1
|
Poudel B, Paudel K, Adhikari B, Paudel R, Bhusal S, Adhikari N, Adhikari TB, Sapkota VP, Shrestha R. Prevalence of common risk factors of major noncommunicable diseases among sexual and gender minorities in Kathmandu valley, Nepal. Medicine (Baltimore) 2024; 103:e37746. [PMID: 38579035 PMCID: PMC10994461 DOI: 10.1097/md.0000000000037746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/07/2024] [Indexed: 04/07/2024] Open
Abstract
Four noncommunicable diseases (NCDs): cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, account for 71% of global deaths. However, little is known about the NCDs risk profile of sexual and gender minorities (SGMs). This study aimed to determine the prevalence of NCDs risk factors among the SGMs of Kathmandu valley, Nepal. A cross-sectional study was conducted among SGMs in the Kathmandu valley, Nepal. We recruited 140 participants using the snowball sampling method. A face-to-face interview was done using a structured questionnaire adapted from World Health Organization Step Wise Approach to Surveillance (STEPS instruments V2.2 2019) along with blood pressure and anthropometric measurements. Data were analyzed using Statistical Package for Social Science (SPSS.v20). More than two-thirds of the participants, 96 (68.6%), had co-occurrence of NCDs risk factors. The prevalence of insufficient fruits and vegetables consumption, current smoking, harmful alcohol consumption, overweight/obesity, and hypertension were 95.7%, 40.0%, 32.9%, 28.5%, and 28.6%, respectively. There was a significant association between hypertension, harmful alcohol consumption, and overweight/obesity with the participants' age, employment status, and marital status, respectively. Study findings indicated a higher prevalence of NCDs risk factors among SGMs. National-level NCDs surveillance, policy planning, prevention, and targeted health interventions should prioritize the SGMs.
Collapse
Affiliation(s)
- Bikram Poudel
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
- Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
| | - Kiran Paudel
- Nepal Health Frontiers, Kathmandu, Nepal
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
| | - Bikram Adhikari
- Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
| | - Rajan Paudel
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Sandesh Bhusal
- Nepal Health Frontiers, Kathmandu, Nepal
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
| | - Nabin Adhikari
- Central Department of Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
- Dhulikhel Hospital Kathmandu University Hospital, Dhulikhel, Nepal
| | - Tara Ballav Adhikari
- Nepal Health Frontiers, Kathmandu, Nepal
- Community-Based Management of Non-communicable Diseases in Nepal Project, Nepal Development Society, Bharatpur, Nepal
- Section for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
- Section of Infectious, Department of Internal Medicine, Yale School of Medicine, New Haven, CT
| |
Collapse
|
2
|
Caba AE, Mallory AB, Simon KA, Renley BM, Rathus T, Watson RJ. Sexual Identity Disclosure and Alcohol Experiences Among LGBTQ+ Adolescents. Behav Med 2024; 50:170-180. [PMID: 37036276 PMCID: PMC10562512 DOI: 10.1080/08964289.2023.2190078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 02/23/2023] [Accepted: 03/04/2023] [Indexed: 04/11/2023]
Abstract
Sexual and gender minority youth (SGMY) report greater alcohol use in comparison to their heterosexual counterparts. Prior research has found that elevated alcohol use among SGMY can be explained by minority stress experiences. Sexual identity outness may be another factor that drives alcohol use among SGMY, given that outness is associated with alcohol use among older sexual and gender minority samples. We examined how patterns of sexual identity outness were associated with lifetime alcohol use, past-30-day alcohol use, and past-30-day heavy episodic drinking. Data were drawn from the LGBTQ National Teen Survey (N = 8884). Participants were SGMY aged 13 to 17 (mean age = 15.59) years living in the US. Latent class analysis was used to identify sexual identity outness patterns. Multinomial regressions were used to examine the probability of class membership by alcohol use. Six outness classes were identified: out to all but teachers (n = 1033), out to siblings and peers (n = 1808), out to siblings and LGBTQ+ peers (n = 1707), out to LGBTQ+ peers (n = 1376), mostly not out (n = 1653), and very much not out (n = 1307). SGMY in classes characterized by greater outness to peers, friends, and family had greater odds of lifetime alcohol use compared with SGMY in classes characterized by lower outness. These findings suggest that SGMY with greater sexual identity outness may be a target for alcohol use prevention programming. Differences in sexual identity outness may be explained by minority stress factors.
Collapse
Affiliation(s)
- Antonia E. Caba
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| | - Allen B. Mallory
- Department of Human Sciences, The Ohio State University, Campbell Hall 151H, 1787 Neil Ave, Columbus, OH 43210
| | - Kay A. Simon
- Department of Family Social Science, University of Minnesota, 1985 Buford Ave, St Paul, MN 55108
| | - Benton M. Renley
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| | - Taylor Rathus
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| | - Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT 06269
| |
Collapse
|
3
|
Coulter RW, Mahal IK, Lin CA, Schneider SK, Mathias AS, Baral K, Miller E, Abebe KZ. Providing Lesbian, Gay, Bisexual, Transgender, Nonbinary, and Queer Adolescents With Nurturance, Trustworthiness, and Safety: Protocol for Pilot Cluster Randomized Controlled Trial Design. JMIR Res Protoc 2024; 13:e55210. [PMID: 38502156 PMCID: PMC10988370 DOI: 10.2196/55210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Sexual and gender minority youths (lesbian, gay, bisexual, transgender, nonbinary, and queer individuals) face elevated risks of substance use (eg, alcohol and tobacco) and mental health issues (eg, depressive symptoms and suicidality) compared to their cisgender heterosexual peers. These inequities are hypothesized to be reduced by building supportive high school environments via the training of school staff. An intervention that trains school staff to better understand and support sexual and gender minority youths and engage in positive bystander behaviors that protect them from bullying exposure may reduce disparities in drug and alcohol use among them. Experts, school staff, and sexual and gender minority youths developed Providing LGBTQ+ Adolescents with Nurturance, Trustworthiness, and Safety (PLANTS), a web-based intervention to train school staff on how to support, affirm, and protect sexual and gender minority youths. OBJECTIVE This paper describes the design of the PLANTS pilot trial primarily aimed at assessing its acceptability, usability, appropriateness, and feasibility. We hypothesize PLANTS will have high acceptability, usability, appropriateness, and feasibility as rated by the school staff. Secondary objectives focus on implementation, safety, and pre-post changes in high school staff outcomes, including self-efficacy and skills (eg, active-empathic listening and bullying intervention). Exploratory objectives focus on the impact of PLANTS on student health outcomes. METHODS In a 2-arm cluster randomized controlled trial, high schools in Massachusetts are allocated to PLANTS or an active comparator group (publicly available sexual and gender minority youths resources or training). High school staff complete pretest and posttest surveys containing validated scales. Primary outcomes are validated measures of acceptability, usability, appropriateness, and feasibility of the intervention completed by staff during posttest surveys. To test our primary hypotheses for each outcome, we will calculate means and 95% CIs and P values using 1-sample 2-sided t tests against a priori thresholds or benchmarks of success. Secondary outcomes include staff's active-empathetic listening skills, self-efficacy for working with sexual and gender minority youths, bystander intervention behaviors for bullying and cyberbullying, and self-efficacy for PLANTS' change objectives completed during pretest and posttest staff surveys. Staff can also complete a posttest interview guided by the Information-Motivation-Behavior model and Consolidated Framework for Implementation Research. Exploratory outcomes include student-level data collected via the 2021 and 2023 MetroWest Adolescent Health Surveys, a health behavior surveillance system in 30 Massachusetts schools. RESULTS School enrollment began in May 2023 and participant enrollment began in June 2023. Data collection is expected to be completed by February 2024. CONCLUSIONS This pilot trial will yield important information about the PLANTS intervention and provide necessary information to conduct a fully powered trial of the efficacy of PLANTS for reducing the deleterious health inequities experienced by sexual and gender minority youths. TRIAL REGISTRATION ClinicalTrials.gov NCT05897827; https://clinicaltrials.gov/study/NCT05897827. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55210.
Collapse
Affiliation(s)
- Robert Ws Coulter
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Isabella Kaur Mahal
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Clarisse A Lin
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Aaryn S Mathias
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Karuna Baral
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Elizabeth Miller
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
| | - Kaleab Z Abebe
- Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| |
Collapse
|
4
|
Kirwan M, Leone RM, Davis KC, Orchowski LM, Gilmore AK. Emotion Regulation Difficulties Moderate the Association Between Typical Drinking and Sexual Assault Victimization Among Sexual and Gender Minority University Students. Violence Against Women 2024; 30:768-790. [PMID: 36794462 PMCID: PMC10427736 DOI: 10.1177/10778012231155178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Sexual and gender minority (SGM) students report higher alcohol consumption, emotion regulation difficulties, and sexual assault victimization severity than cisgender, heterosexual individuals. A sample of 754 undergraduate students completed an online survey assessing alcohol use, emotion regulation, and sexual victimization. Regression analyses indicated that, among SGM students with higher emotion regulation difficulties, typical weekly drinking was positively associated with sexual assault victimization severity, but among cisgender, heterosexual students and SGM students with lower emotion regulation difficulties, there was no association between drinking and victimization severity. Thus, SGM students benefit from interventions targeting alcohol use and emotion regulation difficulties.
Collapse
Affiliation(s)
- Mitchell Kirwan
- Edson College of Nursing and Health Innovation, Arizona State University, USA
| | - Ruschelle M Leone
- Mark Chaffin Center for Healthy Development, Georgia State University, USA
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, USA
| | | | - Amanda K Gilmore
- Mark Chaffin Center for Healthy Development, Georgia State University, USA
| |
Collapse
|
5
|
Micalizzi L, Meisel SN, Thomas SA, Parnes JE, Graves H, Becker SJ, Spirito A. Psychometric properties of the family assessment task parental monitoring scenario among adolescents receiving substance use treatment. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 158:209232. [PMID: 38061631 PMCID: PMC10947900 DOI: 10.1016/j.josat.2023.209232] [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] [Received: 12/05/2022] [Revised: 08/11/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION The Family Assessment Task (FAsTask) is an observer-rated parent-child interaction task used in adolescent substance use intervention. The parental monitoring component of the FAsTask is thought to provide an objective assessment of parental monitoring that can guide treatment planning and circumvent the potential limitations of self-report measures. Yet, the factor structure, measurement invariance, and concurrent validity of the parental monitoring FAsTask has not been evaluated; doing so is essential to effectively guide clinical care. This study examined if the parental monitoring FAsTask can be reliably administered across adolescent age and sex, and to identify which components of the parental monitoring FAsTask are most consistently associated with adolescent substance use. METHODS The study pooled data from 388 adolescent-caregiver dyads across six separate clinical trials (adolescents [Mage = 15.7, 57.5% male, 61.9% White, 31.2% Latine]; caregivers [Mage = 42.14, 88.7% female, 72.7% White, 24.2% Latine]). Dyads completed the FAsTask and the Timeline Followback at baseline, prior to randomization. Analyses proceeded in three steps. First, exploratory factor analysis (EFA) was conducted in half of the sample, followed by a confirmatory factor analysis (CFA) in the second half of the sample. Second, measurement invariance was tested as a function of adolescent age and biological sex. Third, a series of structural equation models were used to assess the associations of each factor with alcohol use, binge drinking, and cannabis use. RESULTS EFA and CFA indicated the presence of four factors (labeled Supervised/Structured, Active Monitoring, Task Engagement, and Parental Rules/Strategies). Evidence of measurement invariance was found across adolescent age and sex. The Supervision/Structure was negatively associated with adolescent alcohol use, binge drinking, and cannabis use. CONCLUSIONS The parental monitoring FAsTask demonstrates validity and retains its structure across adolescent age and sex. Items focused on parental supervision and structure are most strongly associated with adolescent substance use and may best inform clinical care for adolescent substance use.
Collapse
Affiliation(s)
- Lauren Micalizzi
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Department of Behavioral and Social Sciences, Box G-S121-5, Providence, RI 02912, United States.
| | - Samuel N Meisel
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Department of Behavioral and Social Sciences, Box G-S121-5, Providence, RI 02912, United States; Bradley Hasbro Children's Research Center, 25 Hoppin Street Box #36, Providence, RI 02903, United States.
| | - Sarah A Thomas
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States; Bradley Hasbro Children's Research Center, 25 Hoppin Street Box #36, Providence, RI 02903, United States.
| | - Jamie E Parnes
- Center for Alcohol & Addiction Studies, Brown University School of Public Health, Department of Behavioral and Social Sciences, Box G-S121-5, Providence, RI 02912, United States; Bradley Hasbro Children's Research Center, 25 Hoppin Street Box #36, Providence, RI 02903, United States.
| | - Hannah Graves
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States.
| | - Sara J Becker
- Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine, 633 N. St. Clair St., Suite 2000, Chicago, IL 60611, United States.
| | - Anthony Spirito
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Box G-BH, Providence, RI 02912, United States.
| |
Collapse
|
6
|
Dyar C, Crosby S, Newcomb ME, Mustanski B, Kaysen D. Doomscrolling: Prospective associations between daily COVID news exposure, internalizing symptoms, and substance use among sexual and gender minority individuals assigned female at birth. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2024; 11:139-152. [PMID: 38737889 PMCID: PMC11081596 DOI: 10.1037/sgd0000585] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Cross-sectional studies have demonstrated associations between COVID news exposure, anxiety, and depression. However, longitudinal research examining the directionality of these associations is extremely limited. Further, most studies have focused on the general population and neglected sexual and gender minority individuals (SGM), a population disproportionately impacted by the pandemic. To address these limitations, the current study utilized data from a 30-day diary study of SGM assigned female at birth (N = 429). We examined concurrent and prospective associations between COVID news exposure, depressed and anxious affect, COVID distress, substance use, and motives for use. Further, we examined associations between cumulative COVID news exposure across the diary period and prospective changes in anxiety, depression, and COVID distress. When participants were exposed to more COVID news, they experienced more depressed and anxious affect, more COVID distress, less positive affect, and were more likely to use alcohol and cannabis to cope. Further, when participants were exposed to more COVID news, they experienced subsequent increases in depressed affect, decreases in positive affect, and increases in the likelihood of using cannabis to cope. Findings also provided evidence of bi-directional prospective associations between COVID news exposure and COVID distress and of a cumulative impact of COVID news exposure on anxiety, depression, and COVID distress. Findings suggest that individuals should balance the need to remain informed about the pandemic and their own mental health when considering how much COVID news to consume.
Collapse
Affiliation(s)
| | | | - Michael E. Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
| |
Collapse
|
7
|
Mammadli T, Hong C. Substance Use and Misuse among Sexual and Gender Minority Communities Living in Former Soviet Union Countries: A Scoping Review. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:59-76. [PMID: 38600900 PMCID: PMC10903640 DOI: 10.1080/19317611.2024.2303517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/04/2024] [Indexed: 04/12/2024]
Abstract
Objectives We reviewed literature examining substance use among sexual and gender minorities (SGM) living in the former Soviet Union (USSR) nations. Methods Searches were conducted across five databases (PubMed, SocINDEX, CINAHL, PscyInfo, LGBTQ + Source) to identify peer-reviewed literature. Results Across 19 studies, high hazardous substance use prevalence was documented. Substance use was correlated with (a) sexual health and behaviors and (b) mental wellbeing and the use of other substances. Conclusion We discuss minority stress implications and challenges presented by the paucity of evidence in the literature examining substance use among SGM women and SGM living in countries unrepresented in reviewed studies.
Collapse
Affiliation(s)
- Tural Mammadli
- School of Social Work, University of Maryland, Baltimore, MD, USA
| | - Chenglin Hong
- Department of Social Welfare, University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
8
|
Veldhuis CB, Kreski NT, Usseglio J, Keyes KM. Are Cisgender Women and Transgender and Nonbinary People Drinking More During the COVID-19 Pandemic? It Depends. Alcohol Res 2023; 43:05. [PMID: 38170029 PMCID: PMC10760999 DOI: 10.35946/arcr.v43.1.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
PURPOSE This narrative review of research conducted during the first 2 years of the COVID-19 pandemic examines whether alcohol use among cisgender women and transgender and nonbinary people increased during the pandemic. The overarching goal of the review is to inform intervention and prevention efforts to halt the narrowing of gender-related differences in alcohol use. SEARCH METHODS Eight databases (PubMed, APA PsycInfo, CINAHL, Embase, Scopus, Gender Studies Database, GenderWatch, and Web of Science) were searched for peer-reviewed literature, published between March 2020 and July 2022, that reported gender differences or findings specific to women, transgender or nonbinary people, and alcohol use during the pandemic. The search focused on studies conducted in the United States and excluded qualitative research. SEARCH RESULTS A total 4,132 records were identified, including 400 duplicates. Of the remaining 3,732 unique records for consideration in the review, 51 were ultimately included. Overall, most studies found increases in alcohol use as well as gender differences in alcohol use, with cisgender women experiencing the most serious consequences. The findings for transgender and nonbinary people were equivocal due to the dearth of research and because many studies aggregated across gender. DISCUSSION AND CONCLUSIONS Alcohol use by cisgender women seems to have increased during the pandemic; however, sizable limitations need to be considered, particularly the low number of studies on alcohol use during the pandemic that analyzed gender differences. This is of concern as gender differences in alcohol use had been narrowing before the pandemic; and this review suggests the gap has narrowed even further. Cisgender women and transgender and nonbinary people have experienced sizable stressors during the pandemic; thus, understanding the health and health behavior impacts of these stressors is critical to preventing the worsening of problematic alcohol use.
Collapse
Affiliation(s)
- Cindy B Veldhuis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Noah T Kreski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia Irving Medical Center, Columbia University, New York, New York
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| |
Collapse
|
9
|
Carney T, Choi SK, Stephenson R, Bauermeister JA, Carrico AW. Latent class analysis of substance use typologies associated with mental and sexual health outcomes among sexual and gender minority youth. PLoS One 2023; 18:e0290781. [PMID: 37768906 PMCID: PMC10538794 DOI: 10.1371/journal.pone.0290781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 08/16/2023] [Indexed: 09/30/2023] Open
Abstract
Little is known about sexual and gender minority youth (SGMY) who have sex with men's unique patterns of substance use, even though they are at risk for substance use and adverse mental and other health outcomes. We used latent class analysis to examine typologies of substance use and multinomial logistic regression to investigate mental health outcomes (depression and anxiety) and HIV/STI testing correlates associated with different classes of substance use in a sample of SGMY who have sex with men in the USA and use substances (n = 414) who participated in an online survey. The average age was 22.50 years old (SD = 3.22). A four-class solution was identified representing: 'depressant and stimulant use' (3.4%), 'high polysubstance use' (4.6%), 'low substance use with moderate cannabis use' (79.2%), and 'high cannabis, stimulant and alcohol use' (12.8%). Membership to a specified substance use class varied by age, previous arrest, gender identity, anxiety, and lifetime HIV testing. Multivariate logistic regression results indicated that participants in the high polysubstance use (AOR = 5.48, 95% CI 1.51, 19.97) and high cannabis use class (AOR = 3.87, 95% CI 1.25, 11.94) were significantly more likely than those in the low substance use with moderate cannabis use class to report previous arrest. Those in the high polysubstance use class were also significantly less likely to have been tested for HIV than those in the low substance use with moderate cannabis use class (AOR = 0.21, 95% CI 0.05, 0.93). Findings will guide the development and implementation of tailored approaches to addressing the intersection of substance use and HIV risk among SGMY.
Collapse
Affiliation(s)
- Tara Carney
- Mental Health, Alcohol, Substance Use and Tobacco Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Department of Psychiatry and Mental Health, Division of Addiction Psychiatry, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Seul Ki Choi
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Rob Stephenson
- School of Nursing, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Jose A. Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Adam W. Carrico
- Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, United States of America
| |
Collapse
|
10
|
Holmes LG, Xuan Z, Quinn E, Caplan R, Sanchez A, Wharmby P, Holingue C, Levy S, Rothman EF. Alcohol Use Patterns Among Underage Autistic and Non-Autistic Youth. J Autism Dev Disord 2023:10.1007/s10803-023-06086-4. [PMID: 37751088 DOI: 10.1007/s10803-023-06086-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE We explored factors predicting repeated or hazardous alcohol use among autistic and non-autistic U.S. youth ages 16 to 20 years. METHODS Autistic (n = 94) and non-autistic (n = 92) youth completed an online survey. By design, half of each group reported past-year alcohol use. We compared drinking patterns for autistic and non-autistic youth, and within each group between abstinent or infrequent drinkers (0-1 drinking episodes in past year) versus those who drank 2 + times in past year. RESULTS Autistic (vs. non-autistic) youth who drank did so less frequently and consumed fewer drinks per occasion. However, 15% of autistic youth who drank in the past year reported heavy episodic drinking and 9.3% screened positive for AUDIT-C hazardous drinking. For autistic youth only, a diagnosis of depression, bullying or exclusion histories were positively associated with drinking 2 + times in the past year. Autistic youth who put more effort into masking autistic traits were less likely to report drinking 2 + times in the past year. As compared to non-autistic youth, autistic participants were less likely to drink for social reasons, to conform, or to enhance experiences, but drank to cope at similar rates. CONCLUSION Repeated and hazardous underage alcohol occur among autistic youth. Targeted prevention programs designed to address the specific drinking profiles of autistic youth are needed.
Collapse
Affiliation(s)
| | - Ziming Xuan
- Boston University School of Public Health, Boston, USA
| | - Emily Quinn
- Boston University School of Public Health, Boston, USA
| | - Reid Caplan
- Silberman School of Social Work, CUNY Hunter College, New York, USA
| | - Amelia Sanchez
- Silberman School of Social Work, CUNY Hunter College, New York, USA
| | - Peter Wharmby
- Silberman School of Social Work, CUNY Hunter College, New York, USA
| | - Calliope Holingue
- Center for Autism and Related Disorders, Department of Mental Health, Kennedy Krieger Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Sharon Levy
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Emily F Rothman
- Department of Occupational Therapy, Boston University, Boston, USA
| |
Collapse
|
11
|
McDowell MJ, King DS, Gitin S, Miller AS, Batchelder AW, Busch AB, Greenfield SF, Huskamp HA, Keuroghlian AS. Alcohol Use Disorder Treatment in Sexually and Gender Diverse Patients: A Retrospective Cohort Study. J Clin Psychiatry 2023; 84:23m14812. [PMID: 37656181 PMCID: PMC10535851 DOI: 10.4088/jcp.23m14812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Objective: While sexually and gender diverse (SGD) people have higher odds of alcohol use disorder (AUD) compared to heterosexual and cisgender people, AUD treatment access and use disparities are not well characterized. The purpose of this study is to assess differences in AUD treatment among SGD versus non-SGD populations. Methods: A retrospective cohort study was performed using data from a federally qualified health center electronic health record system in Boston, Massachusetts. Patients were 18 years or older with an International Classification of Diseases (ICD)-9 or ICD-10 AUD diagnosis and any clinic visit from January 2013 until June 2021 (N = 3,607). Treatment for AUD was identified using binary variables for medication prescription orders and visits for AUD. Results: Among patients identifying as lesbian/gay, 6.9% had an AUD diagnosis, as compared to 2.6% of patients identifying as straight/heterosexual (P < .001). The prevalence of AUD was higher in the gender diverse group as compared to the cisgender group (5.5% vs 4.4%, P < .001). There were no significant differences in receipt of a prescription for injectable naltrexone, acamprosate, or disulfiram between SGD and non-SGD patients. For oral naltrexone, 16.1% of sexually diverse patients received a prescription, as compared to 9.8% of straight/heterosexual patients (P < .001). For visits, both the straight/heterosexual cohort and the cisgender cohorts had the lowest proportion of AUD-related pharmacotherapy and individual psychotherapy visits, as compared to SGD cohorts. Conclusions: SGD patients had higher proportions of AUD diagnosis and AUD care utilization through behavioral health as compared to non-SGD patients.
Collapse
Affiliation(s)
- Michal J McDowell
- Department of Psychiatry, Massachusetts General Hospital, Boston
- McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Corresponding Author: Michal McDowell, MD, MPH, 15 Parkman St, WACC 812, Boston, MA 02114
| | - Dana S King
- The Fenway Institute, Fenway Health, Boston, Massachusetts
| | - Sy Gitin
- The Fenway Institute, Fenway Health, Boston, Massachusetts
| | - Amitai S Miller
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Abigail W Batchelder
- Department of Psychiatry, Massachusetts General Hospital, Boston
- The Fenway Institute, Fenway Health, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Alisa B Busch
- McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Shelly F Greenfield
- McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Haiden A Huskamp
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Alex S Keuroghlian
- Department of Psychiatry, Massachusetts General Hospital, Boston
- The Fenway Institute, Fenway Health, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
12
|
Dyar C, Feinstein BA, Albright J, Newcomb ME, Whitton SW. Associations between Drinking Contexts, Minority Stress, and Problematic Alcohol Use among Sexual Minority Individuals Assigned Female at Birth. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2023; 10:292-303. [PMID: 37484479 PMCID: PMC10361668 DOI: 10.1037/sgd0000426] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Sexual minority individuals assigned female at birth (SM-AFAB) are at increased risk for problematic alcohol use compared to heterosexual women. Despite evidence that drinking locations and companions play an important role in problematic alcohol use among heterosexuals, few studies have examined these social contexts of alcohol use among SM-AFAB. To address this gap, the current study examined two aspects of social contexts in which SM-AFAB drink (locations and companions). We utilized two waves of data (six-months between waves) from an analytic sample of 392 SM-AFAB ages 17-33 from a larger longitudinal study. The goals were: (1) to identify classes of SM-AFAB based on the contexts in which they drank; (2) to examine the associations between drinking contexts, minority stressors, and problematic alcohol use; and (3) to examine changes in drinking contexts over time. Using latent class analysis, we identified four classes based on drinking locations and companions (private settings, social settings, social and private settings, multiple settings). These classes did not differ in minority stress. Drinking in multiple settings was associated with more problematic alcohol use within the same timepoint and these differences were maintained six months later. However, drinking in multiple settings did not predict subsequent changes in problematic alcohol use when problematic alcohol use at the prior wave was controlled for. Based on these findings, SM-AFAB who drink in multiple settings may be an important subpopulation for interventions to target. Interventions could focus on teaching SM-AFAB strategies to limit alcohol consumption and/or minimize alcohol-related consequences.
Collapse
Affiliation(s)
- Christina Dyar
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science
| | | | - Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | | |
Collapse
|
13
|
Herchenroeder L, Speed S, Ward RM, Yeung EW. Sexual minority status and food and alcohol disturbance among college students: The moderating role of body esteem. Eat Behav 2023; 49:101745. [PMID: 37235994 DOI: 10.1016/j.eatbeh.2023.101745] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
Food and alcohol disturbance (FAD; restricting caloric intake before, during, or after drinking to either offset calories or to increase intoxication) is common among college students and poses a threat to students' health. In conjunction, sexual minority (SM; i.e., not exclusively heterosexual) college students may be at increased risk of engaging in alcohol misuse and disordered eating compared to their heterosexual peers due to exposure to minority stress. However, little research has examined whether engagement in FAD differs by SM status. Body esteem (BE) is an important resilience factor among SMs that may influence SM students' risk of participating in FAD. Therefore, the aim of the present study was to understand the association between SM status and FAD with additional interest in BE as a moderating factor. Participants were 459 college students who engaged in past 30-day binge drinking. Most participants identified as White (66.7 %), female (78.4 %), heterosexual (69.3 %), with a mean age of 19.60 (SD = 1.54) years. Participants completed two surveys (3 weeks apart) over the course of an academic semester. Analyses revealed a significant interaction between SM status and BE, such that SMs with lower BE (T1) reported more engagement in FAD-intoxication (T2), whereas SMs with higher BE (T1) reported less engagement in FAD-calories (T2) and FAD-intoxication (T2) than their heterosexual peers. Stressors associated with body esteem may contribute to increased FAD engagement among SM students. Consequently, BE may be an especially important target for interventions aimed at reducing FAD among SM college students.
Collapse
Affiliation(s)
- Luke Herchenroeder
- Department of Psychological and Brain Sciences, George Washington University, United States of America.
| | - Shannon Speed
- NIH IRP, NIDA/NIAAA, Translational Addiction Medicine Branch Lab, Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, United States of America
| | | | - Ellen W Yeung
- Department of Psychological and Brain Sciences, George Washington University, United States of America
| |
Collapse
|
14
|
Lewis MA, Zhou Z, Parks KA, Evans-Polce R, Litt DM, Fairlie AM, Geusens F, LoParco C, McCabe SE. Polysubstance use among young adults and differences in negative alcohol-related sexual experiences. Addict Behav 2023; 138:107571. [PMID: 36502745 PMCID: PMC9780189 DOI: 10.1016/j.addbeh.2022.107571] [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] [Received: 08/12/2022] [Revised: 11/18/2022] [Accepted: 11/28/2022] [Indexed: 12/05/2022]
Abstract
This study aimed to compare negative alcohol-related sexual experiences among individuals who used (1) alcohol only, (2) alcohol plus marijuana, and (3) alcohol plus marijuana and stimulants. Participants in the analytic sample (N = 1,015; Mean age = 19.16 (SD = 0.79); 45.42% male) completed an online baseline survey as part of an intervention study. A hurdle negative binomial model examined the associations between polysubstance use and negative alcohol-related sexual experiences. Models examined if experiences varied by demographic factors. Compared to participants that only used alcohol, those who used alcohol plus marijuana and stimulants reported a higher likelihood and average number of negative alcohol-related sexual experiences in the past 3 months. Participants that used alcohol plus marijuana had a higher likelihood of having a negative alcohol-related sexual experience in the past 3 months compared to those who only used alcohol. These findings suggest the number and risk for negative alcohol-related sexual experiences increases with the number of substances being used.
Collapse
Affiliation(s)
- Melissa A Lewis
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States.
| | - Zhengyang Zhou
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States
| | - Kathleen A Parks
- Department of Psychology, College of Arts and Sciences, The State University at New York at Buffalo, 1021 Main Street, Buffalo, NY 14203, United States
| | - Rebecca Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI 48109, United States
| | - Dana M Litt
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States
| | - Anne M Fairlie
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behaviors, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, United States
| | - Femke Geusens
- Leuven School for Mass Communication Research, KU Leuven, Parkstraat 45 box 3603, 3000 Leuven, Belgium; Research Foundation Flanders/FWO Vlaanderen, Leuvenseweg 38, 1000 Brussel, Belgium
| | - Cassidy LoParco
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, United States
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 North Ingalls Building, Ann Arbor, MI 48109, United States
| |
Collapse
|
15
|
Fisher Z, Hughes G, Staggs J, Moore T, Kinder N, Vassar M. Health Inequities in Coronary Artery Bypass Grafting Literature: A Scoping Review. Curr Probl Cardiol 2023; 48:101640. [PMID: 36792023 DOI: 10.1016/j.cpcardiol.2023.101640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 02/04/2023] [Indexed: 02/15/2023]
Abstract
Although life saving, health inequities exist regarding access and patient outcomes in Coronary artery bypass grafting (CABG), especially among marginalized groups. This scoping review's goal is to outline existing literature and highlight gaps for future research. Researchers followed guidance from the Joanna Briggs Institute and PRISMA extension for scoping reviews. We conducted a search to identify articles published between 2016 and 2022 regarding CABG and inequity groups, defined by the National Institutes of Health. Fifty-seven articles were included in our final sample. Race/Ethnicity was examined in 39 incidences, Sex or Gender 29 times, Income 17 instances, Geography 10 instances, and Education Level 3 instances. Occupation Status 2 instances, and LGBTQ+ 0 times. Important disparities exist regarding CABG access and outcomes, especially involving members of the LGBTQ+, Native American, and Black communities. Further research is needed to address health disparities and their root causes for focused action and improved health of minoritized groups.
Collapse
Affiliation(s)
- Zachariah Fisher
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK.
| | - Griffin Hughes
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK
| | - Jordan Staggs
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK
| | - Ty Moore
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK
| | | | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK
| |
Collapse
|
16
|
Intersectional stigma subgroup differences in unhealthy drinking and disordered marijuana use among Black and Latino cisgender sexual minority young men. Drug Alcohol Depend 2022; 241:109652. [PMID: 36332595 PMCID: PMC10082566 DOI: 10.1016/j.drugalcdep.2022.109652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 09/18/2022] [Accepted: 09/27/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND We investigated associations of intersectional stigma subgroups with alcohol and marijuana use among Black and Latino sexual minority young men. Subgroups included Minimal Stigma (low to no stigma), Select Social Stigma (occasional stigma in social relationships), Multiform Heterosexism (internalized and interpersonal heterosexism from family/friends), Multiform Racism (racism across diverse contexts), Compound Stigma (frequent, ubiquitous racism and heterosexism). METHODS Cohort of Black and Latino cisgender sexual minority young men (n = 414; baseline ages 16-25) surveyed semiannually 2016-2019. Generalized estimating equations integrated with latent class analysis modeled linear and quadratic age effects and association of stigma subgroups with past 6-month alcohol use, marijuana use, unhealthy drinking, and marijuana use disorder symptoms. RESULTS All past 6-month substance use peaked between ages 21-23 years old. Across all ages and relative to Minimal Stigma, odds of drinking were higher in every subgroup and highest in Compound Stigma (OR=2.72, 95% CI 1.17-6.35); unhealthy drinking was higher in every subgroup and highest in Multiform Heterosexism (β = 3.31, 95% CI 1.92-3.89); marijuana use disorder symptoms were higher in most subgroups and highest in Compound Stigma (β = 1.30, 95% CI 0.76-1.85). Marijuana use odds did not differ among groups. CONCLUSION By examining intersectional stigma subgroups, we identified subgroups for whom substance use was elevated during a development period when use tends to be highest. Young men experiencing stigma patterns characterized primarily by heterosexism or heterosexism together with racism may be especially at risk for developing unhealthy drinking behaviors and marijuana use disorder symptoms.
Collapse
|
17
|
Ott MQ, Clark MA, Balestrieri SG, Gamarel KE, Barnett NP. Social Networks and Sexual and Gender Minority Disparities in Alcohol Use and Consequences Among First-Year College Students. LGBT Health 2022; 9:489-495. [PMID: 35727117 PMCID: PMC9587779 DOI: 10.1089/lgbt.2019.0225] [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] [Indexed: 11/12/2022] Open
Abstract
Purpose: In this work, we investigate the association between social relationships and alcohol use and the related consequences of sexual and gender minority (SGM) college students, and we highlight the importance of SGM social networks as a potential protective factor among SGM college students. Methods: The study used data from 1340 students (47.2% White and non-Hispanic, 55.4% assigned female at birth, 16.3% SGM), which were collected during the 2016 fall semester of the first year of college at one university. The study collected information about alcohol use and related consequences and about the social networks of participants through a peer nomination survey. Results: Regardless of SGM status, students who nominated at least one SGM peer reported significantly lower drinks per week (β = -0.69, p = 0.04) and heavy drinking frequency (β = -0.38, p = 0.02) after adjusting for relevant covariates including peer drinking. SGM participants showed a significantly stronger negative association between having an SGM peer and heavy drinking frequency and alcohol-related consequences than their cisgender heterosexual counterparts (β = -0.90, p = 0.04; β = -1.32, p = 0.03). Conclusion: These findings highlight the importance of SGM social networks as a potential protective factor for reducing alcohol use and related consequences among SGM college students. College campuses should identify ways to support connections among SGM students. Clinical trials registration number is NCT02895984.
Collapse
Affiliation(s)
- Miles Q. Ott
- Program in Statistical and Data Sciences, Smith College, Northampton, Massachusetts, USA
| | - Melissa A. Clark
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Sara G. Balestrieri
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Kristi E. Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Nancy P. Barnett
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| |
Collapse
|
18
|
Andreou E, Plexousakis S, Georgiadi M, Papadopoulos O. Mental Health Problems and Bullying Victimization Among Sexual Minority Adolescents in Greek Secondary Schools. J Genet Psychol 2022; 183:399-412. [DOI: 10.1080/00221325.2022.2098003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Eleni Andreou
- Department of Primary Education, University of Thessaly, Volos, Greece
| | | | - Maria Georgiadi
- Department, of Psychology, University of Crete, Rethymno, Greece
| | | |
Collapse
|
19
|
Eisenberg ME, Gower AL, Watson RJ, Rider GN, Thomas D, Russell ST. Substance Use Behaviors Among LGBTQ+ Youth of Color: Identification of the Populations Bearing the Greatest Burden in Three Large Samples. J Adolesc Health 2022; 71:317-323. [PMID: 35715349 PMCID: PMC9644400 DOI: 10.1016/j.jadohealth.2022.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Research has identified persistent disparities in alcohol, e-cigarette, and marijuana use, by sexual orientation, gender identity, and race/ethnicity. Using an intersectionality framework, the present study analyzes three large datasets to identify intersecting social positions bearing the highest burden of substance use. METHODS Data from adolescents in grades 9-12 in three samples (2019 Minnesota Student Survey, 2017-2019 California Healthy Kids Survey, and 2017 National Teen Survey) were harmonized for an analysis (N = 602,470). A Chi-squared Automatic Interaction Detection analysis compared the prevalence of four types of substance use across all combinations of four social positions (six racial/ethnic identities, five sexual orientations, three gender identities, and two sexes assigned at birth). For each substance, 10 intersectional groups with the highest prevalence of use were examined. RESULTS In the full sample, 12%-14% of participants reported past 30-day alcohol, e-cigarette, or marijuana use and 7% reported past 30-day binge drinking. Several intersecting marginalized social positions were consistently found to bear a high burden of substance use. For example, transgender and gender diverse (TGD) Latina/x/o young people, particularly those assigned male at birth, were in the high prevalence groups for alcohol use, binge drinking, and marijuana use. Black TGD or gender-questioning youth were commonly in the high prevalence groups. DISCUSSION Findings suggest that support, resources, and structural changes specifically tailored to youth with multiple marginalized identities (especially TGD) may be needed. The results argue for intersectional efforts that explicitly address racial/ethnic and cultural differences, while also integrating awareness and understanding of sexual and gender diversity.
Collapse
Affiliation(s)
- Marla E. Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota. 717 Delaware St. SE, Minneapolis, MN, 55414, USA.,Corresponding author:
| | - Amy L. Gower
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota. 717 Delaware St. SE, Minneapolis, MN, 55414, USA
| | - Ryan J. Watson
- Department of Human Development and Family Studies, University of Connecticut, 348 Mansfield Rd U1058, Storrs, CT, 06269, USA
| | - G. Nic Rider
- Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, 1300 S 2nd St., Ste 180, Minneapolis, MN, 55454, USA
| | - De’Shay Thomas
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, University of Minnesota. 717 Delaware St. SE, Minneapolis, MN, 55414, USA
| | - Stephen T. Russell
- Department of Human Development and Family Sciences, University of Texas, 108 Dean Keeton St, Austin, TX, 78712, USA
| |
Collapse
|
20
|
Disparities in alcohol use and heavy episodic drinking among bisexual people: A systematic review, meta-analysis, and meta-regression. Drug Alcohol Depend 2022; 235:109433. [PMID: 35395502 DOI: 10.1016/j.drugalcdep.2022.109433] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Alcohol consumption is more prevalent among sexual minorities than among heterosexuals; however, differences between minority sexual orientation groups are understudied. This systematic review and meta-analysis aimed to summarize existing evidence on the prevalence of alcohol use among bisexual people compared to their lesbian/gay and heterosexual counterparts. METHODS A systematic review of literature from 1995 to May 2020 was performed using Medline, PsycInfo, and Embase (OVID), Scopus, CINHAL and LGBT Life (EBSCO), combining keywords for bisexuality and alcohol use. Peer-reviewed publications that reported quantitative data on alcohol use among bisexual people were included. A random-effects model was used to pool the prevalence of two outcomes: any alcohol use and heavy episodic drinking (HED). Subgroup analysis and random-effects meta-regression were used to explore heterogeneity. RESULTS Of 105 studies eligible for data extraction, the overall prevalence of alcohol use was higher among bisexuals compared to lesbian/gay and heterosexual people. For example, the prevalence of past-month HED was 30.0% (28.2, 31.8) among bisexual people versus 25.5% (23.8, 27.2) among lesbian/gay and 21.3% (19.6, 23.0) among heterosexual individuals. Pooled odds ratio estimates showed that bisexual people were more likely to report alcohol use and HED compared to their counterparts. Gender was a significant effect modifier in meta-regression analysis, with greater disparities among women than among men. CONCLUSIONS These results highlight the need for additional research to understand factors underlying bisexual people's greater risk, and particularly bisexual women, as well as alcohol use interventions that are targeted towards the specific needs of bisexual people.
Collapse
|
21
|
The Associations of Mental Health Disturbances, Self-Esteem, and Partner Violence Victimization with Condom Use in Spanish Adolescents. J Clin Med 2022; 11:jcm11092467. [PMID: 35566593 PMCID: PMC9104900 DOI: 10.3390/jcm11092467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022] Open
Abstract
Risky sexual behaviors, such as not using a condom for preventing sexually transmittable diseases and unwanted pregnancies, are associated with emotional and psychological problems in adolescence, including higher levels of depression, anxiety, stress, and low self-esteem. Adolescents with a history of violence victimization are also at increased risk of engaging in sexual risk behaviors. In this study, we examined the associations between mental health disturbances and partner violence victimization and the non-use of condoms among young people in Spain. We also examined self-esteem as a mediator of mental health problems and unprotected sexual relationships. A cross-sectional study was conducted on a sample of 831 adolescents randomly selected from 25 high schools in Spain. From the initial sample, 285 students (144 men and 141 women) from high schools in Alicante (Spain) who reported having experienced sexual activity with at least one partner were approached. The results showed that one in three adolescents between 14 and 19 years old did not use condoms during sexual intercourse. The factors associated with the non-use of condoms in the estimated models of Poisson robust variance were having a history of physical, psychological, or sexual violence; having been expelled from school because of behavioral problems; and having higher levels of depression, anxiety, and stress and lower levels of self-esteem. Self-esteem was independently associated with the non-use of condoms. Having lower levels of self-esteem increased the risk of not using a condom during participants’ last sexual intercourse. These findings suggest the importance of developing public health strategies for mental health promotion to increase condom use among adolescents.
Collapse
|
22
|
Restar AJ, Quilantang MIN, Surace A, Ogunbajo A, Chan R, Adia A, Cu-Uvin S, Operario D. Characterizing Problematic Drug Use Among Transgender Women and Cisgender Men During the Emerging HIV Crisis in the Philippines: Implications for Policy Research. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:116-130. [PMID: 35438540 PMCID: PMC10442844 DOI: 10.1521/aeap.2022.34.2.116] [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: 06/14/2023]
Abstract
Drug use and HIV are key issues for public health interventions in the Philippines. We examined associations of problematic drug use among 320 Filipinx transgender women (trans-WSM) and cisgender men who have sex with men (cis-MSM). The prevalence of exhibited problematic drug use in this sample was 29.38%. Greater odds of problematic drug use were observed among Filipinx participants who recently engaged in sex work (adjusted OR [aOR] = 2.79, 95% CI [1.08, 7.18]), reported having HIV positive and unknown status vs. negative status (aOR = 3.61, 95% CI [1.39, 9.39], and aOR = 13.99, 95% CI [2.04, 29.69], respectively), exhibited low HIV knowledge (aOR = 4.15, 95% CI [1.82, 9.44]), and displayed hazardous drinking (aOR = 2.77, 95% CI [1.21, 6.33]). Given its correlates of HIV-related indicators, integration of HIV and harm reduction services as a public health intervention could potentially decrease problematic drug use.
Collapse
Affiliation(s)
- Arjee J Restar
- University of Washington School of Public Health, Seattle, Washington and Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
- Brown University School of Public Health, Providence, Rhode Island
| | - Ma Irene N Quilantang
- Brown University School of Public Health, Providence, Rhode Island
- The Philippine Health Initiative for Research, Service, and Training, Brown University Global Health Initiative, Providence, Rhode Island
- University of Philippines, Manila, Philippines
| | - Anthony Surace
- Brown University School of Public Health, Providence, Rhode Island
| | | | | | - Alexander Adia
- Brown University School of Public Health, Providence, Rhode Island
- The Philippine Health Initiative for Research, Service, and Training, Brown University Global Health Initiative, Providence, Rhode Island
| | - Susan Cu-Uvin
- Brown University School of Public Health, Providence, Rhode Island
- The Philippine Health Initiative for Research, Service, and Training, Brown University Global Health Initiative, Providence, Rhode Island
- Providence-Boston Center for AIDS Research, Providence, Rhode Island, and the Department of Medicine Miriam Hospital, Providence, Rhode Island
| | - Don Operario
- Brown University School of Public Health, Providence, Rhode Island
- The Philippine Health Initiative for Research, Service, and Training, Brown University Global Health Initiative, Providence, Rhode Island
| |
Collapse
|
23
|
Talley AE, Harris BN, Le TH, Hohman ZP. Aversive Self-Focus and Alcohol Consumption Behavior in Women with Sexual Identity-Uncertainty: Changes in Salivary Cortisol Stress Response Among Those who Drink-to-Cope. CHRONIC STRESS 2022; 6:24705470221118308. [PMID: 36003324 PMCID: PMC9393684 DOI: 10.1177/24705470221118308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/20/2022] [Indexed: 12/03/2022]
Abstract
Background Individuals who report sexual identity-uncertainty are at-risk for heavy
alcohol consumption and alcohol use disorder symptomology. The current study
examined the impact of states of aversive self-focus on subsequent
consumption of ostensibly alcohol-containing beverages among a sample of
women in early adulthood with varying levels of sexual identity-uncertainty
(N = 75). Methods Utilizing a 2 (self-focus: negative vs. neutral) × 2
(attribution for any psychological discomfort: external
vs. none given) between-subjects design with 3 within-person assessments of
salivary cortisol, both a moderation model and mixed-effects general linear
model were tested. Results States of aversive self-focus caused increases in overall consumption among
women higher in sexual identity-uncertainty. Findings suggested consumption
of ostensibly alcohol-containing beverages was more likely among women
higher in sexual identity-uncertainty who also reported consuming beverages
to cope with distress. Among women who reported higher levels of sexual
identity-uncertainty and drinking-to-cope motives, salivary cortisol
concentrations dampened more quickly over time, as they supposedly consumed
alcohol. Conclusion Findings demonstrate that, among women reporting sexual identity-uncertainty
who are motivated to consume alcohol to forget about troubles or worries,
situations which evoke states of aversive self-focus may contribute to
differences in alcohol consumption in early adulthood.
Collapse
Affiliation(s)
- Amelia E. Talley
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Breanna N. Harris
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Tran H. Le
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Zachary P. Hohman
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| |
Collapse
|
24
|
State LGBTQ policies and binge drinking among sexual minority youth in the US: a multilevel analysis. Soc Psychiatry Psychiatr Epidemiol 2022; 57:183-194. [PMID: 34143248 DOI: 10.1007/s00127-021-02119-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 06/02/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Though higher rates of binge drinking have been reported among sexual minority (lesbian, gay, and bisexual) youths compared to their heterosexual peers in the United States, questions remain about which specific structural factors drive these inequities. We test whether state LGBTQ (lesbian, gay, bisexual, transgender, queer/questioning) policy climate is associated with youth binge drinking, as well as whether that association is unique to sexual minority youth. METHODS We use LGBTQ policy scores compiled by the Movement Advancement Project in 2017 and analyze 2017 Youth Risk Behavior Survey data (126,432 youths living in 24 states). We fit multi-level logistic regression models to estimate odds ratios for binge drinking with state-level LGBTQ policy scores. RESULT More progressive state-level overall LGBTQ policies were associated with lower odds of binge drinking among sexual minority youths (interaction term OR = 0.990, CI 0.984-0.996, p = 0.0009), but not among heterosexuals (OR = 1.001, CI 0.992, 1.009, p = 0.881). For sexual minorities, living in the most LGBTQ-affirming state was associated with a probability of binge drinking 27% lower than that of those living in the least LGBTQ-affirming state. In sensitivity analyses, policies specific to LGBTQ youth (opposed to general LGBTQ people) were even more strongly related to sexual minorities' binge drinking (interaction term: state-level youth policy score × individual-level sexual identity-of OR = 0.949, CI 0.927-0.971, p = 0.00001). In sex-stratified models, associations with overall LGBTQ policy scores were significant only for girls (OR = 0.986, CI 0.979-0.993, p < 0.001), not boys (OR = 0.997, CI 0.986-1.008, p = 0.551), while associations with youth-focused LGBTQ policies were significant for both sexual minority girls and boys. CONCLUSION Our findings point to state-level LGBTQ policy climate as a potential social determinant of binge drinking problems among sexual minority youths.
Collapse
|
25
|
Helminen EC, Scheer JR, Jackson SD, Brisbin CD, Batchelder AW, Cascalheira CJ, Sullivan TP. PTSD Symptoms and Hazardous Drinking Indicators among Trauma-Exposed Sexual Minority Women during Heightened Societal Stress. Behav Med 2021; 49:183-194. [PMID: 34870567 PMCID: PMC9167896 DOI: 10.1080/08964289.2021.2006132] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Trauma-exposed sexual minority women (SMW) are at elevated risk of posttraumatic stress disorder (PTSD) and hazardous drinking compared to trauma-exposed heterosexual women. To understand whether these problems might be exacerbated during times of elevated societal stress, we collected data from a New York-based sample of trauma-exposed SMW between April 2020 and August 2020, a period of notable, compounding societal stressors, including: (a) living in or near one of the first epicenters of the coronavirus disease 2019 (COVID-19) epidemic in the United States and (b) living through multiple high-profile occurrences of racism-related police violence and subsequent racial unrest. SMW (n = 68) completed online self-report questionnaires related to trauma, PTSD symptoms, and alcohol use, and a subset (n = 29) completed semi-structured qualitative interviews. PsycINFO was searched with terms related to SMW, PTSD, and alcohol use to identify studies with samples of SMW from articles published within the last 10 years to which we could compare our sample; this produced nine studies. Welch's t-tests and Chi-square analyses revealed that SMW within our sample reported significantly higher PTSD symptom severity, probable PTSD, and hazardous drinking indicators (i.e., alcohol use disorder and heavy episodic drinking) between April 2020 and August 2020 compared to similar samples (i.e., trauma-exposed SMW and general samples of SMW) assessed previously. Qualitative reports also indicated that the societal stressors of 2020 contributed to mental and behavioral health concerns. These results underscore the need for integrated PTSD and alcohol use prevention and intervention efforts for trauma-exposed SMW during times of heightened societal stress.Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.2006132 .
Collapse
Affiliation(s)
| | | | - Skyler D. Jackson
- Department of Social and Behavioral Sciences, Yale University School of Public Health
| | - Cal D. Brisbin
- Department of Psychology, Syracuse University,Luskin School of Public Affairs, The University of California
| | - Abigail W. Batchelder
- Harvard Medical School, Harvard University,Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital,Fenway Health, The Fenway Institute
| | - Cory J. Cascalheira
- Department of Psychology, Syracuse University,Department of Counseling and Educational Psychology, New Mexico State University
| | | |
Collapse
|
26
|
Gerke DR, Call J, Atteberry-Ash B, Katz-Kattari S, Kattari L, Hostetter CR. Alcohol use at the intersection of sexual orientation and gender identity in a representative sample of youth in Colorado. Am J Addict 2021; 31:61-68. [PMID: 34873759 DOI: 10.1111/ajad.13243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/21/2021] [Accepted: 11/24/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Lesbian, gay, bisexual, and questioning (LGBQ) youth are at greater risk of problematic alcohol use than their heterosexual peers, yet there is a dearth of research examining variability in alcohol use among youth that simultaneously accounts for sexual orientation and gender identity. This paper examines the relationship between alcohol use and intersecting identities of sexual orientation and gender while accounting for this population's disproportionate experiences of depression and dating and sexual violence. METHODS The study used a representative sample (n = 27,621) of high school students. Logistic regressions were used to determine if earlier age at first drink, 30-day alcohol use, and binge drinking were significantly related to intersectional sexual orientation and gender identity. Secondary models added depression, dating violence, and sexual violence to analyses to determine if they explained any of the variance in alcohol use variables in LGBQ and transgender youth. RESULTS Transgender youth who identified as heterosexual or questioning their sexual orientation were at greatest risk for early initiation of alcohol use and binge drinking. These relationships between intersectional identity and alcohol use became nonsignificant when depression, dating violence, and sexual violence were added to the models. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE This is the first study to examine relationships between intersecting identities of sexual orientation and gender identity and alcohol use among youth. Risky alcohol use among transgender youth may be attributed to experiences of depression, dating violence, and sexual violence impacting these populations. Interventions should focus on reducing transgender youth exposure to violence.
Collapse
Affiliation(s)
- Donald R Gerke
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | - Jarrod Call
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| | | | - Shanna Katz-Kattari
- School of Social Work & Department of Women's and Gender Studies, University of Michigan, Ann Arbor, Michigan, USA
| | - Leonardo Kattari
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - C Riley Hostetter
- Graduate School of Social Work, University of Denver, Denver, Colorado, USA
| |
Collapse
|
27
|
Paschen-Wolff MM, Putney JM, Corbeil T, Tse-Hwei C, Hughes TL. The Association between Hazardous Drinking Indicators and Drinking Problem Concerns among Sexual Minority Women. ANNALS OF LGBTQ PUBLIC AND POPULATION HEALTH 2021; 2:317-335. [PMID: 37920249 PMCID: PMC10621598 DOI: 10.1891/lgbtq-2020-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Sexual minority women (SMW) report high rates of hazardous drinking (HD), treatment utilization that is not commensurate with need, and low perceived alcohol use severity. This study examined SMW's drinking problem concerns by sexual identity and other demographic characteristics, and the strength of associations between endorsement of unique HD indicators and drinking problem concerns. Data were from a supplemental sample of SMW added in Wave 3 of the longitudinal, community-based Chicago Health and Life Experiences of Women (CHLEW) study. HD was measured using a validated 13-item HD Index (HDI). Multivariable logistic regression models examined independent associations between past-five-year drinking problem concerns and each HD indicator. Twelve HD indicators were significantly associated with past-five-year drinking problem concerns, adjusting for age and sexual identity. Adjusted odds ratios varied from 2.44 for driving drunk to 15.52 for drinking first thing in the morning. After adjusting for number of HD indicators endorsed, associations were no longer significant, indicating that number of endorsed indicators was a more important predictor of drinking problem concerns than were individual HD indicators. Early intervention and harm reduction strategies could support SMW in addressing salient aspects of HD before progression to alcohol use disorder.
Collapse
Affiliation(s)
- Margaret M. Paschen-Wolff
- Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, USA
- Columbia University Irving Medical Center, Department of Psychiatry, New York, NY, USA
| | | | - Thomas Corbeil
- Columbia University Irving Medical Center, Department of Psychiatry, Mental Health Data Science Division, New York, NY, USA
| | - Choo Tse-Hwei
- Columbia University Irving Medical Center, Department of Psychiatry, Mental Health Data Science Division, New York, NY, USA
| | - Tonda L. Hughes
- Columbia University Irving Medical Center, Department of Psychiatry, New York, NY, USA
- Columbia University School of Nursing, New York, NY, USA
| |
Collapse
|
28
|
Lipperman-Kreda S, Mair C, Gruenewald PJ. Ecological momentary assessments of night-time drinking among California adolescents: bases for informing night-time preventive interventions. Addiction 2021; 116:3408-3421. [PMID: 34159671 PMCID: PMC8578195 DOI: 10.1111/add.15623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/30/2020] [Accepted: 06/09/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND AIM To inform the development of effective night-time preventive interventions, our goal was to assess adolescents' residence (i.e. being at) and transitions across contexts during evening hours and risks for drinking and drinking-related problems in relation to contexts and to these transitions. DESIGN Ecological momentary assessment and survey methods. SETTING Twelve mid-sized cities (50 000-500 000 population) in California, USA from December 2014 to September 2015. ANALYTICAL SAMPLE A total of 153 adolescents (mean age = 16.4, 46.2% female). MEASUREMENT Initial conditions (e.g. past-year heavy drinking, gender, best friend's approval of drinking); adolescents' residence (i.e. being at) and transitions between (a) their own homes, (b) others' homes and (c) public spaces (e.g. restaurants, parks, concert venues) at early, middle and late evening hours; drinking in these contexts at early, middle and late evening hours; and drinking-related problems across evening hours. FINDINGS Risks for drinking were 23.5 times greater in others' homes (P < 0.01) and somewhat less in public spaces [odds ratio (OR) = 6.01, P < 0.01], compared with own home. Risks for problems in any evening time were elevated in relation to being in others' homes (OR = 2.37, P < 0.05) and public spaces (OR = 2.71, P < 0.01) versus at own home. Drinking in others' homes was related to 5.9 times increase in odds of transitioning back to own home (OR = 5.93, P < 0.05), 11.9 times increase in odds of remaining in others' homes (OR = 11.86, P < 0.01) or 7.3 times increase in odds of transitioning from others' homes to public spaces (OR = 7.3, P < 0.05). Initial conditions were associated with being in states, drinking and problems during evening hours and transitions across states. CONCLUSIONS In California, adolescents who are older, female, Hispanic or have greater spending money may be more likely to be outside their own home during evening hours than adolescents who do not match those criteria. In turn, being outside one's home during evening hours appears to be related to greater risks for drinking and drinking-related problems. Finally, transitions between contexts increased differential risks for drinking such that, for example, drinking in others' homes was highly related to transitioning to public spaces and less to returning to own home.
Collapse
Affiliation(s)
- Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704 USA
| | - Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street Pittsburgh, PA 15261 USA
| | - Paul J. Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704 USA
| |
Collapse
|
29
|
Xavier Hall CD, Morgan E, Bundy C, Foran JE, Janulis P, Newcomb ME, Mustanski B. Substance Use Predicts Sustained Viral Suppression in a Community Cohort of Sexual and Gender Minority Youth Living with HIV. AIDS Behav 2021; 25:3303-3315. [PMID: 33582890 DOI: 10.1007/s10461-021-03179-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2021] [Indexed: 12/23/2022]
Abstract
Retention in care and sustained viral suppression are integral outcomes in the care continuum for people living with HIV (PLWH) and HIV prevention; however, less is known about how substance use predicts sustained viral suppression over time. This study seeks to examine the predictive effects of substance use on sustained viral suppression in a sample of cisgender sexual minority men and gender minority PLWH (n = 163) drawn from a longitudinal sample in the Chicago area collected 2015-2019. Using data from 3 visits separated by 6 months, participants were coded persistently detectable, inconsistently virally suppressed, and consistently virally suppressed (< 40 copies/mL at all visits). Multinomial logistic regressions were utilized. About 40% of participants had sustained viral suppression. In multinomial logistic regressions, CUDIT-R predicted persistent detectable status and stimulant use was associated with inconsistent viral suppression. Substance use may create challenges in achieving sustained viral suppression, which has important implications for care and prevention.
Collapse
Affiliation(s)
- Casey D Xavier Hall
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Ethan Morgan
- Infectious Disease Institute, College of Nursing, Ohio State University, Columbus, OH, USA
| | - Camille Bundy
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - James E Foran
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Patrick Janulis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 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, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA.
| |
Collapse
|
30
|
Scheer JR, Clark KA, Maiolatesi AJ, Pachankis JE. Syndemic Profiles and Sexual Minority Men's HIV-Risk Behavior: A Latent Class Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:2825-2841. [PMID: 33483851 PMCID: PMC8295412 DOI: 10.1007/s10508-020-01850-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 09/14/2020] [Accepted: 09/23/2020] [Indexed: 05/10/2023]
Abstract
Syndemic theory posits that "syndemic conditions" (e.g., alcohol misuse, polydrug use, suicidality) co-occur among sexual minority men and influence HIV-risk behavior, namely HIV acquisition and transmission risk. To examine how four syndemic conditions cluster among sexual minority men and contribute to HIV-risk behavior, we conducted latent class analysis (LCA) to: (1) classify sexual minority men (n = 937) into subgroups based on their probability of experiencing each syndemic condition; (2) examine the demographic (e.g., race/ethnicity) and social status (e.g., level of socioeconomic distress) characteristics of the most optimally fitting four syndemic classes; (3) examine between-group differences in HIV-risk behavior across classes; and (4) use syndemic class membership to predict HIV-risk behavior with sexual minority men reporting no syndemic conditions as the reference group. The four classes were: (1) no syndemic, (2) alcohol misuse and polydrug use syndemic, (3) polydrug use and HIV syndemic, and (4) alcohol misuse. HIV-risk behavior differed across these latent classes. Demographic and social status characteristics predicted class membership, suggesting that syndemic conditions disproportionately co-occur in vulnerable subpopulations of sexual minority men, such as those experiencing high socioeconomic distress. When predicting HIV-risk behavior, men in the polydrug use and HIV syndemic class were more likely (Adjusted Risk Ratio [ARR] = 2.93, 95% CI: 1.05, 8.21) and men in the alcohol misuse class were less likely (ARR = 0.17, 95% CI: 0.07, 0.44) to report HIV-risk behavior than were men in the no syndemic class. LCA represents a promising methodology to inform the development and delivery of tailored interventions targeting distinct combinations of syndemic conditions to reduce sexual minority men's HIV-risk behavior.
Collapse
Affiliation(s)
- Jillian R Scheer
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY, 13244, USA.
| | - Kirsty A Clark
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
| | - Anthony J Maiolatesi
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale University School of Public Health, New Haven, CT, USA
- Center for Interdisciplinary Research on AIDS, Yale University School of Public Health, New Haven, CT, USA
| |
Collapse
|
31
|
Drysdale K, Cama E, Botfield J, Bear B, Cerio R, Newman CE. Targeting cancer prevention and screening interventions to LGBTQ communities: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1233-1248. [PMID: 33316150 DOI: 10.1111/hsc.13257] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/13/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
Although some people within LGBTQ communities are at risk of developing some cancers at higher rates than non-LGBTQ people, there is limited evidence of the outcomes of targeted cancer prevention and screening interventions for these communities. This scoping review examined key findings regarding the feasibility, acceptability and efficacy of evaluated intervention studies conducted in high income settings and published in peer reviewed literature (2014-2020) by combining evidence of both cancer risk-reducing behavioural interventions and screening and preventative practice interventions. While there is limited evidence of stronger outcomes from targeted interventions with cohorts of gender and sexuality diverse communities, compared with the use of mainstream or untailored interventions, there is stronger evidence that targeted interventions are more acceptable to these communities and may be more feasible in some contexts. Thus, there is benefit in understanding what targeting entails in these interventions, and to understand what influences acceptability, to inform the design and delivery of such interventions.
Collapse
Affiliation(s)
- Kerryn Drysdale
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Elena Cama
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Jessica Botfield
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | | | - Christy E Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| |
Collapse
|
32
|
Ancheta AJ, Caceres BA, Jackman KB, Kreuze E, Hughes TL. Sexual Identity Differences in Health Behaviors and Weight Status among Urban High School Students. Behav Med 2021; 47:259-271. [PMID: 34719340 PMCID: PMC8560978 DOI: 10.1080/08964289.2020.1763903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 10/24/2022]
Abstract
Although racial/ethnic disparities in childhood obesity are well documented in the United States (U.S.), fewer studies have investigated elevated body mass index (BMI) and related health behaviors among sexual minority youth (SMY; gay/lesbian, bisexual, not sure). We examined pooled data from the 2009-2017 Youth Risk Behavior Surveys, which included high school students from 12 urban U.S. school districts. We used sex-stratified logistic regression models to estimate the association of sexual identity with health behaviors and elevated BMI (reference = heterosexual participants). A total of 133,615 participants were included. Sexual minority boys were more likely to report physical inactivity than heterosexual boys. Gay and not sure boys were also less likely to consume the recommended daily intake of fruit. Bisexual girls were more likely than heterosexual girls to report watching television ≥ 3 hours on a school day and to consume sugar-sweetened beverages (AOR 1.30, 95% CI= 1.18-1.43). All SMY reported higher rates of current tobacco use than their heterosexual peers. Sexual minority girls and bisexual boys had significantly higher rates of obesity than their heterosexual counterparts. These findings can inform tailored health promotion initiatives to reduce obesity risk in SMY.
Collapse
Affiliation(s)
- April J Ancheta
- Columbia University School of Nursing, New York, New York, USA
| | - Billy A Caceres
- Columbia University School of Nursing, New York, New York, USA
| | - Kasey B Jackman
- Columbia University School of Nursing, New York, New York, USA
| | | | - Tonda L Hughes
- Henrik H. Bendixen Professor of International Nursing (in Psychiatry), Columbia University School of Nursing, New York, New York, USA
| |
Collapse
|
33
|
Watson RJ, Fish JN, Poteat VP, Wheldon CW, Cunningham CA, Puhl RM, Eaton LA. Teacher Support, Victimization, and Alcohol Use Among Sexual and Gender Minority Youth: Considering Ethnoracial Identity. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:590-601. [PMID: 33609259 PMCID: PMC8195836 DOI: 10.1007/s11121-021-01216-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 12/28/2022]
Abstract
Although scholarship continues to document higher rates of alcohol use for sexual and gender minority (SGM) youth compared with heterosexual and cisgender youth, research identifying factors that mitigate SGM youths' risk is nascent. Youth spend substantial time in schools; therefore, teachers could play significant roles in attenuating these health concerns. We used data from a nationwide survey of 11,189 SGM youth (Mage = 15.52; 67.7% White) to explore whether perceived teacher social-emotional support attenuated the association between victimization and alcohol use, further conditioned by youths' specific ethnoracial identity. As expected, victimization was associated with more frequent alcohol use; however, greater perceived teacher support attenuated this association. The attenuating effect of perceived teacher support was significantly stronger for Hispanic/Latinx youth than White youth. Our findings have implications for alcohol use prevention among SGM youth, who face significant marginalization in schools and society. If we are to prevent alcohol use disparities among SGM youth, scholars and stakeholders (e.g., school administrators, teachers) should invest in building teacher efficacy to intervene in SGM-specific victimization.
Collapse
Affiliation(s)
- Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA.
| | - Jessica N Fish
- Department of Family Science, University of Maryland, 1142 Valley Drive, College Park, MD, 20742, USA
| | - V Paul Poteat
- Department of Counseling, Developmental, and Educational Psychology, Boston College, Campion Hall 307, 140 Commonwealth Ave., Chestnut Hill, MA, 02467, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, 1301 Cecil B. Moore Ave, Philadelphia, PA, 19122, USA
| | - Casey A Cunningham
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
| | - Rebecca M Puhl
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
| | - Lisa A Eaton
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, Storrs, CT, 06269, USA
| |
Collapse
|
34
|
Phillips Ii G, Wang X, Ruprecht MM, Felt D, McCuskey D, Stephens R, Perez-Bill E, Beach LB. Differential Alcohol Use Disparities by Sexual Identity and Behavior Among High School Students. Alcohol Alcohol 2021; 56:490-499. [PMID: 33290517 DOI: 10.1093/alcalc/agaa131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 11/13/2022] Open
Abstract
AIMS Sexual minority youth (SMY) use alcohol at disproportionate rates compared to their heterosexual peers. However, sexual orientation is multidimensional. Analyzing alcohol use disparities only by one dimension of sexual orientation may result in critical disparities being obscured. METHODS Data from state and local versions of the Youth Risk Behavior Survey were pooled (2009-2017), resulting in a large, diverse sample (n = 201,671). Multivariable logistic regression models were used to analyze associations between sexual identity/sexual behavior and three alcohol use outcomes among sexually active youth: age at first drink, binge drinking and current drinking. RESULTS SMY, when categorized by sexual identity and sexual behavior, reported greater alcohol use than their heterosexual peers, though the magnitude of these disparities varied by subgroup. Both those who identified as bisexual and those who reported sexual behavior with both males and females reported the greatest levels of alcohol use. Decomposition analysis revealed that youth whose reported sexual behavior was not aligned with stereotypical behavioral expectations based on their sexual identity had higher odds of current drinking and drinking before 13 years as compared to other youth. CONCLUSIONS Results highlight the need to incorporate multiple methods of sexual orientation measurement into substance use research. Interventions based solely on identity, rather than both identity and behavior, may not be sufficient; targeted research into the causes of alcohol use disparities is needed, especially for bisexual youth, youth whose sexual behavior and sexual identity are not stereotypically aligned, and youth who report a sexual identity of 'not sure.'
Collapse
Affiliation(s)
- Gregory Phillips Ii
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL 60611, USA
| | - Xinzi Wang
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL 60611, USA
| | - Megan M Ruprecht
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL 60611, USA
| | - Dylan Felt
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL 60611, USA
| | - David McCuskey
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL 60611, USA
| | - Reno Stephens
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL 60611, USA
| | - Esrea Perez-Bill
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL 60611, USA
| | - Lauren B Beach
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL 60611, USA
| |
Collapse
|
35
|
Fish JN, Bishop MD, Russell ST. Developmental Differences in Sexual Orientation and Gender Identity-Related Substance Use Disparities: Findings From Population-Based Data. J Adolesc Health 2021; 68:1162-1169. [PMID: 33478920 PMCID: PMC8154626 DOI: 10.1016/j.jadohealth.2020.10.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 10/05/2020] [Accepted: 10/26/2020] [Indexed: 01/20/2023]
Abstract
PURPOSE Despite well-established substance use disparities between sexual and gender minority adolescents and their heterosexual, cisgender peers, there remain questions about whether there are developmental differences in the onset and progression of these disparities across adolescence. These perspectives are critical for prevention efforts. We therefore estimate age-based patterns of five substance use behaviors across groups of adolescents defined by sexual orientation and gender identity (SOGI). METHODS Data are from the 2013-2015 cycles of the California Healthy Kids Survey (N = 634,454). Substance use was assessed with past 30-day e-cigarette use, combustible cigarette use, alcohol use, heavy episodic drinking, and marijuana use. Two- and three-way interactions were used to assess differences in age-specific prevalence rates of each substance by (1) sex and sexual identity; and (2) gender identity. RESULTS Across all substances, SOGI differences in past 30-day use were present by age 12 years. Most disparities persisted to age 18 years and older. SOGI disparities in combustible and e-cigarette use were wider in late adolescence. Analyses by sexual identity show that sexual minority girls reported the highest rates of substance use across age, followed by sexual minority boys. CONCLUSIONS SOGI differences in substance use emerged in early adolescence and appeared to persist and accelerate by late adolescence. Sexual minority girls had the highest rates of substance use across all ages. The findings underscore the urgent need for screening and prevention strategies to reduce substance use for sexual and gender minority youth.
Collapse
Affiliation(s)
- Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland; School of Public Health, University of Maryland, University of Maryland Prevention Research Center, College Park, Maryland.
| | - Meg D Bishop
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas
| | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas
| |
Collapse
|
36
|
Freitag TM, Chen-Sankey JC, Duarte DA, Ramsey MW, Choi K. Variations in Substance Use and Disorders Among Sexual Minorities by Race/Ethnicity. Subst Use Misuse 2021; 56:921-928. [PMID: 33821743 PMCID: PMC9362562 DOI: 10.1080/10826084.2021.1899225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Little is known about racial/ethnic minority substance use and disorder-related disparities among sexual minorities as compared to their heterosexual counterparts. This study aimed to understand the associations between sexual minority status and substance use and disorders among U.S. adults stratified by race/ethnicity. Methods: We analyzed data from a sample of U.S. adults (n = 35,981) surveyed during the 2012-2013 National Epidemiological Survey on Alcohol and Related Conditions-III. Respondents were categorized into four sexual minority statuses: heterosexual, gay/lesbian, bisexual, and conflicting. Respondents' substance (tobacco, alcohol, and marijuana) use and disorders were also assessed using standard measures. Weighted multivariable logistic regressions were used to examine the relationships between sexual minority status and substance use and disorders, stratified by race/ethnicity, adjusting for socio-demographic characteristics. Results: Sexual minority adults experienced a higher prevalence of substance use and disorders than heterosexuals. For example, bisexuals were more likely than heterosexuals to use marijuana (AOR = 3.45, 95% CI = 2.64-4.50) and have tobacco use disorders (AOR = 2.58, 95% CI = 2.02-3.28). These associations were stronger among racial/ethnic minorities. For instance, bisexual non-Hispanic Blacks were more than twice as likely (AOR = 3.17, 95% CI = 2.16-4.65) to be current tobacco users than their heterosexual counterparts; while this association was weaker for bisexual non-Hispanic Whites (AOR = 1.99, 95% CI = 1.47-2.71). Conclusion: Sexual minority adults, especially those who are also racial/ethnic minorities, experience a significantly higher burden of substance use and disorders than heterosexuals. Efforts to screen and treat substance use and disorders among this particular population are critically needed to improve their health outcomes and reduce health disparities.
Collapse
Affiliation(s)
- Thomas M Freitag
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD.,Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Julia C Chen-Sankey
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD
| | - Danielle A Duarte
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD
| | | | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD
| |
Collapse
|
37
|
Guo Y, Wheldon CW, Shao H, Pepine CJ, Handberg EM, Shenkman EA, Bian J. Statin Use for Atherosclerotic Cardiovascular Disease Prevention Among Sexual Minority Adults. J Am Heart Assoc 2020; 9:e018233. [PMID: 33317368 PMCID: PMC7955377 DOI: 10.1161/jaha.120.018233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Sexual minority, or lesbian, gay, and bisexual (LGB), individuals are at increased risk for cardiovascular disease attributable to elevated rates of health risk factors. However, although there is clear evidence that statin use can prevent cardiovscular disease in certain adult populations, no studies have examined how statins are being used among the LGB population. This study aimed to examine the prevalence and predictors of statin use among LGB and non‐LGB individuals using Facebook‐delivered online surveys. Methods and Results We conducted a cross‐sectional online survey about statin use in adults ≥40 years of age between September and December 2019 using Facebook advertising (n=1531). We calculated the prevalence of statin use by age, sexual orientation, and statin benefit populations. We used multivariable logistic regression to examine whether statin use differed by sexual orientation, adjusting for covariates. We observed a significantly lower rate of statin use in the LGB versus non‐LGB respondents (20.8% versus 43.8%; P<0.001) in the primary prevention population. However, the prevalence of statin use was not statistically different in the LGB versus non‐LGB respondents in the secondary prevention population. Adjusting for the covariates, the LGB participants were less likely to use statins than the non‐LGB respondents in the primary prevention population (odds ratio, 0.37; 95% CI, 0.19–0.70). Conclusions Our results are the first to emphasize the urgent need for tailored, evidence‐based cardiovascular disease prevention programs that aim to promote statin use, and thus healthy aging, in the LGB population.
Collapse
Affiliation(s)
- Yi Guo
- Department of Health Outcomes and Biomedical Informatics College of Medicine University of Florida Gainesville FL.,Cancer Informatics Shared Resource University of Florida Health Cancer Center Gainesville FL
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences College of Public Health Temple University Philadelphia PA
| | - Hui Shao
- Department of Pharmaceutical Outcomes and Policy College of Pharmacy University of Florida Gainesville FL
| | - Carl J Pepine
- Department of Medicine Division of Cardiovascular Medicine College of Medicine University of Florida Gainesville FL
| | - Eileen M Handberg
- Department of Medicine Division of Cardiovascular Medicine College of Medicine University of Florida Gainesville FL
| | - Elizabeth A Shenkman
- Department of Health Outcomes and Biomedical Informatics College of Medicine University of Florida Gainesville FL
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics College of Medicine University of Florida Gainesville FL.,Cancer Informatics Shared Resource University of Florida Health Cancer Center Gainesville FL
| |
Collapse
|
38
|
Bonny-Noach H, Shechory-Bitton M. Differences in substance use by sexual orientation and gender among Jewish young adults in Israel. Isr J Health Policy Res 2020; 9:52. [PMID: 33028401 PMCID: PMC7541271 DOI: 10.1186/s13584-020-00410-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 09/26/2020] [Indexed: 02/06/2023] Open
Abstract
Background This study focuses on sexual orientation and gender-based differences among Israeli young adult substance use behaviors. In addition, it evaluates young adult perception of substance use and acceptance of substances use by close friends. Methods We conducted a cross-sectional study. A self-reported anonymous questionnaire was distributed to a convenience sample of 496 young-adults (age: M = 23.14, SD = 2.48), which included 126 heterosexual males, 128 heterosexual females, 131 gay men, and 111 lesbians. Results This study revealed significant sexual orientation and gender differences in all outcomes examined. Significant substance usage differences were found for same-sex orientation as 52% reported cannabis use and 24% reported using other illegal substances during the past 12 months compared to 34 and 6% (respectively) among heterosexuals. Significant gender differences were found, as male participants reported 50% cannabis use and 19% reported other illegal substance use in the past 12 months compared to 35 and 11% (respectively) among females. Additionally, compared with heterosexuals, gay men and lesbians perceived/assessed significantly higher substance usage rates among their close friends and higher levels of substance use acceptance by close friends. Regression models indicated the important role of respondent perceived and acceptance of substance use among close friends. Binge drinking, cannabis use, and other illegal substance use were positively associated with participants’ perceived substance use and substance use acceptance level by close friends, after controlling for gender, sexual orientation, age, and level of education. Conclusions Close friends and community norms can play an important role in shaping substance usage among young adults, especially among gay men and lesbians. The results of the current study highlight the need for developing prevention and harm reduction drug policies for Israeli young adults, especially for gay men and lesbians. Interventions should also focus on young adult peers and community norms related to substance use by professionals in educational, policy-making, and therapeutic contexts.
Collapse
|
39
|
Sanders JM. Seeking Acceptance: LGBTQ and Membership in Alcoholics Anonymous (AA). ALCOHOLISM TREATMENT QUARTERLY 2020. [DOI: 10.1080/07347324.2020.1738295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Jolene M. Sanders
- Department of Sociology & Social Work, Hood College, Frederick, Maryland, USA
| |
Collapse
|
40
|
Zhang L, Finan LJ, Bersamin M, Fisher DA, Paschall MJ. Sexual Orientation-Based Alcohol, Tobacco, and Other Drug Use Disparities: The Protective Role of School-Based Health Centers. YOUTH & SOCIETY 2020; 52:1153-1173. [PMID: 34321700 PMCID: PMC8315521 DOI: 10.1177/0044118x19851892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study investigated whether the presence of school-based health centers (SBHCs) was associated with six substance use behaviors among sexual minority youth (SMY) and their heterosexual peers. Data from the 2015 Oregon Healthy Teens Survey, including 13,608 11th graders in 137 schools (26 with SBHCs) were used in the current study. Multilevel logistic regression analyses were performed. Results revealed significant SBHC by SMY status interactions indicating a relatively lower likelihood of past 30-day alcohol use (23%), binge drinking (43%), use of e-cigarettes (22%), marijuana (44%), and unprescribed prescription drugs (28%) among SMY in SBHC schools compared with non-SMY at SBHC schools. Furthermore, SMY in SBHC schools reported lower likelihood of aforementioned substance use behaviors than SMY attending non-SBHC schools. Conversely, no differences in these outcomes were observed for non-SMY in SBHC and non-SBHC schools. Findings from this study suggest SBHCs may help to mitigate substance use disparities among marginalized populations, such as SMY.
Collapse
Affiliation(s)
- Lei Zhang
- Pacific Institute for Research and Evaluation, Chapel Hill, NC, USA
| | - Laura J. Finan
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - Melina Bersamin
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | | | - Mallie J. Paschall
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| |
Collapse
|
41
|
Pachankis JE, Williams SL, Behari K, Job S, McConocha EM, Chaudoir SR. Brief online interventions for LGBTQ young adult mental and behavioral health: A randomized controlled trial in a high-stigma, low-resource context. J Consult Clin Psychol 2020; 88:429-444. [PMID: 32271053 DOI: 10.1037/ccp0000497] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To identify scalable interventions for improving sexual minority mental health and health-risk behavior, this study tested the efficacy of two self-guided online writing interventions-expressive writing and self-affirmation. To reach sexual minority young adults living in high-stigma, low-resource settings, we developed and tested these interventions in Appalachian Tennessee. METHOD In consultation with sexual minority young adults (n = 10) and stakeholders (n = 10) living in Appalachian Tennessee, we adapted these two writing interventions that we then delivered to 108 local sexual minority young adults (Mage = 23.68, SD = 3.11). Participants, representing diverse sexual and gender identities and socioeconomic backgrounds, were randomly assigned to participate in a 3-session expressive writing intervention, self-affirmation intervention, or neutral control. Participants completed mental health and health-risk behavior measures at baseline, postintervention, and 3-month follow-up. RESULTS Compared to the neutral control, expressive writing exerted 3-month improvements in depressive symptoms (d = 0.48) and general psychological distress (d = 0.36) whereas self-affirmation exerted improvement in suicidal ideation (d = 0.62) and drug abuse (d = 0.59). Participants who were exposed to greater contextual minority stressors common in rural regions (i.e., discrimination and victimization) experienced significantly greater 3-month reductions in depression from expressive writing and self-affirmation compared to control. Those who experienced greater discrimination also experienced significantly greater 3-month reductions in suicidality from self-affirmation compared to control. CONCLUSION Brief writing interventions exert significant impact on the mental health of young adult sexual minorities, especially those exposed to minority stress. Future research can consider strategies for population-level implementation, especially in high-stigma, low-resource settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health
| | | | - Kriti Behari
- Department of Social and Behavioral Sciences, Yale School of Public Health
| | - Sarah Job
- Department of Psychology, East Tennessee State University
| | - Erin M McConocha
- Department of Social and Behavioral Sciences, Yale School of Public Health
| | | |
Collapse
|
42
|
Clermont D, Gilmer T, Burgos JL, Berliant E, Ojeda VD. HIV and Sexual Health Services Available to Sexual and Gender Minority Youth Seeking Care at Outpatient Public Mental Health Programs in Two California Counties. Health Equity 2020; 4:375-381. [PMID: 32923842 PMCID: PMC7484894 DOI: 10.1089/heq.2020.0014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose: Sexual and gender minority youth (SGMY, ages 16-24 years) face disparities in sexually transmitted infections (STIs) and HIV, in part, due to exposure to settings and behaviors that may harm youth's physical and mental health. This study examines the scope of sexual health and HIV services available to youth living with serious mental illness (SMI), including SGMY, seeking care at publicly funded outpatient mental health programs. Methods: Between 2018 and 2019, we surveyed 183 managers of mental health programs serving youth living with SMI of ages 16-24 years, including SGMY, in San Diego and Los Angeles counties. Participants reported on programs' target populations, sexual health/HIV service provision, and the use of peer providers. Descriptive statistics and Pearson chi-square tests were used to describe sexual health/HIV services and identify programmatic characteristics associated with providing these services. Results: Overall, 46% of all programs surveyed provided sexual health/HIV services. Of these, 62% provided HIV education, 81% provided sexual/reproductive health education, and 69% provided sexual/reproductive health education tailored for lesbian, gay, bisexual, queer, intersex (LGBQI) youth. Peers often provided these services. Chi-squared tests showed that programs employing peer specialists (p=0.009) and targeting LGBQI youth (p=0.045) were significantly more likely to provide sexual health/HIV services. Conclusion: The use of peer providers may reduce stigma around sexual/HIV service utilization and promote SGMY's trust. Publicly funded outpatient mental health programs serving youth and especially those actively engaging SGMY may consider also offering onsite HIV, STI, and sexual health services, creating a one-stop-shop approach.
Collapse
Affiliation(s)
- Donald Clermont
- Department of Family Medicine and Public Health and University of California, San Diego School of Medicine, La Jolla, California, USA
| | - Todd Gilmer
- Department of Family Medicine and Public Health and University of California, San Diego School of Medicine, La Jolla, California, USA
| | - Jose Luis Burgos
- Department of Family Medicine and Public Health and University of California, San Diego School of Medicine, La Jolla, California, USA
| | - Emily Berliant
- Department of Family Medicine and Public Health and University of California, San Diego School of Medicine, La Jolla, California, USA
| | - Victoria D Ojeda
- Department of Family Medicine and Public Health and University of California, San Diego School of Medicine, La Jolla, California, USA.,Department of Medicine, University of California, San Diego School of Medicine, La Jolla, California, USA
| |
Collapse
|
43
|
Olsen EO, Vivolo-Kantor A, Kann L. Physical and Sexual Teen Dating Violence Victimization and Sexual Identity Among U.S. High School Students, 2015. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:3581-3600. [PMID: 29294763 DOI: 10.1177/0886260517708757] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Lesbian, gay, and bisexual (LGB) youth are at risk for many negative behaviors associated with teen dating violence victimization (TDVV). This study describes the prevalence of physical and sexual TDVV by sexual identity and quantifies the increased risk for TDVV among LGB youth compared with heterosexual youth. The participants for this study were students in Grades 9 to 12 participating in the 2015 national Youth Risk Behavior Survey (YRBS) who responded to questions ascertaining sexual identity and both physical and sexual TDVV. Data were analyzed by sexual identity, stratified by sex, and controlled for race/ethnicity and grade in school. Frequencies of physical and sexual TDVV and prevalence of TDVV from a combined TDVV measure were calculated. Associations between these behaviors and sexual identity were identified. Generally, LGB youth had greater prevalence and frequency of TDVV compared with heterosexual youth. Prevalence of TDVV within sexual identity subgroups further differed by sex. Students who were not sure of their sexual identity had the highest risk of most categories of TDVV when adjusting for sex, race/ethnicity, and grade in school. These results are the first to use a nationally representative sample to describe frequency of TDVV and to determine prevalence of a combined physical and sexual TDVV measure by sexual identity among youth. Schools, communities, and families can help prevent teen dating violence and ameliorate the potential impacts of these victimizations.
Collapse
Affiliation(s)
- Emily O'Malley Olsen
- Centers for Disease Control and Prevention, Atlanta, GA, USA
- University of Tampere, Faculty of Social Sciences, Tampere, Finland
| | | | - Laura Kann
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
44
|
Alcohol Use and Suicidality by Sexual Orientation Among U.S. Youth, 2009-2017. Am J Prev Med 2020; 59:394-403. [PMID: 32446749 PMCID: PMC7483808 DOI: 10.1016/j.amepre.2020.03.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/07/2020] [Accepted: 03/06/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Alcohol use and suicidality remain serious risks for U.S. youth. Research has established that disparities exist in these outcomes between heterosexual and sexual minority youth. However, research into the associations between alcohol use and suicidality has yet to consider the differential role of sexual orientation. METHODS Using a pooled, diverse sample from the 2009-2017 Youth Risk Behavior Survey, associations of alcohol use and suicidality by sex and sexual orientation, and changes in these outcomes over time, were investigated. Analyses were conducted in 2019. RESULTS Suicidality was highest among nonheterosexuals, who ranged from twofold to sevenfold higher odds to report suicidality across all time points, with the most striking disparities among male sexual minority youth. Rates among all students remained stable or increased over time; notable exceptions included a decrease in suicide attempts among bisexual students. Among all students, current alcohol use was associated with elevated levels of suicidality. For female students, the association between drinking and suicidality did not significantly differ by sexual identity; for male students, it was significant regardless of sexual identity and most pronounced among not sure youth. CONCLUSIONS These results emphasize the need for additional research into the relationship between contemporaneous alcohol use and suicidality, with attention to differences based on sex, sexual orientation, and other factors that may impact these relationships. There is a particular need for research to examine the temporal nature of the association such that evidence-informed, high-impact interventions can be developed to improve suicidality outcomes among sexual minority youth.
Collapse
|
45
|
Dermody SS, Friedman M, Chisolm DJ, Burton CM, Marshal MP. Elevated Risky Sexual Behaviors Among Sexual Minority Girls: Indirect Risk Pathways Through Peer Victimization and Heavy Drinking. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:2236-2253. [PMID: 29294701 DOI: 10.1177/0886260517701450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Sexual minority girls (SMGs), compared with heterosexual females, are more likely to report negative sexual outcomes including earlier age of sexual intercourse debut, more lifetime and recent sexual partners, pregnancy involvement, and sex while intoxicated. Data describing the mechanisms related to these health disparities are limited. The purpose of this study was therefore to longitudinally assess the roles of sexual minority-related peer victimization and heavy episodic drinking (HED) as mediators of the relation between sexual minority status and sexual outcomes. The girls examined in this study were recruited into a longitudinal study of adolescent health from two large, urban adolescent medicine clinics affiliated with academic medical centers. The final sample for this analysis included 79 SMGs and a comparison group of 127 heterosexual girls aged between 14 and 19 years. Mediation models were run in the structural equation modeling framework. Our results provided evidence to support a serial multiple mediation pathway. SMGs were more likely to report sexual minority-related victimization, and sexual minority-related victimization predicted increased HED, which was subsequently found to prospectively predict increased sexual risk behaviors. Taken together, these novel findings indicate that both sexual minority-related victimization and HED may play important roles in explaining disparities in risky sexual behavior among SMGs.
Collapse
Affiliation(s)
- Sarah S Dermody
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | | | - Deena J Chisolm
- The Ohio State University, Columbus, USA
- Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | | |
Collapse
|
46
|
Swann G, Stephens J, Newcomb ME, Whitton SW. Effects of sexual/gender minority- and race-based enacted stigma on mental health and substance use in female assigned at birth sexual minority youth. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2020; 26:239-249. [PMID: 31021146 PMCID: PMC6814455 DOI: 10.1037/cdp0000292] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE People of color who are also sexual and gender minorities (SGM) experience forms of enacted stigma based on both their racial/ethnic identity and their SGM status. We set out to test the effects of enacted stigma specific to race/ethnicity and SGM identity on mental health and substance use problems among female assigned at birth (FAB) SGM of color. METHOD Data come from a community-based sample of FAB SGM who also identified as racial/ethnic minorities (N = 352). The effects of racial discrimination, SGM victimization, and sexual orientation microaggressions on depression symptoms, anxiety symptoms, alcohol-related problems, and marijuana-related problems were tested using linear regression and negative binomial models. RESULTS Enacted stigma based on both race/ethnicity and SGM status were significant predictors of mental health outcomes and alcohol-related problems within the same model, which suggested that both uniquely contributed to poorer health. There was little support for interactive effects between the multiple forms of enacted stigma. Marijuana-related problems were best explained by enacted stigma based on race/ethnicity only. CONCLUSIONS Racially diverse FAB SGM are at unique risk of experiencing multiple forms of discrimination and aggression based on their minority identities that each contribute negatively to their wellbeing. Consideration of the multiple forms of enacted stigma they face is necessary for understanding health disparities in these populations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Gregory Swann
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Jasmine Stephens
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Michael E Newcomb
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | | |
Collapse
|
47
|
Dyar C, Feinstein BA, Stephens J, Zimmerman A, Newcomb ME, Whitton SW. Nonmonosexual Stress and Dimensions of Health: Within-Group Variation by Sexual, Gender, and Racial/Ethnic Identities. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2020; 7:12-25. [PMID: 32346545 PMCID: PMC7188068 DOI: 10.1037/sgd0000348] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Non-monosexual individuals (i.e., people with attractions to more than one gender) are at heightened risk for numerous negative health outcomes compared to individuals with exclusive attractions to either same-gender or different-gender individuals. This increased risk has been linked to the unique stress non-monosexual individuals experience due to the stigmatization of non-monosexuality (i.e., monosexism). However, research with this population has rarely considered multiple intersecting stigmatized identities (e.g., gender, race/ethnicity) and has focused predominately on internalizing symptoms (i.e., anxiety/depression). The current study aimed to expand this research by taking an intersectional approach to examining a) associations between three non-monosexual stressors (enacted, internalized, and anticipated monosexism) and three dimensions of health (i.e., physical health, internalizing symptoms, substance use and problems) and b) differences in these associations and rates of non-monosexual stressors and health problems by sexual, gender, and racial/ethnic identities among a diverse sample of 360 non-monosexual individuals assigned female at birth. Results indicated that all three non-monosexual stressors were associated with the three dimensions of health for the sample as a whole. There were several notable moderators of these associations. First, enacted monosexism was more strongly associated with physical health and substance use/problems for gender minorities compared to cisgender women. Second, several interactions indicated that non-monosexual stressors were associated with poorer health for White, but not Black or Latinx, individuals. These findings highlight the importance of attending to within-group heterogeneity to understand and address the range of health disparities affecting non-monosexual individuals.
Collapse
Affiliation(s)
- Christina Dyar
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Brian A Feinstein
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Jasmine Stephens
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Arielle Zimmerman
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University
| | | |
Collapse
|
48
|
Effects of victimization on mental health and substance use trajectories in young sexual minority men. Dev Psychopathol 2020; 31:1423-1437. [PMID: 30585567 DOI: 10.1017/s0954579418001013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Young sexual minority men (YSMM) experience more victimization and are at higher risk for mental health and substance use problems compared with heterosexual youth. We attempt to understand change over time in the experience of these constructs among YSMM. Data were taken from a diverse community-based sample of YSMM (N = 450, baseline mean age 18.93) surveyed every 6 months for 2.5 years. Multilevel modeling was used to model within-person change in victimization, internalizing symptoms, externalizing symptoms, alcohol frequency, marijuana use, and illicit drug use. We tested the indirect effect of concurrent and time-lagged victimization on the association between age and mental health and substance use. Victimization, internalizing symptoms, and externalizing symptoms decreased over time. Concurrent victimization was associated with higher internalizing symptoms, externalizing symptoms, alcohol use, marijuana use, and illicit drug use. Analysis of indirect effects suggested that the association between victimization and mental health and substance use outcomes decreased as participants transitioned from adolescence into adulthood. This study found that the reduction in victimization that YSMM experience as they grow older is associated with a reduction in negative mental health and substance use outcomes. Prevention efforts to limit victimization exposure may reduce health disparities for YSMM.
Collapse
|
49
|
Newcomb ME, Hill R, Buehler K, Ryan DT, Whitton SW, Mustanski B. High Burden of Mental Health Problems, Substance Use, Violence, and Related Psychosocial Factors in Transgender, Non-Binary, and Gender Diverse Youth and Young Adults. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:645-659. [PMID: 31485801 PMCID: PMC7018588 DOI: 10.1007/s10508-019-01533-9] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 08/02/2019] [Accepted: 08/05/2019] [Indexed: 05/04/2023]
Abstract
Transgender and gender diverse (TGD) people are disproportionately impacted by various health issues and associated risk factors, but little is known about differences in these outcomes between gender identities within the TGD population. This study characterized the health of a diverse sample of TGD youth and young adults. Data were taken from the baseline visit of two longitudinal studies in the Chicago area, RADAR (N = 1079, M age = 20.8 years) and FAB 400 (N = 488, M age = 19.57 years), which are cohorts of young sexual and gender minorities assigned male at birth (AMAB) and assigned female at birth (AFAB), respectively. There was a combined sample of 214 TGD (128 AFAB, 86 AMAB) individuals across cohorts. We examined differences between gender identities in self-reported health and related psychosocial variables, and compared TGD youth and their cisgender sexual minority peers from their cohort of origin on all variables. Among TGD youth, we found high rates of depression and suicidality (ideation, plan, attempt), violence (trauma, victimization, childhood sexual abuse), and substance use (cigarette, alcohol, illicit drug use). With the exception of depression, transgender women and non-binary AMAB youth reported worse health outcomes than transgender men and non-binary AFAB youth. Non-binary AMAB youth reported the highest rates of certain outcomes, including traumatic experiences and suicidal ideation. TGD youth generally reported worse outcomes than cisgender sexual minority youth; these differences were less pronounced among AFAB youth. Findings point to the diversity of experiences within the TGD population and critical needs for intervention approaches to mitigate health disparities.
Collapse
Affiliation(s)
- Michael E Newcomb
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Department of Medical Social Sciences, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14-059, Chicago, IL, 60611, USA.
| | - Ricky Hill
- Department of Medical Social Sciences, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14-059, Chicago, IL, 60611, USA
| | - Kathleen Buehler
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medical Social Sciences, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14-059, Chicago, IL, 60611, USA
| | - Daniel T Ryan
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medical Social Sciences, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14-059, Chicago, IL, 60611, USA
| | - Sarah W Whitton
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Medical Social Sciences, Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., 14-059, Chicago, IL, 60611, USA
| |
Collapse
|
50
|
Watson RJ, Park M, Taylor AB, Fish JN, Corliss HL, Eisenberg ME, Saewyc EM. Associations Between Community-Level LGBTQ-Supportive Factors and Substance Use Among Sexual Minority Adolescents. LGBT Health 2020; 7:82-89. [PMID: 31985327 DOI: 10.1089/lgbt.2019.0205] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Purpose: Using representative school-based data and community-level primary data, we investigated how environmental factors (e.g., school and community climate) might be protective against substance use behaviors among a vulnerable population of adolescents. Methods: We analyzed a sample of 2678 sexual minority adolescents using a combination of student-level data (British Columbia Adolescent Health Survey) and primary community-level data (assessing lesbian, gay, bisexual, transgender, and queer [LGBTQ]-specific community and school environments). Using multilevel logistic regression models, we examined associations between lifetime substance use (alcohol, illegal drugs, marijuana, nonmedical use of prescription drugs, and smoking) and community-level predictors (community and school LGBTQ supportiveness). Results: Above and beyond student characteristics (e.g., age and years living in Canada), sexual minority adolescents residing in communities with more LGBTQ supports (i.e., more supportive climates) had lower odds of lifetime illegal drug use (for boys and girls), marijuana use (for girls), and smoking (for girls). Specifically, in communities with more frequent LGBTQ events (such as Pride events), the odds of substance use among sexual minority adolescents living in those communities was lower compared with their counterparts living in communities with fewer LGBTQ supports. Conclusions: The availability of LGBTQ community-level organizations, events, and programs may serve as protective factors for substance use among sexual minority adolescents. In particular, LGBTQ-supportive community factors were negatively associated with substance use, which has important implications for our investment in community programs, laws, and organizations that advance the visibility and rights of LGBTQ people.
Collapse
Affiliation(s)
- Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut
| | - Minjeong Park
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, The University of British Columbia, Vancouver, Canada
| | - Ashley B Taylor
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, The University of British Columbia, Vancouver, Canada
| | - Jessica N Fish
- Department of Family Science, School of Public Health, University of Maryland, College Park, Maryland
| | - Heather L Corliss
- School of Public Health and Institute for Behavioral and Community Health, San Diego State University, San Diego, California
| | - Marla E Eisenberg
- Division of General Pediatrics and Adolescent Health, Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Elizabeth M Saewyc
- Stigma and Resilience Among Vulnerable Youth Centre, School of Nursing, The University of British Columbia, Vancouver, Canada
| |
Collapse
|