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INTRODUCTION: The COVID-19 pandemic likely affected adolescent sexual behaviors and alcohol use, although how is not well understood. METHOD: Youth were sampled from the national, online longitudinal Growing up with Media study. They responded via text messaging to open-ended questions about how the COVID-19 pandemic may have impacted the sexual behavior and alcohol use of adolescents. Conventional content analysis summarized open-ended responses. RESULTS: 416 responses were analyzed from 335 participants (aged 15-30, US residents), 81 of whom provided data for both topics. Participants suggested that the pandemic affected some youths' sexual health precautions (increased and varying) and attitudes about sex (positive and negative). They discussed how adolescents met partners during the pandemic, including increased use of online platforms. Participants also suggested researchers investigate sexual risk in the realm of COVID-19 transmission and the practice of "safe sex." Many participants believed adolescents were drinking alcohol more as a result of the pandemic, both alone and with friends; however, others perceived adolescents were drinking less. Participants proposed researchers investigate adolescent drinking habits during the pandemic, as well as how this compares to before the pandemic and the type and quantity of alcohol consumed. CONCLUSIONS: Young people believe adolescent sexual relationships and drinking behaviors changed due to the pandemic, though how varied. Future research could examine the contexts and individual differences that shape these varying behaviors. Overall, this study highlights the importance of directly asking youth about their pandemic experiences and the diversity of views on how the pandemic has influenced adolescent behavior.
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Conducta del Adolescente , COVID-19 , SARS-CoV-2 , Conducta Sexual , Humanos , COVID-19/psicología , COVID-19/epidemiología , COVID-19/prevención & control , Adolescente , Femenino , Masculino , Conducta Sexual/psicología , Conducta del Adolescente/psicología , Adulto Joven , Adulto , Estudios Longitudinales , Consumo de Bebidas Alcohólicas/psicología , Consumo de Bebidas Alcohólicas/epidemiología , Estados Unidos/epidemiología , Consumo de Alcohol en Menores/psicología , Consumo de Alcohol en Menores/estadística & datos numéricos , PandemiasRESUMEN
Long-acting injectable pre-exposure prophylaxis for HIV prevention (LAI-PrEP) was approved for use in the United States in 2021, yet little is known about perceptions of LAI-PrEP among transgender and nonbinary young adults, a group that faces substantial barriers to HIV prevention. We investigated US transgender and nonbinary young adults' perceptions of and attitudes toward LAI-PrEP and how perceived advantages and disadvantages of LAI-PrEP related to the PrEP continuum of care. We conducted semi-structured interviews with 31 transgender and nonbinary young adults who reported oral PrEP use or were PrEP-eligible. We analyzed responses using both a deductive RADaR approach, to identify LAI-PrEP perceptions relevant to the PrEP continuum of care, and an inductive thematic analysis to explore key themes. In this study, all PrEP-experienced and most PrEP-naïve participants indicated an interest in LAI-PrEP, citing advantages over daily oral medication (e.g., fewer adherence challenges). Three key themes emerged: (1) Some participants linked perceived advantages of LAI-PrEP to experiences with gender-affirming care (e.g., familiarity with needles via hormone use). (2) Participants weighed trade-offs and contextual factors that influenced their LAI-PrEP preferences (e.g., interest contingent on whether location for receiving injection was geographically accessible). (3) Participants envisaged alternative delivery methods that could enhance LAI-PrEP acceptability and uptake (e.g., home injection). HIV prevention programs should incorporate the insights of transgender and nonbinary young adults to ensure that emerging HIV prevention technologies are accessible and responsive to the needs and concerns of people of all gender modalities.
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OBJECTIVES: To examine fluidity in sexual orientation identity and behavior among cisgender youth. STUDY DESIGN: Data were analyzed from 5 survey waves of the longitudinal US Growing Up with Media Study (2010-2019). Participants were 989 cisgender youth, aged 13-20 years at baseline, who completed online surveys assessing sexual orientation identity and behavior (gender of sexual partners). Amount of change (mobility) and patterns of change across waves were assessed for identity and behavior. RESULTS: Consistently heterosexual was the most common sexual orientation identity (89%-97% for boys, 80%-90% for girls), followed by gay (3%) for boys, and bisexual (8%) for girls. Sexual minority identities increased (3%-11% for boys, 10%-20% for girls) over time, same-gender sexual behavior also increased. Girls had more identity mobility than boys; no gender difference was found for behavior mobility. Movement from heterosexual to a sexual minority identity occurred for 9% of girls and 6% of boys; movement from different-gender sexual behavior to same-gender sexual behavior occurred for 2% of girls and boys. CONCLUSIONS: Findings highlight the need to assess multiple dimensions and patterns of change of youth sexual orientation in research and clinical care. Recognizing and creating space for conversations about changes in sexual identity and behavior over time will help providers accurately and effectively address the health needs of all patients.
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Conducta Sexual , Minorías Sexuales y de Género , Humanos , Masculino , Adolescente , Femenino , Heterosexualidad , Parejas Sexuales , Identidad de GéneroRESUMEN
Objectives. To assess changes in minor consent laws for sexually transmitted infection (STI) and HIV testing, treatment, and prevention services in all 50 US states and the District of Columbia from 1900 to 2021. Methods. We coded laws into minor consent for (1) health care generally; (2) STI testing, treatment, and prevention; (3) HIV testing, treatment, and prevention; and (4) pre- or postexposure prophylaxis for HIV prevention. We also coded confidentiality protections and required conditions (e.g., threshold clinician judgments). Results. The largest increase in states allowing minors to consent to STI services occurred during the 1960s and 1970s. By 2021, minors could consent independently to STI and HIV testing and treatment in all 50 states plus DC, STI prevention services in 32 jurisdictions, and HIV prevention services in 33 jurisdictions. Confidentiality protections for minors are rare. Prerequisites are common. Conclusions. Although the number of states allowing minors to consent independently to STI and HIV services has increased considerably, these laws have substantial limitations, including high complexity, prerequisites requiring clinician judgments, and neglect of confidentiality concerns. (Am J Public Health. 2023;113(4):397-407. https://doi.org/10.2105/AJPH.2022.307199).
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Infecciones por VIH , Enfermedades de Transmisión Sexual , Humanos , Estados Unidos , Infecciones por VIH/prevención & control , VIH , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/prevención & control , Consentimiento Paterno , District of ColumbiaRESUMEN
Recent research indicates that some young people initially learn about sexual choking through Internet memes. Thus, a qualitative content analysis was performed on 316 visual and textual memes collected from various social media websites and online searches to assess salient categories related to choking during sex. We identified nine main categories: communication, gendered dynamics, choking as dangerous, choking as sexy, sexualization of the nonsexual, shame and worry, romance/rough sex juxtaposition, choking and religious references, instructional/informational. Given that memes, through their humor, can make difficult topics more palatable and minimize potential harm in the phenomenon they depict, more concerted, synergistic effort that integrates media literacy into sexuality education programming on the potential risks that may ensue for those engaging in sexual choking is warranted.
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Obstrucción de las Vías Aéreas , Medios de Comunicación Sociales , Adolescente , Humanos , Asfixia , Coito , Conducta Sexual , Masculino , FemeninoRESUMEN
INTRODUCTION: Knowledge about sexual health is a key determinant of sexual behavior among adolescent sexual minority males (ASMM). No measures exist to assess anal sex knowledge, even though anal sex is the primary route by which ASMM acquire sexually transmitted infections (STIs), including a disproportionate burden of human immunodeficiency virus (HIV). AIM: We developed a new measure as a first step toward assessing the prevalence and correlates of anal sex knowledge and potential effects of interventions to improve knowledge. METHODS: Two coders independently outlined domains of knowledge within 2 sex education videos designed to address anal sex knowledge among ASMM. An initial set of 56 items, some duplicative, encompassed all domains. A larger team, including a psychometrician, then iteratively revised and reduced the set of items, and assessed construct validity via cognitive testing among ASMM (N = 4, aged 16-17 years old, 75% identifying as racial/ethnic minorities). For the final set of 10 items, factor structure and convergent and divergent validity were assessed using baseline responses to an online survey within a randomized controlled pilot trial among 154 ASMM. Open-ended questions assessed their comprehension and the acceptability of items. OUTCOMES: We examined correlates that we anticipated would be theoretically related (ie, the HIV Knowledge Questionnaire [HIV-KQ-18] and the STD-Knowledge Questionnaire [STD-KQ]) and theoretically distinct (ie, the Patient Health Questionnaire [PHQ-2], Generalized Anxiety Disorder scale [GAD-2], and employment status). RESULTS: The one-factor model explained 42% of the items' common variance and demonstrated acceptable internal reliability (Cronbach's alpha = 0.72). The measure withstood tests of convergent and divergent validity when compared to current measures (HIV knowledge, r = 0.35 and STI knowledge, r = 0.24, both P < .05; internalizing mental health symptoms, r = -0.07 and employment status, r = 0.13, both P > .05). Few respondents found words unfamiliar or uncomfortable. CLINICAL IMPLICATIONS: A method for assessing anal sex knowledge may offer opportunities to intervene to lessen harmful sequelae of a lack of knowledge. STRENGTH & LIMITATIONS: We developed a brief, psychometrically valid measure of anal sex knowledge. The measure may neither generalize to all anal health knowledge nor to more sexually experienced, older SMM. CONCLUSION: The resulting 10-item, single-factor measure, the Inventory of Anal Sex Knowledge (iASK), is psychometrically sound and addresses the lack of anal sex knowledge measures among ASMM. The iASK can function to assess the prevalence and sequelae of anal sex knowledge among ASMM as well as the impact of interventions targeting anal sex knowledge. Kutner BA, Perry N, Stout C, et al. The Inventory of Anal Sex Knowledge (iASK): A New Measure of Sexual Health Knowledge Among Adolescent Sexual Minority Males. J Sex Med 2022;19:521-528.
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Infecciones por VIH , Salud Sexual , Minorías Sexuales y de Género , Adolescente , Infecciones por VIH/epidemiología , Humanos , Masculino , Reproducibilidad de los Resultados , Conducta Sexual/psicologíaRESUMEN
The Young Men and Media study developed and pilot tested a community-informed, online HIV prevention program for adolescent sexual minority males (ASMM) in the United States. The developed intervention uses nine interactive modules to increase sexual health knowledge, promote critical examination of pornography, and decrease sexual risk among ASMM. Participants (N = 154, age 14-17 years) were recruited online in Spring 2020 and randomized to the intervention (n = 77) or other existing HIV websites (n = 77). Of the 65 intervention participants who logged in to the website, most completed all nine modules and found the content useful (average module score 4.3 out of 5 stars). The intervention also showed improved HIV/STI knowledge, increased pornography knowledge, and reduced beliefs that pornography is an accurate depiction of male-male sex. Results indicate that the Young Men and Media intervention is feasible, acceptable, and may positively impact sexual health outcomes.
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Infecciones por VIH , Minorías Sexuales y de Género , Enfermedades de Transmisión Sexual , Adolescente , Infecciones por VIH/prevención & control , Homosexualidad Masculina , Humanos , Masculino , Proyectos Piloto , Conducta Sexual , Estados Unidos/epidemiologíaRESUMEN
The COVID-19 pandemic has caused disruptions to health care access for sexual and gender minorities in the U.S. We sought to explore the impact of COVID-19 on HIV pre-exposure prophylaxis (PrEP) use and sexual health services by assessing PrEP eligibility and use, changes in sexual behaviors, and HIV/STI testing during the COVID-19 pandemic. We surveyed 239 young sexual minority men (YSMM) 17-24 years old between April and September 2020 in the U.S. One-in-seven YSMM PrEP users discontinued use during the pandemic, and all those who discontinued PrEP reported a decrease in sexual activity. Twenty percent reported difficulty getting prescriptions and medications from their doctors or pharmacies, and more than 10% reported challenges accessing HIV/STI testing. Among those who met Centers for Disease Control and Prevention criteria for PrEP (n = 104), 86.5% were not currently using PrEP. Among those surveyed 3 months or later after the start of major COVID-19 stay-at-home measures (n = 165), 35.8% reported CAS with a causal partner within the past 3 months during the COVID-19 pandemic. Seeking HIV testing was associated with reporting condomless anal sex in the previous 3 months, indicating the necessity for ensuring continuity of basic sexual health services for YSMM. Failure to adequately adjust HIV prevention services and intervention in the face of pandemic-related adversity undermines efforts to end the HIV epidemic in the U.S.
RESUMEN: La pandemia de COVID-19 ha causado interrupciones en el acceso a la atención médica para las minorías sexuales y de género en los EE. UU. Buscamos explorar el impacto de COVID-19 en el uso de la profilaxis de preexposición al VIH (PrEP) y los servicios de salud sexual mediante la evaluación de la elegibilidad y el uso de PrEP, los cambios en los comportamientos sexuales y las pruebas de VIH/ITS durante la pandemia de COVID-19. Encuestamos a 239 hombres jóvenes de minorías sexuales (YSMM) de 17 a 24 años entre abril y septiembre de 2020 en los EE. UU. Uno de cada siete usuarios de PrEP YSMM interrumpió su uso durante la pandemia, y todos los que interrumpieron la PrEP informaron una disminución en la actividad sexual. El veinte por ciento informó tener dificultades para obtener recetas y medicamentos de sus médicos o farmacias, y más del 10% informó tener dificultades para acceder a las pruebas de VIH/ITS. Entre los que cumplieron con los criterios de los Centros para el Control y la Prevención de Enfermedades para la PrEP (n = 104), el 86,5% no estaba usando PrEP actualmente. Entre los encuestados 3 meses o más después del inicio de las principales medidas de COVID-19 para quedarse en casa (n = 165), el 35,8% informó CAS con una pareja causal en los últimos 3 meses durante la pandemia de COVID-19. La búsqueda de la prueba del VIH se asoció con la notificación de sexo anal sin condón en los 3 meses anteriores, lo que indica la necesidad de garantizar la continuidad de los servicios básicos de salud sexual para YSMM. No ajustar adecuadamente los servicios de prevención del VIH y la intervención frente a la adversidad relacionada con la pandemia socava los esfuerzos para poner fin a la epidemia del VIH en los EE. UU.
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COVID-19 , Infecciones por VIH , Profilaxis Pre-Exposición , Minorías Sexuales y de Género , Enfermedades de Transmisión Sexual , Adolescente , Adulto , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Homosexualidad Masculina , Humanos , Masculino , Pandemias , SARS-CoV-2 , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/prevención & control , Adulto JovenRESUMEN
American Nurses Credentialing Center Magnet® designation is prestigious to healthcare institutions. Setting the expectation for all hospitals within a system to be Magnet designated is a lofty but achievable goal. Nursing leaders at the University of Pittsburgh Medical Center set organization-wide designation as a goal in 2010. A robust system-wide Magnet Program Directors Council facilitated this effort by standardizing practices and supporting members through the journey.
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Habilitación Profesional , Personal de Enfermería en Hospital , Hospitales , Humanos , Estados UnidosRESUMEN
BACKGROUND: Nurses obtaining higher levels of education has been recommended nationally for more than a decade to support improved patient outcomes. LOCAL PROBLEM: Organizational strategies were implemented to achieve a highly educated workforce at the project site over 14 years. However, there was no evaluation of relationship with increasing education levels and pediatric patient outcomes. METHODS: A quality improvement project explored the relationship of Bachelor of Science in Nursing (BSN) or higher prepared nurses with 9 different nurse-sensitive indicators (NSIs). Educational preparation and NSI data were retrieved retrospectively from hospital databases from up to 14 years. RESULTS: Moderate to moderately strong correlations were noted between the proportion of BSN or higher prepared nurses and 2 NSIs (central line-associated bloodstream infections, r = -0.55 and surgical site infections, r = -0.71). Four of the 9 indicators were approaching moderate correlation. CONCLUSIONS: Increasing the proportion of highly educated nurses at the project site correlated with improvements in select NSI outcomes.
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Bachillerato en Enfermería , Niño , Hospitales , Humanos , Estudios Retrospectivos , Recursos HumanosRESUMEN
BACKGROUND: E-cigarette use is common among adolescents and young adults, yet little is known about e-cigarette cessation among this group. The current study assessed e-cigarette cessation attempts, interest in e-cigarette cessation, and methods of e-cigarette cessation most favored by young e-cigarette users. METHODS: A cross-sectional survey was administered via Facebook and Instagram between February and April 2019 to enroll current, regular e-cigarette using adolescents and young adults who reported non-regular use of other tobacco products. Participants included 212 (51.4% female) adolescents and young adults (14 to 21 years of age) who reported six or more days of e-cigarette use and less than four days of other tobacco product use in the last 30 days. RESULTS: More than half (n = 110; 51.9%) of the participants reported at least one past serious e-cigarette quit attempt. Among those, the average number of past quit attempts was 2.9 (SD = 3.9). Of the 157 (74.1%) participants who indicated they were interested in quitting e-cigarettes, 78 (49.7%) endorsed health risks as their primary reason for wanting to quit e-cigarettes. The most frequently endorsed intervention methods to aid in e-cigarette cessation were those delivered via digital methods, such as smartphone apps. CONCLUSION: The current study provides preliminary data to support continued development of e-cigarette cessation treatments for adolescents and young adults. Future research should evaluate the potential use of digital methods to aid in e-cigarette cessation.
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Sistemas Electrónicos de Liberación de Nicotina , Cese del Hábito de Fumar , Tabaquismo , Vapeo , Adolescente , Estudios Transversales , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
This brief report presents a preliminary investigation of the relations between minor consent laws for HIV testing/treatment and testing behavior among adolescent sexual minority males (ASMM; N = 127; ages 14-17). Most participants had legal capacity to consent without parental/guardian permission (HIV testing: 79%; HIV testing/treatment: 65%). Despite having this legal right, few (15%) had ever tested. Capacity to consent was not associated with HIV testing in this sample; nevertheless, those who had not disclosed their sexual activity to parents/guardians were less likely to have tested. Confidentiality concerns may be a barrier to testing for these youth despite laws intended to enable independent testing.
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Confidencialidad/legislación & jurisprudencia , Infecciones por VIH/diagnóstico , Infecciones por VIH/psicología , Consentimiento Informado/legislación & jurisprudencia , Padres , Asunción de Riesgos , Conducta Sexual , Minorías Sexuales y de Género/psicología , Adolescente , Revelación , Infecciones por VIH/epidemiología , Humanos , MasculinoRESUMEN
Increasing attention is being given to improving patient experience in health care. Most children's hospitals have a patient experience office or team that champions and measures patient experience and partners with operations to optimize performance in this area. We outline the activities that our patient experience team undertakes at our pediatric health system to advocate for, measure and improve the experience of our patients and families. The framework we propose for such activities includes those that are proactive in improving patient experience as well as those that are reactive to when patients and families have had a poor experience. Those reactive practices are often centered on the management of patient complaints and grievances and early intervention into patient complaints so that they do not become grievances.
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Hospitales Pediátricos , Atención Dirigida al Paciente/tendencias , Pediatría/tendencias , Mejoramiento de la Calidad , Radiología/tendencias , Humanos , Evaluación del Resultado de la Atención al Paciente , Satisfacción del PacienteRESUMEN
Peroxiredoxins (Prxs) are a ubiquitous family of cysteine-dependent peroxidase enzymes that play dominant roles in regulating peroxide levels within cells. These enzymes, often present at high levels and capable of rapidly clearing peroxides, display a remarkable array of variations in their oligomeric states and susceptibility to regulation by hyperoxidative inactivation and other post-translational modifications. Key conserved residues within the active site promote catalysis by stabilizing the transition state required for transferring the terminal oxygen of hydroperoxides to the active site (peroxidatic) cysteine residue. Extensive investigations continue to expand our understanding of the scope of their importance as well as the structures and forces at play within these critical defense and regulatory enzymes.
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Estrés Oxidativo , Peróxidos/metabolismo , Peroxirredoxinas/metabolismo , Transducción de Señal , Animales , Humanos , Modelos Moleculares , Peróxidos/química , Peroxirredoxinas/químicaRESUMEN
2-Cys peroxiredoxins (Prxs) modulate hydrogen peroxide (H2O2)-mediated cell signaling. At high H2O2 levels, eukaryotic Prxs can be inactivated by hyperoxidation and are classified as sensitive Prxs. In contrast, prokaryotic Prxs are categorized as being resistant to hyperoxidation and lack the GGLG and C-terminal YF motifs present in the sensitive Prxs. Additional molecular determinants that account for the subtle differences in the susceptibility to hyperoxidation remain to be identified. A comparison of a new, 2.15-Å-resolution crystal structure of Prx2 in the oxidized, disulfide-bonded state with the hyperoxidized structure of Prx2 and Prx1 in complex with sulfiredoxin revealed three structural regions that rearrange during catalysis. With these regions in hand, focused sequence analyses were performed comparing sensitive and resistant Prx groups. From this combinatorial approach, we discovered two novel hyperoxidation resistance motifs, motifs A and B, which were validated using mutagenesis of sensitive human Prxs and resistant Salmonella enterica serovar Typhimurium AhpC. Introduction and removal of these motifs, respectively, resulted in drastic changes in the sensitivity to hyperoxidation with Prx1 becoming 100-fold more resistant to hyperoxidation and AhpC becoming 800-fold more sensitive to hyperoxidation. The increased sensitivity of the latter AhpC variant was also confirmed in vivo These results support the function of motifs A and B as primary drivers for tuning the sensitivity of Prxs to different levels of H2O2, thus enabling the initiation of variable signaling or antioxidant responses in cells.
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Peroxirredoxinas/química , Secuencias de Aminoácidos , Secuencia de Aminoácidos , Cristalografía por Rayos X , Cisteína/química , Cisteína/metabolismo , Humanos , Peróxido de Hidrógeno/metabolismo , Modelos Moleculares , Oxidación-Reducción , Peroxirredoxinas/metabolismoRESUMEN
Reactive oxygen species (ROS), in particular H2O2, regulate intracellular signaling through reversible oxidation of reactive protein thiols present in a number of kinases and phosphatases. H2O2 has been shown to regulate mitogen-activated protein kinase (MAPK) signaling depending on the cellular context. We report here that in human articular chondrocytes, the MAPK family member c-Jun N-terminal kinase 2 (JNK2) is activated by fibronectin fragments and low physiological levels of H2O2 and inhibited by oxidation due to elevated levels of H2O2 The kinase activity of affinity-purified, phosphorylated JNK2 from cultured chondrocytes was reversibly inhibited by 5-20 µm H2O2 Using dimedone-based chemical probes that react specifically with sulfenylated cysteines (RSOH), we identified Cys-222 in JNK2, a residue not conserved in JNK1 or JNK3, as a redox-reactive site. MS analysis of human recombinant JNK2 also detected further oxidation at Cys-222 and other cysteines to sulfinic (RSO2H) or sulfonic (RSO3H) acid. H2O2 treatment of JNK2 resulted in detectable levels of peptides containing intramolecular disulfides between Cys-222 and either Cys-213 or Cys-177, without evidence of dimer formation. Substitution of Cys-222 to alanine rendered JNK2 insensitive to H2O2 inhibition, unlike C177A and C213A variants. Two other JNK2 variants, C116A and C163A, were also resistant to oxidative inhibition. Cumulatively, these findings indicate differential regulation of JNK2 signaling dependent on H2O2 levels and point to key cysteine residues regulating JNK2 activity. As levels of intracellular H2O2 rise, a switch occurs from activation to inhibition of JNK2 activity, linking JNK2 regulation to the redox status of the cell.
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Condrocitos/metabolismo , Cisteína/metabolismo , Peróxido de Hidrógeno/metabolismo , Proteína Quinasa 9 Activada por Mitógenos/metabolismo , Células Cultivadas , Fibronectinas , Humanos , Peróxido de Hidrógeno/farmacología , Oxidación-Reducción , Especies Reactivas de Oxígeno/metabolismo , Transducción de SeñalRESUMEN
Adolescent sexual minority males have low rates of HIV testing despite increased risk for HIV acquisition. This study will examine adolescent sexual minority males' (a) HIV testing behaviors and intentions, and (b) associations with disclosure to healthcare providers of male-male attraction. Sexual minority males were recruited using social media sites to obtain a national sample. Participants (N = 207) were 14-17-year-old cisgender males living in the U.S. who (1) self-identified as gay/bisexual, (2) reported sexual attraction to males, or (3) reported past-year voluntary sexual contact with a male. Only 14% of participants reported they had tested for HIV, even though 20% reported a history of condomless anal intercourse with male partners. Three-quarters (77%) planned to test for HIV, but only 48% planned to test annually (i.e., current CDC recommendation). Only 20% of participants had disclosed male-male attraction to their healthcare provider, but adolescents who disclosed had five times the odds of testing for HIV (AOR = 5.40). Rates of HIV testing and disclosure of male-male interests to a healthcare provider are low among adolescent sexual minority males. Given the association between disclosure and HIV testing, creating non-judgmental healthcare settings and optimizing patient-provider communication are likely to improve uptake of HIV testing by at-risk youth.
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Revelación/estadística & datos numéricos , Infecciones por VIH/diagnóstico , Homosexualidad Masculina/psicología , Intención , Tamizaje Masivo/estadística & datos numéricos , Servicios de Salud Reproductiva/estadística & datos numéricos , Conducta Sexual , Adolescente , Conducta del Adolescente , Infecciones por VIH/etnología , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Personal de Salud , Encuestas Epidemiológicas , Homosexualidad Masculina/etnología , Humanos , Internet , Masculino , Tamizaje Masivo/métodos , Conducta Sexual/psicología , Conducta Sexual/estadística & datos numéricos , Parejas Sexuales , Medios de Comunicación Sociales , Estados Unidos/epidemiologíaRESUMEN
Adolescent sexual minority males (ASMM; < 18 years old) do not typically receive sexual education that addresses male-male relationships from traditional sources (i.e., school, parents). Therefore, many rely on sexually explicit online media (SEOM; i.e., pornography) to find sexual health information. The current study describes SEOM use by ASMM in the U.S. and examined the association between exposure to condomless anal sex (CAS) in SEOM and engagement in CAS. In 2017, ASMM (N = 206; M age = 16, range: 14-17; 51% racial/ethnic minorities) from across the U.S. completed an online sexual health survey, including questions about SEOM use and sexual behaviors. Most (86%) reported that they had viewed SEOM. Engagement with SEOM was frequent (86% reported viewing ≥ one time per week) and lengthy (70% reported viewing for ≥ 15 min per session). Youth perceived that SEOM influenced how they, and other ASMM, think and behave sexually. Further, exposure to risky sexual behavior in SEOM appeared to be associated with youths' dyadic sexual behavior. To support the healthy sexual development of ASMM, it is important to acknowledge the near-universal use of SEOM by ASMM, to identify ways to maximize its potential value, and to minimize potential harms.
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Homosexualidad Masculina/psicología , Conducta Sexual/psicología , Minorías Sexuales y de Género/psicología , Medios de Comunicación Sociales/normas , Adolescente , Humanos , Masculino , Encuestas y Cuestionarios , Estados UnidosRESUMEN
Objectives: Substance use is prevalent among young sexual minority men and crime exposure is linked with adverse health behaviors. Guided by the protective model of resilience, we examined the impact of crime exposure and resilience resources on substance use behaviors, and whether resilience moderated associations between crime exposure and substance use behaviors. Methods: A cross-sectional sample of young sexual minority men (n = 720) ages 15-24 participated in a one-time survey conducted in seven cities across the United States. Participants' mean age was 21.2 years; 50% self-identified as Black, and 66% self-identified as gay. Participants self-reported on sociodemographic factors, crime exposure, resilience resources, and substance use behaviors. We fit generalized estimating models to examine associations between crime exposure, resilience resources, and the interaction between crime exposure and resilience resources on substance use behaviors. Results: Overall, 31% reported heavy alcohol use, 54% monthly marijuana use, 14% drug use, and 26% reported being a victim of a crime. Crime exposure was associated with an increased odds of alcohol (AOR = 1.45, 95%CI: 1.02, 2.14), marijuana (AOR = 1.41, 95%CI: 1.07, 2.04), and drug use (AOR = 1.94, 95%CI: 1.14, 2.98). Resilience resources were associated with a reduced odds of alcohol use (AOR = 0.66, 95%CI: 0.47, 0.93), marijuana use (AOR = 0.82, 95%CI: 0.60, 0.98), and drug use (AOR = 0.85, 95%CI: 0.54, 0.96). There was a significant interaction such that resilience resources reduced associations between crime exposure and alcohol and drug use. Conclusions: Findings support the protective effects of resilience resources for young sexual minority men. Results highlight the importance of ensuring the availability of community resources to meet the needs of sexual minority youth.
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Consumo de Bebidas Alcohólicas/psicología , Víctimas de Crimen/psicología , Crimen/psicología , Uso de la Marihuana/psicología , Resiliencia Psicológica , Minorías Sexuales y de Género/psicología , Adolescente , Negro o Afroamericano , Estudios Transversales , Femenino , Humanos , Masculino , Conducta Sexual/estadística & datos numéricos , Estados Unidos , Adulto JovenRESUMEN
Public attitudes toward invasive alien species management and trust in managers' ability to effectively manage non-native species can determine public support for conservation action. The island of Guam has experienced widespread species loss and ecosystem transformation due to invasive species, most notably, the brown treesnake (Boiga irregularis). Despite Guam's long history with invasives and extensive efforts to eradicate them, we know little about the sociological context of invasive species and drivers of public support or opposition on the island. Using focused group discussions, we explore public attitudes toward invasive species management measures. Respondents were familiar with the common invasive species on Guam and recognized that they were not native. They expressed support for management activities, interest in more effective and frequent management initiatives, and desire to participate directly in conservation actions. Participants also expressed frustration with government institutions and lack of confidence in managers' ability to control invasive species. Perceptions of managers' trustworthiness, communication with managers, and positive personal experiences with managers were related to positive attitudes about management and support for existing initiatives, indicating the important role of trust and engagement for invasive species management.