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1.
Artículo en Inglés | MEDLINE | ID: mdl-32549345

RESUMEN

This online survey study aimed to compare the cognitive, affective, and behavioral constructs of health beliefs related to coronavirus disease 2019 (COVID-19) between sexual minority and heterosexual individuals in Taiwan. In total, 533 sexual minority and 1421 heterosexual participants were recruited through a Facebook advertisement. The constructs pertaining to cognition (perceived relative susceptibility to COVID-19, perceived COVID-19 severity, having sufficient knowledge and information on COVID-19, and confidence in coping with COVID-19), affect (worry toward COVID-19), and behavior (adoption of health-protective behaviors) in relation to health beliefs about COVID-19 were compared between sexual minority and heterosexual participants. The results indicated that sexual minority participants had lower perceived susceptibility to COVID-19, greater self-confidence in coping with COVID-19, and lower worry about COVID-19 and were less likely to maintain good indoor ventilation and disinfect their household than heterosexual individuals. Sexual orientation is the modifying factor for the Health Belief Model in the COVID-19 pandemic and should be taken into consideration when medical professionals establish prevention programs for COVID-19.


Asunto(s)
Afecto , Cognición , Infecciones por Coronavirus/psicología , Conductas Relacionadas con la Salud , Heterosexualidad/psicología , Neumonía Viral/psicología , Minorías Sexuales y de Género/psicología , Adaptación Psicológica , Adulto , Betacoronavirus , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Encuestas y Cuestionarios , Taiwán
2.
Am J Nurs ; 120(6): 1-4, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32443134

RESUMEN

Free, evidence-based resources for health care providers, individuals, and families.


Asunto(s)
Atención de Enfermería/normas , Minorías Sexuales y de Género/psicología , Recursos en Salud , Disparidades en Atención de Salud , Humanos , Atención de Enfermería/psicología , Estados Unidos
3.
PLoS One ; 15(4): e0231022, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32255781

RESUMEN

This study identifies how to screen for harmful alcohol use among gender minority (e.g., transgender and gender-expansive) people using brief screening methods and identifies which screening methods perform best among gender-expansive, transfeminine, and transmasculine subgroups, as screening recommendations are not currently available. Using 2018 Annual Questionnaire data from The PRIDE Study, area under the curve (AUC) values were compared to identify which screening methods ("4 or more" or "5 or more" drinks on one occasion in the past year, or one or more items from the Alcohol Use Disorders Identification Test [AUDIT]) best predicted (i) harmful alcohol use and (ii) one or more past year alcohol dependence symptoms or consequences. Among 1892 participants, "5 or more" drinks on one occasion (AUC ranges: 0.82-0.86) performed better than "4 or more" drinks (AUC ranges: 0.78-0.81) in predicting harmful drinking. The screening methods "4 or more" drinks, "5 or more" drinks, and the consumption items of the AUDIT (AUDIT-C) using a cutoff score of 3 all maximized sensitivity and specificity to predict alcohol dependence symptoms or consequences in gender minority people overall (AUC: 0.77-0.78). Screening for "5 or more" drinks on one occasion within the past year performed as well as or better than other screening methods to detect both harmful drinking and alcohol dependence-related symptoms or consequences. This single-item screening method can identify if more extensive alcohol use assessment is warranted with gender minority people.


Asunto(s)
Alcoholismo/diagnóstico , Tamizaje Masivo/métodos , Minorías Sexuales y de Género/psicología , Adulto , Área Bajo la Curva , Femenino , Humanos , Masculino , Sensibilidad y Especificidad , Minorías Sexuales y de Género/estadística & datos numéricos , Encuestas y Cuestionarios
4.
BMC Infect Dis ; 20(1): 299, 2020 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-32321442

RESUMEN

BACKGROUND: Sexualized drug use (SDU) refers to use of any psychoactive substance before/during sexual intercourse. Chemsex is a subset of SDU, which is defined as the use of some specific psychoactive substances (methamphetamine, mephedrone, γ-hydroxybutyrate, ketamine and cocaine) before/during sexual intercourse. SDU and chemsex are prevalent among gay, bisexual and other men who have sex with men (GBMSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among a sample of GBMSM in Hong Kong with experience of SDU in the past year. METHODS: A total of 600 GBMSM were recruited by convenient sampling through outreaching in gay venues, online recruitment and peer referral. Participants completed a cross-sectional anonymous telephone interview. This study was based on a subsample of 580 GBMSM self-reported as HIV negative/unknown sero-status. RESULTS: Of the participants, 82 (14.1%) and 37 (6.4%) had experience of SDU and chemsex in the past year. The prevalence of PrEP uptake was 4.0% among all participants and 14.6% among those with experience of SDU in the past year. Among GBMSM with experience of SDU in the past year who were not on PrEP (n = 70), 67.1% were willing to use daily oral PrEP in the next 6 months. Multivariate logistic regression models showed that positive attitudes toward PrEP (AOR: 2.37, 95%CI: 1.47, 3.82), perceived support from significant others to use PrEP (AOR: 9.67, 95%CI: 2.95, 31.71), and perceived behavioral control of using PrEP (AOR: 19.68, 95%CI: 5.44, 71.26) were significantly associated with higher willingness to use PrEP. CONCLUSION: GBMSM with experience of recent SDU are potentially good candidates of PrEP implementation. This group of GBMSM reported high prevalence of uptake and willingness to use PrEP. Perceptions related to PrEP based on the Theory of Planned Behavior were significantly associated with willingness to use PrEP.


Asunto(s)
Homosexualidad Masculina/estadística & datos numéricos , Participación del Paciente/estadística & datos numéricos , Profilaxis Pre-Exposición/métodos , Psicotrópicos/uso terapéutico , Minorías Sexuales y de Género/estadística & datos numéricos , Enfermedades de Transmisión Sexual/prevención & control , Trastornos Relacionados con Sustancias/epidemiología , Volición , Adolescente , Adulto , Actitud Frente a la Salud , Bisexualidad/psicología , Bisexualidad/estadística & datos numéricos , China/epidemiología , Estudios Transversales , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Homosexualidad Masculina/psicología , Hong Kong/epidemiología , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Profilaxis Pre-Exposición/estadística & datos numéricos , Prevalencia , Conducta Sexual/fisiología , Conducta Sexual/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Enfermedades de Transmisión Sexual/epidemiología , Encuestas y Cuestionarios , Volición/fisiología , Adulto Joven
5.
PLoS One ; 15(3): e0229133, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32134936

RESUMEN

Women's preferences for masculine characteristics in men's faces have been extensively studied. By contrast, little is known about how gay men respond to masculine facial characteristics. One area of disagreement in the emerging literature on this topic is the association between gay men's partnership status and masculinity preference. One study found that partnered gay men showed stronger preferences for masculine faces than did single gay men, while another study found that partnered gay men showed weaker preferences for masculine faces than did single gay men. We re-examined this issue in a sample of 618 gay men, finding no significant difference between partnered and single gay men's masculinity preferences. Together with the mixed previous findings, our null result suggests that the effect of partnership status on gay men's face preferences is not robust.


Asunto(s)
Conducta de Elección/fisiología , Cara , Homosexualidad Masculina/psicología , Masculinidad , Parejas Sexuales/psicología , Minorías Sexuales y de Género/psicología , Adolescente , Adulto , Femenino , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Percepción/fisiología , Adulto Joven
6.
PLoS One ; 15(3): e0229893, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32163450

RESUMEN

Borrowing concepts from public health, we examined the association of several social determinants with the mental health of middle-aged and older queer men in India by combining quantitative and qualitative methodologies. A cross-sectional survey guided by Meyer's Minority Stress Model was carried out to assess the links between minority stressors (internalized homophobia and degree of closetedness), age-related stressors (ageism and fear of ageing) and psychological wellbeing (loneliness, depressive symptoms and sexual compulsivity) among 207 Indian men (aged 40 years and above) who identified themselves as non-heterosexuals. Results from simple and multivariable linear regression models showed significant positive associations of ageism, internalized homophobia, and fear of ageing with loneliness, even after accounting for sociodemographic and stress mitigating factors. Ageism was not significantly related to depressive symptoms. However, fear of ageing and internalized homophobia was positively associated with depressive symptoms after accounting for covariates. Further, regression models demonstrated a consistent and statistically significant inverse association between income and adverse psychological outcomes suggesting the centrality of social class in the lived experience of Indian gay and bisexual men. The qualitative inquiry addressed the same research questions as the quantitative survey through in-depth interviews of thirty middle-aged and older gay and bisexual men in Mumbai. We found that older and midlife gay and bisexual men with higher income (a proxy for social class) found ways to manage their masculinities with no discernible adverse psychological outcomes. Depressive symptoms and loneliness in this population made them further vulnerable to excessive sexual impulses, especially in the older queer men who were passing off as heterosexuals. Overall, the theory-driven empirical findings suggest that even in India, where family and friends are social insurance for later life, the issues of ageism and internalized homophobia have the potential to lead to worse mental health outcomes among older queer men.


Asunto(s)
Depresión/epidemiología , Homosexualidad Masculina/psicología , Salud Mental/estadística & datos numéricos , Minorías Sexuales y de Género/psicología , Estrés Psicológico/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Ageísmo/psicología , Ageísmo/estadística & datos numéricos , Bisexualidad/psicología , Bisexualidad/estadística & datos numéricos , Estudios Transversales , Depresión/etiología , Depresión/psicología , Homofobia/psicología , Homofobia/estadística & datos numéricos , Homosexualidad Masculina/estadística & datos numéricos , Humanos , India/epidemiología , Soledad/psicología , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Minorías Sexuales y de Género/estadística & datos numéricos , Determinantes Sociales de la Salud/estadística & datos numéricos , Estrés Psicológico/etiología , Estrés Psicológico/psicología
7.
PLoS One ; 15(3): e0229533, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32119701

RESUMEN

BACKGROUND: Knowledge of HIV risk factors and reduction strategies is essential for prevention in key populations such as men who have sex with men (MSM) and transgender women (TGW). We evaluated factors associated with HIV-related knowledge among MSM and TGW and the impact of engagement in care at trusted community health centers in Nigeria. METHODS: The TRUST/RV368 cohort recruited MSM and TGW in Lagos and Abuja, Nigeria via respondent driven sampling. During study visits every three months, participants underwent structured interviews to collect behavioral data, received HIV education, and were provided free condoms and condom compatible lubricants. Five HIV-related knowledge questions were asked at enrollment and repeated after 9 and 15 months. The mean number of correct responses was calculated for each visit with 95% confidence intervals (CIs). Multivariable Poisson regression was used to calculate adjusted risk ratios and CIs for factors associated with answering more knowledge questions correctly. RESULTS: From March 2013 to April 2018, 2122 persons assigned male sex at birth were enrolled, including 234 TGW (11.2%). The mean number of correct responses at enrollment was 2.36 (95% CI: 2.31-2.41) and increased to 2.95 (95% CI: 2.86-3.04) and 3.06 (95% CI: 2.97-3.16) after 9 and 15 months in the study, respectively. Among 534 participants who completed all three HIV-related knowledge assessments, mean number of correct responses rose from 2.70 (95% CI: 2.60-2.80) to 3.02 (95% CI: 2.93-3.13) and then 3.06 (95% CI: 2.96-3.16). Factors associated with increased overall HIV-related knowledge included longer duration of study participation, HIV seropositivity, higher education level, and more frequent internet use. CONCLUSIONS: There was suboptimal HIV-related knowledge among Nigerian MSM and TGW at that improved modestly with engagement in care. These data demonstrate unmet HIV education needs among Nigerian MSM and TGW and provide insights into modalities that could be used to address these needs.


Asunto(s)
Conducta Sexual/psicología , Minorías Sexuales y de Género/psicología , Personas Transgénero/psicología , Adulto , Estudios de Cohortes , Femenino , Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Tamizaje Masivo/métodos , Persona de Mediana Edad , Nigeria/epidemiología , Educación del Paciente como Asunto/métodos , Parejas Sexuales/psicología , Estigma Social
9.
J Relig Health ; 59(2): 828-844, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32052279

RESUMEN

There is a growing interest in addressing spirituality in health care with evidence emerging that personal spiritual and religious practices, and support of these, can influence mental health in a positive way. However, there can be distinct challenges to spiritual expression and mental health issues for youth who identify as LGBT+. The goal of this paper was to undertake a systematic review of the available evidence to investigate the relationship between mental health, spirituality and religion as experienced by LGBT+ youth. A comprehensive literature search was conducted using medical and psychological databases that focused on spirituality, mental health and LGBT+ youth. The search yielded a total of ten articles published in English between May 2008 and June 2018. The key findings highlighted issues around discriminatory attitudes, shame related to disclosure, spirituality as a supportive resource, internalised conflict and external factors around sexual orientation concerns. The psychological, social and health implications are presented and discussed.


Asunto(s)
Homosexualidad/psicología , Religión y Psicología , Religión y Sexo , Minorías Sexuales y de Género/psicología , Espiritualidad , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Salud Mental , Adulto Joven
10.
Z Gerontol Geriatr ; 53(3): 216-221, 2020 May.
Artículo en Alemán | MEDLINE | ID: mdl-32072325

RESUMEN

BACKGROUND: There have been relatively few studies concerning gender and sexual identity in research on ageing and nursing or care. Non-heterosexual older people and those in need of care describe fears of rejection and the dependence on third parties in their use of health and social care services in old age. OBJECTIVE: This article examines the question of how gender and sexual diversity can be respected in older adult social services. It focuses on the question of how sexual and gender identity become relevant in particular contexts and how these categories interact with other categories of identity. MATERIAL AND METHODS: Qualitative data from the same sex and nursing in old age (GLEPA) research project with older lesbian, gay, bisexual, trans*and inter* (LGBTI*) people in need of care or help are used. For the analysis, biographical case reconstructions are combined with an intersectional perspective. RESULTS AND CONCLUSION: The analysis of the data shows how sexual and gender identities of older LGBTI* people are represented in differing contexts and depend on their experiences across the course of life. It also shows how specific strategies associated with these identity categories are developed and can be distinguished. Particularly in the act of personal care, the interplay between age, body and gender identity shows how the interviewees experience the normative and sometimes violent, structures of long-term care. Regarding sexual identity, the data show the continuing relevance of life situations and lifestyles for LGBTI* people into old age, demonstrating the importance of taking an intersectional perspective for person-centered care with older adults.


Asunto(s)
Envejecimiento , Disparidades en Atención de Salud , Homosexualidad , Sexismo , Minorías Sexuales y de Género/psicología , Anciano , Anciano de 80 o más Años , Femenino , Identidad de Género , Humanos , Masculino , Investigación Cualitativa , Conducta Sexual , Estigma Social
11.
Acad Med ; 95(5): 704-709, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32079959

RESUMEN

Members of the lesbian, gay, bisexual, transgender, and queer community experience marginalization, bias, and discrimination, including in the world of academic medicine. People who are transgender and nonbinary (TGNB) experience further marginalization compared with individuals who are lesbian, gay, bisexual, and queer. According to a recent survey, more than half of medical students who are TGNB chose not to disclose their gender identities during training due to fears of discrimination, feeling a lack of support, and concerns about future career options. Academic medicine has historically pathologized TGNB individuals, perpetuating discrimination structurally and reinforcing discriminatory behaviors of peers and faculty. In this Perspective, the authors provide a comprehensive overview of the challenges that administrators and educators face in creating a learning environment that is inclusive of TGNB trainees. They outline opportunities for change and provide strategies to address administrative and educational challenges, including those related to institutional climate, policies, data collection, physical spaces, health care, curriculum, mentoring, and the evaluation of TGNB trainees. Finally, the authors issue a call to action for medical educators and administrators to create environments in which trainees who are TGNB can fulfill their educational mission: to learn the practice of medicine.


Asunto(s)
Sexismo/psicología , Minorías Sexuales y de Género/educación , Estudiantes de Medicina/psicología , Diversidad Cultural , Humanos , Facultades de Medicina/organización & administración , Facultades de Medicina/tendencias , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Estudiantes de Medicina/estadística & datos numéricos
12.
Lancet Psychiatry ; 7(6): 538-546, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32006466

RESUMEN

The rates of suicide and self-harm in Northern Ireland are high, and have increased from 143 registered suicides in 1996 to 313 in 2010 and 318 in 2015. This Review summarises the epidemiology of suicidal behaviour, as well as the evidence from a small number of studies that have identified risk factors associated with high suicide rates in Northern Ireland. These risk factors were mental illness, trauma, exposure to the conflict known as the Troubles, deprivation, relationship problems, employment difficulties, financial difficulties, being LGBT, childhood adversities, and alcohol or drug use. We highlight the key challenges and opportunities for suicide prevention, emphasising a so-called lifespan approach. More needs to be done to address the relationship between substance misuse and suicide. Future research and prevention efforts should also focus on the transgenerational effect of the conflict, youth suicide, suicide prevention in minority groups, and the criminal justice context. The provision of and access to suicide-specific psychosocial interventions need to be prioritised, more support for people in crisis is required, as well as interventions for mental illness. Protect Life 2, the national suicide prevention strategy, needs to be implemented in full. Given the legacy of conflict in Northern Ireland, all suicide prevention efforts should be trauma informed.


Asunto(s)
Trastornos Mentales/psicología , Conducta Autodestructiva/prevención & control , Suicidio/prevención & control , Adolescente , Adulto , Experiencias Adversas de la Infancia/estadística & datos numéricos , Alcoholismo/epidemiología , Alcoholismo/psicología , Niño , Preescolar , Conflicto Psicológico , Empleo/psicología , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Irlanda del Norte/epidemiología , Carencia Psicosocial , Sistemas de Apoyo Psicosocial , Factores de Riesgo , Conducta Autodestructiva/epidemiología , Minorías Sexuales y de Género/psicología , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Ideación Suicida , Suicidio/estadística & datos numéricos , Heridas y Traumatismos/epidemiología , Heridas y Traumatismos/psicología , Adulto Joven
14.
Pediatrics ; 145(2)2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31964756

RESUMEN

The largest segment of missing children in the United States includes runaways, children who run away from home, and thrownaways, children who are told to leave or stay away from home by a household adult. Although estimates vary, as many as 1 in 20 youth run away from home annually. These unaccompanied youth have unique health needs, including high rates of trauma, mental illness, substance use, pregnancy, and sexually transmitted infections. While away, youth who run away are at high risk for additional trauma, victimization, and violence. Runaway and thrownaway youth have high unmet health care needs and limited access to care. Several populations are at particular high risk for runaway episodes, including victims of abuse and neglect; lesbian, gay, bisexual, transgender, and questioning youth; and youth in protective custody. Pediatricians and other health care professionals have a critical role to play in supporting runaway youth, addressing their unique health needs, fostering positive relationships within their families and with other supportive adults, and connecting them with available community resources. This report provides clinical guidance for pediatricians and other health care professionals regarding (1) the identification of adolescents who are at risk for running away or being thrown away and (2) the management of the unique medical, mental health, and social needs of these youth. In partnership with national, state, and local resources, pediatricians can significantly reduce risk and improve long-term outcomes for runaway youth.


Asunto(s)
Niño Abandonado , Jóvenes sin Hogar , Evaluación de Necesidades , Adolescente , Niño , Maltrato a los Niños , Niño Abandonado/psicología , Niño Abandonado/estadística & datos numéricos , Predicción , Cuidados en el Hogar de Adopción/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Jóvenes sin Hogar/psicología , Jóvenes sin Hogar/estadística & datos numéricos , Líneas Directas/estadística & datos numéricos , Humanos , Investigación , Medición de Riesgo , Minorías Sexuales y de Género/psicología , Minorías Sexuales y de Género/estadística & datos numéricos , Medios de Comunicación Sociales , Estados Unidos
15.
Pediatrics ; 145(2)2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31974217

RESUMEN

Many transgender and gender-diverse people have a gender identity that does not conform to the binary categories of male or female; they have a nonbinary gender. Some nonbinary individuals are most comfortable with an androgynous gender expression. For those who have not yet fully progressed through puberty, puberty suppression with gonadotrophin-releasing hormone agonists can support an androgynous appearance. Although such treatment is shown to ameliorate the gender dysphoria and serious mental health issues commonly seen in transgender and gender-diverse young people, long-term use of puberty-suppressing medications carries physical health risks and raises various ethical dilemmas. In this Ethics Rounds, we analyze a case that raised issues about prolonged pubertal suppression for a patient with a nonbinary gender.


Asunto(s)
Disforia de Género/tratamiento farmacológico , Consentimiento Informado de Menores/ética , Consentimiento Paterno/ética , Pubertad/efectos de los fármacos , Moduladores Selectivos de los Receptores de Estrógeno/uso terapéutico , Minorías Sexuales y de Género/psicología , Adolescente , Ansiedad/tratamiento farmacológico , Discusiones Bioéticas , Densidad Ósea/efectos de los fármacos , Toma de Decisiones Clínicas/ética , Esquema de Medicación , Ética Médica , Disforia de Género/psicología , Fracturas de Cadera/etiología , Humanos , Autonomía Personal
16.
Health Psychol ; 39(3): 220-229, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31944799

RESUMEN

OBJECTIVE: This study examined psychological and sexual health indicators associated with positive feelings and discrimination at the intersection of race and gender among Black gay, bisexual, and other sexual minority men (SMM). METHOD: Participants were a national sample of 1,064 Black SMM (Mdn age = 28) who responded to self-report measures of positive feelings and discrimination associated with being a Black man, psychological distress, self-efficacy, emotional awareness, and sexual HIV risk and protective behavior. Using structural equation modeling, we examined associations between the positive feelings and discrimination scales and the psychological and sexual health indicators. We also tested age as a moderator of these associations. RESULTS: Our results indicated that positive feelings about being a Black man were significantly positively associated with self-efficacy (b = 0.33), emotional awareness (b = 0.16), and sexual protective behavior (b = 0.93) and negatively associated with psychological distress (b = -0.26) and sexual risk behavior (b = -0.93). Except for emotional awareness and sexual protective behavior, discrimination as a Black man was also associated with these variables, though to a lesser magnitude for positive health indicators. Moderation results showed that, except for the association between positive feelings and emotional awareness, younger men generally had stronger associations between health indicators and the positive feelings and discrimination scales. CONCLUSIONS: These results suggest that positive feelings, in addition to discrimination, at the intersection of race and gender play an important role in the psychological and sexual health of Black SMM, especially earlier in their lives. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Afroamericanos/psicología , Minorías Sexuales y de Género/psicología , Discriminación Social/psicología , Adulto , Emociones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Asunción de Riesgos , Conducta Sexual/psicología
17.
AIDS Patient Care STDS ; 34(1): 7-15, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31944853

RESUMEN

Young black and Latinx men who have sex with men (YBLMSM) and transgender women (YBLTW) are disproportionately impacted by HIV. Structural and social marginalization, the social barriers, and structures that unevenly distribute benefits and burdens to different groups, may contribute to inability for youth to access prevention and treatment care services. Yet, few reports have examined the community and health care experiences of social marginalization among youth service providers who have multiple roles in the community (i.e., serve as a service provider and are a member or prior member of the YBLMSM and YBLTW population). Eighteen key informants (KIs), defined as youth, young adults, or adults who were members of or connected to the YBLMSM and young black and Latinx transgender (YBLTG) community, participated in a one-time, face-to-face, or telephone key informant interview (KII) lasting ∼45 min. KIs were defined as youth service providers because they described working with the target population and either being a member of or closely connected to the target population. KIs described key themes related to marginalization: lack of competent care among health care providers and both clinical and community spaces that left out key populations. HIV stigma and medical mistrust continues to create a barrier to care in this population and for interventions to be effective interventions will need to use an intersectional approach that simultaneously address all identities, and the social and structural needs of youth.


Asunto(s)
Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Homosexualidad Masculina/psicología , Minorías Sexuales y de Género/psicología , Estigma Social , Personas Transgénero/psicología , Confianza , Adolescente , Adulto , Afroamericanos , Baltimore , District of Columbia , Grupo de Ascendencia Continental Europea , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Accesibilidad a los Servicios de Salud , Hispanoamericanos , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Philadelphia , Minorías Sexuales y de Género/estadística & datos numéricos , Personas Transgénero/estadística & datos numéricos , Transexualidad , Adulto Joven
18.
BMC Infect Dis ; 20(1): 44, 2020 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-31941445

RESUMEN

BACKGROUND: Anticipated HIV stigma, i.e., the expectation of adverse experiences from one's seroconversion, is associated with both negative psychological and behavioral outcomes. We know little about anticipated HIV stigma's relationship with emerging technologies, such as HIV self-testing (HIVST) and online sex-seeking platforms, that have become popular among populations that are disproportionately affected by HIV/AIDS. This study examined correlates of anticipated HIV stigma among Chinese men who have sex with men (MSM). METHODS: In July 2016, MSM, who were ≥ 16 years old and self-reported as HIV negative or unknown, were recruited from a gay mobile phone application in China. Information regarding socio-demographics, sexual behaviors, sexual health service utilization, and anticipated HIV stigma were collected. Anticipated HIV stigma (i.e., negative attitude toward future stigmatization of HIV seroconversion by others) was measured as the mean score from a 7-item Likert-scale ranging from 1 (low) to 4 (high). Generalized linear models were conducted to examine the factors associated with the anticipated HIV stigma scores. RESULTS: Overall, 2006 men completed the survey. Most men completed high school (1308/2006, 65.2%) and had an annual personal income of ≤9200 USD (1431/2006, 71.3%). The mean anticipated HIV stigma score for the participants was 2.98 ± 0.64. Using social media to seek sexual partners was associated with higher anticipated HIV stigma (Adjusted ß = 0.11, 95% confidence interval (CI): 0.05 to 0.17, p = 0.001). HIV self-testing (Adjusted ß = - 0.07, 95%CI: - 0.13 to - 0.01, p = 0.02) and having disclosed one's sexual orientation to a healthcare provider (Adjusted ß = - 0.16, 95%CI: - 0.22 to - 0.96, p < 0.001) were associated with lower anticipated HIV stigma. CONCLUSION: Our data suggested that anticipated HIV stigma is still common among Chinese MSM not living with HIV. Tailored anti-HIV stigma campaigns on social media are especially needed, and the promotion of HIVST may be a promising approach.


Asunto(s)
Infecciones por VIH/psicología , Seronegatividad para VIH , Homosexualidad Masculina/psicología , Minorías Sexuales y de Género/psicología , Estigma Social , Adulto , Teléfono Celular , China , Estudios Transversales , Revelación , VIH/inmunología , Infecciones por VIH/virología , Personal de Salud , Humanos , Masculino , Aplicaciones Móviles , Autoinforme , Pruebas Serológicas , Conducta Sexual/psicología , Parejas Sexuales , Medios de Comunicación Sociales , Adulto Joven
19.
Pediatr Emerg Care ; 36(1): e25-e29, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31895204

RESUMEN

This fifth article in our series focuses on burnout in practicing pediatric emergency medicine physicians. As opposed to a general review of burnout, we address understudied and undervalued risk factors, drivers, and individual- and organizational-level solutions applicable to the emergency medicine workplace.Conflicting studies impact our understanding of the prevalence of burnout in our field and the role of depression. This article's story is anonymously submitted and leads us to our discussion of the heightened risk of burnout in underrepresented physicians, those who identify themselves as women, as belonging to a racial, ethnic, gender and/or sexual minority group, and/or as having a physical and/or sensory disability.Thus far, our articles have described coping tools for individuals and health care organizations to prevent and/or mitigate the untoward effects of life-changing stressors on a pediatric emergency physician's life. They include staying healthy and active, cultivating outside interests, and nurturing relationships with peers, friends, and family. We have shared the techniques and benefits of constructive engagement when one is faced with challenging events or individuals. We have underscored the value of peer support, support groups, emotional debriefing, and engaging with outside organizations able to address specific stressors. We have introduced the practice of political engagement as a way of addressing systems-level pressures. Throughout this series, we have emphasized the need to ask for help from family, friends, peers, primary care providers, and mental health professionals. This article describes the benefits of Employee Assistance Programs, Physician Wellness Programs, positive psychology, and grounding behaviors as self-care strategies.


Asunto(s)
Agotamiento Profesional/terapia , Medicina de Emergencia , Médicos/psicología , Autocuidado/métodos , Agotamiento Profesional/epidemiología , Agotamiento Profesional/prevención & control , Depresión/complicaciones , Personas con Discapacidad/psicología , Femenino , Humanos , Masculino , Servicios de Salud del Trabajador , Pediatras/psicología , Factores de Riesgo , Minorías Sexuales y de Género/psicología , Estrés Psicológico
20.
PLoS One ; 15(1): e0226178, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31905216

RESUMEN

Accumulating evidence suggests that sexual minorities experience elevated levels of depressive symptoms compared to heterosexuals in Western countries. Still, little is known about whether there is any difference in depressive symptoms between sexual minority men and heterosexual men in China. This study investigated the differences in depressive symptoms and social support between 302 Chinese sexual minority men and 249 heterosexual men. The association between depressive symptoms, social support and sexual orientation was also explored. Our results indicated that Chinese sexual minority men have more depressive symptoms and perceived lower social support than heterosexual men. Overall, sexual orientation and social support both predicted depressive symptoms. Different from previous Western studies, in our results, social support fully mediates but does not moderate the relationship between sexual orientation and depressive symptoms in Chinese men. The current findings suggest that social support has a significant impact on depressive symptoms among Chinese sexual minority men, highlighting the unique role of social support in understanding depressive symptoms among Chinese sexual minority men. Providing more social support, as well as promoting accepting and positive environments, may lead to better adjustment in this population in China.


Asunto(s)
Depresión/epidemiología , Heterosexualidad/psicología , Conducta Sexual/psicología , Minorías Sexuales y de Género/psicología , Apoyo Social , Adolescente , Adulto , China/epidemiología , Depresión/psicología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Adulto Joven
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