Evaluating the Impact of an Adolescent Sexuality Education Workshop on Medical Student Communication in an Objective Structured Clinical Examination.

PURPOSE: Gaps still exist in medical education about the sexual health needs of sexual diverse populations, and little is known about how translatable current learning modules are to patient encounters. Efforts at an academic medical institution have been made to address this need, including a two-hour adolescent sexuality workshop during the Core Clerkship in Pediatrics. This workshop's efficacy was evaluated in an objective structured clinical examination (OSCE) given to rising fourth-year medical students, where the standardized patient case focused on an adolescent cisgender male with dysuria and in a new, same-sex relationship. METHODS: Performance of students who completed the workshop prior to the OSCE (n = 48) were compared to those of students who did not participate in the workshop prior to the OSCE (n = 17). The encounters were recorded and transcribed, and the deidentified transcripts were scored on a rubric focusing on five domains: sexual identity disclosure, behavioral assessment, psychosocial history, counseling and anticipatory guidance, and relationship building. RESULTS: Student's t-test comparison of the scores found significantly higher scores for the psychosocial history domain (p = .04), particularly concerning disclosure of a new boyfriend and recent sexual activity (p = .008), for students who had the workshop before the OSCE. DISCUSSION: Students who took the adolescent sexuality workshop performed better in gathering psychosocial information in an OSCE encounter a sexual minority adolescent. These results affirm prior work that active learning on sexual diverse health in medical school curricula may prepare students for effective engagement with adolescents exploring their sexuality.

Young black MSM's exposures to and discussions about PrEP while navigating geosocial networking apps.

Young Black gay, bisexual and other men who have sex with men (YBMSM) carry a disproportionate HIV burden perpetuated by exposure to sexual networks with higher untreated HIV prevalence and incidence. In Baltimore, these sexual networks include high utilization of geosocial networking apps (GSN-apps). Our prior work suggests these apps can be important access points for targeted interventions like PrEP. To inform online PrEP outreach we explored YBMSM GSN-app users' exposure to and discussions about PrEP while navigating apps. We actively recruited YBMSM (n=17) age 18-24 from the GSN-app most frequently reported by newly diagnosed HIV-infected MSM in Baltimore. Participants were recruited through direct messaging within the GSN-app while logged-on in high HIV transmission areas. Participants completed 60-90 minute semi-structured interviews, which were analyzed using a 3-stage analytic coding strategy. While some participants had not heard of PrEP, the majority described mentions or conversations about PrEP on GSN-apps. Three themes emerged: (1) Mistrust of PrEP, (2) Association with sexual promiscuity, and (3) Concerns about lack of protection from other STIs. Proper messaging, accurate information, and education are needed to account for the negative perceptions that surround PrEP; otherwise, continued underuse among YBMSM will expand rather than reduce HIV disparities.

Characteristics of the Provider-Patient Encounter Associated With Awareness of and Willingness to Take PrEP Among Young Minority Urban Males in Baltimore City.

We aimed to identify provider encounter characteristics associated with awareness of and willingness to take PrEP among young urban minority males at higher risk for HIV acquisition. The 74 individuals included in this analysis from a cross-sectional survey of males aged 15-24 being seen at a Baltimore city clinic were those who identified as a man who had sex with men (MSM), reported injection drug use, were in a serodiscordant relationship, had a sexually transmitted infection (STI) in the past 6 months, or reported condomless sex with a partner with unknown HIV status. Topics of provider-initiated conversations associated with willingness to take PrEP included one's sexual behavior (OR 7.35, 95% CI [2.23, 24.26]), whether one had been hurt by a partner (OR 4.71, 95% CI [1.40, 15.87]), and risk reduction (OR 6.91, 95% CI [2.10, 22.81]). This study may yield new targets for provider-level interventions for increasing PrEP uptake.

Research accountability groups and mentoring minutes: The M³ approach to promote public health infectious diseases research for diverse graduate students.

Efforts to recruit and retain public health researchers should include scholars that reflect the demographics of the United States. Innovative research mentoring programs that integrate one-to-one and small group learning experiences may result in improved engagement and research productivity among graduate school scholars from underrepresented populations in public health research fields. This study analyzed leadership characteristics and research productivity of 54 graduate scholars who participated in the Dr. James A. Ferguson Emerging Infectious Diseases Fellowship Program (Ferguson Fellowship). Ferguson Fellows participated in 9-week research experience before and after implementation of a multimodal mentorship (M3) designed to support submission of research abstracts to national scientific conferences. M3 strategies included: (a) weekly research content mentoring, (b) myIDP, (c) professional development (process) mentoring, and (d) Research Accountability Groups. Overall, transformational leadership characteristics improved following completion of the Ferguson Fellowship (M = 3.71, SD = 6.37), t(33) = 3.39, p < .01. Transformational leadership characteristics of Ferguson Fellows who received M3 improved significantly (M = 3.88, SD = 6.63), t(24) = 2.93, p < .01 during the program. Fellows who received M3 had almost 4 times (OR = 3.88; 95% CI [1.21, 12.47], p < .05) higher odds of submitting research to scientific meetings compared to their peers who did not participate in M3. Providing process mentoring and research accountability groups were associated with increased research self-efficacy. Graduate scholars from underrepresented populations may benefit from multimodal mentoring strategies that provide scholars with individualized research and professional development support based on the scholar's needs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Intersection of Sociocultural Factors and Health-Related Behavior in Lesbian, Gay, Bisexual, and Transgender Youth: Experiences Among Young Black Gay Males as an Example.

Intersectionality suggests that multiple social identities intersect at the individual or micro level of experience and reflects larger social structural inequities experienced on the macro level. This article uses intersectionality to describe how multiple stigmatized social identities can create unique challenges for young black gay and bisexual men (YBGBM). YBGBM exist at the intersection of multiple stigmatized identities compared with their majority peers. This article examines key intersecting identities and cultural expectations that exist in YBGBM and how those factors may predispose young men to adverse health outcomes and health inequality.

Adolescent psychosocial, social, and cognitive development.

The goal of adolescence is to gain independence and establish a secure identity. • Adolescents' cognitive development can result in abstract thinking that can predispose them to risktaking behavior and a sense of invincibility. • Clinicians can use the primary care visit to promote independence and prepare parents for the features experienced during adolescent development. • Parental or supervisory monitoring is critical in ensuring that teens remain safe while gradually becoming more independent.