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Wright T, Solmi F, Ajnakina O, Ingram E, Kandola A, Lee S, Iob E, Steptoe A, Thomas B, Lewis G. The role of loneliness in the association between sexual orientation and depressive symptoms among older adults: A prospective cohort study. J Affect Disord 2024; 356:137-144. [PMID: 38593941 DOI: 10.1016/j.jad.2024.04.001] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 03/13/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND This study aims to understand the mechanisms contributing to the elevated risk of depression among sexual minority older adults compared to heterosexuals. Specifically, the role of loneliness as a potential mediator is investigated to inform targeted interventions for preventing depression in sexual minority populations. METHODS Data from the English Longitudinal Study of Ageing, focusing on adults aged over 50, were analysed. Sexual orientation (sexual minority or heterosexual) and loneliness scores (UCLA scale) were assessed at wave six (2010-2011), while depressive symptoms (CESD) were assessed at wave seven (2013-14). Linear regression models and mediation analyses, using g-computation formula and adjusted for confounders, were conducted. RESULTS The sample included 6794 participants, with 478 (7.0 %) identifying as sexual minorities. After adjustments, sexual minorities scored higher on depressive symptoms at wave seven (mean difference): 0.23, 95 % CI 0.07 to 0.39) and loneliness at wave six (MD: 0.27, 95 % CI 0.08 to 0.46). Loneliness was positively associated with depressive symptoms (coefficient: 0.27, 95 % CI 0.26 to 0.29). In mediation analyses, loneliness explained 15 % of the association between sexual orientation and subsequent depressive symptoms. LIMITATIONS The dataset used sexual behaviour rather than desire and identity, potentially skewing representation of sexual minorities. Additionally, transgender older adults were not included due to limited gender diversity reported within the ELSA dataset. CONCLUSIONS Loneliness appears to be a significant modifiable mechanism contributing to the heightened risk of depressive symptoms in sexual minority older adults compared with their heterosexual counterparts.
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Affiliation(s)
- Talen Wright
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, United Kingdom.
| | - Francesca Solmi
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, United Kingdom
| | - Olesya Ajnakina
- Institute of Psychiatry, Psychology & Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom
| | - Elizabeth Ingram
- Department of Applied Health Research, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom
| | - Aaron Kandola
- MRC Unit for Lifelong Health and Ageing, University College London, 1-19 Torrington Place, London, United Kingdom
| | - Stephen Lee
- Opening Doors, Unit 4.1b Resource for London, 356 Holloway Road, London N7 6PA, United Kingdom
| | - Eleonora Iob
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, United Kingdom
| | - Ben Thomas
- Opening Doors, Unit 4.1b Resource for London, 356 Holloway Road, London N7 6PA, United Kingdom
| | - Gemma Lewis
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7NF, United Kingdom
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Ocasio MA, Isabel Fernández M. The association between gender identity fluidity and health outcomes in transgender and gender diverse people in New Orleans and Los Angeles, USA. Prev Med Rep 2024; 42:102735. [PMID: 38689888 PMCID: PMC11059450 DOI: 10.1016/j.pmedr.2024.102735] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024] Open
Abstract
Objectives Most studies with transgender and gender diverse people (TGD) examine gender identity cross-sectionally. Gender identity and expression can fluctuate over time, which may have implications for health. The goal of our study was to compare mental health, substance use and healthcare utilization among 163 gender identity fluid (1 + identity change) and gender identity consistent (no change) TGD. Methods Participants were recruited in New Orleans, LA and Los Angeles, CA and assessed at four-month intervals over 24 months between 2017 and 2021. We conducted logistic regression models to test for associations between gender identity fluidity and health outcomes at 24 months. In post hoc analyses, we explore how controlling for cross-sectional report of gender identity at 24 months may impact the association between gender identity fluidity and health outcomes. Results We saw no significant differences across mental health and substance use indicators. Gender identity fluid participants had 5.9 times the adjusted odds (95 % Confidence Interval (CI): 1.9-18.4) of no recent healthcare visit compared to gender identity consistent participants. After controlling for cross-sectional report of gender identity, the association between gender identity fluidity and no recent healthcare visit remained significant (aOR = 4.6; 95 % CI: 1.4-14.8). Conclusions Because providers have limited experience providing gender-affirming care or treating patients with fluid gender identities, gender identity fluid patients may avoid healthcare more than gender identity consistent patients. Our preliminary study highlights the need to measure gender identity longitudinally and examine the relationship between gender identity fluidity and health.
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Affiliation(s)
- Manuel A. Ocasio
- Department of Pediatrics, Tulane University School of Medicine, 1440 Canal Street, Suite 966, New Orleans, LA 70112, USA
| | - M. Isabel Fernández
- College of Osteopathic Medicine, Nova Southeastern University, 3200 S University Drive, Fort Lauderdale, FL 33328, USA
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DeBrosse R, Mao X, Anand NS, Mullins A, Singh P, Sorcher JL, Jung J, Sanders RA, Beach MC, Pahwa AK, Golden WC, Fields EL. Evaluating the Impact of an Adolescent Sexuality Education Workshop on Medical Student Communication in an Objective Structured Clinical Examination. J Adolesc Health 2024; 74:1026-1032. [PMID: 38323963 DOI: 10.1016/j.jadohealth.2023.12.013] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 10/27/2023] [Accepted: 12/12/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE Gaps still exist in medical education about the sexual health needs of sexual diverse populations, and little is known about how translatable current learning modules are to patient encounters. Efforts at an academic medical institution have been made to address this need, including a two-hour adolescent sexuality workshop during the Core Clerkship in Pediatrics. This workshop's efficacy was evaluated in an objective structured clinical examination (OSCE) given to rising fourth-year medical students, where the standardized patient case focused on an adolescent cisgender male with dysuria and in a new, same-sex relationship. METHODS Performance of students who completed the workshop prior to the OSCE (n = 48) were compared to those of students who did not participate in the workshop prior to the OSCE (n = 17). The encounters were recorded and transcribed, and the deidentified transcripts were scored on a rubric focusing on five domains: sexual identity disclosure, behavioral assessment, psychosocial history, counseling and anticipatory guidance, and relationship building. RESULTS Student's t-test comparison of the scores found significantly higher scores for the psychosocial history domain (p = .04), particularly concerning disclosure of a new boyfriend and recent sexual activity (p = .008), for students who had the workshop before the OSCE. DISCUSSION Students who took the adolescent sexuality workshop performed better in gathering psychosocial information in an OSCE encounter a sexual minority adolescent. These results affirm prior work that active learning on sexual diverse health in medical school curricula may prepare students for effective engagement with adolescents exploring their sexuality.
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Affiliation(s)
- Ren DeBrosse
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Xian Mao
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Neha S Anand
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
| | - Alexa Mullins
- Deparment of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Priya Singh
- Department of Orthopedic Surgery, Montefiore Medical Center, Bronx, New York
| | - Jill L Sorcher
- Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
| | - Julianna Jung
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Renata Arrington Sanders
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Mary Catherine Beach
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Amit K Pahwa
- Division of Hospital Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland; Division of Hospital Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - W Christopher Golden
- Eudowood Neonatal Pulmonary Division, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Errol L Fields
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
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Threeton EM, Morris PE, Buckner JD. Sexual orientation-based microaggressions and cannabis use outcomes among sexual minority individuals: The impact of negative affect and coping-motivated cannabis use. J Subst Use Addict Treat 2024; 160:209293. [PMID: 38272122 PMCID: PMC11060912 DOI: 10.1016/j.josat.2024.209293] [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] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/02/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Sexual minority individuals report significantly more cannabis use and problems than their heterosexual peers, possibly due to their frequent experiences with sexual orientation-based microaggressions. As a result, sexual minority individuals may turn to cannabis use to cope with the negative affect associated with these experiences. No known studies have tested this hypothesis; therefore, the current study tested if sexual orientation microaggressions are positively associated with negative affect (anxiety and depression), cannabis coping motives, and cannabis-related outcomes (frequency, problems); if coping motives are positively associated with cannabis-related outcomes; and if negative affect and cannabis use to cope with negative affect serially mediate the relation between sexual orientation microaggressions and cannabis-related outcomes. METHODS Sexual minority undergraduate students who reported cannabis use in the past three months (N = 328; 71.3 % cis-female) completed an online survey. RESULTS Microaggressions were significantly positively correlated with anxiety, depression, coping-motivated cannabis use, cannabis-related problems, non-sexual orientation-related stress, and overt sexual orientation-based discrimination. Additionally, after controlling for non-sexual orientation-related stress and overt sexual orientation-based discrimination, microaggressions were indirectly positively related to cannabis use frequency and problems via the sequential effects of negative affect and coping motives. This relation remained significant when examining negative affect specific to sexual orientation microaggressions and cannabis use to cope with this microaggressions-specific negative affect. CONCLUSIONS Results highlight the adverse impact of sexual orientation microaggressions in terms of negative affect and negative cannabis-related outcomes.
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Affiliation(s)
- Evan M Threeton
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Paige E Morris
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Julia D Buckner
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA.
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Berman ZL, Fish JN. A Preliminary Exploratory Factor Analysis of the BDSM Counselor Competency Scale. Arch Sex Behav 2024; 53:1487-1498. [PMID: 38379109 DOI: 10.1007/s10508-023-02788-z] [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] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 02/22/2024]
Abstract
BDSM practitioners represent a large sexual minority group often overlooked, misunderstood, and unnecessarily pathologized by mental health clinicians. Although developing cultural competence for diverse and marginalized populations is widely understood to be a core component of delivering efficacious therapeutic services that can counteract these stigmatizing mental healthcare experiences, no measures currently exist that assess clinicians' self-reported competence to work with BDSM practitioners. Previous measurement work has been done to establish self-report competency scales for clinicians working with other sexual and gender minority groups, but no such scales exist for working with BDSM practitioners. In the current study, we adapted a version of the Sexual Orientation Counselor Competency Scale (SOCCS) to measure clinicians' self-reported competence to work with BDSM practitioners and did a preliminary exploratory factor analysis of the new scale (n = 124). After an initial 24-item administration, principal axis factoring of our final 17-item solution revealed two latent factors (attitudes and skills/knowledge) consistent with the 2013 SOCCS and the theoretical constructs of cultural competency. The BDSM Counselor Competency Scale (BDSM-CCS) can help clinicians, practices, agencies, and training programs track self-reported cultural competence with the BDSM population. Future research directions for scale development and clinical and training applications are discussed.
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Affiliation(s)
- Zachary Lane Berman
- Department of Family Science, 1142 School of Public Health, University of Maryland, College Park, 2242 Valley Drive, College Park, MD, 20742, USA.
| | - Jessica N Fish
- Department of Family Science, 1142 School of Public Health, University of Maryland, College Park, 2242 Valley Drive, College Park, MD, 20742, USA
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Dyar C, Dworkin ER, Kaysen D. Contexts of social alcohol and cannabis use among sexual minority cisgender women and gender diverse individuals: Event-level differences in alcohol and cannabis use patterns based on the sexual orientations and gender identities of substance use companions. Addict Behav 2024; 151:107935. [PMID: 38104420 PMCID: PMC10872884 DOI: 10.1016/j.addbeh.2023.107935] [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] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE Sexual minority women and gender diverse individuals assigned female at birth (SMWGD) are at elevated risk for alcohol and cannabis use disorders. It has been posited that characteristics of SMWGD's substance use companions (i.e., sexual orientation, gender identity) may influence their own use, but few studies have tested this. The current study aimed to examine whether quantity and consequences of substance use varied based on sexual orientations and gender identities (SOGI) of SMWGD's substance use companions. METHODS We utilized a 30-day ecological momentary assessment study of substance use among a sample of 429 SMWGD. We examined event-level associations between characteristics of substance use companions and quantity and consequences of substance use. RESULTS When SMWGD used alcohol/cannabis with most SOGI groups, they engaged in heavier drinking and cannabis use. Drinking with heterosexual men and SMW was associated with more drinking consequences. Drinking in settings with more SOGI groups and with both LGBTQ+ and heterosexual individuals was associated with heavier drinking and more consequences. Many contextual aspects of cannabis use settings predicted an increased likelihood of alcohol and cannabis co-use, while few contextual aspects of drinking settings were associated with co-use. CONCLUSION Results suggest that SMWGD engage in heavier substance use when individuals from a range of SOGI groups are present, highlighting that heavy alcohol and cannabis use is not limited to use with SMW and nonbinary individuals. Drinking in setting with more SOGI groups present (e.g., parties and bars) appears to be associated with particularly heavy drinking and consequences.
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Affiliation(s)
- Christina Dyar
- College of Nursing, Ohio State University, Columbus, OH, USA.
| | - Emily R Dworkin
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Sigurvinsdottir R, Gisladottir B, Asgeirsdottir BB, Sigfusdottir ID. Sexual Attraction and Non-Suicidal Self-Harm: The Role of Stressors and Psychological Mediators. Arch Sex Behav 2024; 53:1293-1306. [PMID: 38347324 DOI: 10.1007/s10508-023-02792-3] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 03/22/2024]
Abstract
Non-suicidal self-harm (NSSH) is a serious concern for the well-being of youth. Stressors relate to greater NSSH risk, such as being non-heterosexual in a heteronormative society. Other stressors may include traumatic experiences. These relationships may be mediated by psychological factors (depressed mood, anxiety, anger, and self-esteem) as well as contextual factors (support from parents and peers). The purpose of this study was to examine NSHH ideation and behavior among Icelandic youth, as well as relationships with stressors and mediators. Students in Icelandic high schools (N = 8921, 50.8% female) completed an in-class survey in the year 2016. Results showed an elevated risk of NSSH ideation and behavior among bisexual and homosexual youth. Mediation analyses showed that, for girls, being bisexual related to greater NSSH ideation and behavior, and these relationships were mediated by depressed mood, anger, and self-esteem, as well as by support from parents and peers. For boys, however, both homosexual and bisexual attraction related to greater risk for NSSH ideation and behavior, which was mediated by depressed mood, anger, and self-esteem. These results suggest that NSSH risk factors vary by gender and, therefore, they may benefit from different interventions to stop and prevent this behavior. This is the first study of its kind in Iceland, where sexual minority stress may need further study within the Nordic context.
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Affiliation(s)
| | | | | | - Inga Dora Sigfusdottir
- Department of Psychology, Reykjavik University, Menntavegur 1, 102, Reykjavik, Iceland
- Icelandic Centre for Social Research and Analysis, Reykjavik, Iceland
- Teachers College, Columbia University, New York, NY, USA
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Poteat T, Hall P, Adams MA, Gautam DS, Ashenden R, Horn J. Caregiving Among Older Black Same-Gender-Loving Women During the COVID-19 Pandemic: Findings From Qualitative Research. Gerontologist 2024; 64:gnad103. [PMID: 37480588 PMCID: PMC10943494 DOI: 10.1093/geront/gnad103] [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] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Few data on caregiving during the coronavirus disease 2019 pandemic use an intersectional lens to attend to how multiple social categories, such as gender, age, race, and sexual orientation, shape caregiving experiences. This analysis sought to explore caregiving experiences of aging Black same-gender-loving women. RESEARCH DESIGN AND METHODS Sixteen focus groups were conducted with 4-8 participants each (N = 102) from across the United States. Audio-recorded discussions lasted for approximately 90 min and were transcribed verbatim. Two analysts coded transcripts for discussions related to caregiving and used content analysis to identify themes. RESULTS Participants engaged in caregiving for children, parents, family, friends, and neighbors. They provided physical, economical, instrumental, and/or secondary caregiving; and sometimes received care themselves. The pandemic heavily affected their stress level and mental health as well as their intimate partner relationships. Discussions mostly offered descriptions of increased caregiving difficulty caused by the pandemic. However, a few participants identified ways the pandemic made caregiving easier; changed caregiving without making it easier or harder; or thwarted their ability to provide care. DISCUSSION AND IMPLICATIONS Older Black same-gender-loving women described some pandemic caregiving experiences that diverged from the existing literature, demonstrating the importance of considering how gender, race, age, and sexual orientation affect caregiving experiences during a pandemic fraught with health inequities. Ensuring the multiply marginalized caregivers have access to the practical and emotional support they need is critical for advancing health equity and preparing for future pandemics.
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Affiliation(s)
- Tonia Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
- Division of Healthcare in Adult Populations, Duke University School of Nursing, Durham, North Carolina, USA
| | - Porsha Hall
- ZAMI NOBLA: National Organization on Black Lesbians on Aging, Atlanta, Georgia, USA
| | - Mary Anne Adams
- ZAMI NOBLA: National Organization on Black Lesbians on Aging, Atlanta, Georgia, USA
| | - Dipa Sharma Gautam
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Robynn Ashenden
- Department of Health Behavior, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jennifer Horn
- Family Caregiver Support Center, Pikes Peak Area Agency on Aging, Colorado Springs, Colorado, USA
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Gibbs JJ, O'Shields J, DeVane R, Purcell A. Religious Identity Dissonance: Examining the Path of Religious Factors to Depression in Sexual Minority Men in the USA. J Relig Health 2024:10.1007/s10943-024-02025-4. [PMID: 38517583 DOI: 10.1007/s10943-024-02025-4] [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] [Subscribe] [Scholar Register] [Accepted: 02/28/2024] [Indexed: 03/24/2024]
Abstract
Little is known about the religious factors that contribute to religious identity dissonance (ID) for sexual minority men. Our aim was to model the path of religious factors to depression symptoms through ID and internalized stigma (IS). US sexual minority men (N = 168) participated in a survey about religious factors and mental health. Serial mediation of religious factors through ID and IS to depression symptoms was assessed using Hayes PROCESS macro. Results indicate that two religious factors significantly increase depression through ID and IS. Negative parental religious messages about LGBTQ people play a meaningful role in ID and increasing depression.
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Affiliation(s)
- Jeremy J Gibbs
- School of Social Work, University of Georgia, 279 Williams Street, Athens, GA, 30602, USA.
| | - Jay O'Shields
- School of Social Work, University of Georgia, 279 Williams Street, Athens, GA, 30602, USA
| | - Ryan DeVane
- School of Social Work, University of Georgia, 279 Williams Street, Athens, GA, 30602, USA
| | - Anna Purcell
- School of Social Work, University of Georgia, 279 Williams Street, Athens, GA, 30602, USA
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10
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Bernier LB, Foley JD, Salomaa AC, Scheer JR, Kelly J, Hoeppner B, Batchelder AW. Examining sexual minority engagement in recovery community centers. J Subst Use Addict Treat 2024; 161:209340. [PMID: 38494052 DOI: 10.1016/j.josat.2024.209340] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/14/2024] [Accepted: 02/21/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Research indicates that sexual minority (SM) individuals with alcohol and other drug use disorders may underutilize recovery resources generally but be more likely to use recovery community centers (RCCs). To inform recovery supports, this study characterized SM and heterosexual RCC members by demographics and clinical and recovery support service utilization. METHODS Cross-sectional secondary analyses compared SM and heterosexual RCC members in the northeastern U.S. (n = 337). Qualitative analyses coded the top three recovery facilitators. RESULTS Of the 337 participants (Meanage[SD] = 40.98[12.38], 51.8 % female), SM RCC members were more likely than heterosexuals to endorse lifetime psychiatric diagnoses and emergency department mental health treatment (p < .01). RCC service utilization and qualitatively derived recovery facilitators were mostly consistent across groups. CONCLUSIONS RCCs engaged SM individuals in recovery in ways consistent with heterosexuals. Despite otherwise vastly similar demographic characteristics across sexual identity, findings suggest a need for additional mental health resources for SM individuals in recovery.
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Affiliation(s)
- Lauren B Bernier
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Jacklyn D Foley
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA; The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Anna C Salomaa
- Boston University School of Medicine, Boston, MA, USA; VA Boston Healthcare System, Boston, MA, USA
| | | | - John Kelly
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Bettina Hoeppner
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Abigail W Batchelder
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA; The Fenway Institute, Fenway Health, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA.
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11
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Testa A, Jackson DB, Del Toro J, Karbeah J, Nagata JM, Ganson KT. Sexual orientation and experiences with police contact in Canada. Ann Epidemiol 2024; 91:85-90. [PMID: 38070693 DOI: 10.1016/j.annepidem.2023.12.002] [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] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/16/2023] [Accepted: 12/06/2023] [Indexed: 01/22/2024]
Abstract
PURPOSE To investigate the relationship between sexual orientation and police contact-including police contact with intrusion (i.e., use of intrusive verbal or physical force) and police contact with harassment (i.e., actions making one feel inferior based on appearance, identity, or demographic background)-among a national sample in Canada. METHODS Logistic and multinomial logistic regression were used to assess the association between sexual orientation and experiences with police contact among a sample of 940 persons ages 16-30 across Canada. RESULTS Compared to heterosexual participants, persons identifying as bisexual were significantly more likely to report having any police contact in the past 12 months (OR = 1.72, 95% CI = 1.09, 2.70). Bisexual (RRR = 3.45, 95% CI = 1. 83, 6.50) and queer, questioning, and other (RRR = 2.33, 95% CI = 1.15, 4.73) identifying participants were more likely to report having experienced police contact with harassment relative to no police contact, compared to heterosexual individuals. CONCLUSIONS The current study provides the first analysis of the relationship between sexual minority identity and experiences with adverse police contact in Canada, revealing higher levels of police contact and police contact with harassment, especially among bisexual and queer, questioning, other individuals. Findings suggest that sexual minority persons in Canada experience potentially harmful police contact at elevated rates, which may have significant ramifications for health and traumatic stress responses.
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Affiliation(s)
- Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Juan Del Toro
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - J'Mag Karbeah
- Division of Health Policy Management, University of Minnesota, Minneapolis, MN, USA
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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12
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Lu J, Yang J, Sadikova E, Tiemeier H. The association of sexual minority status and bullying victimization is modified by sex and grade: findings from a nationally representative sample. BMC Public Health 2024; 24:504. [PMID: 38365609 PMCID: PMC10874033 DOI: 10.1186/s12889-024-17988-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Sexual minority status is associated with face-to-face bullying and cyberbullying victimization. However, limited studies have investigated whether such a relationship differs by sex or grade in a nationally representative sample. METHODS We concatenated the national high school data from the Youth Risk Behavior Surveillance System (YRBSS) chronologically from 2015 to 2019, resulting in a sample of 32,542 high school students. We constructed models with the interaction term between sexual minority status and biological sex assigned at birth to test the effect modification by sex on both the multiplicative and additive scales. A similar method was used to test the effect modification by grade. RESULTS Among heterosexual students, females had a higher odds of being bullied than males, while among sexual minority students, males had a higher odds of being bullied. The effect modification by sex was significant on both the multiplicative and additive scales. We also found a decreasing trend of bullying victimization as the grade increased among both heterosexual and sexual minority students. The effect modification by the grade was significant on both the multiplicative and the additive scale. CONCLUSIONS Teachers and public health workers should consider the difference in sex and grade when designing prevention programs to help sexual minority students.
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Affiliation(s)
- Junjie Lu
- Department of Social and Behavior Sciences, Harvard University T.H. Chan School of Public Health, Boston, USA
| | - Jiarui Yang
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Ekaterina Sadikova
- Department of Epidemiology, Harvard University T.H. Chan School of Public Health, Boston, USA
| | - Henning Tiemeier
- Department of Social and Behavior Sciences, Harvard University T.H. Chan School of Public Health, Boston, USA.
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13
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Harris EA, Morgenroth T, Crone DL, Morgenroth L, Gee I, Pan H. Sexual Consent Norms in a Sexually Diverse Sample. Arch Sex Behav 2024; 53:577-592. [PMID: 38017253 PMCID: PMC10844416 DOI: 10.1007/s10508-023-02741-0] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/30/2023]
Abstract
Sexual consent has received increased attention in mainstream media, educational, and political settings since the rise of the #MeToo movement in 2017. However, long before #MeToo, sexual consent has been a core practice among people who engage in Bondage and Discipline, Dominance and Submission, Sadism, and Masochism (BDSM). This study examined sexual consent norms among a sexually diverse sample, including people who practice BDSM (n = 116), people who identify with another sexual minority group, such as swingers and sex workers (n = 114), and people who did not identify with a sexual minority group, termed sexual majority group members (n = 158). Explicit consent for both BDSM- and non-BDSM-related activities was rated as more common (descriptively normative) among people who were a member of the BDSM community compared to majority participants. Further, BDSM participants rated consent discussions as less sexually disruptive compared to majority participants. We found no significant group differences in the extent to which people thought sexual consent should be discussed. We also discuss findings from an open-ended question asking participants to recall a recent sexual experience with a new partner. This study demonstrates variability in consent norms between groups and points to the potential to shift sexual consent behaviors among majority participants.
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Affiliation(s)
- Emily A Harris
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.
| | - Thekla Morgenroth
- Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | - Damien L Crone
- Positive Psychology Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Lena Morgenroth
- Berufsverband erotische und sexuelle Dienstleistungen e.V., Berlin, Germany
| | - Isabel Gee
- Department of Psychology, University of Exeter, Exeter, UK
| | - Harry Pan
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
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14
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Kidd G, Marston L, Nazareth I, Osborn D, Pitman A. Suicidal thoughts, suicide attempt and non-suicidal self-harm amongst lesbian, gay and bisexual adults compared with heterosexual adults: analysis of data from two nationally representative English household surveys. Soc Psychiatry Psychiatr Epidemiol 2024; 59:273-283. [PMID: 37291332 PMCID: PMC10838834 DOI: 10.1007/s00127-023-02490-4] [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: 01/17/2023] [Accepted: 04/30/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE We aimed to compare differences in suicidality and self-harm between specific lesbian, gay and bisexual (LGB) groups, and investigate whether minority stress factors might contribute to any associations, addressing methodological limitations of previous research. METHODS We analysed data combined from two population-based representative household surveys of English adults (N = 10,443) sampled in 2007 and 2014. Using multivariable logistic regression models adjusted for age, gender, educational attainment, area-level deprivation, and common mental disorder, we tested the association between sexuality and three suicide-related outcomes: past-year suicidal thoughts, past-year suicide attempt, and lifetime non-suicidal self-harm (NSSH). We added bullying and discrimination (separately) to final models to explore whether these variables might mediate the associations. We tested for interactions with gender and survey year. RESULTS Lesbian/gay people were more likely to report past-year suicidal thoughts [adjusted odds ratio (AOR) = 2.20; 95% CI 1.08-4.50] than heterosexuals. No minority group had an increased probability of suicide attempt. Bisexual (AOR = 3.02; 95% CI = 1.78-5.11) and lesbian/gay (AOR = 3.19; 95% CI = 1.73-5.88) individuals were more likely to report lifetime NSSH than heterosexuals. There was some evidence to support a contribution of bullying in the association between lesbian/gay identity and past-year suicidal thoughts, and of each minority stress variable in the associations with NSSH. There was no interaction with gender or survey year. CONCLUSION Specific LGB groups are at elevated risk of suicidal thoughts and NSSH, with a possible contribution of lifetime bullying and homophobic discrimination. These disparities show no temporal shift despite apparent increasing societal tolerance towards sexual minorities.
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Affiliation(s)
- Garrett Kidd
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Louise Marston
- UCL Research Department of Primary Care and Population Health, Upper Third Floor, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK
| | - Irwin Nazareth
- UCL Research Department of Primary Care and Population Health, Upper Third Floor, UCL Medical School (Royal Free Campus), Rowland Hill Street, London, NW3 2PF, UK
| | - David Osborn
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, St Pancras Way, London, NW1 0PE, UK
| | - Alexandra Pitman
- UCL Division of Psychiatry, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
- Camden and Islington NHS Foundation Trust, St Pancras Hospital, St Pancras Way, London, NW1 0PE, UK.
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15
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Chang KK, Rogge RD, Starr LR. Characterizing Life Stress Exposure Among Sexual Minority Adolescents: Temporality, Content, And Mediating Role in Mental Health Disparities. Res Child Adolesc Psychopathol 2024:10.1007/s10802-023-01165-7. [PMID: 38214850 DOI: 10.1007/s10802-023-01165-7] [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] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/13/2024]
Abstract
Though sexual minority adolescents face a wide array of deleterious stressors, few studies have examined the role of specific types of stress exposure (i.e., chronic vs. episodic, interpersonal vs. non-interpersonal) on mental health disparities. This study utilizes a contextual threat-based assessment to (a) compare levels of stress exposure types between sexual minority and non-sexual minority adolescents, and (b) examine stress type as a mediator between sexual orientation and two outcomes: depressive symptoms and emotion dysregulation. Data comes from a longitudinal sample (14-17 years-old, N = 241; 17.6% sexual minority; 54% assigned female at birth; 73.9% White), with two time-points (T1 and T2) utilized. Sexual minority adolescents reported higher chronic interpersonal stress, but no differences in non-interpersonal chronic or episodic stress, relative to non-sexual minority adolescents. Chronic interpersonal stress exposure mediated the link between membership in an oppressed group (i.e., sexual minority teens) and the primary outcomes (emotion dysregulation and depressive symptoms) at both T1 and T2. Findings demonstrate the utility of contextual threat-based assessments within sexual minority research.
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Affiliation(s)
- Katharine K Chang
- Department of Psychology, University of Rochester, Rochester, NY, USA.
| | - Ronald D Rogge
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Lisa R Starr
- Department of Psychology, University of Rochester, Rochester, NY, USA
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16
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Coulter RWS, Szoko N, Frankeberger J, Adams B, Jones KA, Chugani CD, Anderson J, Talis J, McCauley HL, Miller E. Gender and Sexual Orientation Differences in Sexual Violence Knowledge, Prevention Behaviors, and Care-Seeking Behaviors. Prev Sci 2024:10.1007/s11121-023-01640-z. [PMID: 38214789 DOI: 10.1007/s11121-023-01640-z] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 01/13/2024]
Abstract
Sexual violence (SV) on college campuses disproportionately affects cisgender (nontransgender) women, sexual minorities (e.g., gays/lesbians, bisexuals), and gender minority (e.g., transgender/nonbinary) people. This study investigates gender and sexual behavior differences in common SV intervention targets-SV-related knowledge, prevention behaviors, and care-seeking. We analyzed cross-sectional survey data, collected in 9/2015-3/2017, from 2202 students aged 18-24 years attending college health and counseling centers at 28 Pennsylvania and West Virginia campuses. Multivariable multilevel models tested gender and sexual behavior differences in SV history; recognition of SV; prevention behaviors (self-efficacy to obtain sexual consent, intentions to intervene, positive bystander behaviors); and care-seeking behaviors (knowledge of, self-efficacy to use, and actual use of SV services). Adjusting for lifetime exposure to SV, compared with cisgender men, cisgender women had higher recognition of SV and reproductive coercion, prevention behaviors, and care-seeking self-efficacy (beta range 0.19-1.36) and gender minority people had higher recognition of SV and intentions to intervene (beta range 0.33-0.61). Cisgender men with any same-gender sexual partners had higher SV knowledge (beta = 0.23) and self-efficacy to use SV services (beta = 0.52) than cisgender men with only opposite-gender partners. SV history did not explain these differences. Populations most vulnerable to SV generally have higher SV knowledge, prevention behaviors, and care-seeking behaviors than cisgender men with only opposite-gender sexual partners. Innovative SV intervention approaches are necessary to increase SV-related knowledge among heterosexual cisgender men and may need to target alternative mechanisms to effectively reduce inequities for sexual and gender minority people.
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Affiliation(s)
- Robert W S Coulter
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, 120 Lytton Ave, Pittsburgh, PA, 15213, USA.
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA.
| | - Nicholas Szoko
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, 120 Lytton Ave, Pittsburgh, PA, 15213, USA
| | - Jessica Frankeberger
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Brian Adams
- Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
| | - Kelley A Jones
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, 120 Lytton Ave, Pittsburgh, PA, 15213, USA
| | - Carla D Chugani
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, 120 Lytton Ave, Pittsburgh, PA, 15213, USA
| | - Jocelyn Anderson
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, 120 Lytton Ave, Pittsburgh, PA, 15213, USA
- College of Nursing, Pennsylvania State University, University Park, PA, 16802, USA
| | - Janine Talis
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, 120 Lytton Ave, Pittsburgh, PA, 15213, USA
| | - Heather L McCauley
- School of Social Work, Michigan State University, East Lansing, MI, 48824, USA
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, 120 Lytton Ave, Pittsburgh, PA, 15213, USA
- Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA, 15261, USA
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17
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Paquette MM, Dion J, Bőthe B, O'Sullivan LF, Perrier Léonard D, Bergeron S. How Does Sexual Subjectivity Vary on the Basis of Gender and Sexual Orientation? Validation of the Short Sexual Subjectivity Inventory (SSSI-11) in Cisgender, Heterosexual and Sexual and Gender Minority Adolescents. Arch Sex Behav 2024; 53:275-292. [PMID: 37679506 DOI: 10.1007/s10508-023-02675-7] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 07/13/2023] [Accepted: 07/24/2023] [Indexed: 09/09/2023]
Abstract
Through sexual exploration, adolescents learn that they are sexual beings with choices, desires, and are deserving of pleasure, which corresponds to sexual subjectivity. However, the two measures of this construct (i.e., Female Sexual Subjectivity Inventory and Male Sexual Subjectivity Inventory) have not been validated with younger adolescents and have different items for boys and girls (with no scale available for gender diverse individuals), limiting gender comparisons. This study examined (1) the factor structure of the adapted Short Sexual Subjectivity Inventory-11 items (SSSI-11) in a large sample of young cisgender, heterosexual and sexual and gender minority adolescents, (2) measurement invariance across language (English and French), gender, and sexual orientation, (3) validity with sexuality-related outcomes, and (4) one-year temporal stability. Results of a confirmatory factor analysis among 2001 adolescents (Mage = 15.5 years, SD = 0.60) revealed a multidimensional factor structure. The SSSI-11, in both English and French, showed adequate reliability and one-year temporal stability, and was invariant across genders, sexual orientations, and languages. Girls had lower scores on the entitlement to self-pleasure and self-efficacy in achieving pleasure factors, and higher scores on the entitlement to pleasure from a partner factor. No significant differences were observed on the basis of language or between heterosexual and sexual minority adolescents. The SSSI-11 correlated positively with sexuality-related variables. Findings support the strong psychometric properties of the SSSI-11, rendering it of considerable use in clinical, education, and research applications.
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Affiliation(s)
- Marie-Michèle Paquette
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.
| | - Jacinthe Dion
- Département des Sciences de la Santé, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Lucia F O'Sullivan
- Department of Psychology, University of New Brunswick, Fredericton, NB, Canada
| | - Delphine Perrier Léonard
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - Sophie Bergeron
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
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18
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Le TP, Ali SH, Atkin AL, Ching THW, Csizmadia A, Tran NK, DiClemente RJ. Family connectedness and sexual minority Asian Americans' eating behavior regulation. Eat Behav 2023; 51:101817. [PMID: 37734352 DOI: 10.1016/j.eatbeh.2023.101817] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 09/23/2023]
Abstract
To date, psychosocial and interpersonal protective factors such as family connectedness have received little attention in studies of eating behaviors among sexual minority Asian Americans. Therefore, we investigated associations of family connectedness and two types of eating behavior regulation motives and the moderating role of individualism in these associations among 134 sexual minority Asian American young adults. Linear regression models assessed the main and interaction effects of family connectedness and individualism on introjected and identified eating behavior regulation motives. We observed a significant interaction effect between family connectedness and individualism only on introjected regulation. For participants with low levels of individualism, those who reported high levels of family connectedness had lower scores for introjected regulation of eating behavior. The findings of this study highlight the importance of examining strengths related to sexual minority Asian Americans by demonstrating the important role family connectedness plays in eating behavior regulation motives, particularly for those with lower individualism.
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Affiliation(s)
- Thomas P Le
- Department of Psychology, Bryn Mawr College, Philadelphia, PA, USA; Department of Psychology, The University of Maryland, College Park, MD, USA.
| | - Shahmir H Ali
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA
| | - Annabelle L Atkin
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA
| | - Terence H W Ching
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Annamaria Csizmadia
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Nguyen K Tran
- School of Medicine, Stanford University, Stanford, CA, USA
| | - Ralph J DiClemente
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, USA
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19
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Reidy DE, Baumler ER, Temple JR. Sexual violence against sexual minority women in STEM: Compound backlash. Soc Sci Med 2023; 338:116366. [PMID: 37949019 DOI: 10.1016/j.socscimed.2023.116366] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Recent research has found that gender parity (i.e., the ratio of women to men) in Science, Technology, Engineering, and Math (STEM) disciplines is associated with sexual violence (SV) victimization for women. This finding may reflect a type of backlash wherein SV is a means of punishing women who are perceived to be violating their gender roles and threatening the male hegemony. Sexual minorities, who are likewise disproportionately victims of SV, report experiencing heterosexist hostility and harassment in STEM disciplines. There is reason to suspect that the combination of these marginalized identity positions (e.g., a sexual minority woman in gender-balanced STEM) may amplify perceived gender role violations and exacerbate the risk of SV victimization. METHODS Data were collected from undergraduate women at five institutions of higher education in the United States. Sampling was stratified by STEM vs. non-STEM majors and male-dominated vs. gender-balanced majors. Sexual violence was measured via the revised Sexual Experiences Survey. We tested the interaction of sexual minority status and gender parity in STEM on SV via fixed effects OLS regression. RESULTS Sexual minority women in gender-balanced STEM were most frequently victims of SV. Women in male-dominated STEM majors were at no greater risk of SV victimization, regardless of sexual minority status, than their peers in non-STEM majors. IMPLICATIONS These findings suggest the possibility of a compound form of backlash, wherein women are exponentially victimized because their sexual identity and their membership in these STEM fields are seen as dual challenges to the male hegemony. If true, this could exacerbate health disparities rather than promote health equity for these sexual minority women. Findings point to the ongoing need to challenge hegemonic gender norms, focus prevention programs on populations most at risk, and ensure they are provided the appropriate resources for support.
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Affiliation(s)
- Dennis E Reidy
- School of Public Health & Center for Research on Interpersonal Violence, Georgia State University, United States.
| | - Elizabeth R Baumler
- Center for Violence Prevention, University of Texas Medical Branch, United States
| | - Jeff R Temple
- Center for Violence Prevention, University of Texas Medical Branch, United States
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20
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Lee M. Validation and measurement invariance of a Korean version of the Body Appreciation Scale-2 in cisgender sexual minorities and heterosexual adults. Body Image 2023; 47:101625. [PMID: 37713742 DOI: 10.1016/j.bodyim.2023.101625] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/17/2023]
Abstract
The Body Appreciation Scale-2 (BAS-2) has been validated in various languages across samples with different characteristics. However, its validation and invariance based on sexual orientation in Korean samples have yet to be examined. The current study validated the psychometric properties of the BAS-2 in Korean sexual minorities, and examined measurement invariance between sexual minority and heterosexual individuals and between sexual minority cisgender women and men. Responses from 449 sexual minority and 400 heterosexual individuals were analyzed. In the sexual minority sample, a confirmatory factor analysis supported the scale's unidimensional structure, exhibiting strong factorial validity; further, a correlation analysis revealed positive correlations with body satisfaction, positive sexual minority identity, life satisfaction, and self-esteem, supporting the convergent and criterion-related validity. A hierarchical regression analysis confirmed the incremental validity of the BAS-2 on life satisfaction and self-esteem. The BAS-2 was invariant across women and men at the scalar level in the sexual minority sample, and across sexual minorities and heterosexuals at the partial scalar level in the total sample. Latent mean comparisons indicated no significant differences in BAS-2 scores between sexual minority women and men, while sexual minorities scored significantly lower than heterosexuals. The multiple-indicators multiple-causes model provided evidence of differential item functioning.
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Affiliation(s)
- Minsun Lee
- Dept. of Fashion Design, Konkuk University Glocal Campus, 268 Chungwon-daero, Chungju, Chungcheongbuk-do 27478, South Korea.
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21
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Schuler A, Wedel A, Kelsey SW, Wang X, Quiballo K, Beatrice Floresca Y, Phillips G, Beach LB. Suicidality by Sexual Identity and Correlates Among American Indian and Alaska Native High School Students. J Adolesc Health 2023; 73:1030-1037. [PMID: 37737757 PMCID: PMC10840863 DOI: 10.1016/j.jadohealth.2023.07.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/16/2022] [Revised: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE This study aims to determine the prevalence of suicidality among American Indian and Alaskan Native (AI/AN) adolescents. Additionally, we measured suicidality, stratified by sex, and its association with sexual identity, sexual violence, and binge drinking. METHODS We pooled data from the Youth Risk Behavior Survey from 2005 to 2019 to analyze the prevalence of sexual minorities, forced sex, and binge drinking, and their association with suicidality using basic descriptive statistics followed by adjusted odds ratios stratified by sex among AI/AN youth. RESULTS 19% of AI/AN participants reported having suicidal thoughts and 14% reported having a previous suicide attempt. More than 17% of AI/AN participants identified as sexual minority youth (SMY). Compared to AI/AN heterosexual youth, AI/AN bisexual youth had significantly higher odds of reporting suicidal thoughts (aOR = 16.01), planning (aOR = 12.4), and previous attempts (aOR = 7.73). This pattern was also significantly demonstrated for AI/AN gay/lesbian youth. 43% of all AI/AN participants reported being forced into sexual intercourse. The presence of binge drinking was associated with higher odds of suicidal thoughts for both females and males compared to those who did not binge drink. DISCUSSION At the intersection of multiple marginalization, AI/AN SMY have a high mental health burden, demonstrating the need for culturally informed, community-led, and targeted mental health support focused on SMY AI/AN. Though this study fails to capture the heterogeneity within the AI/AN community, as nuances exist at the tribal level, these results demonstrate work needs to be done to support the health burden that AI/AN youth carry.
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Affiliation(s)
- Adrienne Schuler
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anneliese Wedel
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Scar Winter Kelsey
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Xinzi Wang
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kay Quiballo
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ysabel Beatrice Floresca
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Gregory Phillips
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Lauren B Beach
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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22
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Kinitz DJ, Shahidi FV, Ross LE. Job quality and precarious employment among lesbian, gay, and bisexual workers: A national study. SSM Popul Health 2023; 24:101535. [PMID: 38021458 PMCID: PMC10661442 DOI: 10.1016/j.ssmph.2023.101535] [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] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/23/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background Employment outcomes among sexual minority (i.e., lesbian, gay, bisexual) workers are poorly understood, and previous research on this topic has focused almost exclusively on inequities in earnings, neglecting other important dimensions of job quality. We address this gap by describing and comparing the job quality of straight and sexual minority workers in Canada. Methods Data are from the 2016 General Social Survey: Canadians at Work and Home, the only national survey providing both a measure of sexual orientation and a multidimensional view of job quality in Canada. We identified 25 unique job quality indicators (e.g., temporary employment; job insecurity; health benefits; low income; job satisfaction; job control; discrimination). Latent class cluster analysis was used to establish a typology of job quality describing standard, flexible, and precarious employment types. We used multivariable regression methods to examine the association between sexual orientation and job quality. Results Sexual minorities reported lower job quality than their straight counterparts along many dimensions, with bisexual people reporting the lowest job quality. While inequities were generally observed among both sexual minority men and women, they sometimes differed in magnitude by gender. The prevalence of precarious employment was nearly three times higher among lesbian, gay, and bisexual workers (PR: 2.94, CI: 1.89-4.58 among all sexual minorities; PR: 3.04, CI: 1.71-5.43 among gay/lesbian workers; and PR: 2.81, CI: 1.45-5.47 among bisexual workers) compared to their straight counterparts. Conclusion Inequities in job quality among sexual minorities persist despite comprehensive human rights protections in Canada. These inequities are pervasive, extending well beyond conventional indicators such as dollars earned and hours worked. Multi-pronged interventions are needed that move beyond simply ensuring that sexual minority workers are employed. Sexual minority workers deserve access to secure, well-paid work with benefits where they can foster connection and be free from discrimination.
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Affiliation(s)
- David J Kinitz
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, Ontario, M5T 3M7, Canada
| | - Faraz Vahid Shahidi
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, Ontario, M5T 3M7, Canada
- Institute for Work & Health, 400 University Avenue, Suite 1800, Toronto, Ontario, M5G 1S5, Canada
| | - Lori E Ross
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, Ontario, M5T 3M7, Canada
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23
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Bhatia D, Berg O, Davies R, Mikulich Gilbertson S, Sakai J. The Association Between Sexual Identity, Depression, and Adolescent Substance Use. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01630-w. [PMID: 38019347 DOI: 10.1007/s10578-023-01630-w] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/30/2023]
Abstract
Sexual minority youth (SMY) represent a population vulnerable to several adverse health consequences. Specifically, SMY experience depression and substance use at substantially higher rates than heterosexual peers. Better understanding the relationship between depression and substance use among SMY may help reduce morbidity and mortality. We hypothesize that depression will moderate increased substance use rates seen in SMY. Weighted logistical analyses of covariance, adjusted for race/ethnicity, sex, and age, compared the relationship between sexual identity, depression, and substance use (14 outcomes), using data from the 2019 Youth Risk Behavior Survey (n = 13,677) of high school students. SMY reported depression at rates nearly double than heterosexual peers (63.9% vs 33.0%). Except for vaping and alcohol, SMY had significantly higher odds of all SU (aORs 1.41-2.45, p < 0.001-0.0011). After adjusting for depression, odds of all SMY substance use decreased; most relationships remained significant (aORs 0.73-1.89), though the relationship between SMY and lifetime cannabis use became non-significant. The relationship between SMY and current vaping became significant and the relationship between SMY and alcohol and binge-drinking remained non-significant. SMY are at higher risk for use of most substances and depression compared to heterosexual youth. As depression consistently plays a role in the relationship between sexual minority status and adolescent substance use across a wide variety of substances, it may be a modifiable risk factor for substance use among sexual minority youth that should be screened for and treated. This study additionally provides important information for future studies examining nuances of SMY substance use patterns.
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Affiliation(s)
- Devika Bhatia
- University of Colorado School of Medicine, Anschutz Health Sciences Building, Suite 5242, 1890 N Revere Ct, Aurora, CO, 80045, USA.
| | - Owen Berg
- University of Colorado School of Medicine, Anschutz Health Sciences Building, Suite 5242, 1890 N Revere Ct, Aurora, CO, 80045, USA
| | - Robert Davies
- University of Colorado School of Medicine, Anschutz Health Sciences Building, Suite 5242, 1890 N Revere Ct, Aurora, CO, 80045, USA
| | - Susan Mikulich Gilbertson
- University of Colorado School of Medicine, Anschutz Health Sciences Building, Suite 5242, 1890 N Revere Ct, Aurora, CO, 80045, USA
| | - Joseph Sakai
- University of Colorado School of Medicine, Anschutz Health Sciences Building, Suite 5242, 1890 N Revere Ct, Aurora, CO, 80045, USA
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24
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Hickey PM, Best LA, Speed D. Access to Healthcare and Unmet Needs in the Canadian Lesbian-Gay-Bisexual Population. J Homosex 2023:1-19. [PMID: 38019536 DOI: 10.1080/00918369.2023.2287034] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Individuals who identify as a sexual minority, including those who are lesbian, gay, or bisexual (LGB), face barriers to healthcare as well as increased discrimination, stigmatization, and negative experiences during healthcare use. Further, few healthcare providers have education and training focused on the specific healthcare needs of individuals who are part of a sexual minority group. Given the limited research on Canadian healthcare access for sexual minorities, our purpose was to use data (n > 2,800) from the 2015-16 Canadian Community Health Survey (CCHS) to investigate the perceptions of healthcare access for LGB and non-LGB Canadians. Although non-LGB and LGB participants reported comparable access to a regular care provider and were equally likely to have consulted with a general practitioner in the past 12 months, LGB respondents were more likely to have seen a specialist and reported more unmet health needs. Although we expected the linear effects of both race and sex to vary by LGB status, this effect only occurred in one model. Current results have implications for addressing health inequalities for sexual minorities, including poorer health outcomes and greater discrimination.
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Affiliation(s)
- Patrick M Hickey
- Department of Psychology, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
| | - Lisa A Best
- Department of Psychology, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
| | - David Speed
- Department of Psychology, University of New Brunswick Saint John, Saint John, New Brunswick, Canada
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25
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Paquette MM, Bőthe B, Dion J, Girouard A, Bergeron S. Can I Love My Body Even if It Doesn't Look Like the Porn Stars'? Longitudinal Associations Between Pornography Use Frequency and Body Appreciation in a Diverse Sample of Adolescents. Arch Sex Behav 2023; 52:3471-3489. [PMID: 37644359 DOI: 10.1007/s10508-023-02679-3] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 04/13/2023] [Accepted: 07/25/2023] [Indexed: 08/31/2023]
Abstract
Online technologies could play an important role in the sexual development of adolescents as they watch more pornography than before. Pornography may relate to adolescents' perceptions of their bodies, especially among those identifying as a sexual and/or gender minority (SGM) as they have an increased risk of body image concerns compared to their heterosexual, cisgender (HC) peers. The present study examined the cross-sectional and longitudinal associations over 3 years between adolescents' pornography use frequency and body appreciation, considering potential gender and sexual orientation-based differences. Results from linear univariate and parallel processes latent growth curve models with a multi-group approach among 2904 adolescents (MageT1 = 14.5 years, SD = 0.61; 51.4% girls, 16.3% sexual minority) demonstrated that HC and SGM girls' body appreciation slightly decreased over time. Moreover, HC boys, HC girls and SGM girls' pornography use frequency slightly increased over time. Cross-sectionally, greater pornography use frequency was associated with lower levels of body appreciation in HC girls and SGM boys, with a small effect size. However, longitudinally, pornography use frequency and body appreciation were not related to each other in either group. Our findings support that pornography use, in the short term, is negatively associated with adolescents' body appreciation, although these associations might not hold in the long term. Adolescents may be more critical of body ideals represented in pornography as they learn to think with more discernment about the pornographic depictions of bodies and sexuality.
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Affiliation(s)
- Marie-Michèle Paquette
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montreal, QC, H3C 3J7, Canada.
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montreal, QC, H3C 3J7, Canada
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Jacinthe Dion
- Département des Sciences de la Santé, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Alice Girouard
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montreal, QC, H3C 3J7, Canada
| | - Sophie Bergeron
- Département de Psychologie, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montreal, QC, H3C 3J7, Canada
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26
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Waller CR, Méndez Leal AS, Silvers JA. Disparities in Depression and Anxiety That Impact Self-Identified Sexual Minority People Affect a Broader Group of Same-Gender Attracted Young Adults. J Adolesc Health 2023; 73:739-745. [PMID: 37436352 DOI: 10.1016/j.jadohealth.2023.05.024] [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: 09/19/2022] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE Prior work suggests sexual minority (e.g., gay, bisexual) young adults are at greater risk for depression and anxiety. However, the majority of said work focuses exclusively on self-reported sexual minority identity and neglects same-gender attraction. The current study aimed to characterize links between identity- and attraction-based indicators of sexual minority status and depression and anxiety in young adults, and to examine the ongoing significance of caregiver support in mental health during this key developmental period. METHODS 386 youth (mean age = 19.92 years; SD = 1.39) reported their sexual orientation identity and experiences of attraction toward men and/or women. Participants also reported on anxiety, depression, and caregiver social support. RESULTS While less than 16% of participants identified as sexual minority individuals, nearly half reported same-gender attraction. Self-identified sexual minority participants reported significantly higher depression and anxiety than self-identified heterosexual participants. Similarly, same-gender attracted individuals exhibited heightened depression and anxiety compared to exclusively different-gender attracted individuals. Greater caregiver social support predicted lower depression and anxiety. DISCUSSION The present findings suggest that not only are self-identified sexual minority individuals at heightened risk for depression and anxiety symptoms, but also that this risk extends to a larger group of young people who experience same-gender attraction. These results demonstrate that better mental health supports may be needed for youth who identify as sexual minority individuals or report same-gender attraction. That higher caregiver social support was associated with lower mental illness risk suggests caregivers may be key to mental health promotion during young adulthood.
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Affiliation(s)
- Claire R Waller
- UCLA Department of Psychology, University of California, Los Angeles, Los Angeles, California.
| | - Adriana S Méndez Leal
- UCLA Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Jennifer A Silvers
- UCLA Department of Psychology, University of California, Los Angeles, Los Angeles, California
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27
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Dion J, Hébert M, Sadikaj G, Girouard A, Godbout N, Martin-Storey A, Blais M, Bergeron S. Dating Violence Trajectories in Adolescence: How Do They Relate to Sexual Outcomes in Canada? Arch Sex Behav 2023; 52:2749-2765. [PMID: 37341862 DOI: 10.1007/s10508-023-02625-3] [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] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/31/2023] [Accepted: 05/15/2023] [Indexed: 06/22/2023]
Abstract
Dating violence during adolescence is a major public health issue: it is highly prevalent and extensive research has documented its physical and psychological consequences, yet very little has focused on its sexual consequences. The present study investigated the longitudinal associations between dating violence victimization (psychological, sexual or physical) and sexual well-being (sexual satisfaction and sexual distress) among 1442 sexually active adolescents aged between 14 and 17 years who completed at least one of three data waves (51.1% girls; 45.7% boys; 0.3% non-binary; 3.0% varying gender identity). The study also examined whether these associations differed by gender identity and sexual minority status. Adolescents completed online questionnaires on electronic tablets during class. The results indicated that psychological, physical (except for boys), and sexual dating violence victimization were all associated with lower sexual satisfaction and greater sexual distress over time. Moreover, the between-level associations between dating violence and poorer sexual outcomes were stronger among girls and gender varying adolescents than among boys. The within-level association between physical dating violence and sexual satisfaction was significant among adolescents with a nonvarying sexual minority status, but not among those with a nonvarying heterosexual status or that varied in sexual minority status. Findings offer cues for dating violence prevention and intervention programs by suggesting the need to examine sexual well-being over time.
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Affiliation(s)
- Jacinthe Dion
- Département des Sciences de la Santé, Université du Québec à Chicoutimi, Chicoutimi, 555, Boul. de l'Université, Saguenay, QC, G7H 2B1, Canada.
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada.
| | - Martine Hébert
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Gentiana Sadikaj
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Alice Girouard
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Natacha Godbout
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Alexa Martin-Storey
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Blais
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Sophie Bergeron
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
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28
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Matouk KM, Schulman JK, Case JAC. Mental Health Disparities in Sexual Minority and Transgender Women: Implications and Considerations for Treatment. Psychiatr Clin North Am 2023; 46:583-595. [PMID: 37500252 DOI: 10.1016/j.psc.2023.04.012] [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: 07/29/2023]
Abstract
Minority stress theory offers an explanation of how discrimination, marginalization, harassment, and violence against sexual minority and transgender women are connected to mental health disparities. Particularly, these groups are vulnerable to body image issues, disordered eating, higher rates of mood and anxiety disorders, suicide and nonsuicidal self-injury, and substance use. Discrimination is also experienced within clinical settings, which may lead this population to postpone or avoid treatment. Clinicians play a crucial role in reducing barriers to health care by developing cultural competency and ensuring safe and affirming spaces within their practice.
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Affiliation(s)
- Kareen M Matouk
- Department of Psychiatry, Columbia University Irving Medical Center, 710 West 168th Street, 12th Floor, New York, NY 10032, USA.
| | - Julie K Schulman
- Department of Psychiatry, Columbia University Irving Medical Center, 5141 Broadway, 3 River East, New York, NY 10034, USA
| | - Julia A C Case
- Department of Psychiatry, Columbia University Irving Medical Center, 710 West 168th Street, 12th Floor, New York, NY 10032, USA
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29
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Williams R, Romm KF, LoParco CR, Berg CJ. Experiences of Microaggressions, Attributions, and Impact Among US Young Adults: An Intersectional Perspective Regarding Sexual/Gender and Racial/Ethnic Minorities. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01710-6. [PMID: 37531018 DOI: 10.1007/s40615-023-01710-6] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Understanding discrimination (e.g., microaggressions) toward sexual/gender minorities (SGM) and racial/ethnic minorities (REM) from an intersectional perspective is critical in informing interventions to reduce such experiences and their impacts. PURPOSE This study examined US young adults identifying as SGM, REM, both, or neither in relation to microaggression experiences, and these factors in relation to mental health. METHODS Using 2022 data from 932 US adults (Mage = 27.61) in an online survey study, we compared subgroups (SGM-only, REM-only, both, neither) in relation to microaggression experiences and mental health symptoms, stratified by sex (male, female). Multivariable linear regression examined: 1) sex and intersectional subgroup in relation to number of microaggressions experienced; and 2) sex, subgroup, and number of microaggression experiences in relation to mental health symptoms. RESULTS Among females (n = 612), 42.0% were SGM-only, 17.3% REM-only, 15.2% both, and 25.5% neither. Among males (n = 320), 25.0% were SGM-only, 25.0% REM-only, 8.4% both, and 41.6% neither. Females (vs. males) reported more microaggressions (M = 5.67, SD = 3.00 vs. M = 3.95, SD = 3.46, p < .001). Those with intersecting minority identities experienced the most microagressions (females: M = 6.98, SD = 2.64; males: M = 6.44, SD = 2.95, respectively). In multivariable analyses, females and those in any of the 3 minority-identifying subgroups experienced more microaggressions; those with intersecting minority identities experienced more microaggressions than SGM-only and REM-only. Identifying as SGM-only or both SGM and REM, as well as experiencing more microaggressions, was associated with greater mental health symptoms. CONCLUSIONS Intersecting minority identities increase risk for microaggressions and mental health consequences. Multilevel interventions must reduce minority subgroups' experiences of microaggressions and their impacts.
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Affiliation(s)
- River Williams
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Cassidy R LoParco
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
- George Washington Cancer Center, George Washington University, Washington, DC, USA.
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30
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Lauckner C, Haney K, Sesenu F, Kershaw T. Interventions to Reduce Alcohol Use and HIV Risk among Sexual and Gender Minority Populations: a Systematic Review. Curr HIV/AIDS Rep 2023; 20:231-250. [PMID: 37225923 PMCID: PMC10436179 DOI: 10.1007/s11904-023-00660-2] [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] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
PURPOSE OF REVIEW Sexual and gender minority (SGM) individuals are diagnosed with HIV at disproportionate rates, and hazardous alcohol use can increase their HIV risk. This review assessed the state of the literature examining interventions for addressing alcohol use and sexual HIV risk behaviors among SGM individuals. RECENT FINDINGS Fourteen manuscripts from 2012 to 2022 tested interventions that address both alcohol use and HIV risk behaviors among SGM populations, with only 7 randomized controlled trials (RCTs). Virtually all the interventions targeted men who have sex with men, with none focused on transgender populations or cisgender women. While they demonstrated some evidence of effectiveness in reducing alcohol use and/or sexual risk, the outcomes varied widely between studies. More research is needed that tests interventions in this area, particularly for transgender individuals. The use of larger-scale RCTs with diverse populations and standardized outcome measures are needed to strengthen the evidence base.
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Affiliation(s)
- Carolyn Lauckner
- Center for Health Equity Transformation, University of Kentucky, 465 Healthy Kentucky Research Bldg, 760 Press Ave., Lexington, KY, 40536, USA.
| | - Kimberly Haney
- Center for Health Equity Transformation, University of Kentucky, 465 Healthy Kentucky Research Bldg, 760 Press Ave., Lexington, KY, 40536, USA
| | - Fidelis Sesenu
- Center for Health Equity Transformation, University of Kentucky, 465 Healthy Kentucky Research Bldg, 760 Press Ave., Lexington, KY, 40536, USA
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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31
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Gustafson KE, Manning WD, Kamp Dush CM. Emotional support among partnered sexual minority and heterosexual individuals during the COVID-19 pandemic. Soc Sci Res 2023; 114:102910. [PMID: 37597926 PMCID: PMC10492653 DOI: 10.1016/j.ssresearch.2023.102910] [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] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 05/17/2023] [Accepted: 07/06/2023] [Indexed: 08/21/2023]
Abstract
Emotional support, particularly support from family and friends, is essential to health outcomes especially for marginalized communities. Although emotional support is recognized as a critical resource, especially during the COVID-19 pandemic, to date no research has examined access to support during the pandemic for sexual diverse populations. This study aims to apply minority stress theory by drawing on a new population-based data source of 3,642 respondents, the National Couples' Health and Time Study (NCHAT), which oversampled sexual and gender diverse populations during the pandemic. We focus on two sources of emotional support: family members and friends. Exclusively heterosexual respondents relied more on emotional support from family than respondents who identified as exclusively gay/lesbian, bisexual including pan, omni, and queer, and those reporting another sexual identity or multiple sexual identities. However, respondents who did not identify as heterosexual relied more on emotional support from friends compared to exclusively heterosexual respondents. There were no significant differences among respondents with sexual minority identities in regard to family or friend support. Other factors, such as outness to friends and family, identity centrality, aggressions, and relationship satisfaction are found to be associated support from friends and family. The findings presented here add to a growing body of work on social support while adding sexual minority-specific factors that may affect receipt of, need for, and outcomes relating to support. This work contributes to understanding of the social climate and resources available to sexual diverse populations during a major public health crisis.
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Affiliation(s)
- Kristen E Gustafson
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH, 43403, USA.
| | - Wendy D Manning
- Department of Sociology and Center for Family and Demographic Research, Bowling Green State University, Bowling Green, OH, 43403, USA
| | - Claire M Kamp Dush
- Department of Sociology, Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA
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32
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Liu Y, O’Grady MA. A cross-sectional study of the relationship between depression status, health care coverage, and sexual orientation. Discov Ment Health 2023; 3:13. [PMID: 37861944 PMCID: PMC10501004 DOI: 10.1007/s44192-023-00039-0] [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] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 06/22/2023] [Indexed: 10/21/2023]
Abstract
Health care coverage is an important factor in receipt of behavioral healthcare. This study uses data from the New York City Community Health Survey to examine how sexual minority status impacts the relationship between depression status and having health care coverage. Approximately 10% of the sample (n = 9571; 47% 45+ years old; 35% White Non-Hispanic; 7% sexual minority) reported probable depression and low health care coverage. Compared to heterosexual participants, a greater proportion of sexual minority participants had low health care coverage (17% vs. 9%) and probable depression (19% vs. 9%). Logistic regression examining the association between probable depression status and health care coverage showed that those with probable depression have odds of low health care coverage that are were 3.08 times those who did not have probable depression; this relationship was not modified by sexual orientation. Continued research to understand the interplay of health care coverage, mental health, and sexual orientation is needed.
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Affiliation(s)
- Yang Liu
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, USA
| | - Megan A. O’Grady
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, USA
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Maroney MR, Levitt HM, Horne SG. Exploring the Efficacy of an Online Intervention in Processing Experiences of Heterosexism Among Autistic-LGBQ + Individuals. J Autism Dev Disord 2023:10.1007/s10803-023-06027-1. [PMID: 37344732 DOI: 10.1007/s10803-023-06027-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2023] [Indexed: 06/23/2023]
Abstract
This experimental study explored the use of online expressive writing interventions to cope with distress from heterosexist events among a sample of autistic-LBGQ + individuals. This study included an open writing condition and an emotion focused therapy guided writing condition. Over 89% of the participants indicated that the writing exercises were helpful in processing the event, with significant decreases for measures of depressive and trauma/stressor symptoms. A thematic analysis identified specific aspects of each condition that were helpful for participants in coping with heterosexist distress, such as the development of insight through the emotion-focused exercises. This low-demand exercise is promising as a solo exercise or as a therapy homework assignment, especially given the accessibility of this online intervention for autistic-LGBQ + people.
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Affiliation(s)
- Meredith R Maroney
- Counselling Psychology, Werklund School of Education, University of Calgary, Calgary, AB, T2N 1N4, Canada.
| | - Heidi M Levitt
- Department of Psychology, University of Massachusetts, Boston, USA
| | - Sharon G Horne
- Department of Counseling and School Psychology, University of Massachusetts, Boston, USA
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34
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Escarfuller SG, Mitchell JW, Sanchez M. HIV Prevention Intervention-related Research with Adult, Sexual Minority Hispanic Men in the United States: A Systematic Review. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01659-6. [PMID: 37340124 DOI: 10.1007/s40615-023-01659-6] [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] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/22/2023]
Abstract
The systematic review describes aims to synthesize the HIV prevention intervention-related research conducted among adult, US sexual minority Hispanic men since 2012. Following PRISMA guidelines, 15 articles representing 14 studies were included in the review: 4 randomized controlled trials, 5 pilots, and 5 formative projects. Two interventions had PrEP-related outcomes whereas 7 focused on behavioral (e.g., condoms, testing) and/or educational outcomes. Few studies used digital health. All but one study was theoretically guided. Community engagement was a common and important thread in the included studies, with community-based participatory research being the most prevalent framework. The inclusion of cultural factors varied widely, as did the availability of Spanish language or bilingual study materials. Future research opportunities are discussed and recommendations to bolster HIV prevention interventions (e.g., tailoring) are presented. These include the need for greater integration of cultural factors (e.g., nuances related to the heterogeneity of Hispanic subgroups) and mitigating critical barriers to help improve uptake of evidence-based strategies in this population.
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Affiliation(s)
- Sebastian G Escarfuller
- Stempel College of Public Health and Social Work, Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL, 33199, USA.
| | - Jason W Mitchell
- Stempel College of Public Health and Social Work, Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL, 33199, USA
| | - Mariana Sanchez
- Stempel College of Public Health and Social Work, Department of Health Promotion and Disease Prevention, Florida International University, Miami, FL, 33199, USA
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Wang XX, Cosquer M, Zhuang M, Ali A, Falissard B, Corruble E, Gressier F, Jousselme C. The role of parents' and friends' support in preventing suicide attempts among French sexual minority adolescents. Rev Epidemiol Sante Publique 2023; 71:101594. [PMID: 36966599 DOI: 10.1016/j.respe.2023.101594] [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] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 12/27/2022] [Accepted: 02/14/2023] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVES French sexual minority adolescents are at higher risk for suicide attempts than their heterosexual peers. However, little is known about the role of parents' and friends' support among French lesbian, gay and bisexual (LGB) youth. This study aimed to research the role of their support in preventing suicide attempts among LGB adolescents in France. MATERIALS AND METHODS Data were drawn from a French cross-sectional study entitled "Portraits d'adolescents". Parental support was defined by satisfactory relations between participants and their parents. Friends' support was defined by satisfactory relations between participants and their friends. Chi-square and multiple logistic regression analyses were used to estimate and identify associated factors of suicide attempts in LGB as opposed to heterosexual youth. RESULTS Data from a sample of 14,265 French adolescents aged 13 to 20 were analyzed. Among them, 637 (4.47%) identified as LGB. Attempted suicide was independently associated with sexual orientation (30.7% vs 10.6%; OR = 2.59 [2.11-3.18]; p < 0.0001). Both parents' and friends' support appeared to be protective factors in suicide attempts among heterosexuals (adjusted ORs = 0.40 [0.35-0.46] and 0.61 [0.51-0.75], respectively), whereas in the LGB group, only parental support was significant (adjusted OR = 0.42 [0.27-0.65]), independently of other variables. DISCUSSION Prevention efforts might be carried out by identifying within-group differences among French adolescents with different sexual orientations. The supportive role of family members should be strengthened. Positive resources and salutary support systems may effectively prevent suicide attempts. CONCLUSIONS French LGB adolescents have a higher risk for suicide attempts than their heterosexual peers. Parental support was reconfirmed as a major protective factor against suicide attempts in sexual minority adolescents.
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Affiliation(s)
- Xavier Xu Wang
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Centre Hospitalier Fondation Vallée, Gentilly, France.
| | - Mireille Cosquer
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Centre Hospitalier Fondation Vallée, Gentilly, France
| | - Min Zhuang
- Saint Louis University, 1 N. Grand Blvd. St. Louis, MO 63103, USA
| | - Aminata Ali
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Fondation Santé des Etudiants de France (FSEF), 75014, Paris, France
| | - Bruno Falissard
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France
| | - Emmanuelle Corruble
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Department of Psychiatry, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Saclay, Le Kremlin-Bicêtre, France
| | - Florence Gressier
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Department of Psychiatry, Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Saclay, Le Kremlin-Bicêtre, France
| | - Catherine Jousselme
- CESP, U1018, Moods Team, Paris-Saclay University, Bicêtre University Hospital, Le Kremlin Bicêtre, France; Centre Hospitalier Fondation Vallée, Gentilly, France
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Abstract
The minority stress model has been influential in guiding research on sexual and gender minority health and well-being in psychology and related social and health sciences. Minority stress has theoretical roots in psychology, sociology, public health, and social welfare. Meyer provided the first integrative articulation of minority stress in 2003 as an explanatory theory aimed at understanding the social, psychological, and structural factors accounting for mental health inequalities facing sexual minority populations. This article reviews developments in minority stress theory over the past two decades, focusing on critiques, applications, and reflections on its continued relevance in the context of rapidly changing social and policy contexts.
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Affiliation(s)
| | - Ilan H Meyer
- University of California, Los Angeles, United States
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Wood OR, Schnall R, Kay ES, Jia H, Abua JA, Nichols TK, Olender SA, Mugavero MJ, Batey DS. A community health worker and mobile health app intervention to improve adherence to HIV medication among persons with HIV: the CHAMPS study protocol. BMC Public Health 2023; 23:942. [PMID: 37226141 DOI: 10.1186/s12889-023-15616-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/05/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Persons with HIV (PWH) can now achieve a near-normal life expectancy due to antiretroviral therapy (ART). Despite widespread availability of ART in the United States (US), many of the country's approximate 1.1 million PWH are not achieving viral suppression due to poor ART adherence. Viral suppression rates are particularly low in Alabama (AL, 62%) and New York City (NYC, 67%). There is mixed evidence on the efficacy of community health workers (CHW) and mHealth interventions for improving ART adherence and viral suppression in PWH thus, we sought to combine these interventions and test the efficacy for improving health outcomes in PWH. METHODS The CHAMPS study is a two-arm randomized controlled trial among 300 PWH with suboptimal primary care appointment adherence (n = 150 in AL and 150 in NYC) over the course of 12 months. Participants are randomly assigned to CHAMPS (intervention) or a standard-of-care (control) arm. Participants in the intervention arm are given a CleverCap pill bottle that syncs to the WiseApp to track medication adherence, reminds users to take their medication at a set time, and enables communication with CHW. All participants complete baseline, 6-month, and 12-month follow-up visits where surveys are administered and, CD4 and HIV-1 viral load are obtained through blood draw. DISCUSSION Maintaining ART adherence has significant implications in HIV management and transmission. mHealth technologies have been shown to optimize the provision of health services, produce positive changes in health behavior, and significantly improve health outcomes. CHW interventions also provide personal support to PWH. The combination of these strategies may provide the necessary intensity to increase ART adherence and clinic attendance among PWH at highest risk for low engagement. Delivering care remotely enables CHW to contact, assess, and support numerous participants throughout the day, reducing burden on CHW and potentially improving intervention durability for PWH. The adoption of the WiseApp coupled with community health worker sessions in the CHAMPS study has the potential to improve HIV health outcomes, and will add to the growing knowledge of mHealth and CHW efforts to improve PWH medication adherence and viral suppression. TRIAL REGISTRATION This trial was registered with Clinicaltrials.gov (NCT04562649) on 9/24/20.
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Affiliation(s)
- Olivia R Wood
- School of Nursing, Columbia University, 560 West 168th Street, New York, NY, 10032, USA
| | - Rebecca Schnall
- School of Nursing, Columbia University, 560 West 168th Street, New York, NY, 10032, USA.
| | - Emma S Kay
- Magic City Research Institute, Birmingham AIDS Outreach, Birmingham, AL, USA
| | - Haomiao Jia
- School of Nursing, Columbia University, 560 West 168th Street, New York, NY, 10032, USA
| | | | - Tyler K Nichols
- School of Nursing, Columbia University, 560 West 168th Street, New York, NY, 10032, USA
| | - Susan A Olender
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
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Zivony A, Reggev N. Beliefs About the Inevitability of Sexual Attraction Predict Stereotypes About Asexuality. Arch Sex Behav 2023:10.1007/s10508-023-02616-4. [PMID: 37212956 DOI: 10.1007/s10508-023-02616-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/07/2022] [Accepted: 12/10/2022] [Indexed: 05/23/2023]
Abstract
Similar to other sexual minorities, asexual individuals often face prejudice and stereotyping. However, the source of these attitudes and beliefs is not well understood. We hypothesized that asexual stereotypes stem from the belief that sexual attraction is an inevitable part of human development. This attraction inevitability assumption can lead to the deduction that people who identify as asexual do so because they are going through a transitory stage or excusing socially avoidant tendencies. To test this stereotype deduction account, we examined whether specific asexual stereotypes (immaturity and non-sociality) were associated with adherence to the attraction inevitability assumption. Heterosexual participants (N = 322; 201 women, 114 men; mean age 34.6 yrs.) from the UK and the US read vignettes describing a target character that was either asexual or heterosexual. People who assumed that attraction is inevitable were more likely to evaluate asexual targets (but not heterosexual targets) as immature and non-social. The impact of the sexual inevitability assumption was present even when social dominance orientation, an attitude closely related to negativity toward all sexual minorities, was accounted for. Participants who adhered to the attraction inevitability assumption also showed a reduced inclination to befriend asexual individuals. These findings suggest that generalized negativity toward sexual minorities does not fully explain stereotypes and prejudice against asexual people. Instead, the current study highlights how perceived deviation from the shared understanding of sexuality uniquely contributes to anti-asexual bias.
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Affiliation(s)
- Alon Zivony
- Department of Psychological Sciences, Birkbeck College, University of London, Malet Street, London, WC1E 7HX, UK.
| | - Niv Reggev
- Department of Psychology, University of Sheffield, Sheffield, UK
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Janssen T, Gamarel KE, Mereish EH, Colby SM, Haikalis M, Jackson KM. Associations Among Enacted Stigma, Perceived Chances for Success, Life Satisfaction, and Substance Use Among Sexual Minority and Heterosexual Youth. Subst Use Misuse 2023; 58:1121-1131. [PMID: 37216278 PMCID: PMC10388366 DOI: 10.1080/10826084.2023.2212282] [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] [Indexed: 05/24/2023]
Abstract
Background: Sexual minority youth report high rates of substance use compared to heterosexual youth. Stigma can diminish perceptions of future success and life satisfaction and contribute to elevated substance use. This study examined whether experiences of enacted stigma (i.e., discrimination) and substance use among sexual minority and heterosexual youth were indirectly associated through perceived chances for success and life satisfaction. Method: In a sample of 487 adolescents who indicated their sexual identity (58% female, M age = 16.0, 20% sexual minority), we assessed substance use status and factors that might explain sexual minority disparities in substance use. Using structural equation modeling, we examined indirect associations between sexual minority status and substance use status through these factors. Results: Compared to heterosexual youth, sexual minority youth reported greater stigma, which was associated with both lower perceived chances for success and life satisfaction, which were in turn associated with greater likelihood of substance use. Conclusions: Findings highlight the importance of attending to stigma, perceived chances for success, and general life satisfaction to understand and intervene to prevent substance use among sexual minority youth.
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Affiliation(s)
- Tim Janssen
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Kristi E. Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health
| | - Ethan H. Mereish
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
- Department of Health Studies, American University
| | - Suzanne M. Colby
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Michelle Haikalis
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health
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Hodges JC, Goings TC, Vaughn MG, Oh S, Salas-Wright CP. Sexual minorities and substance use treatment utilization: New evidence from a national sample. J Subst Use Addict Treat 2023:209060. [PMID: 37207837 DOI: 10.1016/j.josat.2023.209060] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/06/2023] [Accepted: 05/01/2023] [Indexed: 05/21/2023]
Abstract
INTRODUCTION Minority stress theory suggests that sexual minorities would be, on average, less likely than heterosexual individuals to seek out substance use treatment (due to concerns of stigma and rejection). However, prior research on the subject is mixed, and largely dated. In light of historic increases in societal acceptance and legal protections for sexual minorities, the field needs an up-to-date assessment of treatment utilization among this population. METHODS This study used data from the 2015-2019 National Survey on Drug Use and Health to examine the association between key independent variables (sexual identity, gender) and substance use treatment utilization using binary logistic regression. We conducted analyses using a sample of adults with a past-year substance use disorder (N = 21,926). RESULTS Controlling for demographic factors, with heterosexual individuals as the comparison group, gay/lesbian individuals (AOR = 2.12, CI = 1.19-3.77) were significantly more likely and bisexual individuals (AOR = 0.49, CI = 0.24-1.00) significantly less likely to report treatment utilization. Bisexual individuals were also less likely than gay/lesbian individuals to report treatment utilization (AOR = 0.10, CI = 0.05-0.23). Interaction tests examining sexual orientation and gender showed no difference in treatment utilization between gay men and lesbian women, and revealed that bisexual identity was associated with decreased likelihood of treatment utilization for men (p = .004) but not for women. CONCLUSION Sexual orientation, particularly in the context of social identity, plays a significant role in substance use treatment utilization. Bisexual men face unique barriers to treatment, which is concerning given the high rates of substance use among this and other sexual minority populations.
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Affiliation(s)
- James C Hodges
- School of Social Work, Boston College, Chestnut Hill, MA, United States of America.
| | - Trenette C Goings
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Michael G Vaughn
- School of Social Work, Saint Louis University, St. Louis, MO, United States of America
| | - Sehun Oh
- College of Social Work, The Ohio State University, Columbus, OH, United States of America
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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: 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] [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.
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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
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Ogaz D, Allen H, Reid D, Brown JRG, Howarth AR, Pulford CV, Mercer CH, Saunders J, Hughes G, Mohammed H. COVID-19 infection and vaccination uptake in men and gender-diverse people who have sex with men in the UK: analyses of a large, online community cross-sectional survey (RiiSH-COVID) undertaken November-December 2021. BMC Public Health 2023; 23:829. [PMID: 37147609 PMCID: PMC10161154 DOI: 10.1186/s12889-023-15779-5] [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] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Men and gender-diverse people who have sex with men are disproportionately affected by health conditions associated with increased risk of severe illness due to COVID-19 infection. METHODS An online cross-sectional survey of men and gender-diverse people who have sex with men in the UK recruited via social networking and dating applications from 22 November-12 December 2021. Eligible participants included self-identifying men, transgender women, or gender-diverse individuals assigned male at birth (AMAB), aged ≥ 16, who were UK residents, and self-reported having had sex with an individual AMAB in the last year. We calculated self-reported COVID-19 test-positivity, proportion reporting long COVID, and COVID-19 vaccination uptake anytime from pandemic start to survey completion (November/December 2021). Logistic regression was used to assess sociodemographic, clinical, and behavioural characteristics associated with SARS-CoV-2 (COVID-19) test positivity and complete vaccination (≥ 2 vaccine doses). RESULTS Among 1,039 participants (88.1% white, median age 41 years [interquartile range: 31-51]), 18.6% (95% CI: 16.3%-21.1%) reported COVID-19 test positivity, 8.3% (95% CI: 6.7%-10.1%) long COVID, and 94.5% (95% CI: 93.3%-96.1%) complete COVID-19 vaccination through late 2021. In multivariable models, COVID-19 test positivity was associated with UK country of residence (aOR: 2.22 [95% CI: 1.26-3.92], England vs outside England) and employment (aOR: 1.55 [95% CI: 1.01-2.38], current employment vs not employed). Complete COVID-19 vaccination was associated with age (aOR: 1.04 [95% CI: 1.01-1.06], per increasing year), gender (aOR: 0.26 [95% CI: 0.09-0.72], gender minority vs cisgender), education (aOR: 2.11 [95% CI: 1.12-3.98], degree-level or higher vs below degree-level), employment (aOR: 2.07 [95% CI: 1.08-3.94], current employment vs not employed), relationship status (aOR: 0.50 [95% CI: 0.25-1.00], single vs in a relationship), COVID-19 infection history (aOR: 0.47 [95% CI: 0.25-0.88], test positivity or self-perceived infection vs no history), known HPV vaccination (aOR: 3.32 [95% CI: 1.43-7.75]), and low self-worth (aOR: 0.29 [95% CI: 0.15-0.54]). CONCLUSIONS In this community sample, COVID-19 vaccine uptake was high overall, though lower among younger age-groups, gender minorities, and those with poorer well-being. Efforts are needed to limit COVID-19 related exacerbation of health inequalities in groups who already experience a greater burden of poor health relative to other men who have sex with men.
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Affiliation(s)
- Dana Ogaz
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK.
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK.
| | - Hester Allen
- COVID-19 Vaccines and Epidemiology Division, UK Health Security Agency, London, UK
| | - David Reid
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
- Sigma Research, Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Jack R G Brown
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Alison R Howarth
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Caisey V Pulford
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
| | - Catherine H Mercer
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - John Saunders
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- Institute for Global Health, University College London, London, UK
| | - Gwenda Hughes
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
- UK Public Health Rapid Support Team, London School of Hygiene & Tropical Medicine, London, UK
| | - Hamish Mohammed
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, 61 Colindale Avenue, London, NW9 5EQ, UK
- The National Institute for Health and Care Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London in partnership with the, UK Health Security Agency, London, UK
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Blayney JA, Jaffe AE, Hequembourg AL, Parrott DJ. Sexual Victimization Among Sexual and Gender Minoritized Groups: Recent Research and Future Directions. Curr Psychiatry Rep 2023; 25:183-191. [PMID: 37014545 PMCID: PMC10947481 DOI: 10.1007/s11920-023-01420-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Accepted: 02/22/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE OF THE REVIEW Sexual victimization is a significant public health concern. Compared to heterosexual and cisgender peers, sexual and gender minoritized (SGM) individuals are at elevated risk for sexual victimization. Prominent theories suggest that this risk is due in part to the stigma SGM individuals face when navigating heteronormative cultures. The goal of this article is to review the prevalence, risk factors, and consequences of sexual victimization in SGM individuals. RECENT FINDINGS Studies continue to show that SGM individuals-bisexual and/or gender minoritized in particular-are at higher risk for sexual victimization. Little work has focused on risk factors, though recent research continues to highlight post-victimization disparities among SGM individuals. Emerging studies also point to theoretically informed factors that may influence victimization risk and recovery, including sexual and gender-related stigma. To inform prevention and intervention efforts, future research would benefit from streamlining assessment, methodology, and dissemination practices.
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Affiliation(s)
- Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Anna E Jaffe
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Amy L Hequembourg
- School of Nursing, State University of New York at Buffalo, Buffalo, NY, USA
| | - Dominic J Parrott
- Department of Psychology, Georgia State University, Atlanta, GA, USA
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Adzrago D, Evans GS, Dias EM, Kwentua V, White GE, Wilkerson JM. Association of receiving opioid medication-assisted treatment with sexual identity and mental health/substance use disorder symptoms in a nationally representative sample of adults. Res Sq 2023:rs.3.rs-2837899. [PMID: 37162987 PMCID: PMC10168441 DOI: 10.21203/rs.3.rs-2837899/v1] [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] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Although the literature suggests that medication-assisted treatment (MAT) is an effective treatment for opioid use disorder, limited studies have assessed the prevalence or the association between MAT use and sexual identity, mental health, or substance use disorder among a nationally representative sample. We assessed the prevalence and association of opioid MAT use between sexual identity, depressive disorder symptoms, alcohol use dependence, and marijuana use dependence in the United States. Methods We used the 2019 National Survey on Drug Use and Health public-use data on adults aged 18-64 years (N = 38,841) to conduct a weighted multivariable logistic regression analysis. Results A total of 4.80% and 2.32% of the population identified as bisexual and lesbian/gay, respectively. About 0.31% (612,750 people) of the population reported receiving opioid MAT, 3.73% had alcohol use dependence, 1.42% had marijuana use dependence, and 9.13% had major depressive episode (MDE) symptoms. Of those who had received opioid MAT, 0.57% were bisexuals and 1.07% were lesbians/gays, 0.65% were people with alcohol use dependence, 2.32% with marijuana use dependence, and 1.59% with MDE symptoms. Lesbian/gay individuals were more likely to receive opioid MAT (AOR = 3.43, 95% CI = 1.42, 8.25) compared to heterosexual individuals. The odds were higher for people with marijuana use dependence (AOR = 3.44, 95% CI = 1.47, 8.06) and MDE symptoms (AOR = 5.22, 95% CI = 3.46, 7.89) than their counterparts. Conclusions In this study, sexual minorities, people with MDE symptoms, and those dependent on marijuana use were more likely to receive opioid MAT, suggesting the need to investigate further opioid use disorder symptoms and their risk factors among these populations.
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Affiliation(s)
- David Adzrago
- The University of Texas Health Science Center at Houston (UTHealth)
| | | | - Emanuelle M Dias
- The University of Texas Health Science Center at Houston (UTHealth)
| | - Victoria Kwentua
- The University of Texas Health Science Center at Houston (UTHealth)
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Kiekens WJ, Baams L, Feinstein BA, Veenstra R. Development and Validation of the Sexual Minority Adolescent Rejection Sensitivity Scale. Arch Sex Behav 2023; 52:971-989. [PMID: 36454435 PMCID: PMC10102110 DOI: 10.1007/s10508-022-02474-6] [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] [Received: 02/10/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 05/11/2023]
Abstract
Because no measure for sexual orientation-related rejection sensitivity (RS) for adolescents exists, we aimed to develop and validate the Sexual Minority Adolescent Rejection Sensitivity Scale (SMA-RSS). In Study 1, interviews with 22 sexual minority youth were conducted (M age = 18.86, SD = 3.03). Based on these interviews, 29 scenarios were developed as potential items for the SMA-RSS. In Study 2, exploratory factor analyses were conducted on these 29 scenarios in a sample of 397 sexual minority adolescents (M age = 16.63, SD = 1.07). The 14 best performing items were selected and a two-factor structure best fit the data. In Study 3, a confirmatory factor analysis was conducted and the test-retest reliability, criterion validity, convergent validity, and incremental validity of the SMA-RSS were assessed in a sample of 499 sexual minority adolescents (M age = 16.61, SD = 1.34). A bifactor model best fit the data and evidence was provided for a strong enough general factor to justify unidimensionality. For criterion validity, the SMA-RSS evidenced small to moderate correlations with minority stressors and mental health indicators. For convergent validity, we found a moderate correlation with general RS. For incremental validity, the SMA-RSS was associated with mental health indicators over and above minority stressors and general RS. Participants were moderately stable in their scores on the SMA-RSS over a one-month period. Taken together, the SMA-RSS captured unique situations in which sexual minority adolescents anxiously expect rejection and can aid in better understanding health disparities among sexual minority adolescents.
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Affiliation(s)
- Wouter J Kiekens
- Department of Sociology/Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
| | - Laura Baams
- Department of Pedagogy and Educational Sciences, University of Groningen, Groningen, The Netherlands
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - René Veenstra
- Department of Sociology/Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands
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Mishra AA, Halpern CT, Schwab-Reese LM, Harris KM. Cumulative life-course victimization and inflammation in a U.S. national sample: Comparing intersections based on sexual orientation, gender, race/ethnicity, and education. Prev Med 2023; 169:107455. [PMID: 36804566 DOI: 10.1016/j.ypmed.2023.107455] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Received: 08/10/2022] [Revised: 01/18/2023] [Accepted: 02/14/2023] [Indexed: 02/21/2023]
Abstract
Violence victimization has been associated with low-grade inflammation. Lesbian, Gay, and Bisexual (LGB) individuals are at greater risk for victimization in childhood and young adulthood compared to heterosexuals. Moreover, the intersection of LGB identity with gender, race/ethnicity, and educational attainment may be differentially associated with victimization rates. However, no previous study has examined the role of cumulative life-course victimization during childhood and young adulthood in the association between 1) LGB identity and low-grade inflammation during the transition to midlife, and 2) intersection of LGB identity with gender, race/ethnicity, and educational attainment and low-grade inflammation during the transition to midlife. We utilized multi-wave data from a national sample of adults entering midlife in the United States- the National Longitudinal Study of Adolescent to Adult Health (Add Health; n = 4573) - and tested four bootstrapped mediation models. Results indicate LGB identity, LGB and White, and LGB and Black identities were indirectly associated with low-grade inflammation during the transition to midlife via higher levels of cumulative life-course victimization. Moreover, among LGB adults, the association between 1) less than college education and 2) some college education, and low-grade inflammation was mediated by cumulative life-course victimization. For LGB females, there was a direct association between identity and low-grade inflammation and this association was mediated by cumulative life-course victimization . Reducing accumulation of victimization could be critical for preventing biological dysregulation and disease onset among LGB individuals, particularly for those with multiple marginalized identities.
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Livingston NA, Gatsby E, Shipherd JC, Lynch KE. Causes of alcohol-attributable death and associated years of potential life lost among LGB and non-LGB veteran men and women in Veterans Health Administration. Addict Behav 2023; 139:107587. [PMID: 36571942 DOI: 10.1016/j.addbeh.2022.107587] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/08/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Alcohol use is a significant concern nationally and research now highlights higher rates of alcohol attributable death (AAD) and years of potential life lost (YPLL) among lesbian, gay, and bisexual (LGB) veterans compared to non-LGB veterans. In this study, we examined specific causes of AAD and associated YPLL between LGB and non-LGB veteran men and women to highlight needed outreach, prevention, and treatment strategies. METHODS Using data from the nationwide Veterans Health Administration electronic health record and National Death Index from 2014 to 2018, we examined the top ten ranked causes of AAD among LGB (n = 102,085) and non-LGB veteran (n = 5,300,521) men and women, as well as associated YPLL per AAD. RESULTS We observed higher rates of AAD among men than women, but higher rates among LGB veterans relative to their same-sex non-LGB counterparts. We noted greater YPLL per AAD among LGB men and all women compared to non-LGB men, even when of similar or same rank in cause of death. Acute-cause AAD death (e.g., alcohol-related suicide, poisonings) was ranked higher among LGB men and all women. YPLL was greater for both acute- and chronic-cause AAD (e.g., liver disease) among LGB men and all women compared to non-LGB men. CONCLUSIONS Causes of AAD differ between LGB and non-LGB men and women. The differences observed highlight disparities in acute- and chronic-cause AAD between groups help explain the higher number of YPLL per AAD that disfavor LGB men and women veterans, and essential next steps in primary and secondary prevention of hazardous drinking and mortality risk.
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Affiliation(s)
- Nicholas A Livingston
- Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States.
| | - Elise Gatsby
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT, United States
| | - Jillian C Shipherd
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States; LGBTQ+ Health Program, Veterans Health Administration, Washington, DC, United States; Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA, United States
| | - Kristine E Lynch
- VA Informatics and Computing Infrastructure, VA Salt Lake City Health Care System, Salt Lake City, UT, United States; Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
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Clark MA, Behl-Chadha B, Winter M, Ozonoff A, Boehmer U. Recruitment of sexual minority and heterosexual colorectal cancer survivors through US cancer registries. J Cancer Surviv 2023:10.1007/s11764-023-01343-y. [PMID: 36840834 DOI: 10.1007/s11764-023-01343-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/25/2023] [Indexed: 02/26/2023]
Abstract
PURPOSE Describe the process, outcomes, and costs of cancer registry recruitment and enrollment of sexual minority and heterosexual non-metastatic colorectal cancer survivors into an observational survivorship study. METHODS We recruited stage I-III colorectal cancer survivors from four US cancer registries. Potential participants were screened for eligibility, and all eligible sexual minority and every 10th heterosexual survivor was invited to participate in a 45-min telephone interview. RESULTS We mailed study packets to 17,855 individuals and obtained 6370 screening surveys of presumed eligible individuals. After screening, there were 182 eligible sexual minority and 5568 eligible heterosexual survivors. Of the 719 invited survivors, 127 sexual minority and 353 heterosexual individuals participated in the interview. There were some small differences in personal and neighborhood sociodemographic characteristics for the survivors who screened eligible and completed the interview relative to the registry sample. The per-participant direct costs were about $40, $120, and $1425 in the registry, screened eligible, and interviewed samples, respectively. CONCLUSIONS Although we did not observe substantial selection biases, the costs of enrolling a representative sample were high. IMPLICATIONS FOR CANCER SURVIVORS Inclusion of sexual orientation and gender identity as standard demographic questions in cancer registries is needed for reliable and cost-efficient monitoring of population health.
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Affiliation(s)
- Melissa A Clark
- Department of Health Services, Policy and Practice, Brown University School of Public Health, One Davol Square, Box 1886, Providence, RI, 02912, USA.
| | - Bittie Behl-Chadha
- Commonwealth Medicine, University of Massachusetts Medical School, Shrewsbury, MA, USA
| | - Michael Winter
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA
| | - Al Ozonoff
- Harvard Medical School, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
| | - Ulrike Boehmer
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
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Lu J, Yang J, Liang J, Mischoulon D, Nyer M. The descriptive analysis of depressive symptoms and White Blood Cell (WBC) count between the sexual minorities and heterosexual identifying individuals in a nationally representative sample: 2005-2014. BMC Public Health 2023; 23:294. [PMID: 36759803 PMCID: PMC9909981 DOI: 10.1186/s12889-022-14847-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 12/09/2022] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Sexual minorities are at a higher risk of suffering from depressive symptoms compared with heterosexual individuals. Only a few studies have examined the conditions of having depressive symptoms within different sexual minority groups, especially people with sexual orientation uncertainty in a nationally representative sample. Furthermore, few studies have explored whether the mean white blood count (WBC) is different between people with and without depressive symptoms among different sexual minority groups in a nationally representative sample. METHODS We analyzed the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2014 with a sample of 14,090 subjects. We compared the prevalence of depressive symptoms in subpopulations stratified by sex, sexual minority status, and race. We also examined the difference in mean WBC count between depressed and non-depressed people among heterosexual individuals and different sexual minority groups. Additionally, two multivariable logistic regression models were used to explore the association between sexual minority status and depressive symptoms, treating sexual minority status as both a binary and categorical variable. RESULTS Female sex (OR: 1.96, 95% CI: 1.72-2.22) and sexual minority status (OR: 1.79, 95% CI: 1.47-2.17) were both independently associated with depressive symptoms. Within the sexual minority population, subjects who were unsure about their sexual identities had the highest odds of having depressive symptoms (OR: 2.56, 95% CI: 1.40-4.68). In the subgroup analysis considering intersectionality, black sexual minority females had the highest rate of depressive symptoms (19.4%, 95% CI: 7.72-40.98). Finally, the mean WBC count differed significantly between people with and without depressive symptoms among male heterosexual individuals, female heterosexual individuals, and female sexual minorities, but not among male sexual minorities. CONCLUSIONS Based on sex, race, and sexual minority status, black females of sexual minority status had the highest rate of depressive symptoms. Within sexual minority groups, participants who were unsure about their sexual identities had the highest odds of having depressive symptoms. Finally, the mean WBC count was significantly higher among people with depressive symptoms than those without depressive symptoms only among male heterosexuals, female heterosexuals, and female sexual minorities, but not among male sexual minorities. Future research should investigate the social and biological mechanisms of the differences.
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Affiliation(s)
- Junjie Lu
- grid.38142.3c000000041936754XDepartment of Social and Behavior Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Jiarui Yang
- grid.38142.3c000000041936754XDepartment of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Jingyang Liang
- grid.265219.b0000 0001 2217 8588Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
| | - David Mischoulon
- grid.38142.3c000000041936754XDepression Clinical & Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Maren Nyer
- Depression Clinical & Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
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Chambers LC, Morgan JL, Lowens MS, Robinson TS, Romano SS, Leipertz GL, Glick SN, Khosropour CM, Hughes JP, Golden MR, Fredricks DN, Manhart LE. The Incidence Rate of Sexual Behaviors Among Cisgender Men Who Have Sex with Men Attending a Sexual Health Clinic. Arch Sex Behav 2023; 52:751-759. [PMID: 35930134 PMCID: PMC9892175 DOI: 10.1007/s10508-022-02370-z] [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] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/27/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
Although nuanced parameterization of sexual behavior may improve estimates from mathematical models of human immunodeficiency virus and sexually transmitted infection transmission, prospective estimates of the incidence of specific sexual behaviors among men who have sex with men (MSM) are limited. From December 2014 to July 2018, MSM with and without nongonococcal urethritis (NGU) completed weekly diaries over 3-12 weeks. Incidence rates of any sex, receptive anal sex, insertive anal sex, insertive oral sex, receptive rimming, and receptive hand-penile contact were 1.19, 0.28, 0.66, 0.90, 0.24, and 0.85 episodes per person-week, respectively, among 104 MSM with NGU at baseline, and 1.33, 0.54, 0.32, 0.95, 0.44, and 0.88 episodes per person-week, respectively, among 25 MSM without NGU at baseline. Most receptive anal sex (NGU + 83%, NGU - 86%) and insertive anal sex (NGU + 85%, NGU - 76%) episodes were condomless. MSM engaged in sex just over once per week, and condom use was infrequent. Insertive oral sex and receptive hand-penile contact were the most common behaviors.
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Affiliation(s)
- Laura C Chambers
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA.
| | - Jennifer L Morgan
- HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, USA
| | - M Sylvan Lowens
- HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, USA
| | - Tashina S Robinson
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
| | - Sarah S Romano
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
| | - Gina L Leipertz
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
| | - Sara N Glick
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
- HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Christine M Khosropour
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
| | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Matthew R Golden
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
- HIV/STD Program, Public Health-Seattle and King County, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - David N Fredricks
- Department of Medicine, University of Washington, Seattle, WA, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Microbiology, University of Washington, Seattle, WA, USA
| | - Lisa E Manhart
- Department of Epidemiology, University of Washington, UW Box #351619, Seattle, WA, 98195, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
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