≥ 1 online-met partner; most were met via sexual networking applications and were older than offline-met partners. Having met partners online, but not whether a particular partner was met online, was associated with greater odds of receptive condomless sex. Findings support the self-selection hypothesis, which has implications for HIV prevention in ASMM.
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Affiliation(s)
- Kathryn Macapagal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA.
| | - Kevin Moran
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Michael E Newcomb
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - David A Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Christopher Owens
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
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9
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Meyer IH, Blosnich JR, Choi SK, Harper GW, Russell ST. Suicidal Behavior and Coming Out Milestones in Three Cohorts of Sexual Minority Adults. LGBT Health 2021; 8:340-348. [PMID: 34096796 DOI: 10.1089/lgbt.2020.0466] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Purpose: We describe the timing of suicidality across the life span in three cohorts of sexual minority adults. We hypothesized that suicide attempts coincide with the coming out period and that younger sexual minority people, who grew up in more accepting social environments, will have lower prevalence of suicide attempts than older generations. Methods: A U.S. national probability sample of 1518 sexual minority adults in three age cohorts of 18-25, 34-41, and 52-59 years (collected 2016-2018) completed a self-administered survey. Results: Sexual minority adults had high prevalence of lifetime suicidal thoughts, plans, and attempts, with the highest attempted suicides in the younger cohort (30.8%, 95% confidence interval [CI] = 26.8-35.1) compared with the middle (23.7%, 95% CI = 19.0-29.1) and older (20.3%, 95% CI = 16.3-25.1) cohorts. There were no differences in suicidal behavior by race and ethnicity or between men and women, but gender nonbinary people had higher prevalence of suicidal thoughts. The mean age at suicidal thoughts, plans, and attempts tracked closely with age of first realization of sexual minority identity. Most suicide attempts (60.9%) occurred within 5 years of realizing one's sexual minority identity, but a significant proportion of attempts (39.1%) occurred outside this range. Conclusion: Our findings are contrary to the hypothesis that younger cohorts of sexual minority people are at lower risk of suicidality.
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Affiliation(s)
- Ilan H Meyer
- The Williams Institute, School of Law, University of California, Los Angeles, Los Angeles, California, USA
| | - John R Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Soon Kyu Choi
- The Williams Institute, School of Law, University of California, Los Angeles, Los Angeles, California, USA
| | - Gary W Harper
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Stephen T Russell
- Department of Human Development and Family Sciences, The University of Texas at Austin, Austin, Texas, USA
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10
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Newcomb ME, Swann G, Ma J, Moskowitz D, Bettin E, Macapagal K, Whitton SW. Interpersonal and Intrapersonal Influences on Sexual Satisfaction in Young Male Couples: Analyses of Actor-Partner Interdependence Models. JOURNAL OF SEX RESEARCH 2021; 58:183-194. [PMID: 32955948 PMCID: PMC7855530 DOI: 10.1080/00224499.2020.1820933] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Very little research has examined sexual satisfaction in young gay, bisexual, queer, and other men who have sex with men (YMSM). Sexual satisfaction has important implications for individual wellbeing and is a central component of romantic relationship functioning and satisfaction. In order to fill this gap, this study examined interpersonal and intrapersonal factors associated with sexual satisfaction in a large sample of young male couples. Data for these analyses came from the baseline visits of two ongoing randomized controlled trials of 2GETHER, a relationship education and HIV prevention program for young male couples. Participants for the current analytic sample were 419 couples (individual N = 838) from across the United States who were diverse in terms of race/ethnicity, HIV status, and geographic region. Analyses found that relationship functioning (i.e., relationship satisfaction, communication) was positively associated with sexual satisfaction, while not having a specified relationship agreement (i.e., monogamy/non-monogamy agreement) was associated with less sexual satisfaction. Intrapersonal factors (i.e., depression, substance use) were associated with sexual satisfaction, but most of these effects became non-significant in a full multivariate model. Relationship functioning plays a central role in sexual satisfaction and should be addressed in couple-based programs to optimize relationship functioning and sexual health.
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Affiliation(s)
- Michael E. Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Gregory Swann
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Junye Ma
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - David Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Emily Bettin
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Kathryn Macapagal
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL
| | - Sarah W. Whitton
- Department of Psychology, University of Cincinnati, Cincinnati, OH
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11
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Social-Ecological Examination of Non-Consensual Sexting Perpetration among U.S. Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249477. [PMID: 33348870 PMCID: PMC7766393 DOI: 10.3390/ijerph17249477] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 11/29/2022]
Abstract
Adolescent sexting is a serious public health concern and is associated with adverse psychosocial outcomes, including depression, anxiety, low self-esteem, declining academic performance, and health problems. Effective prevention of sexting requires a comprehensive and deep understanding of the multiple contexts whereby sexting is likely to occur. The present study explores individual and contextual risk and protective factors that are associated with sexting behavior among a large sample of adolescents. Participants were high school students in midwestern U.S. (N = 2501; LGB n = 309, 76.4% female; non-LGB n = 2192, 47.4% female) who completed self-report measures of sexting and risk (e.g., pornography exposure, impulsivity) and protective (e.g., social support) factors. Path analysis models were conducted with the sexting outcome for groups of LGB and non-LGB students. Among LGB students, results indicated a significant association between sexting and parental monitoring (b = −0.08, p < 0.01); pornography exposure (b = 0.13, p < 0.05); dating partners (b = 0.01, p < 0.01); bullying perpetration (b = 0.17, p < 0.001); and delinquency (b = 0.13; p < 0.001). Among non-LGB students, significant associations were found between sexting and alcohol/substance use (b = 0.05, p < 0.001); bullying (b = 0.08, p < 0.001); and delinquency (b = 0.06, p < 0.001). Moderation analyses suggest that parental monitoring may have a buffering effect between sexting and several risk factors. Recommendations for practitioners include considering the protective factors of sexting perpetration and encouraging appropriate levels of parental monitoring and the continued importance of bullying and alcohol and drug prevention programming to decrease risk factors of sexting perpetration.
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12
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Mustanski B, Espelage DL. Why Are We Not Closing the Gap in Suicide Disparities for Sexual Minority Youth? Pediatrics 2020; 145:peds.2019-4002. [PMID: 32041814 PMCID: PMC7049942 DOI: 10.1542/peds.2019-4002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/23/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois;
| | - Dorothy L. Espelage
- Applied Developmental Sciences and Special Education, Peabody School of Education, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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13
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Norris AL, Orchowski LM. Peer Victimization of Sexual Minority and Transgender Youth: A Cross-Sectional Study of High School Students. PSYCHOLOGY OF VIOLENCE 2020; 10:201-211. [PMID: 35979532 PMCID: PMC9380522 DOI: 10.1037/vio0000260] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To identify rates of victimization experiences by gender identity and sexual orientation in a large regional sample of 14-to-17-year old high school students. METHOD All 10th grade students from 27 Northeastern high schools were invited to participate in a survey of dating and sexual experiences (N = 2,766). RESULTS Compared with heterosexual youth, sexual minority youth reported greater peer victimization of every kind (i.e., bullying, sexual harassment, unwanted sexual contact and intercourse, and every type of dating conflict [threatening behavior, physical abuse, and sexual abuse]). Sexual minority girls evinced particularly high levels of bullying. Similarly, transgender youth were more likely than nontransgender youth to experience every form of peer victimization except physical abuse in a dating relationship. Cumulatively, 91% of sexual minority girls, 86% of transgender youth, and 79% of sexual minority boys experienced at least one form of peer victimization, compared to 78% of heterosexual girls and 63% of heterosexual boys. Further, 14% of transgender youth experienced all 4 victimization types in the past year alone. Finally, bias-based harassment was rarely the only form of victimization experienced by these youth. CONCLUSION The victimization of sexual minority youth, particularly girls, and transgender youth was pervasive across individual forms of victimization and multiple forms of victimization concurrently. Further, bias-based harassment was imbedded within a pattern of victimization, such that youth experienced it in concert with multiple other forms of victimization. Researchers implementing prevention-based programs for interpersonal violence should examine the experiences of and impact on youth of diverse gender and sexual identities.
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Affiliation(s)
- Alyssa L Norris
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Coro West, Suite 309, Providence, RI, 02903
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University Providence, RI, 02912
| | - Lindsay M Orchowski
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University Providence, RI, 02912
- Rhode Island Hospital, 146 West River Street, Suite 11B, Providence, RI, 02904
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14
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Shrestha M, Boonmongkon P, Peerawaranun P, Samoh N, Kanchawee K, Guadamuz TE. Revisiting the 'Thai gay paradise': Negative attitudes toward same-sex relations despite sexuality education among Thai LGBT students. Glob Public Health 2019; 15:414-423. [PMID: 31661368 DOI: 10.1080/17441692.2019.1684541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
School settings are volatile and often violent for LGBT teens who are first coming to terms with their sexuality. We explored the attitudes of LGBT students in Thai secondary schools towards homosexuality. Students aged 12-19 years were surveyed in 393 public institutions providing secondary-school education in six regions of Thailand, selected by a multistage cluster sampling. Among 1088 LGBT-identified students, 378 (35%) reported negative attitudes toward homosexuality. Factors associated with homonegative attitudes in a multivariable logistic regression analysis were identifying as a transgender (Adjusted Odds Ratio [aOR] 2.5, 95% CI 1.5-4.1), having low academic performance (GPA scores of 2-3 [aOR 2.6, 95% CI 1.7-4.1] or less than 2 [aOR 2.1, 95% CI 1.5-2.]), and attending sexuality education classes covering topics such as bullying LGBT students (aOR 1.9, 95% CI 1.2-3.1) and safe homosexual practices (aOR 2.1, 95% CI 1.7-4.1). Sexuality education in its current form in Thai public schools may not be effective in reducing homonegative attitudes of LGBT-identified students. A more comprehensive sexuality education emphasising gender and rights along with strategies addressing social disparities due to sexual orientation is needed to enable Thai LGBT teens to accept their sexuality without shame and self-disrespect.
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Affiliation(s)
- Manash Shrestha
- Center of Excellence in Research on Gender, Sexuality, and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand.,Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Pimpawun Boonmongkon
- Center of Excellence in Research on Gender, Sexuality, and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand.,Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Pimnara Peerawaranun
- Center of Excellence in Research on Gender, Sexuality, and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Nattharat Samoh
- Center of Excellence in Research on Gender, Sexuality, and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Kunakorn Kanchawee
- Center of Excellence in Research on Gender, Sexuality, and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Thomas E Guadamuz
- Center of Excellence in Research on Gender, Sexuality, and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand.,Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
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15
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Newcomb ME, LaSala MC, Bouris A, Mustanski B, Prado G, Schrager SM, Huebner DM. The Influence of Families on LGBTQ Youth Health: A Call to Action for Innovation in Research and Intervention Development. LGBT Health 2019; 6:139-145. [PMID: 30844341 DOI: 10.1089/lgbt.2018.0157] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Lesbian, gay, bisexual, transgender, queer, questioning, and other sexual and gender minority youth (LGBTQ) experience myriad health inequities relative to their cisgender heterosexual peers. Families have a profound impact on adolescent health, but little is known about this influence on LGBTQ youth specifically. We draw on work presented at a public symposium that aimed to characterize existing scientific evidence, identify gaps in knowledge, and set priority areas for future research on the influence of family factors on LGBTQ youth health. We review the evidence in each identified priority area and propose promising avenues for future research and opportunities for innovation.
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Affiliation(s)
- Michael E Newcomb
- 1 Department of Medical Social Sciences and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Michael C LaSala
- 2 School of Social Work, Rutgers, the State University of New Jersey, New Brunswick, New Jersey
| | - Alida Bouris
- 3 School of Social Service Administration, University of Chicago, Chicago, Illinois
| | - Brian Mustanski
- 1 Department of Medical Social Sciences and Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Guillermo Prado
- 4 Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Sheree M Schrager
- 5 Office of Research and Sponsored Programs, California State University, Northridge, Northridge, California
| | - David M Huebner
- 6 Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia
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16
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Mittleman J. Sexual Minority Bullying and Mental Health From Early Childhood Through Adolescence. J Adolesc Health 2019; 64:172-178. [PMID: 30392862 DOI: 10.1016/j.jadohealth.2018.08.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/17/2018] [Accepted: 08/17/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Sexual minority adolescents face well-documented disparities in terms of peer victimization and mental health. Less is known about how these disparities emerge and change throughout childhood. Providing prospective evidence on sexual minorities' peer victimization and mental health from early childhood through adolescence, the current study addresses this gap. METHODS Analyses used data from the Fragile Families and Child Wellbeing Study, a population-based cohort study of children born in twenty American cities between 1998 and 2000. Teens reported sexual minority status during interviews conducted (primarily by phone) between 2014 and 2017. Multivariate regression analyses examined disparities in peer victimization and mental health at ages 5, 9, and 15. RESULTS Compared to their peers, sexual minorities experienced similar rates of peer victimization at age 5 but substantially higher rates at ages 9 and 15. Sexual minority children's elevated bullying rates at age 9 were confirmed using independent reports from both parents and the children themselves. Disparities in depressive/anxious symptoms were not documented until age 15, at which time large disparities were reported across three diagnostic scales and two measures of professional diagnosis/treatment. Both current and prior peer victimization were robust predictors of adolescent mental health, explaining about 20% of the disparities between sexual minority teens and their peers. CONCLUSIONS Sexual minority children's social vulnerabilities appear to emerge between ages 5 and 9, followed by the emergence of mental health disparities between 9 and 15. Results underscore the importance of intervening early to prevent the emergence of bullying behaviors.
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Affiliation(s)
- Joel Mittleman
- Department of Sociology and Office of Population Research, Princeton University, Princeton, New Jersey.
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17
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Norris AL, Brown LK, DiClemente RJ, Valois RF, Romer D, Vanable PA, Carey MP. African-American sexual minority adolescents and sexual health disparities: An exploratory cross-sectional study. J Natl Med Assoc 2018; 111:302-309. [PMID: 30514572 DOI: 10.1016/j.jnma.2018.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 11/06/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE To better understand sexual health disparities among African-American sexual minority adolescents. METHODS African-American adolescents (N = 1120; mean age = 15.24 years) were recruited from 4 cities (Columbia, SC; Macon, GA; Providence, RI; Syracuse, NY) to a larger trial. The current analyses used data from the 18-month follow-up when adolescents reported on their sexual partnerships, condom use knowledge, self-efficacy and outcome expectancies for condom use, sexual risk behavior, and STI testing history. RESULTS Compared with heterosexual adolescents, sexual minority adolescents reported more concerns about potential relationship harms resulting from safer sex negotiation. Sexual minority adolescents were also more likely to engage in riskier sexual behaviors, with females reporting more sexual partners and drug use prior to sex, and males reporting inconsistent condom use and higher rates of HIV. CONCLUSIONS African-American sexual minority adolescents evidence disparities in sexual risk behavior and STI history that appear to result from interpersonal and relationship concerns. These concerns need to be targeted in sexual health interventions for sexual minority adolescents.
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Affiliation(s)
- Alyssa L Norris
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University Providence, RI, 02912, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Coro East, Suite 309, Providence, RI, 02903, USA.
| | - Larry K Brown
- Department of Psychiatry, Rhode Island Hospital, Brown University, Providence, RI, 02903, USA
| | - Ralph J DiClemente
- Department of Social & Behavioral Sciences, College of Global Public Health, New York University, New York, NY, 10012, USA
| | - Robert F Valois
- Emory Center for AIDS Research, 1518 Clifton Rd, NE, Ste 8050, Atlanta, GA, 30322, USA; Arnold School of Public Health, Discovery 534A, 915 Greene Street, University of South Carolina, Columbia, SC, 29201, USA
| | - Daniel Romer
- Annenberg Public Policy Center, 202 S. 36th ST, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Peter A Vanable
- Department of Psychology, 430 Huntington Hall, Syracuse University, Syracuse, NY, 13244, USA
| | - Michael P Carey
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University Providence, RI, 02912, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 164 Summit Avenue, Coro East, Suite 309, Providence, RI, 02903, USA; Department of Behavioral and Social Sciences, Brown University, Providence, RI, 02903, USA
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18
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Luk JW, Miller JM, Gilman SE, Lipsky LM, Haynie DL, Simons-Morton BG. Sexual Minority Status and Adolescent Eating Behaviors, Physical Activity, and Weight Status. Am J Prev Med 2018; 55:839-847. [PMID: 30344031 PMCID: PMC6296226 DOI: 10.1016/j.amepre.2018.07.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/15/2018] [Accepted: 07/19/2018] [Indexed: 12/01/2022]
Abstract
INTRODUCTION This study examined sexual orientation differences in eating behaviors, physical activity, and weight status among adolescents in the U.S. Moreover, this study tested whether parental and peer influences contribute to sexual orientation disparities in adolescent eating behaviors, physical activity, BMI, and examined disparities in weight misperception. METHODS Cross-sectional data were from 1,926 adolescents who participated in the NEXT Generation Health Study in 2010-2011. Linear and multinomial logistic regressions conducted in 2017-2018 were used to test disparities and interactions with social influences. RESULTS Relative to their heterosexual peers, sexual minority males and females consumed fruits and vegetables more frequently; sexual minority males engaged in less frequent physical activity; and sexual minority females were more likely to be overweight, perceive themselves as overweight, and to overestimate their weight. High parental expectation for physical activity was associated with more frequent vigorous physical activity among heterosexual adolescents, but less frequent vigorous physical activity among sexual minority males. Exercising with a same-sex peer buffered against the risk of higher BMI among sexual minority females. CONCLUSIONS Parental and peer influences may serve as potential intervention targets to reduce disparities in weight-related behaviors. Longitudinal research is needed to understand the consequences of weight misperception among sexual minority females.
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Affiliation(s)
- Jeremy W Luk
- Social and Behavioral Sciences Branch, Division of Intramural Population Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
| | - Jacob M Miller
- Social and Behavioral Sciences Branch, Division of Intramural Population Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; Department of Economics and Business, Colorado College, Colorado Springs, Colorado
| | - Stephen E Gilman
- Social and Behavioral Sciences Branch, Division of Intramural Population Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Division of Intramural Population Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Denise L Haynie
- Social and Behavioral Sciences Branch, Division of Intramural Population Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
| | - Bruce G Simons-Morton
- Social and Behavioral Sciences Branch, Division of Intramural Population Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
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19
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Green AE, Willging CE, Ramos MM, Shattuck D, Gunderson L. Factors Impacting Implementation of Evidence-Based Strategies to Create Safe and Supportive Schools for Sexual and Gender Minority Students. J Adolesc Health 2018; 63:643-648. [PMID: 30205932 PMCID: PMC6289584 DOI: 10.1016/j.jadohealth.2018.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/01/2018] [Accepted: 06/04/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The Centers for Disease Control and Prevention recommends six evidence-based strategies to improve safety and support for sexual and gender minority (SGM) youth in U.S. schools. However, only a small minority of schools implement all strategies. This study draws on implementation science to assess contextual challenges to strategy implementation. METHODS Semistructured interviews were conducted with at least two stakeholders at each of 42 high schools in New Mexico. Interviews consisted of open-ended questions centered on attitudes toward, access to, and availability of school and community supports for SGM youth, school policies, and practices, and organizational factors believed to impact implementation. Transcripts were imported into NVivo 11 for iterative coding and qualitative analysis. RESULTS We identified eleven overarching sets of factors related to the preparedness of schools to implement the evidence-based strategies: (1) political climate; (2) community context; (3) community resources; (4) policies and practices; (5) staff knowledge and exposure to SGM issues; (6) training deficits; (7) prevalence of neutrality discourses suggesting SGM students should not be singled out for "special treatment" or intervention; (8) student attitudes and support; (9) de facto safe spaces; (10) health education curricula; and (11) pragmatic considerations, such as time, staff turnover, and workloads. Key factors believed to hinder implementation included lack of resources, staffing concerns, and knowledge deficits. CONCLUSIONS These results can be used to inform the development of implementation strategies to modify school health systems from within to best support evidence-based practices for SGM youth and other stigmatized populations.
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Affiliation(s)
- Amy E Green
- Department of Psychiatry, University of California, La Jolla, California; Child and Adolescent Services Research Center, San Diego, California.
| | - Cathleen E Willging
- Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
| | - Mary M Ramos
- Division of Adolescent Medicine, Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico, USA
| | - Daniel Shattuck
- Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
| | - Lara Gunderson
- Behavioral Health Research Center of the Southwest, Pacific Institute for Research and Evaluation, Albuquerque, New Mexico, USA
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20
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Jiang Y, Reilly-Chammat R, Cooper T, Viner-Brown S. Disparities in Health Risk Behaviors and Health Conditions Among Rhode Island Sexual Minority and Unsure High School Students. THE JOURNAL OF SCHOOL HEALTH 2018; 88:803-812. [PMID: 30300929 DOI: 10.1111/josh.12688] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/06/2017] [Accepted: 07/20/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Sexual minority students have higher risk for health-related behaviors. We examined 5 domains including 34 health risk behaviors and health conditions among sexual minorities and unsure students in Rhode Island. We also included sexual contact of heterosexually identified students to capture heterosexually identified students who may be considered sexual minorities by their behavior. METHODS We used the 2007-2015 Rhode Island Youth Risk Behavior Survey data (N = 14,264). We categorized students into 4 groups: students self-identified as heterosexual and reported no sexual contact with same sex only or both sexes (group 1); self-identified as heterosexual and reported sexual contact with same sex only or both sexes (group 2); self-identified as lesbian, gay, bisexual (group 3); and responded as unsure (group 4). We used multivariable adjusted logistic regression analyses to evaluate associations of sexual minority and unsure students with 34 health risk behaviors and health conditions accounting for complex sampling design. RESULTS Students in groups 2-4 were more likely to engage in health-risk behaviors including violent behaviors, attempted suicide, substance use, and no physical activity than their peers. CONCLUSIONS As sexual minority youth continue to report higher rates of health-related risk behaviors, targeted evidence-based prevention approaches must focus on reducing these risk behaviors among those youth.
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Affiliation(s)
- Yongwen Jiang
- Center for Health Data and Analysis, Rhode Island Department of Health, Three Capitol Hill, Providence, RI 02908
- Department of Epidemiology, School of Public Health, Brown University, 121 South Main Street, Providence, RI 02912
| | - Rosemary Reilly-Chammat
- Office of Student, Community and Academic Supports, Rhode Island Department of Elementary and Secondary Education, 255 Westminster Street, Providence, RI 02903
| | - Tara Cooper
- Rhode Island Department of Health, Three Capitol Hill, Suite 407, Providence, RI 02908
| | - Samara Viner-Brown
- Center for Health Data and Analysis, Rhode Island Department of Health, Three Capitol Hill, Providence, RI 02908
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21
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Ricca P, Wahlskog C, Bergren MD. Enhancing Cultural Sensitivity in a Community Health Care Setting for LGBTQ Patients. J Community Health Nurs 2018; 35:165-178. [DOI: 10.1080/07370016.2018.1516420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Paige Ricca
- College of Nursing, Department of Women, Children, Family Health Service and Department of Health System Sciences, University of Illinois at Chicago, Chicago, Illinois
| | - Carolyn Wahlskog
- LGBTQ Transitional Housing Program, 360 Youth Services/Youth Outlook, Naperville, Illinois
| | - Martha Dewey Bergren
- College of Nursing, Department of Women, Children, Family Health Service and Department of Health System Sciences, University of Illinois at Chicago, Chicago, Illinois
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22
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Porta CM, Watson RJ, Doull M, Eisenberg ME, Grumdahl N, Saewyc E. Trend Disparities in Emotional Distress and Suicidality Among Sexual Minority and Heterosexual Minnesota Adolescents From 1998 to 2010. THE JOURNAL OF SCHOOL HEALTH 2018; 88:605-614. [PMID: 29992605 DOI: 10.1111/josh.12650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 10/10/2017] [Accepted: 10/18/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Sexual minority young people have demonstrated higher rates of emotional distress and suicidality in comparison to heterosexual peers. Research to date has not examined trends in these disparities, specifically, whether there have been disparity reductions or increases and how outcomes have differed over time by sex and sexual orientation group. METHODS Minnesota Student Survey data, collected from 9th and 12th graders in 3 cohorts (1998, 2004, 2010) were used to examine emotional distress and suicidality rates. Logistic regression analyses were completed to examine outcome changes over time within and across sexual orientation/sex groups. RESULTS With few exceptions, sexual minority youth are at increased risk of endorsing emotional distress and suicidality indicators in each surveyed year between 1998 and 2010. Young people with both-sex partners reported more emotional distress across all health indicators compared to their opposite-sex partnered peers. With a few exceptions, gaps in disparities between heterosexual and sexual minority have not changed from 2004 to 2010. CONCLUSIONS Disparities in emotional health persist among youth. Research is needed to advance understanding of mental health disparities, with consideration of sexual orientation differences and contextualized to sociocultural status and changes over time. Personalized prevention strategies are needed to promote adolescent mental health.
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Affiliation(s)
- Carolyn M Porta
- School of Nursing, University of Minnesota, 5-160 Weaver Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455
| | - Ryan J Watson
- Department of Human Development and Family Studies, University of Connecticut, 348 Mansfield Road U1058, Storrs, CT, 06269, USA
| | - Marion Doull
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, T222-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN 55414
| | - Nathan Grumdahl
- School of Nursing, University of Minnesota, 5-160 Weaver Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455
| | - Elizabeth Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, University of British Columbia, T222-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5, Canada
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23
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Berona J, Stepp SD, Hipwell AE, Keenan KE. Trajectories of Sexual Orientation from Adolescence to Young Adulthood: Results from a Community-Based Urban Sample of Girls. J Adolesc Health 2018; 63:57-61. [PMID: 30060858 PMCID: PMC6534354 DOI: 10.1016/j.jadohealth.2018.01.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 12/22/2017] [Accepted: 01/17/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To examine the longitudinal cohesion and stability of sexual minority status indicators. METHODS The sample comprised 2,450 girls recruited from the city of Pittsburgh at ages 5-8 years. Sexual attraction, sexual partnering, romantic partnering, and sexual orientation identity were assessed between 14 and 22 years. RESULTS Repeated measures latent class analysis identified three sexual minority trajectories: primarily other-sex oriented (n = 716), primarily same-sex oriented (n = 90), and bisexually oriented (n = 235). Sexual minority status indicators displayed fluidity over time but cohered within latent classes. CONCLUSIONS Within this large sample of girls, several distinct sexuality trajectories emerged. Trajectories are relatively stable from adolescence to young adulthood.
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Affiliation(s)
- Johnny Berona
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago Medical Center, Chicago, Illinois.
| | - Stephanie D. Stepp
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kate E. Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago Medical Center, Chicago, Illinois
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24
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Newcomb ME, Feinstein BA, Matson M, Macapagal K, Mustanski B. "I Have No Idea What's Going On Out There:" Parents' Perspectives on Promoting Sexual Health in Lesbian, Gay, Bisexual, and Transgender Adolescents. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2018; 15:111-122. [PMID: 30245747 PMCID: PMC6145819 DOI: 10.1007/s13178-018-0326-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Lesbian, gay, bisexual, transgender, and other sexual and gender minority (LGBTQ) adolescents experience higher rates of negative sexual health outcomes relative to their heterosexual and cisgender peers. Healthy parent-adolescent relationships and effective parenting are robust predictors of sexual health in heterosexual adolescents, but very little is known about barriers to and facilitators of effective parenting from the perspective of parents of LGBTQ adolescents. This study conducted online focus groups with 44 parents of LGBTQ adolescents in order to describe the factors influencing effective sexual health communication and parental monitoring in this population. Parents described generally positive relationships with teens, but many noted they went through a transition process in which they struggled with their child's identity and were less supportive of their LGBTQ teen. Lack of understanding about LGBTQ-specific sexuality was a commonly endorsed barrier to effective communication, and this was most commonly endorsed by parents of cisgender girls. Parents of cisgender boys and transgender/gender-nonconforming teens described fears about long-term sexual health (i.e., sexual predators, consent) as a barrier to parental monitoring. Parents of LGBTQ adolescents need information and skills to optimize their teen's sexual health. Parent-based programs for LGBTQ adolescents are long overdue for addressing these issues.
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Affiliation(s)
- Michael E. Newcomb
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., 14-059, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian A. Feinstein
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., 14-059, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Margaret Matson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., 14-059, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Kathryn Macapagal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., 14-059, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., 14-059, Chicago, IL 60611, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
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25
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Widman L, Nesi J, Kamke K, Choukas-Bradley S, Stewart JL. Technology-Based Interventions to Reduce Sexually Transmitted Infections and Unintended Pregnancy Among Youth. J Adolesc Health 2018; 62:651-660. [PMID: 29784112 PMCID: PMC5966833 DOI: 10.1016/j.jadohealth.2018.02.007] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/12/2018] [Accepted: 02/12/2018] [Indexed: 01/19/2023]
Abstract
PURPOSE Technology-based interventions to promote sexual health have proliferated in recent years, yet their efficacy among youth has not been meta-analyzed. This study synthesizes the literature on technology-based sexual health interventions among youth. METHODS Studies were included if they (1) sampled youth ages 13-24; (2) utilized technology-based platforms; (3) measured condom use or abstinence as outcomes; (4) evaluated program effects with experimental or quasi-experimental designs; and (5) were published in English. RESULTS Sixteen studies with 11,525 youth were synthesized. There was a significant weighted mean effect of technology-based interventions on condom use (d = .23, 95% confidence interval [CI] [.12, .34], p < .001) and abstinence (d = .21, 95% CI [.02, .40], p = .027). Effects did not differ by age, gender, country, intervention dose, interactivity, or program tailoring. However, effects were stronger when assessed with short-term (1-5 months) than with longer term (greater than 6 months) follow-ups. Compared with control programs, technology-based interventions were also more effective in increasing sexual health knowledge (d = .40, p < .001) and safer sex norms (d = .15, p = .022) and attitudes (d = .12, p= .016). CONCLUSIONS After 15 years of research on youth-focused technology-based interventions, this meta-analysis demonstrates their promise to improve safer sex behavior and cognitions. Future work should adapt interventions to extend their protective effects over time.
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Affiliation(s)
- Laura Widman
- Department of Psychology, North Carolina State University, Raleigh, North Carolina.
| | - Jacqueline Nesi
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kristyn Kamke
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
| | | | - J L Stewart
- Department of Psychology, North Carolina State University, Raleigh, North Carolina
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26
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Hookup App Use, Sexual Behavior, and Sexual Health Among Adolescent Men Who Have Sex With Men in the United States. J Adolesc Health 2018; 62:708-715. [PMID: 29784114 PMCID: PMC5967650 DOI: 10.1016/j.jadohealth.2018.01.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 01/02/2018] [Accepted: 01/02/2018] [Indexed: 11/21/2022]
Abstract
PURPOSE Geosocial networking applications (e.g., "hookup apps") are widely used among adult men who have sex with men (MSM). Little is known about adolescent MSM's (AMSM) use of these apps. Exploratory research is needed as AMSM's app use poses various ethical, legal, and sexual health concerns. This article examined AMSM's app use patterns and its associations with their sexual health and behavior. METHODS Two hundred sexually experienced AMSM in the United States (M age = 16.6, 49% racial/ethnic minority) completed online survey questions assessing their use of apps specific to MSM and not specific to MSM to meet partners for dating and sex, as well as their sexual behavior and HIV risk. RESULTS Overall, 52.5% of participants (n = 105) reported using MSM-specific apps to meet partners for sex. Of these, most participants reported having oral (75.7%, n = 78) and anal sex (62.1%, n = 64) with those partners. Of those who reported having anal sex, 78.1% (n = 50) had sex with those partners more than once, and only 25.0% (n = 16) always used condoms with those partners. Relative to those who used only non-MSM-specific apps, MSM-specific app users reported more sex partners and condomless anal sex partners, greater perceived risk of HIV, more engagement in sexual health services, and greater odds of HIV testing. CONCLUSIONS Use of MSM-specific apps was not uncommon among this sample of AMSM. Patterns of risk behavior and HIV testing were similar to samples of adult MSM app users. Further research should investigate AMSM's app-related sexual and HIV/sexually transmitted infection prevention decision-making to guide sexual health education efforts for AMSM.
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Toomey RB, Ryan C, Diaz RM, Russell ST. Coping With Sexual Orientation-Related Minority Stress. JOURNAL OF HOMOSEXUALITY 2018; 65:484-500. [PMID: 28441107 PMCID: PMC5656566 DOI: 10.1080/00918369.2017.1321888] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Little is known about how adolescents cope with minority stressors related to sexual orientation. This study examined 245 lesbian, gay, and bisexual (LGB) young adult's (ages 21-25) retrospective reports of coping in response to LGB minority stress during adolescence (ages 13-19) to test the reliability and validity of a measure of minority stress coping. Further, the study examined associations between LGB minority stress coping and young adult psychosocial adjustment and high school attainment. Validation and reliability was found for three minority stress coping strategies: LGB-specific strategies (e.g., involvement with LGBT organizations), alternative-seeking strategies (e.g., finding new friends), and cognitive strategies (e.g., imagining a better future). LGB-specific strategies were associated with better psychosocial adjustment and greater likelihood of high school attainment in young adulthood, whereas alternative-seeking and cognitive-based strategies were associated with poorer adjustment and less likelihood of high school attainment.
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Affiliation(s)
- Russell B. Toomey
- Norton School of Family and Consumer Sciences, The University of Arizona
| | - Caitlin Ryan
- Family Acceptance Project, San Francisco State University,
| | - Rafael M. Diaz
- Family Acceptance Project, San Francisco State University,
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28
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Affiliation(s)
- Ilan H Meyer
- Ilan H. Meyer is with the Williams Institute, School of Law, University of California, Los Angeles
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29
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Hubach RD. Disclosure Matters: Enhancing Patient-Provider Communication is Necessary to Improve the Health of Sexual Minority Adolescents. J Adolesc Health 2017; 61:537-538. [PMID: 29061229 DOI: 10.1016/j.jadohealth.2017.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 08/29/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Randolph D Hubach
- School of Community Health Sciences, Counseling, and Counseling Psychology, Oklahoma State University,Stillwater, Oklahoma
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30
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Comparison of Treatment Outcomes Between Lesbian, Gay, Bisexual and Heterosexual Individuals Receiving a Primary Care Psychological Intervention. Behav Cogn Psychother 2017; 46:332-349. [PMID: 28978366 DOI: 10.1017/s1352465817000583] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Lesbian, gay and bisexual individuals experience more anxiety and depression than heterosexual people. Little is known about their comparative treatment response to psychological interventions. AIMS To compare sociodemographic/clinical characteristics and treatment outcomes across sexual orientation groups, for adults receiving primary care psychological interventions from Improving Access to Psychological Therapies (IAPT) services in London, adjusting for possible confounders. METHOD Data from 188 lesbian women, 222 bisexual women, 6637 heterosexual women, 645 gay men, 75 bisexual men and 3024 heterosexual men were analysed from pre-treatment and last treatment sessions. Males and females were analysed separately. RESULTS Before treatment, lesbian and bisexual women were more likely to report clinical levels of impairment (Work and Social Adjustment Scale) than heterosexual women; there were no significant differences in depression (PHQ-9) or anxiety (GAD-7). Bisexual men were more likely to meet depression caseness than gay men but less likely to meet anxiety caseness than gay or heterosexual men. Compared with heterosexual women, lesbian and bisexual individuals showed smaller reductions in depression and impairment, controlling for age, ethnicity, employment, baseline symptoms, number of sessions and intervention type. Bisexual women experienced significantly smaller reductions in anxiety than heterosexual women and were less likely to show recovery or reliable recovery. There were no significant differences in treatment outcomes between gay, bisexual and heterosexual men. CONCLUSIONS Reasons for poorer outcomes in lesbian and bisexual women require investigation, for example lifetime trauma or stigma/discrimination regarding gender or sexual orientation in everyday life or within therapy services.
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31
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Chaudoir SR, Wang K, Pachankis JE. What reduces sexual minority stress? A review of the intervention "toolkit". THE JOURNAL OF SOCIAL ISSUES 2017; 73:586-617. [PMID: 29170566 PMCID: PMC5695701 DOI: 10.1111/josi.12233] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Sexual orientation health disparities are rooted in sexual minorities' exposure to stress and challenges to effective coping. This paper reviews the "toolkit" of psychosocial interventions available to reduce sexual minority stress effects. A systematic search uncovered 44 interventions that both seek to reduce sexual minority stress at its source in unjust and discriminatory social structures as well as bolster sexual minorities' stigma-coping abilities. These interventions were implemented in a variety of contexts (e.g., education, health care delivery) and utilized heterogeneous modalities to create change (e.g., policy implementation, role-playing activities). They were designed to affect change across structural, interpersonal, and individual levels. The interventions reviewed here, while in early stages of efficacy testing, possess potential for meeting the needs and resources of mental and medical health care providers, policy makers, and other stakeholders who aim to lessen the burden of sexual minority stress and the health disparities it generates.
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32
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Legate N, Ryan RM, Rogge RD. Daily Autonomy Support and Sexual Identity Disclosure Predicts Daily Mental and Physical Health Outcomes. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2017; 43:860-873. [DOI: 10.1177/0146167217700399] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Using a daily diary methodology, we examined how social environments support or fail to support sexual identity disclosure, and associated mental and physical health outcomes. Results showed that variability in disclosure across the diary period related to greater psychological well-being and fewer physical symptoms, suggesting potential adaptive benefits to selectively disclosing. A multilevel path model indicated that perceiving autonomy support in conversations predicted more disclosure, which in turn predicted more need satisfaction, greater well-being, and fewer physical symptoms that day. Finally, mediation analyses revealed that disclosure and need satisfaction explained why perceiving autonomy support in a conversation predicted greater well-being and fewer physical symptoms. That is, perceiving autonomy support in conversations indirectly predicted greater wellness through sexual orientation disclosure, along with feeling authentic and connected in daily interactions with others. Discussion highlights the role of supportive social contexts and everyday opportunities to disclose in affecting sexual minority mental and physical health.
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Affiliation(s)
| | - Richard M. Ryan
- Australian Catholic University, Strathfield, Australia
- University of Rochester, NY, USA
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33
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Zaza S, Kann L, Barrios LC. Lesbian, Gay, and Bisexual Adolescents: Population Estimate and Prevalence of Health Behaviors. JAMA 2016; 316:2355-2356. [PMID: 27532437 PMCID: PMC5541373 DOI: 10.1001/jama.2016.11683] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Stephanie Zaza
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laura Kann
- US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lisa C Barrios
- US Centers for Disease Control and Prevention, Atlanta, Georgia
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Kuyper L, de Roos S, Iedema J, Stevens G. Growing Up With the Right to Marry: Sexual Attraction, Substance Use, and Well-Being of Dutch Adolescents. J Adolesc Health 2016; 59:276-282. [PMID: 27423901 DOI: 10.1016/j.jadohealth.2016.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 03/30/2016] [Accepted: 05/16/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the well-being and substance use of sexual minority adolescents growing up in a tolerant society, we examined differences among same-sex attracted (SSA), those who do not know their attraction yet (not yet attracted [NYA]), and heterosexual Dutch adolescents. METHODS Unadjusted and adjusted logistic and linear multilevel analyses were performed using representative data of the 2013 Health Behaviour in School-Aged Children study (N = 5,995; 11-16 years old). The adjusted analyses controlled for sociodemographics (gender, age, education type, ethnicity, urbanicity, and religion). RESULTS Adjusted results showed that SSA adolescents substantially more often reported alcohol use (adjusted odds ratio [AOR] = 2.01), tobacco smoking (AOR = 2.37), and cannabis smoking (AOR = 3.52) than their heterosexual peers, while NYA participants less often reported alcohol use (AOR = .57) and equal levels of tobacco (AOR = .71) and cannabis smoking (AOR = .87) compared with heterosexual adolescents. SSA adolescents reported lower levels of life satisfaction (b = -1.25) and higher levels of psychosomatic complaints (b = .61) and emotional problems (b = 1.57) than heterosexual adolescents. NYA adolescents reported equal levels of life satisfaction (b = -.18) and psychosomatic complaints (b = .06) as heterosexual adolescents, but higher levels of emotional problems (b = .51). CONCLUSIONS In Dutch society, with over 20 years of inclusive policies for sexual minorities and generally tolerant population attitudes toward sexual minorities, SSA adolescents are still at increased risk of substance use and have lower levels of well-being compared with peers.
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Affiliation(s)
- Lisette Kuyper
- Department of Education, Minorities and Methodology, The Netherlands Institute for Social Research, The Hague, The Netherlands; Research Institute of Child Development and Education, Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam, The Netherlands.
| | - Simone de Roos
- Department of Care, Emancipation, and Time Use, The Netherlands Institute for Social Research, The Hague, The Netherlands
| | - Jurjen Iedema
- Department of Education, Minorities and Methodology, The Netherlands Institute for Social Research, The Hague, The Netherlands
| | - Gonneke Stevens
- Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
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35
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Gyura AN, McCauley SO. The Whole Family Serves: Supporting Sexual Minority Youth in Military Families. J Pediatr Health Care 2016; 30:414-23. [PMID: 26597449 DOI: 10.1016/j.pedhc.2015.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/08/2015] [Accepted: 10/23/2015] [Indexed: 11/18/2022]
Abstract
Sexual minority youth in military families have a unique set of stressors that affect their mental, emotional, and physical health. There is a pronounced gap in data addressing the specific stressors of this population and how they interact to impact the health of the adolescent. The culture of the United States military has historically been heterosexist and homophobic, propelled primarily by policies that restricted the recruitment and service of lesbian, gay, bisexual, or transgender individuals, leading to a continued secrecy around sexual orientation that may affect how sexual minority youth within the community view themselves. Homophobia, social stigma, and victimization lead to significant health disparities among sexual minority youth, and youth connected to the military have additional stressors as a result of frequent moves, parental deployment, and general military culture. Primary care providers must be aware of these stressors to provide a safe environment, thorough screening, and competent care for these adolescents.
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36
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Newcomb ME, Mustanski B. Developmental Change in the Effects of Sexual Partner and Relationship Characteristics on Sexual Risk Behavior in Young Men Who Have Sex with Men. AIDS Behav 2016; 20:1284-94. [PMID: 25861731 PMCID: PMC4600632 DOI: 10.1007/s10461-015-1046-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Young men who have sex with men are substantially impacted by HIV/AIDS, and most new infections occur in serious romantic dyads. Young people experience substantial psychosocial and neurocognitive change between adolescence and emerging adulthood which impacts engagement in risk behaviors. We aimed to examine developmental change in the association between sexual partnership characteristics and condomless anal intercourse (CAI). Data were taken from an analytic sample of 114 young adult MSM from a longitudinal study of lesbian, gay, bisexual and transgender youth with 4-year follow-up. Rates of CAI were approximately 12 times higher in serious compared to casual partnerships, but this effect diminished in size over time. Partner age differences and violence were associated with more CAI, and these associations strengthened across development. Characteristics of serious relationships (e.g., power dynamics) were also examined. We discuss the need for HIV prevention strategies that address dyadic influences on CAI during this critical developmental period.
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Affiliation(s)
- Michael E Newcomb
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA.
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611, USA
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37
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Feinstein BA, Newcomb ME. The role of substance use motives in the associations between minority stressors and substance use problems among young men who have sex with men. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2016; 3:357-366. [PMID: 27713906 DOI: 10.1037/sgd0000185] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Young men who have sex with men (YMSM) report higher rates of substance use than their heterosexual peers and minority stress has been posited as a risk factor for substance use. The associations between specific types of minority stress and substance use have been inconsistent throughout the literature and few studies have examined mechanisms underlying these associations. Drawing on minority stress theory and the motivational model of alcohol use, we propose that one mechanism underlying these associations may be people's motivations for using substances, including using substances to cope with negative emotions and to enhance pleasure. The goals of the current study were: (1) to examine the associations among minority stressors, substance use motives, and substance use problems; and (2) to examine substance use motives as mediators of the associations between minority stressors and substance use problems. Baseline self-report data were used from a cohort of 370 YMSM enrolled in a larger study of substance use and sexual behavior. Results indicated that using marijuana to cope mediated the association between victimization and marijuana use problems. Using other drugs to cope mediated the associations between victimization and drug use problems and between internalized stigma and drug use problems. Drinking to cope and to enhance pleasure mediated the association between internalized stigma and alcohol use problems. In sum, substance use motives, especially using substances to cope, act as mechanisms through which certain types of minority stress influence substance use problems among YMSM.
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Affiliation(s)
- Brian A Feinstein
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL 60611
| | - Michael E Newcomb
- Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL 60611
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38
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Macleod C, Nhamo-Murire M. The emancipatory potential of nursing practice in relation to sexuality: a systematic literature review of nursing research 2009-2014. Nurs Inq 2016; 23:253-66. [PMID: 27147132 DOI: 10.1111/nin.12131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2015] [Indexed: 11/28/2022]
Abstract
Nurses play a key role in the provision of services in relation to sexuality in both primary and sexual and reproductive health-care. Given the intersection of sexualities with a range of social injustices, this study reviews research on nursing practice concerning sexuality from an emancipatory/social justice perspective. A systematic review of English articles published in nursing journals appearing on the Web of Science database from 2009 to 2014 was conducted. Thirty-eight articles met the inclusion criteria. Analysis consisted of a descriptive phase (types and location of studies, aspects of sexualities focused on, target health users and aspects of nursing practice focused on) and a critical/emancipatory phase. In terms of practice, our analysis revealed that: barriers exist to the integration of issues relating to sexuality in nursing practice; the social location of nurses and their personal feelings regarding sexuality influence their practice; content that addresses gendered norms and media that assist in communication underpin some emancipatory practices. Few studies locate analyses of nursing practice within gendered, cultural and social norms; consider advocacy as part of the practice of nurses; or analyse the promotion of health user participation in health services and structures. The implications for emancipatory practice are drawn out.
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Affiliation(s)
- Catriona Macleod
- Psychology Department, Critical Studies of Sexualities and Reproduction (CSSR), Rhodes University, Grahamstown, South Africa
| | - Mercy Nhamo-Murire
- Psychology Department, Critical Studies of Sexualities and Reproduction (CSSR), Rhodes University, Grahamstown, South Africa
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39
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Mustanski B, Andrews R, Puckett JA. The Effects of Cumulative Victimization on Mental Health Among Lesbian, Gay, Bisexual, and Transgender Adolescents and Young Adults. Am J Public Health 2016; 106:527-33. [PMID: 26794175 PMCID: PMC4815715 DOI: 10.2105/ajph.2015.302976] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine the effects of the cumulative victimization experienced by lesbian, gay, bisexual, and transgender youths on mental disorders. METHODS We recruited 248 participants from the Chicago, Illinois, area in 7 waves of data collected over 4 years, beginning in 2007 (83.1% retention rate). Mean age at enrollment was 18.7 years, and 54.7% were Black. We measured depression and posttraumatic stress disorder using structured psychiatric interviews. RESULTS Latent class analyses of victimization over time identified a 4-class solution. Class 1 (65.4%) had low, decreasing victimization. Class 2 (10.3%) had moderate, increasing victimization. Class 3 (5.1%) had high, steady victimization. Class 4 (19.2%) had high, decreasing victimization. Controlling for baseline diagnoses and birth sex, lesbian, gay, bisexual, and transgender youths in classes 2 and 3 were at higher risk for depression than were those in class 1; youths in classes 2, 3, and 4 were at elevated risk for posttraumatic stress disorder. CONCLUSIONS Lesbian, gay, bisexual, and transgender youths with steadily high or increasing levels of victimization from adolescence to early adulthood are at higher risk for depression and posttraumatic stress disorder.
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Affiliation(s)
- Brian Mustanski
- All of the authors are with the Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Rebecca Andrews
- All of the authors are with the Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jae A Puckett
- All of the authors are with the Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
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40
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Abstract
Today's lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT youth continue to be at high risk for compromised mental health? We provide an overview of the contemporary context for LGBT youth, followed by a review of current science on LGBT youth mental health. Research in the past decade has identified risk and protective factors for mental health, which point to promising directions for prevention, intervention, and treatment. Legal and policy successes have set the stage for advances in programs and practices that may foster LGBT youth mental health. Implications for clinical care are discussed, and important areas for new research and practice are identified.
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Affiliation(s)
| | - Jessica N Fish
- Population Research Center, University of Texas at Austin, Austin, Texas 78712; ,
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41
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Mustanski B, Birkett M, Kuhns LM, Latkin CA, Muth SQ. The Role of Geographic and Network Factors in Racial Disparities in HIV Among Young Men Who have Sex with Men: An Egocentric Network Study. AIDS Behav 2015; 19:1037-47. [PMID: 25430501 DOI: 10.1007/s10461-014-0955-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of this study was to characterize and compare individual and sexual network characteristics of Black, White, and Latino young men who have sex with men (YMSM) as potential drivers of racial disparities in HIV. Egocentric network interviews were conducted with 175 diverse YMSM who described 837 sex partners within 167 sexual-active egos. Sexual partner alter attributes were summarized by ego. Descriptives of ego demographics, sexual partner demographics, and network characteristics were calculated by race of the ego and compared. No racial differences were found in individual engagement in HIV risk behaviors or concurrent sexual partnership. Racial differences were found in partner characteristics, including female gender, non-gay sexual orientations, older age, and residence in a high HIV prevalence neighborhood. Racial differences in relationship characteristics included type of relationships (i.e., main partner) and strength of relationships. Network characteristics also showed differences, including sexual network density and assortativity by race. Most racial differences were in the direction of effects that would tend to increase HIV incidence among Black YMSM. These data suggest that racial disparities in HIV may be driven and/or maintained by a combination of racial differences in partner characteristics, assortativity by race, and increased sexual network density, rather than differences in individual's HIV risk behaviors.
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Affiliation(s)
- Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave, Suite 2700, Chicago, IL, 60611, USA,
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42
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Macapagal K, Greene GJ, Rivera ZA, Mustanski B. "The best is always yet to come": Relationship stages and processes among young LGBT couples. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2015; 29:309-320. [PMID: 26053345 PMCID: PMC4644068 DOI: 10.1037/fam0000094] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Limited research has examined relationship development among lesbian, gay, bisexual, and transgender (LGBT) couples in emerging adulthood. A better understanding of LGBT couples can inform the development of relationship education programs that reflect their unique needs. The following questions guided this study: (a) What are the stages and processes during young LGBT couples' relationship development? and (b) How do these compare with existing literature on heterosexual adults? A secondary goal was to explore similarities and differences between couples assigned male (MAAB) and female at birth (FAAB). Thirty-six couples completed interviews on their relationship history. Qualitative analyses showed that relationship stages and processes were similar to past research on heterosexuals, but participants' subjective experiences reflected their LGBT identities and emerging adulthood, which exerted additional stress on the relationship. These factors also affected milestones indicative of commitment among heterosexual adults (e.g., introducing partner to family). Mixed methods analyses indicated that MAAB couples described negotiating relationship agreements and safe sex in more depth than FAAB couples. Relationship development models warrant modifications to consider the impact of sexual and gender identity and emerging adulthood when applied to young LGBT couples. These factors should be addressed in interventions to promote relationship health among young LGBT couples.
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Affiliation(s)
- Kathryn Macapagal
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - George J. Greene
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Zenaida A. Rivera
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
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43
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Baams L, Grossman AH, Russell ST. Minority stress and mechanisms of risk for depression and suicidal ideation among lesbian, gay, and bisexual youth. Dev Psychol 2015; 51:688-96. [PMID: 25751098 DOI: 10.1037/a0038994] [Citation(s) in RCA: 221] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The experience of minority stress is often named as a cause for mental health disparities among lesbian, gay, and bisexual (LGB) youth, including higher levels of depression and suicidal ideation. The processes or mechanisms through which these disparities occur are understudied. The interpersonal-psychological theory of suicide posits 2 key mechanisms for suicidal ideation: perceived burdensomeness and thwarted belongingness (Joiner et al., 2009). The aim of the current study is to assess the mental health and adjustment among LGB youth emphasizing the minority stress model (Meyer, 2003) and the interpersonal-psychological theory of suicide (Joiner et al., 2009). With a survey of 876 LGB self-identified youth, levels of coming-out stress, sexual orientation victimization, perceived burdensomeness, thwarted belongingness, depression, and suicidal ideation were examined. The results of a multigroup mediation model show that for all gender and sexual identity groups, the association of sexual orientation victimization with depression and suicidal ideation was mediated by perceived burdensomeness. For gay, lesbian, and bisexual girls coming-out stress was also found to be related to depression and suicidal ideation, mediated by perceived burdensomeness. The results suggest that feeling like a burden to "people in their lives" is a critical mechanism in explaining higher levels of depression and suicidal ideation among LGB youth. These results have implications for community and social support groups, many of which base their interventions on decreasing social isolation rather than addressing youths' beliefs of burdensomeness. Implications for future research, clinical and community settings are discussed.
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Affiliation(s)
- Laura Baams
- Department of Developmental Psychology, Utrecht University
| | - Arnold H Grossman
- Department of Applied Psychology, Steinhardt School of Culture, Education, and Human Development, New York University
| | - Stephen T Russell
- Norton School of Family and Consumer Sciences, University of Arizona
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44
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Greene GJ, Fisher KA, Kuper L, Andrews R, Mustanski B. "Is this normal? Is this not normal? There's no set example": Sexual Health Intervention Preferences of LGBT Youth in Romantic Relationships. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2015; 12:1-14. [PMID: 25678895 PMCID: PMC4321759 DOI: 10.1007/s13178-014-0169-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Limited research has examined the romantic relationships of lesbian, gay, bisexual and transgender youth (LGBT) despite evidence of relationship-oriented risks, including STI/HIV infection, unplanned pregnancy, and interpersonal violence. In efforts to inform future dyadic sexual health interventions for LGBT youth, this couples-based study aimed to identify the most salient sexual and relationships concerns of young same-sex couples and to assess their preferences for intervention content and format. Participants were a subset 36 young, racially and ethnically diverse, same-sex couples (N = 72 individuals) recruited from two on-going longitudinal studies. Interviews were coded using a constant comparison method and a process of inductive and deductive thematic analysis was used to interpret the data. The analysis yielded the following intervention themes: addressing sexual risk and protective behaviors, improving communication, coping with family and relationship violence, and identifying role models and sources of support. The couples reported a clear preference for small group interventions and many recommended a mixed format approach for intervention delivery (i.e., including dyadic and online sessions). Additionally, recommendations for participant recruitment included a combination of Internet-based and social network referrals.
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Affiliation(s)
| | | | | | | | - Brian Mustanski
- To whom correspondence should be addressed at Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2700, Chicago, IL, 60611; telephone: 312-503-6509; fax: 312-503-4800;
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Mustanski B. Future directions in research on sexual minority adolescent mental, behavioral, and sexual health. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2015; 44:204-19. [PMID: 25575125 PMCID: PMC4314941 DOI: 10.1080/15374416.2014.982756] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This article describes current knowledge on sexual, mental, and behavioral health of sexual minority (SM) youth and identifies gaps that would benefit from future research. A translational sciences framework is used to conceptualize the article, discussing findings and gaps along the spectrum from basic research on prevalence and mechanisms, to intervention development and testing, to implementation. Relative to adults, there has been much less research on adolescents and very few studies that had longitudinal follow-up beyond 1 year. Due to historical changes in the social acceptance of the SM community, new cohorts are needed to represent contemporary life experiences and associated health consequences. Important theoretical developments have occurred in conceptualizing mechanisms that drive SM health disparities and mechanistic research is underway, including studies that identify individual and structural risk/protective factors. Research opportunities exist in the utilization of sibling-comparison designs, inclusion of parents, and studying romantic relationships. Methodological innovation is needed in sampling SM populations. There has been less intervention research and approaches should consider natural resiliencies, life-course frameworks, prevention science, multiple levels of influence, and the importance of implementation. Regulatory obstacles are created when ethics boards elect to require parental permission and ethics research is needed. There has been inconsistent inclusion of SM populations in the definition of "health disparity population," which impacts funding and training opportunities. There are incredible opportunities for scholars to make substantial and foundational contributions to help address the health of SM youth, and new funding opportunities to do so.
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Affiliation(s)
- Brian Mustanski
- a Department of Medical Social Sciences , Northwestern University
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Mustanski B, Greene GJ, Ryan D, Whitton SW. Feasibility, acceptability, and initial efficacy of an online sexual health promotion program for LGBT youth: the Queer Sex Ed intervention. JOURNAL OF SEX RESEARCH 2015; 52:220-30. [PMID: 24588408 DOI: 10.1080/00224499.2013.867924] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Lesbian, gay, bisexual, and transgender (LGBT) youth experience multiple sexual health inequities driven, in part, by deficits in parental and peer support, school-based sex education programs, and community services. Research suggests that the Internet may be an important resource in the development of sexual health among LGBT youth. We examined the feasibility of recruiting youth in same-sex relationships into an online sexual health intervention, evaluated intervention acceptability, and obtained initial estimates of intervention efficacy. LGBT youth (16 to 20 years old) completed Queer Sex Ed (QSE), an online, multimedia sexual health intervention consisting of five modules. The final sample (N = 202) completed the pretest, intervention, and posttest assessments. The primary study outcomes were sexual orientation identity and self-acceptance (e.g., coming-out self-efficacy), sexual health knowledge (e.g., sexual functioning), relationship variables (e.g., communication skills), and safer sex (e.g., sexual assertiveness). Analyses indicated that 15 of the 17 outcomes were found to be significant (p < .05). Effect sizes ranged from small for sexual orientation (e.g., internalized homophobia) and relationship variables (e.g., communication skills) to moderate for safer sex (e.g., contraceptive knowledge) outcomes. This study demonstrated the feasibility, acceptability, and initial efficacy of QSE, an innovative online comprehensive sexual health program for LGBT youth.
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Baams L, Bos HMW, Jonas KJ. How a romantic relationship can protect same-sex attracted youth and young adults from the impact of expected rejection. J Adolesc 2014; 37:1293-302. [PMID: 25291236 DOI: 10.1016/j.adolescence.2014.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 09/18/2014] [Accepted: 09/19/2014] [Indexed: 11/18/2022]
Abstract
Same-sex attracted youth's well-being is jeopardized by components of minority stress, but this stress can be buffered by social support. What is unknown is whether a romantic relationship can also serve as a buffer. With an online survey we examined the link between components of minority stress, psychological well-being, and its moderated relation by romantic relationship status among 309 Dutch same-sex attracted youth (16-24 years old, 52.9% female). The results showed that minority stress components (internalized homophobia, expected rejection, and meta-stereotyping) were negatively related to psychological well-being. Moderation analyses revealed that only the impact of "expected rejection" on psychological well-being was buffered for those involved in a romantic relationship. This shows the particular functional link of romantic support in rejection contexts.
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Affiliation(s)
- Laura Baams
- Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands.
| | - Henny M W Bos
- Child Development and Education, University of Amsterdam, Nieuwe Prinsengracht 130, 1018 VZ Amsterdam, The Netherlands
| | - Kai J Jonas
- Social Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, The Netherlands
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Jadwin-Cakmak LA, Pingel ES, Harper GW, Bauermeister JA. Coming Out to Dad: Young Gay and Bisexual Men's Experiences Disclosing Same-Sex Attraction to Their Fathers. Am J Mens Health 2014; 9:274-88. [PMID: 24989422 DOI: 10.1177/1557988314539993] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Few studies have examined the relationship between young gay and bisexual men (YGBM) and their fathers. Based on a phenomenological framework, this study investigated the role of fathers in YGBM's coming-out experience, focusing on how fathers responded to disclosure of same-sex attraction, how fathers' responses compared with sons' expectations, and what sons perceived as having influenced their fathers' responses. Semistructured in-depth interviews with 30 gay and bisexual men aged 18 to 24 years were conducted as part of a larger study; topics explored in the interview included experiences coming out to family and others. Nineteen participants' narratives included discussion about their fathers and were included in the current analyses. The YGBM who were interviewed perceived a complex range of responses upon coming out to their fathers, ranging from enthusiastic acceptance to physical violence. Participants spoke of fathers who were accepting in different manners and who often held contradictory attitudes about same-sex attraction. Fathers' responses commonly differed from sons' expectations, which were informed by homophobic talk and gendered expectations. Sons spoke about what informed their expectations as well as what they perceived as influencing their fathers' responses, including gender norms, beliefs regarding the cause of same-sex attraction, religious and sociopolitical views, and concerns about HIV/AIDS. Particularly striking was the pervasive influence of hegemonic masculinity throughout the YGBM's stories. The implications of these findings for future research and intervention development are discussed, as well as study strengths and limitations.
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Affiliation(s)
| | - Emily S Pingel
- University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Gary W Harper
- University of Michigan School of Public Health, Ann Arbor, MI, USA
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Mustanski B, Andrews R, Herrick A, Stall R, Schnarrs PW. A syndemic of psychosocial health disparities and associations with risk for attempting suicide among young sexual minority men. Am J Public Health 2014; 104:287-94. [PMID: 24328641 PMCID: PMC3935701 DOI: 10.2105/ajph.2013.301744] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2013] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined a syndemic of psychosocial health issues among young men who have sex with men (MSM), with men and women (MSMW), and with women (MSW). We examined hypothesized drivers of syndemic production and effects on suicide attempts. METHODS Using a pooled data set of 2005 and 2007 Youth Risk Behavior Surveys from 11 jurisdictions, we used structural equation modeling to model a latent syndemic factor of depression symptoms, substance use, risky sex, and intimate partner violence. Multigroup models examined relations between victimization and bullying experiences, syndemic health issues, and serious suicide attempts. RESULTS We found experiences of victimization to increase syndemic burden among all male youths, especially MSMW and MSM compared with MSW (variance explained = 44%, 38%, and 10%, respectively). The syndemic factor was shown to increase the odds of reporting a serious suicide attempt, particularly for MSM (odds ratio [OR] = 5.75; 95% confidence interval [CI] = 1.36, 24.39; P < .001) and MSMW (OR = 5.08; 95% CI = 2.14, 12.28; P < .001) compared with MSW (OR = 3.47; 95% CI = 2.50, 4.83; P < .001). CONCLUSIONS Interventions addressing multiple psychosocial health outcomes should be developed and tested to better meet the needs of young MSM and MSMW.
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Affiliation(s)
- Brian Mustanski
- Brian Mustanski and Rebecca Andrews are with the Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL. Amy Herrick and Ron Stall are with the University of Pittsburgh School of Public Health, Pittsburgh, PA. Phillip W. Schnarrs is with the University of Texas, San Antonio
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