Brief report: Identified barriers and proposed solutions for recruiting young Black sexual minority men in HIV-related research.

INTRODUCTION: Young Black sexual minority men represent a high priority population for HIV prevention research yet the existing literature is not proportional to the current health disparity observed. The challenge of engaging this intersectional population in research on a stigmatized topic likely contributes to the dearth of literature. METHODS: This brief report examines the current recruitment strategies for engaging sexual minority men in HIV-related research and identifies individual and system-level barriers that contribute to the underrepresentation of Black sexual minority men in HIV-related research. Qualitative data is integrated from Project HATCH (Helping African American Teens Combat HIV), an ongoing recruitment effort of 14-21-year-old Black sexual minority men in Washington D.C., United States. RESULTS: Identified barriers to recruiting young Black sexual minority men include cultural stigma, mistrust of research institutions, the 'coming out' process for queer youth, assent procedures for youth, and others. CONCLUSIONS: We propose several solutions for recruitment including geospatial technology, social media, and community spaces of trust (i.e., churches and schools). Additional larger scale solutions include destigmatizing youths' sexuality and prioritizing the advancement of Black scholars in academia and research endeavors.

The impact of COVID-19 on college students from communities of color.

Objective: To assess the impact of the COVID-19 pandemic on daily living, mental well-being, and experiences of racial discrimination among college students from communities of color. Participants: Sample comprised 193 ethnically diverse college students, aged 18 to 25 years (M = 20.5 years), who were participating in virtual internships due to the COVID-19 pandemic. Methods: A cross-sectional 16-item survey was developed as a partnership between two nonprofit organizations. The survey included both close-ended and open-ended questions assessing the impact of COVID-19. Results: The students of color reported disruptive changes in finances (54%), living situation (35%), academic performance (46%), educational plans (49%), and career goals (36%). Primary mental health challenges included stress (41%), anxiety (33%), and depression (18%). Students also noted challenges managing racial injustice during the COVID-19 pandemic. Conclusions: Higher education institutions will benefit from financially and emotionally supporting students of color during the COVID-19 pandemic and growing visibility of systemic racism.

Comparison of anxiety and depression rates among LGBTQ college students before and during the COVID-19 pandemic.

OBJECTIVE: To compare rates of anxiety and depression among LGBTQ college students before and during the COVID-19 pandemic and examine pandemic-related stressors and protective factors. PARTICIPANTS: Two cohorts of LGBTQ college students, aged 18-25, sampled before (N = 3,484) and during (N = 1,647) the pandemic. METHODS: The Healthy Minds Study (HMS) is an annual mental health survey administered to college students in the United States, which included additional items related to the COVID-19 pandemic. RESULTS: Mean anxiety symptoms were significantly lower mid-pandemic compared to pre-pandemic, but no differences in mean depressive symptoms were detected. Results varied by sexual and gender minority status. Financial stress, pandemic-related concerns, and witnessing discrimination were risk factors while academic persistence, positive mental health, and formal support were protective factors. CONCLUSIONS: Mental health and instrumental support from institutions will be critical for college students during the pandemic. Affirming and empowering spaces for LGBTQ college students may leverage protective factors.

Anti-LGBT Victimization, Fear of Violence at School, and Suicide Risk Among Adolescents.

We investigated whether strengths of the relationships between anti-lesbian, gay, bisexual, and transgender (LGBT) victimization, fear of violence at school, and suicide risk differ by sexual orientation among a predominantly ethnic minority sample of adolescents. Using the 2012 District of Columbia Youth Risk Behavior Survey high school data set, we performed a 4-stage, stepwise logistic regression for suicide attempts, suicidal ideation, and suicide planning. First, we tested the independent variables, sexual orientation and anti-LGBT victimization. Second, we added an anti-LGBT victimization by sexual orientation interaction term. Third, we tested the independent variable, fear of violence at school, in an additive model. Fourth, we added a fear of violence at school by sexual orientation interaction term. In Model 1, sexual orientation and anti-LGBT victimization were both significantly associated with each suicide risk behavior. In Model 2, the anti-LGBT victimization by sexual orientation interaction term was not significant for any of the dependent variables. In Model 3, fear of violence at school was significantly associated with each suicide risk behavior. In Model 4, the fear of violence at school by sexual orientation interaction term was not significant for suicide attempts or suicidal ideation but was significant for suicide planning in the direction opposite to our hypotheses. Anti-LGBT victimization, sexual orientation, and fear of violence at school were associated with suicidal ideation, suicide planning, and suicide attempts. The strength of the association between fear of violence at school and suicide planning was weaker for sexual minority adolescents than for heterosexual adolescents.

Cultural considerations in adolescent suicide prevention and psychosocial treatment.

Ethnic groups differ in rates of suicidal behaviors among youths, the context within which suicidal behavior occurs (e.g., different precipitants, vulnerability and protective factors, and reactions to suicidal behaviors), and patterns of help-seeking. In this article, the authors discuss the cultural context of suicidal behavior among African American, American Indian and Alaska Native, Asian American and Pacific Islander, and Latino adolescents, and the implications of these contexts for suicide prevention and treatment. Several cross-cutting issues are discussed, including acculturative stress and protective factors within cultures; the roles of religion and spirituality and the family in culturally sensitive interventions; different manifestations and interpretations of distress in different cultures; and the impact of stigma and cultural distrust on help-seeking. The needs for culturally sensitive and community- based interventions are discussed, along with future opportunities for research in intervention development and evaluation.

Developing suicide prevention programs for African American youth in African American churches.

Suicide prevention programs for African American youth in African American churches may have broad appeal because: (1) the Black Church has a strong history of helping community members, regardless of church membership; (2) African Americans have the highest level of public and private religiousness; and (3) the church can help shape religious and cultural norms about mental health and help-seeking. The proposed gatekeeper model trains lay helpers and clergy to recognize the risk and protective factors for depression and suicide, to make referrals to the appropriate community mental health resources, and to deliver a community education curriculum. Potential barriers and suggestions for how to overcome these barriers are discussed.

Suicide and African American teenagers: risk factors and coping mechanisms.

In this study we investigated whether locus of control, hopelessness, and depression were primary risk factors for suicide ideation and attempts in African American youth, and whether congruency between locus of control and religious coping style reduced suicide risk. The sample consisted of 176 African American high school students (115 females; 61 males). Multiple and logistic regression were used to determine relationships among study variables. Depression was found to mediate the relationship between hopelessness and suicidal behaviors. External locus of control led to greater risk for hopelessness and depression, with a trend in the predicted direction for suicide attempts. Religious coping style alone was not always associated with reduction of risk of suicidal behaviors, yet some evidence suggests that congruency between locus of control and religious coping style reduces risk. Results provide additional support for suicide interventions to target depressive symptoms. Results also highlight the importance of examining the role of culturally salient variables such as fatalism and religious coping style when developing intervention programs for suicide.

Suicidal Behaviors in the African American Community.

This article reviews the risk and protective factors associated with suicidal thoughts and behaviors in the African American community. The authors provide a brief review of the history of suicide research in African American communities and critique some of the paradigms and underlying assumptions that have made it difficult to address the problem of suicidal behaviors in the African American community. The article also summarizes the articles that are presented in this special edition of the Journal of Black Psychology on suicidality in the African American community.

Relationship Between Religious Coping and Suicidal Behaviors Among African American Adolescents.

This study investigated whether hopelessness and depression were risk factors for suicidal thoughts and behaviors in African American adolescents and looked at whether religious participation and religious coping protected these students from suicidality. Participants were 212 African American high school students (133 females, 79 males). The results of multiple and logistic regression analyses found that hopelessness and depression were risk factors for suicidal ideation and attempts. Religious coping style was significantly related to suicidal behaviors: Self-directed coping was related to increased hopelessness, depression, and suicide attempts, and collaborative coping was related to increased reasons for living. Gender differences were found in symptoms of depression, religious coping style and religious participation. Results provide additional support for suicide interventions to target hopelessness and depressive symptoms and highlight the importance of examining the role of culturally salient variables, such as religious participation and religious coping style, when developing intervention programs for suicide.

Suicidality and depression among african american adolescents: the role of family and peer support and community connectedness.

Rates of suicide are increasing among African American adolescents and pose a significant public health concern. One area that has received little attention is the relationship between various types of social support and suicide, and the extent to which support moderates the relationship between depressive symptoms and suicidality. A total of 212 African American adolescents completed in-school surveys on three types of social support: family support, peer support, and community connectedness. The survey also addressed depressive symptoms and suicidality, as measured by reasons for living, a cognitive measure of suicide risk. Hierarchical multiple regression analyses were used to examine direct and moderating relationships between types of social support and suicidality. The results indicated that increased family support and peer support are associated with decreased suicidality, and peer support and community connectedness moderated the relationship between depressive symptoms and suicidality. Over a third of the variability in reasons for living was predicted by family support, peer support, and community connectedness. Implications for research and preventative interventions for African American adolescents are discussed.

Qualitative study of suicidality and help-seeking behaviors in African American adolescents.

This qualitative study explores adolescents' perceptions of help-seeking behaviors in the context of a hypothetical suicide crisis. Cauce and colleague's (2002, Journal of Consulting and Clinical Psychology, 70, 44-55) model was used to examine help-seeking behaviors in 3 domains: problem recognition, decision to seek help, and selection of helpers. Forty-two church-going African American adolescents participated in 1 of 6 focus groups that discussed ways to help a hypothetically suicidal student in a vignette. Findings suggest that although the majority of youth had been exposed to a suicidal peer (76%), they were unsure of the seriousness of suicide as a problem in the African American community. The findings suggest that youth were less comfortable with formal interventions in school, religious institutions or traditional mental health settings. However, youth were open to community-based programs that could be located in school, church or community settings if helpers were: young adults, empathic listeners, non-judgmental, maintained confidentiality, and viewed as "natural helpers". Implications for developing church-based suicide interventions are discussed.