RESUMEN
BACKGROUND: In Brazil, ~35% of people living with HIV (PLHIV) have poor adherence to antiretroviral therapy (ART). HIV-related stigma is associated with worst continuum of care outcomes, however evidence from Brazil is scarce. We explored pathways between HIV-related stigma dimensions and ART adherence among Brazilian cisgender gay, bisexual and other men who have sex with men (MSM) living with HIV. METHODS: A sample of MSM ≥18 years was recruited online between February/March 2020 through advertisements on Hornet, a location-based dating app. Validated scales were used to assess ART adherence and HIV-related stigma. Indirect and direct pathways between HIV-related stigma dimensions and ART adherence were estimated using structural equation models while considering socio-demographic and substance use related variables. Models were estimated using mean- and variance-adjusted weighted least squares, and goodness of fit indices were calculated. FINDINGS: Among 1,719 MSM living with HIV who reported starting ART, 70% were adherent. There was evidence of indirect effects of concerns about public attitudes (standardized coefficient (SC) = -0.095, 95% confidence interval (95%CI) = -0.172 - -0.017) and personalized HIV-stigma (SC = -0.022, 95%CI = -0.043 - -0.001) on ART adherence mediated through negative self-image. Personalized HIV stigma and concerns about public attitudes were both positively associated with negative self-image (SC = 0.129, 95%CI = 0.066-0.193; SC = 0.549, 95%CI = 0.494-0.603), and concerns about public attitudes was associated with HIV disclosure concerns (SC = 0.522, 95%CI = 0.463-0.581). However, the direct paths from personalized HIV stigma and concerns about public attitudes to ART adherence were not significant. INTERPRETATION: Our research underscores the critical need for multifaceted interventions to eliminate HIV-related stigma at both individual and societal levels. At the individual level, psychotherapeutic interventions to improve self-image might helpful. Additionally, public policy should aim to dismantle structural stigma with awareness campaigns on various media channels, integration of anti-stigma curriculum into schools, and training for professionals.
Asunto(s)
Infecciones por VIH , Homosexualidad Masculina , Cumplimiento de la Medicación , Estigma Social , Humanos , Masculino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Brasil , Adulto , Homosexualidad Masculina/psicología , Cumplimiento de la Medicación/psicología , Minorías Sexuales y de Género/psicología , Persona de Mediana Edad , Adulto Joven , Fármacos Anti-VIH/uso terapéutico , Adolescente , Bisexualidad/psicologíaRESUMEN
This study aimed to analyze the association between internalized homophobia and its domains and depression in homosexual and bisexual individuals and to quantify its results in depression. This is a cross-sectional online and anonymous study based on the LGBT+ health study conducted in Brazil from August to November, 2020, summing 926 respondents. Depression was self-reported. Internalized Homophobia was measured by the Brazilian Internalized Homophobia Scale for Gays and Lesbians, using 80% percentile to classify elevated total and by domain scores. Statistical analysis was based on Poisson Regression models with robust variance. Depression prevalence was 23.7%. The results revealed that internalized homophobia was positively associated with depression only among homosexuals (Prevalence Ratio (RP) = 1.80; 95% confidence interval (95%CI) 1.12-2.90). We found no statistical association for stigma and oppression domains. Population attributable fraction of depression was 2.3% (95%CI 0.1-4.5) in relation to internalized homophobia. Our findings highlight the need of controlling internalized homophobia to decrease the prevalence of depression among homosexuals.
Objetivou-se analisar a associação entre homofobia internalizada e seus domínios e a depressão em indivíduos homossexuais e bissexuais e quantificar o resultado da sua diminuição na depressão. Trata-se de um estudo transversal baseado em dados do inquérito de saúde LGBT+, realizado no Brasil entre agosto e novembro de 2020, de forma on-line e anônima, totalizado 926 participantes. A depressão foi avaliada por autorrelato. A homofobia internalizada foi medida pela Escala de Homofobia Internalizada para Gays e Lésbicas Brasileiros, adotando-se como escores elevados total e por domínio os percentis de 80%. A análise estatística baseou-se na regressão de Poisson com variância robusta. A prevalência de depressão foi de 23,7%. Os resultados mostraram que a homofobia internalizada associou-se positivamente à depressão apenas entre os homossexuais (Razão de Prevalência (RP) = 1,80; intervalo de confiança de 95% (IC95%) 1,12-2,90). Não houve associação com os domínios isolados de estigma e opressão. A fração atribuível populacional de depressão foi de 2,3% (IC95% 0,1-4,5) em relação à homofobia internalizada. Esses achados destacam a importância do combate à homofobia que é internalizada para a diminuição da depressão em indivíduos homossexuais.
Asunto(s)
Bisexualidad , Depresión , Encuestas Epidemiológicas , Homofobia , Homosexualidad Femenina , Homosexualidad Masculina , Minorías Sexuales y de Género , Estigma Social , Humanos , Homofobia/psicología , Homofobia/estadística & datos numéricos , Estudios Transversales , Masculino , Adulto , Brasil/epidemiología , Femenino , Depresión/epidemiología , Adulto Joven , Homosexualidad Masculina/psicología , Homosexualidad Masculina/estadística & datos numéricos , Bisexualidad/psicología , Bisexualidad/estadística & datos numéricos , Prevalencia , Homosexualidad Femenina/psicología , Homosexualidad Femenina/estadística & datos numéricos , Persona de Mediana Edad , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Adolescente , AutoinformeRESUMEN
OBJECTIVES: Some studies suggest that homosexual identity, compared to heterosexual, may be associated with a reduced risk of premature ejaculation (PE). The aim of this study was to test this relationship and to investigate possible underlaying mechanisms. METHODS: The present study drew on a database obtained from a cross-sectional online study of the sexuality of Polish heterosexual (HM; N = 1,121), gay (GM; N = 1,789) and bisexual (BM; N = 743) men. The dependent variable was the PE diagnosis based on the PEDT questionnaire. The explanatory variables were characteristics of sexual and partnership patterns, health and minority stress among GM and BM. Statistical one- and multifactor analyses were performed. RESULTS: Homosexual identity proved to be an independent negative predictor of PE diagnosis. The preference for insertive penetration activity (including vaginal), performance anxiety and financial difficulties increased the risk of PE, while the experience of insertive and receptive forms of oral and anal sex but not vaginal sex, a higher level of education, better general sexual functioning and regular physical activity reduced such risk. The predictive meaning of homosexual identity has not been present in multifactor models for group of men in relationships. CONCLUSIONS: Homosexual identity is associated with a lower risk of PE diagnosis. This may be due to the differences in sexualities of GM and HM, as well as other psychosocial factors.
Asunto(s)
Eyaculación Prematura , Humanos , Masculino , Eyaculación Prematura/psicología , Eyaculación Prematura/epidemiología , Adulto , Estudios Transversales , Polonia , Homosexualidad Masculina/psicología , Homosexualidad Masculina/estadística & datos numéricos , Conducta Sexual/psicología , Conducta Sexual/estadística & datos numéricos , Adulto Joven , Parejas Sexuales/psicología , Persona de Mediana Edad , Encuestas y Cuestionarios , Factores de Riesgo , Heterosexualidad/psicología , Heterosexualidad/estadística & datos numéricos , Bisexualidad/psicología , Bisexualidad/estadística & datos numéricosRESUMEN
Bisexuality in fatherhood is largely invisible, with very little known about the experiences of bisexual fathers. Conducted by researchers in the United Kingdom, this study is one of the first to explore the experiences of bisexual fathers, and, using an identify-focused approach, it aims to understand bisexual fathers' experiences of managing their bisexuality and role as a father. Twenty-four bisexual fathers in Europe and North America took part in qualitative, semistructured interviews that focused on their bisexual identity, becoming a parent, experiences of family life, and community involvement. Reflexive thematic analysis was conducted, and four themes were identified: valuing different types of authenticity, seeking safety in the community, reconciling bisexuality with the traditional family, and sharing and learning across age groups. Despite describing their identity as often invisible, fathers indicated that their personal identity had a significant impact on their social interactions as well as their individual parenting and family practices. Findings contrast stage models of LGBTQ+ identity development, as fathers' identity work practices were often more important for their identity development and integration than aspiring for full "outness." Findings expand our scholarly understanding of the role of identity in parenting and highlight the need to improve representation and support for bisexual fathers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Asunto(s)
Bisexualidad , Padre , Responsabilidad Parental , Humanos , Masculino , Padre/psicología , Adulto , Bisexualidad/psicología , Persona de Mediana Edad , Responsabilidad Parental/psicología , Investigación Cualitativa , Identificación Social , Europa (Continente) , Adulto Joven , Minorías Sexuales y de Género/psicología , América del NorteRESUMEN
Despite significant progress in Ghana's HIV response, disparities in HIV prevalence persist among different populations. Gays, bisexuals, and other men who have sex with men (GBMSM) in the country remain vulnerable to HIV infection due to high levels of stigma and discrimination, limited access to healthcare services, and low HIV knowledge levels. While limited studies focus on HIV prevention and care in the Ghanaian GBMSM context, we did not find studies on GBMSM in slums. We, therefore, explored stigma and motivations of HIV testing among GBMSM in slums. In collaboration with our community partners, we recruited and conducted face-to-face interviews among 12 GBMSM from slums in Accra and Kumasi, Ghana. Our multiple-reviewer summative content analysis identified the following: under HIV stigma, we identified two categories, avoidance of GBMSM living with HIV and fear of testing positive for HIV. Under motivations for HIV testing, we identified three categories; HIV vulnerability, knowing one's HIV status, and positive messaging about HIV. Our findings provide valuable insights into stigma and motivations for HIV testing among GBMSM in Ghanaian slums. They also highlight the importance of targeted HIV education interventions to empower GBMSM to take responsibility for their sexual health and address the unique challenges they face accessing HIV testing services.
Asunto(s)
Infecciones por VIH , Prueba de VIH , Homosexualidad Masculina , Motivación , Áreas de Pobreza , Estigma Social , Humanos , Masculino , Ghana/epidemiología , Infecciones por VIH/psicología , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Adulto , Homosexualidad Masculina/psicología , Minorías Sexuales y de Género/psicología , Adulto Joven , Persona de Mediana Edad , Bisexualidad/psicologíaRESUMEN
BACKGROUND: Mental health disparities have been documented among lesbian, gay, and bisexual (LGB) adults in the United States. Substance use disorders and suicidal ideation have been identified as important health concerns for this population. However, the interrelationships among these factors are not well understood. OBJECTIVE: This study aims to investigate the interrelationships among mental health, substance use disorders, and suicidal ideation among LGB adults in the United States using a population-based statewide survey. METHODS: Our study was an observational cross-sectional analysis, and the data for this study were collected from a sample of LGB adults who participated in the statewide survey. The survey collected information on mental health, substance use disorders, and suicidal ideation using validated measures. Descriptive statistics and inferential data analysis were conducted to explore the interrelationships among these factors. RESULTS: The results showed that LGB adults who reported higher levels of depression and drug abuse and dependence also reported higher levels of suicidal tendency and mental illness. Inferential data analysis using χ2 tests revealed significant differences in depression score (χ22=458.241; P<.001), drug abuse and dependence score (χ22=226.946; P<.001), suicidal tendency score (χ22=67.795; P<.001), and mental illness score (χ22=363.722; P<.001) among the 3 sexual identity groups. Inferential data analysis showed significant associations between sexual identity and mental health outcomes, with bisexual individuals reporting the highest levels of depression, drug abuse and dependence, suicidal tendency, and mental illness. CONCLUSIONS: This study provides important insights into the interrelationships among mental health, substance use disorders, and suicidal ideation among LGB adults in the United States. The findings underscore the need for targeted interventions and research aimed at addressing the mental health needs of sexual minority populations. Future research should aim to better understand the underlying mechanisms driving these disparities and develop culturally sensitive and tailored interventions that meet the unique needs of LGB individuals. Reducing stigma and discrimination against sexual minority populations is also crucial to improving their mental health outcomes.
Asunto(s)
Minorías Sexuales y de Género , Trastornos Relacionados con Sustancias , Ideación Suicida , Humanos , Adulto , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Masculino , Estudios Transversales , Femenino , Estados Unidos/epidemiología , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Persona de Mediana Edad , Adulto Joven , Adolescente , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Encuestas y Cuestionarios , Salud Mental/estadística & datos numéricos , Bisexualidad/psicología , Bisexualidad/estadística & datos numéricos , AncianoRESUMEN
Using baseline data of the Engage Cohort Study, a Canadian study of sexually active gay, bisexual and other men who have sex with men (GBM), we evaluated the association between sexual behavior and risk perception among HIV-negative participants and whether HIV treatment optimism moderated this relationship. Participants were recruited by respondent-driven-sampling (RDS). We defined high-risk sexual behavior in the past six months as any condomless anal sex with a casual partner (i.e. not the participant's main partner) with either unknown HIV-status where neither used pre-exposure prophylaxis or with a partner living with HIV having detectable/unknown viral load. We assessed HIV treatment optimism-skepticism using a 12-item scale. RDS-II-weighted adjusted logistic regression models examined associations with risk perception measured by the question "How would you assess your current risk of getting HIV?" (response options were on a 6-point Likert-scale ranging from "very unlikely" to "very likely", dichotomized into "No Perceived Risk" (very unlikely/unlikely) and "Perceived Risk" (somewhat likely/likely/very likely/I think I already have HIV). Of 1961 participants, engagement in high-risk sexual behavior was reported by 155 (17.0%), 62 (12.4%), 128 (17.2%) of participants in Montréal, Toronto, and Vancouver, respectively. High-risk sexual behavior increased the odds of perceived HIV risk (pooled adjusted odds ratio = 2.9, 95%CI = 2.2-3.8). HIV treatment optimism-skepticism scores moderated the relationship: for GBM engaging in high-risk sexual behavior, higher HIV treatment optimism-skepticism scores increased perceived HIV risk. Promoting awareness around advances related to HIV prevention and treatment is important for appropriate risk assessment and for increased engagement in prevention interventions.
RESUMEN: Evaluamos la asociación entre el comportamiento sexual y la percepción de riesgo entre los participantes VIH negativos y si el optimismo sobre el tratamiento del VIH moderó esta asociación. Definimos comportamiento sexual de alto riesgo en los últimos seis meses como cualquier sexo anal sin condón con una pareja casual con un estado de VIH desconocido donde ninguno utilizó profilaxis previa a la exposición o con una pareja que vive con el VIH y que tiene una carga viral detectable/desconocida. Se evaluó el optimismo sobre el tratamiento del VIH mediante una escala de 12 ítems. Los modelos de regresión logística ajustados examinaron las asociaciones con la percepción del riesgo ("Riesgo no percibido" vs. "Riesgo percibido"). De 1961 participantes, 155 (17,0%), 62 (12,4%), 128 (17,2%) de los participantes en Montreal, Toronto y Vancouver, informaron comportamiento sexual de alto riesgo. El comportamiento sexual de alto riesgo se mostró asociado con riesgo percibido. El optimismo sobre el tratamiento modero la asociación. Promover la conciencia sobre los avances relacionados con la prevención y el tratamiento del VIH es importante para una evaluación adecuada de los riesgos y una mayor participación en las intervenciones de prevención.
Asunto(s)
Infecciones por VIH , Homosexualidad Masculina , Optimismo , Asunción de Riesgos , Parejas Sexuales , Minorías Sexuales y de Género , Humanos , Masculino , Infecciones por VIH/psicología , Infecciones por VIH/tratamiento farmacológico , Adulto , Homosexualidad Masculina/psicología , Homosexualidad Masculina/estadística & datos numéricos , Canadá/epidemiología , Parejas Sexuales/psicología , Persona de Mediana Edad , Optimismo/psicología , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Sexo Inseguro/psicología , Sexo Inseguro/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Conducta Sexual/psicología , Bisexualidad/psicología , Población Urbana , Percepción , Adulto Joven , Estudios de CohortesRESUMEN
Homosexual (lesbian or gay) and bisexual (i.e., LGB) people tend to suffer from social exclusion and thus distress. To prevent or relieve distress, the people's assertiveness about justice and rights is an advocated means, but its effectiveness is uncertain, considering possible conflict with social exclusion. To clarify the effectiveness, this study analyzed data collected from 189 Chinese LGB adults in Hong Kong, which is a special administrative region of China generally Westernized and liberal to sexual orientation. Controlling for prior distress reported, the analysis showed that distress was lower when assertiveness was higher or social exclusion experienced was lower. However, distress was higher when both assertiveness and social exclusion experienced were higher. The higher distress implies a conflict between assertiveness and social exclusion to raise distress. It also implies the need to avoid conflict when promoting assertiveness and eliminating social exclusion to prevent distress in LGB people.
Asunto(s)
Asertividad , Humanos , Masculino , Adulto , Femenino , Hong Kong , Persona de Mediana Edad , Adulto Joven , Minorías Sexuales y de Género/psicología , Bisexualidad/psicología , Estrés Psicológico/psicologíaRESUMEN
Muscle Dysmorphia (MD) and its psychological impacts on women, especially within sexual minorities, are still relatively understudied. The objective of this study was to compare the relationship of MD symptoms and psychological distress between heterosexual women and lesbian/bisexual women. Our sample consisted of 479 Brazilian cisgender women from the community, aged between 18 and 70 years (M = 32.78; SD = 10.45). Among them, 327 (68.27 %) identified as heterosexual, 134 (27.98 %) as bisexual, and 18 (3.76 %) as lesbian. To ensure there was no bias due to measurement error, the psychometric properties of the instruments in the sample were tested, and invariance between the groups was assessed. t-tests, structural equation modeling, and latent profile analyses were conducted to comprehend the differences between the groups. The results indicated significant differences and a greater severity of MD symptoms and distress for lesbian/bisexual women. The implications of these results are discussed, emphasizing the need for further exploration of MD studies within sexual minorities.
Asunto(s)
Heterosexualidad , Homosexualidad Femenina , Distrés Psicológico , Humanos , Femenino , Adulto , Heterosexualidad/psicología , Persona de Mediana Edad , Adulto Joven , Adolescente , Homosexualidad Femenina/psicología , Anciano , Minorías Sexuales y de Género/psicología , Trastorno Dismórfico Corporal/psicología , Brasil , Bisexualidad/psicología , Imagen Corporal/psicología , Psicometría/instrumentación , Encuestas y CuestionariosRESUMEN
Suicide in young people is a challenge, but suicide rates in lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ) youth are alarming. The current article explores the influence of several social determinates of health, specifically mental health care access and quality and education, on suicide among LGBTQ youth. Providers must recognize the mental health challenges and disparities in LGBTQ youth and address them to improve mental health and decrease suicide rates. [Journal of Psychosocial Nursing and Mental Health Services, 62(4), 6-8.].
Asunto(s)
Homosexualidad Femenina , Minorías Sexuales y de Género , Personas Transgénero , Femenino , Humanos , Adolescente , Prevención del Suicidio , Bisexualidad/psicología , Conducta Sexual , Personas Transgénero/psicologíaRESUMEN
The bond with healthcare services is a crucial dimension in facilitating the maternal journey of lesbian and bisexual women couples. This study aimed to analyze the culturally constructed meanings regarding the bond with healthcare services and professionals by lesbian and bisexual women who experienced dual motherhood. It is a qualitative investigation grounded in interpretative anthropology. The research corpus was built based on in-depth interviews with 10 lesbian and bisexual women, aged 30 to 39 years. The results indicate that access to parenthood, until its realization, involved a journey permeated by satisfactions and sufferings triggered by failed attempts and gestational losses. Challenges experienced in healthcare provision were also reported due to prejudices, lack of empathy, and unpreparedness of professionals in dealing with prenatal care for lesbian and bisexual women couples. Manifestations of discrimination were more pronounced concerning non-gestational mothers. The findings offer insights into implementing policies that prioritize humanization and planning programs and healthcare services based on culturally sensitive care for lesbian and bisexual women couples as they transition into dual motherhood.
O vínculo com os serviços de saúde é uma dimensão crucial para viabilizar o projeto materno de casais de mulheres lésbicas e bissexuais. Este estudo teve como objetivo analisar os significados culturalmente construídos sobre o vínculo com os serviços e profissionais de saúde por mulheres lésbicas e bissexuais que vivenciaram a dupla maternidade. Investigação qualitativa fundamentada na antropologia interpretativa. O corpus de pesquisa foi construído com base em entrevista em profundidade com 10 mulheres de 30 a 39 anos. Os resultados mostram que o acesso à parentalidade implicou um itinerário permeado por satisfações e sofrimentos devido a tentativas frustradas e perdas gestacionais. Também foram relatados percalços vivenciados na produção do cuidado em saúde devido a preconceitos, falta de empatia e despreparo de profissionais para lidarem com acompanhamento de pré-natal aos casais de mulheres lésbicas/bissexuais. As manifestações de discriminação foram mais contundentes em relação às mães não gestantes. Os resultados oferecem subsídios para implementação de políticas de humanização e planejamento de programas e serviços de saúde baseados em cuidados culturalmente sensíveis à diversidade para casais de mulheres lésbicas/bissexuais que vivenciam a transição para a maternidade.
Asunto(s)
Homosexualidad Femenina , Entrevistas como Asunto , Minorías Sexuales y de Género , Humanos , Femenino , Adulto , Homosexualidad Femenina/psicología , Minorías Sexuales y de Género/psicología , Embarazo , Atención Prenatal , Madres/psicología , Bisexualidad/psicología , Atención a la Salud/organización & administración , Prejuicio , Empatía , Investigación Cualitativa , Accesibilidad a los Servicios de SaludRESUMEN
The literature unequivocally demonstrates that lesbian, gay, and bisexual (LGB) individuals experience disproportionate mental health and social wellbeing impacts. Here, we respond to recent calls for research in the field of sexual minority health to better understand why various overlapping and intersecting identities can further drive health disparities. In this paper, we focus on the specific intersections of ethnicity and sexuality for Asian LGB individuals and the role of internalized stigma in driving poorer mental health outcomes for this group. We recruited 148 LGB Asian participants residing in the United States (Mage = 22.82 years, SD = 4.88) to participate in our online cross-sectional survey in which we collected data on their internalized stigma, levels of guilt and shame about their sexuality, and measures of depression, anxiety, and distress. Contrary to our predictions, there were no bivariate relationships between internalized sexual stigma and any of the mental health outcomes. However, a parallel mediation analysis revealed that guilt, but not shame, mediates the relationship between internalized sexual stigma and all mental health outcomes (depression, anxiety, and stress) for LGB Asian American individuals. This research highlights the important of exploring additional variables that may exacerbate of protect against poor mental health for individuals with multiple intersecting identities.
Asunto(s)
Asiático , Culpa , Salud Mental , Minorías Sexuales y de Género , Vergüenza , Estigma Social , Humanos , Femenino , Masculino , Adulto , Adulto Joven , Asiático/psicología , Minorías Sexuales y de Género/psicología , Estudios Transversales , Estados Unidos , Adolescente , Bisexualidad/psicología , Homosexualidad Masculina/psicología , Homosexualidad Masculina/etnología , Depresión/psicología , Depresión/etnologíaRESUMEN
OBJECTIVE: This study investigates Japanese gay and bisexual men's experiences of seeking help for emotional support from others regarding their sexual orientation concerns. It examines the relationship between their help-seeking and presence of gay and bisexual peers, duration between questioning their sexual orientation and accepting it, and experience of coming out to family members by multiple logistic regression analysis. RESULTS: We conducted a cross-sectional survey using a self-reported paper questionnaire. There were 360 valid responses. Eighty-two respondents (22.8%) had experience of help-seeking for emotional support, and this was associated with age, occupation, presence of gay/bisexual friends, and experience of coming out to family members about their sexual orientation. Respondents sought the most help from their male friends (70.0%), followed by female friends (25.0%), mothers (17.5%), and the Internet (16.3%). Even after controlling for age and occupation, experience of help-seeking for emotional support was higher among participants who had gay/bisexual friends when they were aware of their sexual orientation, took < 1 year from questioning to realizing their sexual orientation, and had come out to their family about their sexual orientation.
Asunto(s)
Conducta de Búsqueda de Ayuda , Minorías Sexuales y de Género , Adulto , Humanos , Masculino , Adulto Joven , Bisexualidad/psicología , Estudios Transversales , Pueblos del Este de Asia , Amigos/psicología , Homosexualidad Masculina/psicología , Japón , Minorías Sexuales y de Género/psicología , Apoyo Social , Encuestas y CuestionariosRESUMEN
This study examined the relationship between exposure to community violence and HIV care engagement among 107 Black gay or bisexual men living with HIV in Chicago. Measures assessed the importance of demographic covariates (age, annual income, health insurance status, and years living with HIV), community violence exposures, mental health, social support, in explaining variations in missed doses of antiretroviral therapy (ART) medication and missed HIV care appointments. Results showed that participants who reported higher rates of exposure to community violence were two times more likely to have missed ART doses and HIV care appointments. Participants who reported depression scores were two times more likely to have greater non-ART adherence. Finally, older participants were more likely to report fewer missed ART doses. More research is needed to clarify the mechanisms between age or depression and ART adherence given community violence exposure. Health care providers should screen for depression when attempting to promote better ART adherence and keeping HIV care appointments for Black gay and bisexual men living with HIV. Younger Black gay and bisexual men living with HIV may be more vulnerable than older men for missed ART doses and may require additional screening and follow-up.
Asunto(s)
Bisexualidad , Negro o Afroamericano , Infecciones por VIH , Homosexualidad Masculina , Cumplimiento de la Medicación , Humanos , Masculino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Adulto , Chicago/epidemiología , Negro o Afroamericano/psicología , Negro o Afroamericano/estadística & datos numéricos , Homosexualidad Masculina/psicología , Homosexualidad Masculina/estadística & datos numéricos , Persona de Mediana Edad , Cumplimiento de la Medicación/psicología , Cumplimiento de la Medicación/estadística & datos numéricos , Bisexualidad/psicología , Bisexualidad/estadística & datos numéricos , Depresión/epidemiología , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Apoyo Social , Violencia/estadística & datos numéricos , Violencia/psicología , Fármacos Anti-VIH/uso terapéuticoRESUMEN
Older gay and bisexual men constitute diverse, sizable, and potentially vulnerable populations. They have and continue to face discrimination and stigma in multiple settings, including health care. Older gay and bisexual men report worse health, higher rates of alcohol and tobacco use, and higher HIV rates compared with their heterosexual counterparts. They have unique needs and experiences in multiple realms of health care including mental health, sexual health, and cancer screenings. Geriatric medicine physicians and providers can educate themselves on these unique needs and risks and take steps to provide inclusive, affirming care.
Asunto(s)
Homosexualidad Masculina , Minorías Sexuales y de Género , Masculino , Humanos , Anciano , Homosexualidad Masculina/psicología , Conducta Sexual/psicología , Bisexualidad/psicología , Salud MentalRESUMEN
Background: Bisexual women, compared to heterosexual women, report greater amounts of alcohol use and heavy drinking. Alcohol expectancies (i.e., beliefs about alcohol outcomes) are a strong predictor of alcohol use, but few studies have examined the importance of alcohol expectancies in relation to alcohol use among bisexual women specifically or in comparison to heterosexual women. Objectives: The current study examined 262 heterosexual and 225 bisexual women using an online survey about alcohol use, sexual risk-taking, and alcohol expectancy subtypes (sexuality, tension reduction, and aggression). Results: Compared to heterosexual women, bisexual women reported greater sexuality and tension reduction expectancies after accounting for their level of drinking, but groups did not differ on aggression expectancies. Moreover, sexual identity status moderated the associations between sexuality and tension reduction expectancies and alcohol use, respectively. Specifically, our study findings suggested that sexuality and tension reduction alcohol expectancies were more strongly tied to alcohol use among bisexual women than heterosexual women. Conclusions: Taken together, in our study, bisexual women held stronger sexuality and tension reduction expectancies, as compared to heterosexual women. Interventions targeting alcohol expectancies may be considered when tailoring intervention content for this population.
Asunto(s)
Consumo de Bebidas Alcohólicas , Bisexualidad , Heterosexualidad , Humanos , Femenino , Heterosexualidad/psicología , Consumo de Bebidas Alcohólicas/psicología , Consumo de Bebidas Alcohólicas/epidemiología , Adulto , Adulto Joven , Bisexualidad/psicología , Bisexualidad/estadística & datos numéricos , Asunción de Riesgos , Conducta Sexual/psicología , Adolescente , Agresión/psicología , Encuestas y Cuestionarios , Persona de Mediana EdadRESUMEN
Gay men who believe to sound 'gay' expect to be discriminated against because of their voices and gay-sounding men are discriminated against in the hiring process. We examined whether uttering an agency-based message decreased discrimination expectancy and enactment. In Study 1a (N = 256; gay and bisexual men) and Study 1b (N = 216; gay men), speakers uttered agentic (vs. neutral) messages. We assessed their self-perception as gay sounding, agency self-attribution and discrimination expectancy. Uttering agentic (vs. neutral) messages made the speakers self-perceive as more agentic and this decreased discrimination expectancy. Additionally, self-perception as gay sounding predicted discrimination expectancy. In Study 2 (N = 466), heterosexual participants listened to gay- and straight-sounding speakers uttering either neutral or agentic messages and rated them in terms of agency and employability. Gay-sounding speakers uttering agentic messages were less likely to be discriminated against than when uttering neutral messages. Results show the positive impact of linguistic strategies involving agentic messages to reduce discrimination expectancy and hiring biases.
Asunto(s)
Homosexualidad Masculina , Humanos , Masculino , Adulto , Femenino , Adulto Joven , Homosexualidad Masculina/psicología , Minorías Sexuales y de Género/psicología , Persona de Mediana Edad , Autoimagen , Bisexualidad/psicología , Selección de Personal , AdolescenteRESUMEN
BACKGROUND: Chemsex is the intentional combining of specific drugs with sex, primarily by gay, bisexual, and other men who have sex with men (GBMSM), to enhance intimacy, pleasure, and prolong sexual sessions. Practices vary across geographic and social settings. Participants report benefits and risks of chemsex. Studies have previously reviewed chemsex practices and harm reduction interventions separately. This review aims to examine both together by describing and understanding practices that men employ to navigate the perceived benefits and risks of chemsex. METHODS: We conducted a systematic meta-ethnographic review of published qualitative literature, screening titles, abstracts, and full texts on defined inclusion and exclusion criteria. Using reciprocal and refutational translation techniques, we analysed study participants' (first-order) and researchers' (second-order) accounts of benefit-enhancing and risk-reducing chemsex practices. Finally, we employed line-of-argument synthesis techniques to develop our own higher-level interpretations (third-order constructs) of these chemsex practices. RESULTS: Our search yielded 6356 records, from which, we included 23 articles in our review. Most studies were conducted in high-income Western countries. Across studies, participants acted at the individual, interpersonal, and community levels to enhance benefits and reduce risks, which made up our third-order constructs. Eight themes emerged from first- and second-order constructs to describe these practices, which included personal preparation, personal boundaries, biomedical measures, structured use of drugs, leaning on partners, injecting practices, group organising, watching out for others, and teaching and learning. Contextual factors like trust, agency, access, stigma, and setting moderated whether and how participants engaged in these practices, and if practices enhanced benefits or reduced risks. CONCLUSION: Health promotion programmes and research focused on chemsex must account for the benefits and the risks that GBMSM associate with this type of sexualised drug use and target the moderating factors that shape the practices they employ to navigate these benefits and risks.
Asunto(s)
Reducción del Daño , Homosexualidad Masculina , Minorías Sexuales y de Género , Humanos , Masculino , Homosexualidad Masculina/psicología , Minorías Sexuales y de Género/psicología , Antropología Cultural , Conducta Sexual , Bisexualidad/psicología , Trastornos Relacionados con Sustancias/prevención & control , Drogas IlícitasRESUMEN
Lesbian, gay, bisexual, transgender, queer, or similarly identified (LGBTQ+) people experience substantial mental health disparities compared to heterosexuals. The "Let's Connect" intervention was designed to improve mental health outcomes for LGBTQ+ people. This impact evaluation aimed to assess effectiveness of this intervention during its pilot phase, using a single arm pilot trial. Respondents completed baseline surveys at intervention start, a post survey on the last day of the intervention (at 6 weeks), then a follow-up survey 6 weeks after the intervention ended (at 12 weeks). Pre-post differences in outcomes were analyzed using paired t-tests, chi-square tests, and generalized estimating equations to evaluate impact on mental health outcomes at 6 and 12 weeks, and identify characteristics associated with loss to follow-up. The average value of all three outcome measures decreased substantially between the baseline and post surveys; all of these differences were highly statistically significant, and further decreased between the end of the intervention at 6 weeks and the 12 week follow-up survey. Let's Connect participants did experience substantial improvements in mental health outcomes, on average, between the start and end of this intervention. Further study of this intervention using a randomized design and control group is warranted.
Asunto(s)
Minorías Sexuales y de Género , Femenino , Humanos , Bisexualidad/psicología , Identidad de Género , Inequidades en Salud , Conducta Sexual , MasculinoRESUMEN
Black men face high rates of police violence, including direct victimization and indirect exposure to or knowledge of harmful policing. This violence can result in death and physical harm, as well as in numerous poor mental health outcomes. There has been little research examining experiences of police violence experienced by Black gay and bisexual men or the effects of police brutality on HIV continuum of care outcomes. To address this important gap, in this exploratory study, we examined the effects of police brutality on engagement in HIV care and adherence to antiretroviral medications. Cross-sectional survey data were collected from 107 Black gay and bisexual men living with HIV. The path analysis showed that men with greater exposure to police violence had increased symptoms of post-traumatic stress disorder and were more likely to have missed HIV care appointments in the past year. Additionally, there was a significant indirect effect of exposure to police violence on missed medication doses via PTSD symptoms.