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1.
Am J Mens Health ; 15(3): 15579883211022180, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34088238

RESUMEN

Little is known about the impact of the coronavirus pandemic and control measures on gay, bisexual, and other men who have sex with men (GBMSM) couples. The goal of this study was to investigate individual-level relationship satisfaction during the COVID-19 pandemic in a sample of 209 coupled GBMSM in the United States. We analyzed reported happiness and feelings about a relationship's future and assessed the odds of changing relationship happiness and investment associated with pandemic-related life changes (pandemic-related employment change; COVID-19 illness; high-risk of severe illness), using logistic and multinomial logit models. Fifty-five percent of participants (N = 114) reported that their relationship happiness had not changed during the pandemic, but 30% (N = 62) reported increased relationship happiness. 25% (N = 53) reported they had become more invested in their relationship's future during the pandemic, and only one participant reported decreased investment. The odds of increased relationship investment was significantly associated with pandemic-related employment change (adjusted odds ratio (aOR), 95% confidence interval (CI): 2.19 [1.04, 4.61]) and increased sex during the pandemic (aOR: 4.38 [1.55, 12.41]). Those with a pandemic-related employment change also had significantly higher odds of increased relationship happiness than those without a change (aOR: 2.10 [1.01, 4.35]). COVID-19 cases that reported being at higher risk of serious COVID-19 disease had higher odds of decreased relationship happiness than high-risk non-cases (aOR: 6.58 [1.10, 39.39]). Additional research in this area is warranted to minimize the long-term impacts of the pandemic on coupled GBMSM.


Asunto(s)
COVID-19/psicología , Homosexualidad Masculina/psicología , Salud Mental/estadística & datos numéricos , Satisfacción Personal , Distanciamiento Físico , Minorías Sexuales y de Género/psicología , Adulto , Felicidad , Humanos , Masculino , Persona de Mediana Edad , Conducta Sexual/psicología , Estados Unidos
2.
J Couns Psychol ; 68(3): 299-315, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34043376

RESUMEN

Social scientists are increasingly interested in methodological advances that can illuminate the distinct experiences and health outcomes produced by various systems of inequality (e.g., race, gender, religion, sexual orientation). However, innovative methodological strategies are needed to (a) capture the breadth, complexity, and dynamic nature of moments co-constructed by multiple axes of power and oppression (i.e., intersectional experiences) and (b) keep pace with the increasing interest in testing links between such events and health among underresearched groups. Mixed methods designs may be particularly well suited for these needs, but are seldom adopted. In light of this, we describe a new mixed methods experience sampling approach that can aid researchers in detecting and understanding intersectional experiences, as well as testing their day-to-day associations with aspects of health. Drawn from two separate experience sampling studies examining day-to-day links between intersectional experiences and psychological health-one focusing on Black American LGBQ individuals and another on Muslim American LGBQ individuals-we provide quantitative and qualitative data examples to illustrate how mixed methods investigations can advance the assessment, interpretation, and analysis of everyday experiences constructed by multiple systems of power. Limitations, possible future adaptations, implications for research, and relevance to the clinical context are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Afroamericanos/psicología , Evaluación Ecológica Momentánea , Islamismo/psicología , Minorías Sexuales y de Género/psicología , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Adulto Joven
3.
Exp Clin Psychopharmacol ; 29(2): 178-190, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33793290

RESUMEN

Alcohol use is a key risk factor for HIV infection among men who have sex with men (MSM), primarily because it interferes with condom use. However, little is known about the cognitive-emotional mechanisms through which alcohol influences decisions to use condoms with high-risk partners among MSM. In this study, we tested whether alcohol-related deficits in inhibitory control and attention bias toward sexual cues (vs. condoms and neutral cues) accounted for increases in condomless anal sex (CAS) intentions after drinking among MSM. Heavy-drinking, high-risk MSM (N = 83) were randomly assigned to receive (a) alcohol, (b) placebo, or (c) control beverages before behavioral tasks assessing inhibitory control and attention bias, and a video-based sexual risk scenario that assessed several aspects of sexual decision making. Results showed that inhibitory control and attention bias to sexual cues did not mediate associations between intoxication and CAS intentions. Inhibitory control deficits also did not moderate the indirect effects of intoxication on CAS intentions through attention bias. Three-way interactions between alcohol/placebo condition, inhibitory control, and attention bias were also not significant. Together, these findings provide little evidence that these two processes play a significant role in alcohol-involved HIV risk, at least as assessed by the specific tasks used in this study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Intoxicación Alcohólica/psicología , Infecciones por VIH/psicología , Homosexualidad Masculina/psicología , Conducta Sexual/psicología , Adulto , Consumo de Bebidas Alcohólicas/psicología , Cognición , Condones/estadística & datos numéricos , Emociones , Humanos , Intención , Masculino , Persona de Mediana Edad , Factores de Riesgo , Asunción de Riesgos , Parejas Sexuales/psicología , Minorías Sexuales y de Género/psicología , Sexo Inseguro/estadística & datos numéricos , Adulto Joven
4.
Health Qual Life Outcomes ; 19(1): 117, 2021 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-33836775

RESUMEN

BACKGROUND: Valid and reliable instruments are needed to measure the multiple dimensions of perceived risk. The Perceived Risk of HIV Scale is an 8-item measure that assesses how people think and feel about their risk of infection. We set out to perform a cross-cultural adaptation of the scale to Brazilian Portuguese among key populations (gay, bisexual and other men who have sex with men and transgender/non-binary) and other populations (cisgender heterosexual men and cisgender women). METHODS: Methodological study with cross-sectional design conducted online during October/2019 (key populations [sample 1] and other populations) and February-March/2020 (key populations not on pre-exposure prophylaxis [sample 2]). Cross-cultural adaptation of the Perceived Risk of HIV Scale followed Beaton et al. 2000 guidelines and included confirmatory factor analysis, differential item functioning (DIF) using the Multiple-Indicator Multiple-Cause model, and concurrent validity to verify if younger individuals, those ever testing for HIV, and engaging in high-risk behaviors had higher scores on the scale. RESULTS: 4342 participants from key populations (sample 1 = 235; sample 2 = 4107) and 155 participants from other populations completed the measure. We confirmed the single-factor structure of the original measure (fit indices for sample 1 plus other populations: CFI = 0.98, TLI = 0.98, RMSEA = 0.07; sample 2 plus other populations: CFI = 0.97, TLI = 0.95, RMSEA = 0.09). For the comparisons between key populations and other populations, three items (item 2: "I worry about getting infected with HIV", item 4: "I am sure I will not get infected with HIV", and item 8: "Getting HIV is something I have") exhibited statistically significant DIF. Items 2 and 8 were endorsed at higher levels by key populations and item 4 by other populations. However, the effect of DIF on overall scores was negligible (0.10 and 0.02 standard deviations for the models with other populations plus sample 1 and 2, respectively). Those ever testing for HIV scored higher than those who never tested (p < .001); among key populations, those engaging in high-risk behaviors scored higher than those reporting low-risk. CONCLUSION: The Perceived Risk of HIV Scale can be used among key populations and other populations from Brazil.


Asunto(s)
Comparación Transcultural , Grupos Étnicos/psicología , Infecciones por VIH/psicología , Homosexualidad Masculina/psicología , Medición de Riesgo/normas , Minorías Sexuales y de Género/psicología , Encuestas y Cuestionarios/normas , Personas Transgénero/psicología , Adolescente , Adulto , Brasil/epidemiología , Estudios Transversales , Grupos Étnicos/estadística & datos numéricos , Análisis Factorial , Femenino , Infecciones por VIH/epidemiología , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Medición de Riesgo/métodos , Minorías Sexuales y de Género/estadística & datos numéricos , Personas Transgénero/estadística & datos numéricos , Adulto Joven
5.
Cancer Causes Control ; 32(6): 645-651, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33846853

RESUMEN

PURPOSE: Extensive prior research has shown that sexual minority women are more likely to have a number of cancer risk factors, thereby putting them at higher risk for cancer than heterosexual women. However, there has been little research evaluating the association between sexual orientation and diet quality. METHOD: Data come from participants (aged 24-54 years) enrolled in Nurses' Health Study 3, an ongoing, U.S.-based cohort study (N = 15,941). We measured diet using recommendations from the Dietary Approach to Stop Hypertension (DASH) and American Health Association (AHA) 2020 Strategic Impact Goals. RESULTS: We found limited evidence of differences across diet quality by sexual orientation. When examining predicted DASH scores, mostly heterosexual [predicted mean score (95% confidence interval), 24.0 (23.8, 24.3)] and lesbian [24.3 (23.8, 24.9)] women had healthier predicted DASH scores than the reference group of completely heterosexual women with no same-sex partners [23.6 (23.5, 23.7)]. Even though certain sexual minority women had overall healthier predict DASH scores, their consumption of certain food groups-low-fat dairy and fruit-was lower than completely heterosexual women with no same-sex partners. When measuring AHA scores, most sexual minority groups (completely heterosexual women with same-sex partners, mostly heterosexual women, and lesbian women) had higher diet quality compared to the reference group of completely heterosexual women with no same-sex partners. CONCLUSION: Sexual minority women, particularly mostly heterosexual women and lesbian women, had healthier diet quality than completely heterosexual women with no same-sex partners. These data suggest that cancer risk factors (e.g., smoking, drinking, and inactivity) other than diet would drive higher cancer rates among sexual minority compared to heterosexual women. Nonetheless, it is critical for all women to improve their diet quality since diet quality was poor among participants of all sexual orientations.


Asunto(s)
Dieta/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Adulto , Bisexualidad/psicología , Bisexualidad/estadística & datos numéricos , Estudios de Cohortes , Dieta/psicología , Dieta/normas , Femenino , Heterosexualidad/psicología , Heterosexualidad/estadística & datos numéricos , Homosexualidad Femenina/psicología , Homosexualidad Femenina/estadística & datos numéricos , Humanos , Estudios Longitudinales , Persona de Mediana Edad , Neoplasias/epidemiología , Enfermeras y Enfermeros/psicología , Enfermeras y Enfermeros/estadística & datos numéricos , Factores de Riesgo , Conducta Sexual/psicología , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Encuestas y Cuestionarios , Estados Unidos , Adulto Joven
6.
J Adolesc Health ; 68(6): 1053-1058, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33875330

RESUMEN

PURPOSE: The COVID-19 pandemic has resulted in major life disruptions for sexual minority adolescents (SMAs), who already face and cope with pervasive and disproportionate rates of social, behavioral, and mental health challenges. Current research suggests that SMAs are struggling with COVID-19-related shelter in place orders navigating family proximity and dynamics and experiencing isolation from SMA-specific supports. Given identified challenges that may exacerbate known mental health disparities in SMAs, this work explores self-care practices among SMAs during the COVID-19 pandemic. METHODS: The present study uses data from open-ended questions to understand SMA experiences of self-care within a nationwide sample of SMAs (N = 770; M = 17.48 years, SD = 1.00) who are part of an ongoing prospective study. Data were collected via online questionnaire between May 13 and 31, 2020. Thematic analysis guided data exploration. RESULTS: Thematic analysis revealed five self-care practices among SMAs: (1) relationships, (2) routines, (3) body and mind, (4) rest and reset, and (5) tuning out. SMAs engaged in many positive coping strategies (i.e., exercise, establishing routine) and often linked these activities to positive well-being. Other SMAs engaged in activities to distract or disengage from stressors (i.e., excessive TV and alcohol and drug use). CONCLUSIONS: These findings highlight the resiliency of SMAs during the current pandemic, opportunities for providers to emphasize adaptive coping skills with youths, and the need for more research on adolescent self-care practices.


Asunto(s)
Adaptación Psicológica , COVID-19/psicología , Minorías Sexuales y de Género/psicología , Estrés Psicológico , Adolescente , COVID-19/epidemiología , Femenino , Humanos , Masculino , Pandemias , Estudios Prospectivos , SARS-CoV-2 , Autocuidado , Estrés Psicológico/etiología , Estrés Psicológico/prevención & control
7.
LGBT Health ; 8(4): 263-272, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33887160

RESUMEN

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has accentuated long-standing population health disparities in the United States. We examined how the pandemic and its social consequences may differentially impact sexual minority adults, relative to heterosexual adults. Methods: Data are from a U.S. national sample of adults (n = 2996; 18.06%) collected from online panels from April to May 2020. We used eight indicators of well-being-mental health, physical health, quality of life, stress, loneliness, psychological distress, alcohol use, and fatigue-to assess the degree to which sexual identity subgroups (i.e., heterosexual, gay/lesbian, bisexual, and "other" sexual minority) varied in retrospective pre- and postpandemic onset indicators of well-being and whether groups varied in their rate of change from pre- and postpandemic onset. Results: The results showed consistent patterns of decline in well-being across sexual identity subgroups, although changes in mental health, physical health, quality of life, stress, and psychological distress were more robust among sexual minority adults in general, relative to heterosexual adults. Adjusted multivariate models testing differences in change in retrospective pre- and postpandemic onset found that well-being among bisexual men and women was most negatively impacted by the pandemic. Conclusion: The COVID-19 pandemic may have distinct health consequences for sexual minority adults in the United States. Our findings support and further legitimize calls for more comprehensive surveillance and cultural responsiveness in emergency preparedness as it relates to sexual minority people and the COVID-19 pandemic.


Asunto(s)
COVID-19/epidemiología , Identidad de Género , Disparidades en el Estado de Salud , Trastornos Mentales/epidemiología , Minorías Sexuales y de Género/psicología , Adulto , Femenino , Humanos , Masculino , Minorías Sexuales y de Género/estadística & datos numéricos , Estados Unidos/epidemiología
8.
BMJ Open ; 11(4): e045258, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33795308

RESUMEN

INTRODUCTION: The COVID-19 pandemic and its control measures have impacted health and healthcare provision in various levels. Physical distancing measures, for instance, may affect sexual health, impacting access to HIV prevention supplies and changing sexual behaviour, as well as mental health, increasing feelings of unsafety and weakening community support ties. These effects can be worsened among socially marginalised groups, such as men who have sex with men (MSM) and transgender women (TGW). Brazil is among the countries most affected by COVID-19 in the world, where control measures have been inconsistently implemented. We aim to investigate the effects of the COVID-19 pandemic on the sexual and mental health of adolescent and adult MSM and TGW in Brazil. METHODS: Convergent mixed-method prospective cohort study, nested in two ongoing HIV pre-exposure prophylaxis (PrEP) cohorts in Brazil, named PrEP1519 and Combina. Participants will be invited to answer, at baseline and after 6 months, a questionnaire about the effects of the COVID-19 pandemic on sexual behaviour, HIV prevention and mental health. Data on HIV infection and sexually transmitted infections (STI) will be collected as part of routine follow-up from the cohorts. Main outcome measures (HIV infection, STI and depression symptoms) will be observed within 12 months after baseline. Sample size is estimated at 426 participants. Complementarily, 50 participants will be invited to in-depth interviews through video calls or interactive voice response, and 20 will be invited to chronicle their lives during the pandemic through digital diaries. Triangulation will be done across qualitative methods and with the quantitative data. ETHICS AND DISSEMINATION: The study was approved by Research Ethics Committees from the Brazilian Universities coordinating the study. Findings will be published in scientific journals and presented at meetings. Informative flyers will be elaborated to communicate study findings to participants and key stakeholders.


Asunto(s)
COVID-19 , Infecciones por VIH/prevención & control , Salud Mental , Profilaxis Pre-Exposición , Minorías Sexuales y de Género/psicología , Personas Transgénero/psicología , Adolescente , Adulto , Anciano , Brasil/epidemiología , Estudios de Cohortes , Femenino , Infecciones por VIH/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estudios Prospectivos , Adulto Joven
9.
J Consult Clin Psychol ; 89(2): 73-80, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33705164

RESUMEN

OBJECTIVES: Sexual minority adolescents have previously been found to experience disparities in self-injurious thoughts and behaviors (SITBs) compared to heterosexual adolescents. However, there is a paucity of data on SITBs amongst children. Thus, the aim of the current study is to assess the prevalence of SITBs in a large sample of U.S. children and to test whether rates vary by sexual orientation. METHODS: Data were drawn from the 2.0 baseline release of the Adolescent Brain Cognitive Development (ABCD) study. The full sample included 11,777raw 9-10-year-old children (sexual minority n = 150raw). Children completed a computerized version of the youth Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5), including items assessing suicide ideation, suicide attempts, and nonsuicidal self-injury (NSSI). Unadjusted and adjusted models compared the prevalence of outcomes by sexual orientation. Models also compared the co-occurrence of NSSI and suicide ideation by sexual orientation. RESULTS: Across all outcomes, sexual minority children reported elevated prevalence rates compared to heterosexual children, with odds ratios ranging from 4.4 to 6.5. Among children who reported NSSI, a greater proportion of sexual minority versus heterosexual children reported co-occurring suicide ideation (OR = 3.8). CONCLUSIONS: In a large sample of 9-10-year-old U.S. children, sexual orientation disparities emerged across NSSI, suicide ideation, and suicide attempts. Results indicate that sexual minority children are a vulnerable population for SITBs. Inclusion of children in prevention programs is encouraged. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Conducta Autodestructiva/epidemiología , Minorías Sexuales y de Género/psicología , Ideación Suicida , Intento de Suicidio/estadística & datos numéricos , Niño , Femenino , Humanos , Masculino , Prevalencia , Factores de Riesgo , Conducta Autodestructiva/psicología , Intento de Suicidio/psicología
10.
Arch Sex Behav ; 50(3): 897-911, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33763803

RESUMEN

Despite the growing interest in the experiences of transgender individuals, the phenomenon of fetishization of transgender bodies and identities has been overlooked. The present study was aimed at investigating the experiences of fetishization of transgender and nonbinary (TGNB) people. Participants in the current study represent a sample of 142 TGNB volunteers from the community who answered the prompt: "If you feel comfortable, could you describe your experience of being fetishized?" Using thematic analysis, we developed three overarching themes relevant to the experiences of fetishization of TGNB participants: (1) context of fetishization; (2) negative experiences of fetishization; and (3) positive or ambiguous experiences of fetishization. The results demonstrated that, in most cases, fetishization was understood by TGNB people as a negative experience of sexual objectification, although some individuals experienced fetishization as a positive experience, perceiving the sexual desire of the other person or living it as a kink. Consistent with the integrated theory of dehumanization, the results demonstrated that both sexual objectification and minority stress contributed to participants' understanding of fetishization for TGNB individuals. Implications for clinical work with TGNB individuals are discussed.


Asunto(s)
Fetichismo Psiquiátrico/psicología , Conducta Sexual/psicología , Personas Transgénero/psicología , Identidad de Género , Humanos , Minorías Sexuales y de Género/psicología
11.
J Homosex ; 68(7): 1169-1195, 2021 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-33646070

RESUMEN

The current exploratory study utilized a mixed-methods design to study 18 lesbian Muslims' mental health in relation to familial and online social support (M Age = 24, Sd = 9). Due to the threat of familial rejection, the majority of participants (n = 11) selectively disclosed their sexual identity and four participants publicly disclosed. Half of participants scored as mildly to severely depressed on the Beck Depression Inventory (M = 15, Sd = 9). Participants reporting changes in their familial relationships due to their sexual orientation scored as the most highly depressed, F (2, 15) = 4.75, p = .025. Participants' depression scores varied significantly between those that belonged to online support groups addressing religion and sexuality (n = 8, M = 8.712, SD = 6.183) and those that did not (n = 10, M = 20.250, SD = 7.772), t(16) = 3.416, p = .004. Future research would benefit from exploring how therapeutic alliances and family of choice networks can help buffer lesbian Muslims' experiences of familial rejection.


Asunto(s)
Homosexualidad Femenina/psicología , Islamismo/psicología , Salud Mental , Minorías Sexuales y de Género/psicología , Adulto , Depresión/etiología , Emociones , Relaciones Familiares , Femenino , Humanos , Sexualidad/psicología , Apoyo Social , Adulto Joven
12.
J Homosex ; 68(7): 1196-1222, 2021 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-33705249

RESUMEN

The complexity of the lives of sexual and gender diverse Muslims within the United States calls for mental health providers to own our power and privilege. Embracing cultural humility in service of aligning ourselves with liberation psychology, we call for an intersectionally informed, strengths-based approach to empowering/affirming clients whose diverse religious experiences intersect with their experiences of marginalization as sexual and gender diverse (SGD) Muslims. Drawing on extant personal narratives around mental health and therapy of this population, the authors offer critical reflections, processes and opportunities for clinicians to take responsibility in honoring the diverse journeys and experiences of SGD Muslims in serving them in journeys of healing.


Asunto(s)
Identidad de Género , Homosexualidad/fisiología , Islamismo/psicología , Minorías Sexuales y de Género/psicología , Relaciones Familiares , Femenino , Homofobia , Humanos , Masculino , Salud Mental , Sexismo , Conducta Sexual , Estados Unidos
13.
J Homosex ; 68(7): 1106-1143, 2021 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-33724910

RESUMEN

In Singapore, discrimination toward LGBT citizens has been reinforced through a monolithic notion of the traditional Asian family. This ethnography focuses on the lived experiences of 7 ethnic minority Malay Muslim "butch" individuals and their journey to parenthood. Drawing upon frameworks of intersectionality and piety, I explore how butches negotiate and reconcile their queer practices and desires as Muslim daughters around "coming out," foster children with same-sex partners, being a biological parent and their perceptions of Assisted Reproductive Technologies (ART). Reproductive futures, enacted by Malay Muslim butches, disrupt yet reinforce the durability of "natural" life trajectories scripted through conventions of marriage, family and fatherhood that have, insofar, excluded them. Further, their experiences also offer alternatives to existing literature on same-sex families that tend to render other nonwhite and/or non-Western queer family practices invisible.


Asunto(s)
Homosexualidad Femenina/psicología , Islamismo/psicología , Masculinidad , Prejuicio , Religión y Sexo , Minorías Sexuales y de Género/psicología , Adulto , Femenino , Rol de Género , Humanos , Masculino , Matrimonio , Padres , Singapur
14.
J Homosex ; 68(7): 1083-1105, 2021 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-33764281

RESUMEN

The current study utilized data from the Social Justice Sexuality Project to investigate influences on psychological well-being of LGBT+ Muslims (N = 75) in the United States. Specifically, path analyses were used to examine the association between spiritual and religious engagement, LGBT community involvement, outness, and family support with psychological well-being. Control variables included lifespan Islam involvement, age, income, and the age at which the participant came out to themselves. Findings illustrate spiritual and religious engagement, outness, and income were all positively related to psychological well-being. Moreover, individuals who had converted to Islam but were not raised in the faith had significantly lower psychological well-being than those who had a consistent experience with Islam from their childhood until the time of the study. The present investigation provides critical contributions to the study of gender and sexual minorities in the United States and the experiences of currently practicing LGBT+ Muslims and those who were raised Muslim. Clinical implications and future research suggestions are discussed.


Asunto(s)
Participación de la Comunidad , Islamismo/psicología , Religión y Sexo , Minorías Sexuales y de Género/psicología , Espiritualidad , Adolescente , Adulto , Niño , Relaciones Familiares , Femenino , Homosexualidad , Humanos , Masculino , Persona de Mediana Edad , Autorrevelación , Estados Unidos , Adulto Joven
15.
Drug Alcohol Depend ; 221: 108594, 2021 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-33689965

RESUMEN

BACKGROUND: Sexual and gender minority (SGM) young persons are experiencing compounding effects of COVID-19 due to unique social inequalities and existent mental health and substance use challenges. Given that 41% of all young persons are enrolled in universities, and the increased vulnerabilities faced by SGM young persons during the pandemic, it is imperative to understand the effects of alcohol use on mental health among SGM university students amid COVID-19. This study aims to examine the associations between changes in alcohol use since the start of COVID-19 and mental distress among SGM university students in the U.S., and to explore sex-stratified differences. METHODS: A nonprobability cross-sectional sample of 509 SGM university students (Mage = 22.04 years, SD = 3.99) were retrospectively surveyed online between May-August 2020 and asked if their alcohol use had changed since the start of COVID-19. Statistical analyses explored the association between changes in alcohol use since the start of COVID-19 and mental distress. RESULTS: Average psychological distress (M = 27.79, SD = 7.82) was relatively high as per existing research and established clinical cutoff scores. Roughly 32% had increased alcohol use since the start of COVID-19. Subsequently, greater alcohol use (p < .05) since the start of COVID-19 was associated with higher psychological distress among SGM university students, and among females but not males assigned at birth. CONCLUSIONS: Higher education, medical, and behavioral health professionals should consider how to adapt their practice to address alcohol use and psychological burdens among SGM university students (especially females) who are facing health inequities during and beyond COVID-19, requiring SGM-affirmative care.


Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , COVID-19/psicología , Salud Mental , Distrés Psicológico , Minorías Sexuales y de Género/psicología , Estudiantes/psicología , Adolescente , Adulto , Consumo de Bebidas Alcohólicas/tendencias , Estudios Transversales , Femenino , Humanos , Masculino , Estudios Retrospectivos , Minorías Sexuales y de Género/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Universidades , Adulto Joven
16.
Lancet Glob Health ; 9(4): e446-e455, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33740407

RESUMEN

BACKGROUND: Men who have sex with men (MSM) in India are extremely marginalised and stigmatised, and therefore experience immense psychosocial stress. As current HIV prevention interventions in India do not address mental health or resilience to these stressors, we aimed to evaluate a resilience-based psychosocial intervention in the context of HIV and sexually transmitted infection (STI) prevention. METHODS: We did a multicity, randomised, clinical efficacy trial in Chennai (governmental tuberculosis research institute) and Mumbai (non-governmental organisation for MSM), India. Inclusion criteria were MSM, aged 18 years or older, who were at risk of HIV acquisition or transmission, defined as having any of the following in the 4 months before screening: anal sex with four or more male partners (protected or unprotected), diagnosis of an STI, history of transactional sex activity, or condomless anal sex with a man who was of unknown HIV status or serodiscordant. Participants were required to speak English, Tamil (in Chennai), or Hindi (in Mumbai) fluently. Eligible individuals were randomly assigned (1:1) to either a resilience-based psychosocial HIV prevention intervention, consisting of group (four sessions) and individual (six sessions) counselling alongside HIV and STI voluntary counselling and testing, or a standard-of-care control comprising voluntary counselling and testing alone. The primary outcomes were number of condomless anal sex acts with male partners during the past month (at baseline and 4 months, 8 months, and 12 months after randomisation), and incident bacterial STIs (at 12 months after randomisation). Resilience-related mediators included self-esteem, self-acceptance, and depression. Recruitment is now closed. This trial is registered with ClinicalTrials.gov, NCT02556294. FINDINGS: Between Sept 4, 2015, and June 28, 2018, we enrolled 608 participants; 305 (50%) were assigned to the psychosocial intervention condition and 303 (50%) were assigned to the control condition. 510 (84%) of 608 men completed an assessment at 4 months after randomisation, 483 (79%) at 8 months, and 515 (85%) at 12 months. 512 (99%) of 515 men had STI data from the 12-month assessment. The intervention condition had a 56% larger reduction in condomless anal sex acts (95% CI 35-71; p<0·0001) from baseline to 4-month follow-up, 72% larger reduction (56-82; p<0·0001) from baseline to 8-month follow-up, and 72% larger reduction (53-83; p<0·0001) from baseline to 12-month follow-up, compared with the standard-of-care control condition (condition by time interaction; χ2=40·29, 3 df; p<0·0001). Improvements in self-esteem and depressive symptoms both mediated 9% of the intervention effect on condomless anal sex acts. Bacterial STI incidence did not differ between study conditions at 12-month follow-up. INTERPRETATION: A resilience-based psychosocial intervention for MSM at risk of HIV acquisition or transmission in India was efficacious in reducing condomless anal sex acts, with evidence for mediation effects in two key target resilience variables. HIV prevention programmes for MSM in India should address mental health resilience to augment reductions in the risk of sexually transmitted HIV. FUNDING: National Institute of Mental Health.


Asunto(s)
Infecciones por VIH/prevención & control , Rehabilitación Psiquiátrica/métodos , Resiliencia Psicológica , Minorías Sexuales y de Género/psicología , Estigma Social , Adulto , Consejo/métodos , Estudios de Seguimiento , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Prueba de VIH , Humanos , India/epidemiología , Masculino , Conducta de Reducción del Riesgo , Conducta Sexual/psicología , Resultado del Tratamiento , Sexo Inseguro/prevención & control , Sexo Inseguro/psicología , Adulto Joven
17.
Psychiatry Res ; 299: 113855, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33721788

RESUMEN

The COVID-19 pandemic has caused unprecedented isolation and mental health effects; few studies have characterized this in sexual and gender (SGM) minority young people, a particularly vulnerable population. This cross-sectional study sought to analyze the mental health outcomes of SGM young people (18-30 years) during the early stages of the pandemic in the United States (April 13-June 18, 2020) and to explore how factors related to SGM identity impact mental health, such as lifetime discrimination, family support, and pre-existing mental health conditions. An online survey collected socio-demographic information and assessed for both mental health (depression (PHQ-8), anxiety (GAD-7), PTSD (PCL-C)) and COVID-19-related outcomes (COVID-19-related worries and COVID-19-related grief). Out of 981 participants, 320 (32.6%) identified as SGM. SGM had significantly higher levels of depression and PTSD symptoms as well as COVID-19-related worries and grief than non-SGM, even after controlling for family support, lifetime discrimination, and pre-existing mental health diagnoses. These findings suggest that not only has the COVID-19 pandemic disproportionately impacted SGM mental health, but that minority stress factors cannot fully explain this impact. Thus, clinicians and societal stakeholders (schools, employers, policymakers) must think beyond traditional minority stress factors (family support, discrimination) and pre-pandemic disparities to support this vulnerable population as the pandemic progresses.


Asunto(s)
COVID-19/psicología , Carga Global de Enfermedades , Salud Mental/estadística & datos numéricos , Factores Sexuales , Conducta Sexual/psicología , Minorías Sexuales y de Género/psicología , Adolescente , Ansiedad/psicología , COVID-19/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Pandemias , Cuestionario de Salud del Paciente , SARS-CoV-2 , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Adulto Joven
18.
Arch Sex Behav ; 50(3): 1003-1014, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33599884

RESUMEN

Individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ) are at a higher risk for suicidality compared to the general population. A growing body of research has investigated this risk, particularly with attention to systemic factors such as discrimination and harassment. Unfortunately, research has only examined the impact of direct discrimination on suicidality and has neglected to examine how ambient discrimination (i.e., witnessing or being made aware of discriminatory behaviors directed at someone other than yourself in your group) relates to suicidality. Additionally, although some links exist between discrimination and suicidality, the mechanisms by which these are related are understudied. This study aimed to address these gaps by exploring the effect of ambient discrimination on suicidal ideation and examining psychological pain as a mediator in this relationship. Data were collected from a sample of 200 LGBTQ-identified individuals (M age = 35 years; 53.5% female; 86% White). Results of independent t tests and a one-way multivariate ANOVA revealed greater vulnerability for ambient/direct discrimination and psychache among individuals identifying as transgender, queer, and other. Regression and mediation analyses revealed that while both ambient and direct discrimination predicted suicidal ideation, only direct discrimination accounted for unique variance in the outcome; however, both ambient and direct discrimination contributed unique variance to psychological pain, which fully mediated their relationships to suicidal ideation. Results of this study may begin to provide insight into the pathways of risk and points of intervention for suicidality in the LGBTQ community.


Asunto(s)
Víctimas de Crimen , Prejuicio , Minorías Sexuales y de Género , Ideación Suicida , Adulto , Femenino , Humanos , Masculino , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Estados Unidos
19.
JAMA Netw Open ; 4(2): e2036136, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33528552

RESUMEN

Importance: Medical trainee burnout is associated with poor quality care and attrition. Medical students in sexual minority groups report fear of discrimination and increased mistreatment, but the association between sexual orientation, burnout, and mistreatment is unknown. Objective: To evaluate whether medical student burnout differs by sexual orientation and whether this association is mediated by experiences of mistreatment. Design, Setting, and Participants: This cross-sectional study surveyed US medical students graduating from Association of American Medical Colleges (AAMC)-accredited US allopathic medical schools who responded to the AAMC graduation questionnaire in 2016 and 2017. Statistical analyses were performed from March 15, 2019, to July 2, 2020, and from November 20 to December 9, 2020. Main Outcomes and Measures: Burnout was measured using the Oldenburg Burnout Inventory for Medical Students, and sexual orientation was categorized as either heterosexual or lesbian, gay, or bisexual (LGB). Logistic regression models were constructed to evaluate the association between sexual orientation and experiencing burnout (defined as being in the top quartile of exhaustion and disengagement burnout dimensions) and to test the mediating association of mistreatment. Results: From 2016 to 2017, 30 651 students completed the AAMC Graduation Questionnaire, and 26 123 responses were analyzed. Most respondents were younger than 30 years (82.9%) and White (60.3%). A total of 13 470 respondents (51.6%) were male, and 5.4% identified as LGB. Compared with heterosexual students, a greater proportion of LGB students reported experiencing mistreatment in all categories, including humiliation (27.0% LGB students vs 20.7% heterosexual students; P < .001), mistreatment not specific to identity (17.0% vs 10.3%; P < .001), and mistreatment specific to gender (27.3% vs 17.9%; P < .001), race/ethnicity (11.9% vs 8.6%; P < .001), and sexual orientation (23.3% vs 1.0%; P < .001). Being LGB was associated with increased odds of burnout (adjusted odds ratio, 1.63 [95% CI, 1.41-1.89]); this association persisted but was attenuated after adjusting for mistreatment (odds ratio, 1.36 [95% CI, 1.16-1.60]). The odds of burnout increased in a dose-response manner with mistreatment intensity. Lesbian, gay, or bisexual students reporting higher mistreatment specific to sexual orientation had and 8-fold higher predicted probability of burnout compared with heterosexual students (19.8% [95% CI, 8.3%-31.4%] vs 2.3% [95% CI, 0.2%-4.5%]; P < .001). Mediation analysis showed that mistreatment accounts for 31% of the total association of LGB sexual orientation with overall burnout (P < .001). Conclusions and Relevance: This study suggests that LGB medical students are more likely than their heterosexual peers to experience burnout, an association that is partly mediated by mistreatment. Further work is needed to ensure that medical schools offer safe and inclusive learning environments for LGB medical students.


Asunto(s)
Agotamiento Profesional/epidemiología , Heterosexualidad/estadística & datos numéricos , Minorías Sexuales y de Género/estadística & datos numéricos , Discriminación Social , Estudiantes de Medicina/estadística & datos numéricos , Adulto , Bisexualidad , Agotamiento Profesional/psicología , Estudios de Casos y Controles , Estudios Transversales , Grupos Étnicos , Femenino , Heterosexualidad/psicología , Homofobia , Homosexualidad , Humanos , Modelos Logísticos , Masculino , Racismo , Sexismo , Minorías Sexuales y de Género/psicología , Estudiantes de Medicina/psicología , Encuestas y Cuestionarios , Estados Unidos/epidemiología
20.
J Homosex ; 68(7): 1075-1082, 2021 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-33629927

RESUMEN

This article serves as the first in a series of six articles providing a theoretically and empirically informed approach to understanding Muslim LGBTQ lives from an intersectional positive-growth framework, transformative intersectional psychology (TIP). Within this perspective, LGBTQ Muslims' religious, gender and sexual identities are mutually interactive and situated within the dynamic systems of power, privilege and oppression. This approach recognizes that LGBTQ individuals negotiate multiple minority identities as they navigate oppression and build pathways of resilience. In the present article, we provide an introduction to TIP and this theory's relevance to the distinct experiences of LGBTQ Muslims. We then conclude with an overview of the goals of this Special Issue, The LGBTQ Muslim Experience, and introduce the subsequent articles in the series. The articles in this Special Issue address the implications of transformative intersectional psychology for LGBTQ Muslim research, training and clinical practice.


Asunto(s)
Homosexualidad , Islamismo/psicología , Religión y Sexo , Minorías Sexuales y de Género/psicología , Femenino , Identidad de Género , Humanos , Masculino , Teoría Psicológica
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