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Beaton MA, Gratch I, Cha CB. Specificity, frequency, and intent: Multiple characteristics of adolescents' suicide plan correlate with their history of suicidal behavior. Suicide Life Threat Behav 2023; 53:1025-1037. [PMID: 37720928 DOI: 10.1111/sltb.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 08/12/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Suicide plans (SP) can be a common precipitant to suicidal behavior (SB) during adolescence, and SPs can vary in how specific they are, how frequently they are thought about, and how strongly they are intended to be enacted. To date, we have limited understanding of how discrete SP characteristics (i.e., specificity, frequency, and intent to act) present among adolescents, and whether they relate to SB. In the current study, we investigated SP characteristics and their association with SB history among adolescents who had previously considered suicide. METHODS Participants were 142 community-based adolescents (14-19 years; M = 17.6, SD = 1.4) who reported a history of suicidal ideation. Adolescents provided responses pertaining to their SP history, SP characteristics, and SB history, via the Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R). RESULTS Greater specificity, frequency, and intent were each associated with modestly increased odds of reporting an SB history. The associations between plan specificity and SB history, as well as between frequency of thinking about one's SP and SB history, were mediated by adolescents' intent to act on their SP. CONCLUSIONS It may not only be whether, but how, adolescents plan for suicide that relates to their tendency to engage in SB.
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Affiliation(s)
- Maura A Beaton
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
- Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
| | - Ilana Gratch
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
| | - Christine B Cha
- Department of Counseling & Clinical Psychology, Teachers College - Columbia University, New York, New York, USA
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Spears AP, Gratch I, Nam RJ, Goger P, Cha CB. Future Directions in Understanding and Interpreting Discrepant Reports of Suicidal Thoughts and Behaviors Among Youth. J Clin Child Adolesc Psychol 2023; 52:134-146. [PMID: 36473063 PMCID: PMC9898197 DOI: 10.1080/15374416.2022.2145567] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Both the quality and utility of youth suicide research depend on how we assess our outcomes of interest: suicidal thoughts and behaviors (STBs). We now have access to more STB assessments than ever before, with measures for youth that vary in what exact experiences are asked about, how such measures elicit information, when and how frequently measures are administered, and who the informants are. This growing armamentarium of assessments has the potential to improve the study and treatment of STBs among youth, but it hinges on meaningful interpretation of assessment responses. Interpretation can be especially challenging when different STB assessments yield conflicting information. Determining how to manage discrepant reports of STBs is a pivotal step toward achieving meaningfully comprehensive STB assessment batteries. Here, we outline several discrepant reporting patterns that have been detected, discuss the potential significance of these observed discrepancies, and present initial steps to formally investigate discrepant reports of STBs among youth. Developing coherent, interpretable, and comprehensive batteries assessing STBs among youth would address a fundamental step to uncovering etiology, improving clinical decision-making and case management, informing intervention development, and tracking prognosis.
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Affiliation(s)
- Angela Page Spears
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Ilana Gratch
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Rachel J Nam
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Pauline Goger
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
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Bell KA, Gratch I, Ebo T, Cha CB. Examining Discrepant Reports of Adolescents' Self-Injurious Thoughts and Behaviors: A Focus on Racial and Ethnic Minority Families. Arch Suicide Res 2022; 26:1505-1519. [PMID: 34019780 DOI: 10.1080/13811118.2021.1925607] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Adolescents and their parents do not always see eye to eye. This principle applies to multi-informant reports of adolescents' self-injurious thoughts and behaviors. Although prior work has revealed the presence of parent-adolescent discrepant reports, we have little insight into exactly who is most likely to display such discrepancies. To address this knowledge gap, the present investigation examines demographic correlates of parent-adolescent reports of adolescents' self-injurious thoughts and behaviors, with a focus on race and ethnicity. METHOD The sample included 45 dyads of adolescents (M = 15.79 years, SD = 1.42) and their parents reporting on adolescents' history of suicide ideation, suicide plan, suicide gesture, suicide attempt, and nonsuicidal self-injury (NSSI). RESULTS Greater discrepancies in reports of adolescents' suicide ideation and NSSI were observed among racial minority parent-adolescent dyads (Black, Asian, Multiracial, Other) relative to White dyads. Racial minority parents tended to report less suicide ideation and NSSI observed in their adolescents compared to adolescents' self-report. Moreover, Hispanic parents tended to report less NSSI relative to adolescents' self-report. Parent-adolescent discrepancies did not consistently correspond with other characteristics such as age and sexual orientation. CONCLUSION Racial minority parent-adolescent dyads, relative to White parent-adolescent dyads, are less likely to see eye to eye on adolescents' suicidal and nonsuicidal self-harming tendencies.
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Gratch I, Tezanos KM, Fernades SN, Bell KA, Pollak OH, Cha CB. Single- vs. Multi-Item Assessment of Suicidal Ideation Among Adolescents. R I Med J (2013) 2022; 105:16-21. [PMID: 35476730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Several barriers exist to routine assessment of suicidal ideation (SI) in adolescents across settings, including insufficient time, tools, and training. Such barriers often result in the use of brief or even single-item assessments of SI, which may result in misclassification. The present study sought to compare single- and multi-item assessment of SI in adolescents, and to examine factors associated with different response profiles. Adolescents (n =206) were recruited from the community and completed a lab visit including a single and multi-item assessment for SI. Results suggest that two thirds of adolescents with passive SI go undetected when relying solely on a single-item screener, yet they present a similar clinical profile to those with passive SI who endorse the screener question. The present study provides support for the notion that multi-item assessment paints a more accurate, nuanced picture of SI among adolescents and may be an important component of routine screening.
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Affiliation(s)
- Ilana Gratch
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY
| | - Katherine M Tezanos
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY; Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI
| | | | - Kerri-Anne Bell
- Department of Psychology, University of Notre Dame, Notre Dame, IN
| | - Olivia H Pollak
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY
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Gratch I, Fernandes SN, Bell KA, Pollak OH, Fox KR, Tezanos K, Ebo T, Cha CB. Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R): Reliability, Validity, and Inter-Informant Agreement in an Adolescent Sample. J Clin Child Adolesc Psychol 2021; 51:484-494. [PMID: 33847199 DOI: 10.1080/15374416.2021.1901229] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: The present study sought to evaluate the psychometric properties and inter-informant agreement of the Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R) in adolescents and their parents.Method: Suicidal and nonsuicidal adolescents from the community (N = 206), ages 12-19 years, were administered the SITBI-R during a lab visit. Approximately half of the adolescents' parents opted to complete a parent assessment, including the SITBI-R, on behalf of their child. Inter-rater reliability, convergent validity, and inter-informant agreement were assessed.Results: The SITBI-R exhibited overall excellent inter-rater reliability and good convergent validity in adolescents. Parent-adolescent agreement ranged from fair to poor across most outcomes, with parents tending not to report past self-injurious thoughts and behaviors endorsed by their children.Conclusions: The present study suggests that the SITBI-R can be extended for use with adolescents. Future research should evaluate moderators and implications of parent-adolescent disagreement, particularly with regard to suicide risk.
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Affiliation(s)
- Ilana Gratch
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Sara N Fernandes
- New York State Psychiatric Institute, Columbia University Irving Medical Center
| | - Kerri-Anne Bell
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Olivia H Pollak
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | | | - Katherine Tezanos
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Theresa Ebo
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
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Stanley B, Martínez-Alés G, Gratch I, Rizk M, Galfalvy H, Choo TH, Mann JJ. Coping strategies that reduce suicidal ideation: An ecological momentary assessment study. J Psychiatr Res 2021; 133:32-37. [PMID: 33307352 PMCID: PMC8659118 DOI: 10.1016/j.jpsychires.2020.12.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 11/20/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND While suicide-specific psychosocial interventions often teach coping skills to suicidal individuals, little is known about the strategies that individuals intuitively use on their own to cope with suicidal ideation in everyday life. AIMS The present study used Ecological Momentary Assessment (EMA) to examine the effectiveness of specific coping strategies individuals use naturally to reduce the intensity of suicidal thinking. METHOD Fifty participants endorsing suicidal ideation with co-morbid mood disorder and borderline personality disorder completed one week of EMA. Real-time use, perceived effectiveness of 7 common coping strategies and intensity of suicidal ideation were assessed at 6 epochs (i.e., timepoints) each day. RESULTS Participants reported using an average of 4 coping strategies per epoch. Factor analysis (FA) (exploratory followed by confirmatory FA) identified two coping factors: one that included distraction/positive activity-based strategies (i.e., keeping busy, socializing, positive thinking, and doing something good for self) and a second that contained mindfulness-oriented strategies (i.e., finding perspective, calming self, and sitting with feelings until they pass). Although participants perceived all coping strategies as effective, only strategies in the first factor, distraction/positive activity-oriented strategies, lowered the intensity of suicidal thoughts in everyday life. Furthermore, baseline suicidal ideation was inversely related to overall use of coping strategies and particularly use of coping strategies that were found to lead to lowered suicidal ideation. CONCLUSIONS Distraction/positive activity based strategies are helpful in decreasing suicidal ideation in the short-term. These findings can help clinicians advise patients about strategies to use to cope with suicidal thoughts to prevent acting on them in a crisis and they also have the potential to inform development of psychosocial interventions to prevent suicide.
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Affiliation(s)
- Barbara Stanley
- Department of Psychiatry, Columbia University Irving Medical Center, United States; New York State Psychiatric Institute, United States.
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Columbia University Mailman School of Public Health, United States
| | - Ilana Gratch
- Department of Psychiatry, Columbia University Irving Medical Center, United States
| | - Mina Rizk
- Department of Psychiatry, Columbia University Irving Medical Center, United States
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia University Irving Medical Center, United States
| | | | - J John Mann
- Department of Psychiatry, Columbia University Irving Medical Center, United States; New York State Psychiatric Institute, United States
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Gratch I, Choo TH, Galfalvy H, Keilp JG, Itzhaky L, Mann JJ, Oquendo MA, Stanley B. Detecting suicidal thoughts: The power of ecological momentary assessment. Depress Anxiety 2021; 38:8-16. [PMID: 32442349 DOI: 10.1002/da.23043] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 04/11/2020] [Accepted: 05/08/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Researchers and clinicians have typically relied on retrospective reports to monitor suicidal thoughts and behaviors. Smartphone technology has made real-time monitoring of suicidal thoughts possible via mobile ecological momentary assessment (EMA). However, little is known about how information gleaned from EMA compares with that obtained by retrospective reports. The authors sought to compare suicidal ideation (SI) assessed over 1 week using EMA with a retrospective gold-standard interviewer-administered measure covering the same period. METHODS Fifty-one adults with major depressive disorder completed 1 week of EMA (6×/day) assessing SI. Following completion of EMA, participants completed an interviewer-administered Scale for Suicide Ideation (SSI) retrospectively assessing the same week. RESULTS SI severity assessed through EMA was positively correlated with scores on the retrospective SSI. However, 58% of participants reporting ideation with EMA denied any past-week ideation on the SSI. Participants who endorsed SI during EMA but not on the SSI were no less likely to have a history of suicidal behavior than those who reported SI in both formats. CONCLUSION EMA captures instances of suicidal thinking that go undetected through retrospective report and thereby may help us to identify an at-risk subgroup otherwise missed.
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Affiliation(s)
- Ilana Gratch
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York City, New York
- Department of Psychiatry, Columbia University Medical Center, New York City, New York
| | - Tse-Hwei Choo
- Department of Psychiatry, Columbia University Medical Center, New York City, New York
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York City, New York
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia University Medical Center, New York City, New York
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York City, New York
| | - John G Keilp
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York City, New York
- Department of Psychiatry, Columbia University Medical Center, New York City, New York
| | - Liat Itzhaky
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York City, New York
- Department of Psychiatry, Columbia University Medical Center, New York City, New York
| | - J John Mann
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York City, New York
- Department of Psychiatry, Columbia University Medical Center, New York City, New York
| | - Maria A Oquendo
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Barbara Stanley
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York City, New York
- Department of Psychiatry, Columbia University Medical Center, New York City, New York
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Itzhaky L, Galfalvy H, Keilp JG, Gratch I, Brodsky BS, Stanley BH. Stress Response in Suicide Attempters with Borderline Personality Disorder: The Role of Behavioral Problems in Childhood. Psychiatry 2020; 83:221-230. [PMID: 32069167 PMCID: PMC8721090 DOI: 10.1080/00332747.2020.1716439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Suicidal individuals are a heterogeneous population and may differ in systematic ways in their responsiveness to stress. The primary aim of the present study was to identify whether a different pattern of physiological stress response exists among adult suicide attempters with a history of behavioral problems during childhood and adolescence, which earlier studies have related to both decreased activity of the HPA axis and to suicidal behaviors. Method: Seventy-eight participants with Borderline Personality Disorder were assessed using the SCID-II, and completed self-report measures assessing their history of suicide attempts, history of aggressive behaviors, depressive symptoms, history of lifetime abuse and demographics. Participants' cortisol reactivity was assessed using the Trier Social Stress Test. Results: Analyses indicated that suicide attempters with a history of behavioral problems in youth (n = 30) had a significantly lower response to stress than both suicide attempters without such a history (n = 26) and non-attempters (n = 22), when controlling for lifetime history of abuse. The groups did not differ in basal cortisol. Conclusions: These findings suggest a unique subtype of suicide attempter among those with Borderline Personality Disorder, characterized by a blunted physiological stress response.
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Affiliation(s)
- Liat Itzhaky
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY,Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Hanga Galfalvy
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY,Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - John G. Keilp
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY,Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Ilana Gratch
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY,Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Beth S. Brodsky
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY,Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
| | - Barbara H. Stanley
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY,Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY
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Moeller RW, Seehuus M, Wahl L, Gratch I. Use of PrEP, sexual behaviors and mental health correlates in a sample of gay, bisexual and other men who have sex with men. Journal of Gay & Lesbian Mental Health 2019. [DOI: 10.1080/19359705.2019.1688216] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Robert W. Moeller
- Department of Psychology, Middlebury College, Middlebury, Vermont, USA
| | - Martin Seehuus
- Department of Psychology, Middlebury College, Middlebury, Vermont, USA
- Department of Psychological Science, University of Vermont, Burlington, Vermont, USA
| | - Logan Wahl
- Department of Psychology, Middlebury College, Middlebury, Vermont, USA
| | - Ilana Gratch
- Department of Psychology, Middlebury College, Middlebury, Vermont, USA
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Chang BP, Tezanos K, Gratch I, Cha C. Depressed and suicidal patients in the emergency department: an evidence-based approach. Emerg Med Pract 2019; 21:1-24. [PMID: 31033267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 02/10/2019] [Indexed: 06/09/2023]
Abstract
With more than 12 million emergency department visits annually related to substance abuse and mental health crises, and approximately 650,000 patients evaluated for suicide attempts, the ED is a critical clinical setting for intervention. This review presents an ED-focused approach to assessing depression and suicide risk, including background information on the classification, epidemiology, and known pathology of depression, as well as the assessment of suicide risk within depression. Best-practice recommendations are made regarding current mental status evaluation and management strategies. Cutting-edge interventions and approaches, including the use of assessment and screening tools, implementation of safety planning, the Zero Suicide model, continuing postdischarge contact, lethal-means counseling, and novel pharmacotherapy approaches are also reviewed.
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Affiliation(s)
- Bernard P Chang
- Assistant Professor of Emergency Medicine, Columbia University Medical Center, New York, NY
| | - Katherine Tezanos
- Doctoral Student, Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY
| | - Ilana Gratch
- Department of Psychiatry, Columbia University Medical Center, New York, NY
| | - Christine Cha
- Assistant Professor, Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY
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Cahill S, Trieweiler S, Guidry J, Rash N, Stamper L, Conron K, Turcotte N, Gratch I, Lowery P. High Rates of Access to Health Care, Disclosure of Sexuality and Gender Identity to Providers Among House and Ball Community Members in New York City. J Homosex 2017; 65:600-614. [PMID: 28537845 DOI: 10.1080/00918369.2017.1328221] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The House and Ball community is an important cultural manifestation of resiliency for Black and Latino gay and bisexual men and transgender women. Participants at the August 2013 House of Latex Ball in New York City were surveyed about insurance coverage, health care access, experiences in health care, and housing instability. The sample (n = 367) was 58% Black/African American and 20% Hispanic/Latino, with a mean age of 31. Fifty-five percent were gay and bisexual men. Although only 6% identified as transgender, nearly one half were gender nonconforming. Strong majorities had health insurance, were in regular medical care, and were "out" to their providers. Some were unstably housed and had recently exchanged sex for shelter or money. High rates of health care access and disclosure indicate resiliency and agency. Unstable housing and income insecurity may be structural drivers of vulnerability for this population to HIV infection and other health risks.
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Affiliation(s)
- Sean Cahill
- a The Fenway Institute , Boston , Massachusetts , USA
- b School of Public Policy and Urban Affairs , Northeastern University , Boston , Massachusetts , USA
| | - Sarah Trieweiler
- a The Fenway Institute , Boston , Massachusetts , USA
- c Department of Sociology , Northeastern University , Boston , Massachusetts , USA
| | - John Guidry
- d Department of Community Health and Research, Gay Men's Health Crisis (GMHC) , New York , New York , USA
| | - Nelisa Rash
- a The Fenway Institute , Boston , Massachusetts , USA
| | - Layla Stamper
- a The Fenway Institute , Boston , Massachusetts , USA
| | - Kerith Conron
- a The Fenway Institute , Boston , Massachusetts , USA
- e The Williams Institute, UCLA School of Law , Boston , Massachusetts , USA
| | - Nicole Turcotte
- d Department of Community Health and Research, Gay Men's Health Crisis (GMHC) , New York , New York , USA
| | - Ilana Gratch
- a The Fenway Institute , Boston , Massachusetts , USA
- f Middlebury College , Middlebury , Vermont , USA
| | - Paige Lowery
- d Department of Community Health and Research, Gay Men's Health Crisis (GMHC) , New York , New York , USA
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Meyers K, Rodriguez K, Moeller RW, Gratch I, Markowitz M, Halkitis PN. High interest in a long-acting injectable formulation of pre-exposure prophylaxis for HIV in young men who have sex with men in NYC: a P18 cohort substudy. PLoS One 2014; 9:e114700. [PMID: 25502768 PMCID: PMC4263701 DOI: 10.1371/journal.pone.0114700] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/30/2014] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE In the context of continued high rates of condomless anal intercourse and HIV-1 infection, young men who have sex with men (YMSM) need additional effective and desirable HIV prevention tools. This study reports on the willingness of a racially-ethnically diverse cohort of YMSM to use a new biomedical prevention approach, a long-acting injectable pre-exposure prophylaxis (LAI-PrEP) agent. METHODS A cross-sectional study conducted between June-August 2013 recruited participants from an ongoing cohort study of YMSM in NYC. Participants included 197 YMSM, of whom 72.6% (n = 143) identified as men of color. Two outcomes were measured through computer-assisted self-interviews: 1) willingness to use long-acting injectable PrEP and 2) preference for route of administration of PrEP. In addition, concerns about perceived impacts of PrEP on health and risk behavior, access to health services, and stigma were investigated. RESULTS Over 80% (n = 159/197, p<0.001) of participants stated they would be willing to use LAI-PrEP. With regards to preference for mode of delivery 79.2% (n = 156/197, p<0.001) stated they would prefer an injection administered every three months over a daily pill or neither one. CONCLUSIONS This study is the first to explore acceptability of LAI-PrEP in the US. A significant majority of participants expressed willingness to use LAI and the majority preferred LAI-PrEP. LAI-PrEP holds great promise in that it could circumvent the adherence challenges associated with daily dosing, especially if nested within appropriate psycho-behavioral support. Medical providers whose patients include YMSM at high risk for HIV infection should note the positive attitudes toward PrEP, and specifically LAI-PrEP.
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Affiliation(s)
- Kathrine Meyers
- Aaron Diamond AIDS Research Center, New York, New York, United States of America
| | - Kristina Rodriguez
- Aaron Diamond AIDS Research Center, New York, New York, United States of America
| | | | - Ilana Gratch
- Middlebury College, Middlebury, Vermont, United States of America
| | - Martin Markowitz
- Aaron Diamond AIDS Research Center, New York, New York, United States of America
| | - Perry N. Halkitis
- Center for HIV, Identity, Behavior and Prevention Studies, New York University, New York, New York, United States of America
- Global Institute of Public Health and Department of Population Health, New York University, New York, New York, United States of America
- * E-mail:
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