Person-centred language and HIV research: a cross-sectional examination of stigmatising terminology in medical literature.

OBJECTIVE: We sought to quantify the use of person-centred language (PCL) in research journals that publish high volumes of HIV-related manuscripts. DESIGN: In this cross-sectional study, we searched PubMed for HIV-related articles published between 1 January 2017 and 7 March 2021. After journal reduction and article randomisation, title and abstract screening was conducted among 500 studies in a masked, duplicate fashion. METHODS: Studies that were included were systematically searched for prespecified, stigmatising terms, partial terms and phrases. Prevalence rates of non-person-centred terminology were totalled, and the total number of articles adherent to PCL guidelines were reported. Fisher's exact tests were used to determine associations between PCL adherence and article funding source, type of article, continent of origin and research, among others. RESULTS: Among 237 studies included, 21.52% (51) of HIV-related publications in this cross-sectional analysis were found to be PCL adherent. Stigmatising labels such as 'HIV- or AIDS-infected' and 'HIV- or AIDS-person or patient' were used most frequently, with the former appearing in 57.38% of articles and the latter appearing in 30.80% of articles. CONCLUSION: Despite numerous guidelines and requirements for the use of PCL in research, our findings suggest that an alarming number of HIV-related articles are not following these guidelines. This is concerning because this labelling likely contributes to the persistence of stigma in HIV-centred care. The intentional use of person-centred language in medical research has the potential to minimise the use of stigmatising language among medical professionals, in medical education, in medical records and patient encounters, and thus reduce stigma.

Education, Perceptions, and Delivery: Factors Shaping the Perceived Role in the Pre-Exposure Prophylaxis (PrEP) Care Continuum Among a Sample of Osteopathic Medical Students.

Pre-exposure prophylaxis (PrEP) uptake has been suboptimal despite its demonstrated efficacy in reducing the risk of HIV acquisition. Medical education is one distal determinant that shapes medical providers' perceived role in the PrEP care continuum. However, there is limited understanding of how osteopathic medical students and those wanting to practice in rural areas perceive their role in the PrEP care continuum in the domains of PrEP awareness, uptake, and adherence and retention. Twenty-one semistructured interviews were conducted (March 2019-April 2020) to assess what shapes osteopathic medical students' perceived role in the PrEP care continuum. Participants noted a lack of adequate sexual health training, personal perceptions concerning PrEP use, and ambiguity concerning which of the medical specialties should deliver PrEP. Osteopathic medical schools can incorporate more inclusive and holistic sexual health and PrEP curricula to address these barriers and better prepare osteopathic medical students for their future role in the PrEP care continuum.

Identifying Distinct Subgroups of Lesbian, Gay, and Bisexual Youth for Suicide Risk: A Latent Profile Analysis.

PURPOSE: The purpose of the study was to identify profiles of lesbian, gay, and bisexual (LGB) youth who are at risk for suicidal behavior. METHOD: Data were collected through the Youth Risk Behavior Surveillance System (N = 2,738). We used latent profile analysis to create identity profiles using variables associated with suicide, including bullying, alcohol use, poor grades, electronics use, and sleep hours. RESULTS: The LPA revealed a 6-class solution. Class 6 represented the highest risk profile with the highest scores in alcohol, bullying, poor grades, electronics use, and the least sleep and were 17 times more likely to attempt suicide compared to class 2 (the lowest-risk class). Classes 1, 3, 4, and 5 had a mixture of both high and low risk mean scores across the variables, with class 3 showing the strongest relationship to suicide (7 times more likely than class 2). CONCLUSION: Because high-risk classes in our study had multiple factors contributing to associations to suicide, programming aimed at attenuating youth suicide among LGB youth may benefit from addressing multiple issues simultaneously (e.g., substance use and bullying). This would be a departure from more traditional programs for LGB youth which are predicated on one specific risk behavior, such as coping with bullying or substance use separately.

Assessing the Health Care Experiences of Rural Men Who Have Sex with Men (MSM).

Research investigating the health care experiences of men who have sex with men (MSM) predominately concerns urban populations. This study examines the health care experiences of MSM residing in rural Oklahoma. A total of 40 MSM (aged 21 through 66) living in rural areas were interviewed. Data were analyzed using a qualitative approach to identify emerging concepts. Three themes emerged from the data: First, participants cited cultural differences related to religious conservative ideologies as a central motif of health care experiences. Next, doctor-patient relationship quality was a contributing factor to health care experiences. Last, health care experiences were predicated on the idea of doctors' knowledge of lesbian, gay, bisexual and transgender (LGBT) health issues. Certain health care aspects regarding the rural experiences of MSM that were identified differed between rural and urban MSM. Implications include support for programs that bridge the gap between practitioners and patients, while better informing both MSM and health care providers of current LGBT health issues.

Experiences of Stigma by Gay and Bisexual Men in Rural Oklahoma.

Purpose: The unique experiences of men who have sex with men (MSM) residing in culturally conservative rural areas are not well represented in the scientific literature. The human immunodeficiency virus (HIV) epidemic in the United States has shifted toward rural areas where populations are dispersed and health care resources are limited. Methods: We recruited 40 sexual minority men, ages 22-66, residing in rural Oklahoma for in-depth, qualitative sexual health interviews that sought to understand how cultural and social environments impacted health behaviors. Findings: Participants described a stigmatizing social environment and less access to quality, sexual minority medical care within rural communities and perceived these as substantial barriers to enhancing health. Structural issues, including lack of sexual minority-affirming policies, institutional practices, and hostile cultural norms, were noted. Conclusions: Results indicate the need to develop greater awareness of stigma as an etiologic factor that contributes to the health of rural sexual minority populations, specifically when it relates to provision of culturally appropriate care.