Identity Processes and Psychological Wellbeing Upon Recall of a Significant "Coming Out" Experience in Lesbian, Gay and Bisexual People.

This study focuses on the relations between minority stressors, protective factors and psychological wellbeing among lesbian, gay and bisexual (LGB) people. Experimental data based on a sample of 156 showed that participants asked to recall a negative coming out experience to somebody significant reported more identity threat and distress and less positive affect compared to those recalling a neutral coming out experience. In the negative recall condition, the effects of the stressors of discrimination and rejection on the variance of distress through the mediation of identity threat were statistically significant but not in the neutral recall condition and the two conditions statistically significantly differed in regards to the relationship between discrimination and distress. Identity resilience-continuity was associated with less identity threat and distress in the negative recall condition only, while social support was negatively associated and LGB stigma sensitivity was positively associated with distress in both conditions. Degree of outness (operating as a coping strategy) was associated with increased positive affect in both the neutral and negative recall conditions. When recalling a negative coming out experience, LGB people may be more susceptible to distress associated with minority stressors but also capitalize on available coping strategies.

From danger to destination: changes in the language of endemic disease during the COVID-19 pandemic.

At the beginning of 2022, the word 'endemic' became a buzzword, especially in the UK and the USA, and a kernel for the formation of novel social representations of the COVID-19 pandemic. The word normally refers to a disease which is continuously present, whose incidence is relatively stable and is maintained at a baseline level in any given locality. Over time, 'endemic' migrated from scientific discourse into political discourse, where it was mainly used to argue that the pandemic was over and people now had to learn to 'live with' the virus. In this article, we examine the emerging meanings, images and social representations of the term 'endemic' in English language news between 1 March 2020 and 18 January 2022. We observe a change over time, from the representation of 'endemic' as something dangerous and to be avoided to something desirable and to be aspired to. This shift was facilitated by anchoring COVID-19, especially its variant Omicron, to 'just like the flu' and by objectifying it through metaphors depicting a path or journey to normality. However, the new language of hope and aspiration did not go entirely unchallenged. Our analysis suggests that two competing polemic social representations emerged: one of endemicity as hope and aspiration and the other focusing on misguided optimism. We discuss these findings in the context of emerging polarisations in beliefs about the pandemic, politics and disease management.

Identity resilience, science mistrust, COVID-19 risk and fear predictors of vaccine positivity and vaccination likelihood: A survey of UK and Portuguese samples.

Based on Identity Process Theory, we hypothesised that two elements of identity resilience (identity worth and identity continuity) differentially predict variance in COVID-19 fear and risk, science mistrust, vaccine positivity, and vaccination likelihood. Data from an online survey of 643 UK and 485 Portuguese adults collected during March 2021 showed the UK and Portuguese did not differ significantly on vaccination likelihood or identity resilience. UK respondents reported less science mistrust, COVID-19 risk, and fear, but higher vaccine positivity than the Portuguese. Identity worth and identity continuity differed between countries in their effects on science mistrust, COVID-19 fear, risk, vaccine positivity and vaccination likelihood. Science mistrust and COVID-19 fear proved key factors in predicting vaccine positivity and vaccination likelihood. We conclude the roles of discrete elements of identity resilience in health behaviour require further examination and action reducing prevalence of specific forms of science mistrust can improve vaccination likelihood.

Predicting sexual risk and sexual health screening in a sample of university students in Lebanon: a cross-sectional study.

OBJECTIVE: The present study focuses on factors that predict sexual risk behaviors and sexual health screening behaviors in a sample of university students in Lebanon. PARTICIPANTS: A convenience sample of 250 undergraduate students was recruited at a private university in Beirut, Lebanon. METHODS: Students completed measures of religiosity, psychological distress, contraceptives usage, human immunodeficiency virus (HIV)/sexually transmitted infections (STI) screening, and sexual risk behaviors. RESULTS: Religiosity was negatively associated with a range of risky sexual behaviors whereas psychological distress was positively associated with these behaviors. Sex under the influence of alcohol/drugs, discussing methods of contraception, and engaging in sexual activities later regretted had significant effects on having had condomless vaginal sex. Gender (being female) and sex under the influence of alcohol had significant effects on STIs screening. CONCLUSION: Interventions that focus on managing drug and alcohol use in students, unwanted pregnancy, religion, stigma related to screening, and sexual health education are recommended.

Internalized Sexual Orientation Stigma and Mental Health in a Religiously Diverse Sample of Gay and Bisexual Men in Lebanon.

This study explores the correlates of internalized sexual orientation stigma, psychological distress and depression in a religiously diverse sample of gay and bisexual men in Lebanon. A convenience sample of 200 participants completed a cross-sectional survey. Bisexual men reported greater internalized sexual orientation stigma and less outness to their family and were more likely to face family pressure to have a heterosexual marriage than gay men. People of no religion reported more outness than Muslims and Christians but also higher psychological distress and depression. Multiple regression analyses showed that religiosity, outness, family pressure to marry and being bisexual were positively associated with internalized sexual orientation stigma; and that frequency of attending one's place of worship was negatively associated with psychological distress and depression. Individuals may be coping with adversity through engagement with institutionalized religion, which also appears to be a source of negative social representations concerning their sexuality.

The choice of response alternatives in COVID-19 social science surveys.

Social science research is key for understanding and for predicting compliance with COVID-19 guidelines, and this research relies on survey data. While much focus is on the survey question stems, less is on the response alternatives presented that both constrain responses and convey information about the assumed expectations of the survey designers. The focus here is on the choice of response alternatives for the types of behavioral frequency questions used in many COVID-19 and other health surveys. We examine issues with two types of response alternatives. The first are vague quantifiers, like "rarely" and "frequently." Using data from 30 countries from the Imperial COVID data hub, we show that the interpretation of these vague quantifiers (and their translations) depends on the norms in that country. If the mean amount of hand washing in a country is high, it is likely "frequently" corresponds to a higher numeric value for hand washing than if the mean in the country is low. The second type are sets of numeric alternatives and they can also be problematic. Using a US survey, respondents were randomly allocated to receive either response alternatives where most of the scale corresponds to low frequencies or where most of the scale corresponds to high frequencies. Those given the low frequency set provided lower estimates of the health behaviors. The choice of response alternatives for behavioral frequency questions can affect the estimates of health behaviors. How the response alternatives mold the responses should be taken into account for epidemiological modeling. We conclude with some recommendations for response alternatives for behavioral frequency questions in surveys.

Chemsex, Identity and Sexual Health among Gay and Bisexual Men.

This article focuses on some of the social, cultural and psychological aspects of drug use in sexualized settings in gay and bisexual men (referred to as "chemsex"). Using a narrative review approach, the article examines previous empirical research in this area and presents a novel theoretical approach for understanding and predicting chemsex behavior. Tenets of identity process theory from social psychology are drawn upon to offer an integrative theoretical framework within which the social, cultural and psychological underpinnings of chemsex can be collectively examined. Existing empirical research suggests that gay and bisexual men may experience sexuality-related stressors that can undermine feelings of self-esteem, self-efficacy, continuity and positive distinctiveness. Identity process theory examines how individuals react to threats to identity brought about by these stressors. In response to identity threat, gay and bisexual men may engage in chemsex as a coping response that encompasses and facilitates various, largely maladaptive, coping strategies and tactics. The more chemsex is perceived as enhancing identity processes and as averting identity threat, the more central it is likely to be to the identities of participants. The centrality of chemsex to one's identity may preclude self-withdrawal from the practice. Several directions for future research are presented based on existing work on chemsex viewed through the lens of identity process theory. These should form the basis of future empirical research in the sphere of sexual health among gay and bisexual men and the outcomes of this research should inform policy and practice in this area.

A Mixed-Methods Evaluation of "The Quest," A Health and Well-Being Intervention for British-Based Black, Asian and Minority Ethnic Gay and Bisexual Men.

This article provides an evaluation of a health and well-being workshop-based intervention, "The Quest" for gay and bisexual men from British Black Asian and Minority Ethnic (BAME) communities. A quantitative component assessed reported and intended sexual risk, drugs and alcohol use alongside measures of psychological well-being with pre and post-program data collected from 26 men. Fourteen men participated in focus groups that discussed experiences of the intervention. Significant improvements were found on measures of internalized homophobia, self-esteem and self-efficacy but not for health behaviors including safer sex or substance use. Qualitative feedback was generally positive especially around enhanced psychological well-being, identity integration, and enhanced self-awareness. There were some concerns over group size and whether non-BAME gay men were appropriate as facilitators. Theoretically informed, culturally competent interventions can demonstrate significant potential in enhancing the well-being of BAME gay and bisexual men but follow-up data are needed to show longer-term benefits.

Social psychological aspects of gay identity development.

This article focuses upon the social psychological aspects of identity development among gay men. Key stage-based models of, and contemporary empirical research into, gay identity development are outlined. Three levels of sexual identity development are examined: the psychological, the interpersonal and the collective. It is argued that, in order to develop an effective theory of gay identity development, empirical research should focus upon these levels of analysis, acknowledging that there is a dynamic interplay between them; the multiplicity of identity itself (consisting of sometimes competing elements); and the motives that underpin the construction, management and protection of identity (principally self-esteem, self-efficacy, continuity, positive distinctiveness and belongingness). Identity process theory is proposed as a useful theoretical framework for doing so.

Imaginaries of patienthood: Constructions of HIV patients by HIV specialist health professionals.

This paper explores the ways in which HIV specialists based in the United Kingdom (UK) construct, conceptualise and imagine their patient group via the concept of the 'imaginary', a notion encompassing the symbols, concepts and values through which people make sense of their social environment. In discussing their work with men who have sex with men (MSM), practitioners described patients as knowledgeable and highly adherent to treatment, yet apt to pursue hedonistic lives involving sex and recreational drugs. Recent innovations in treatment were formulated in terms of optimism and progress and the ascent of biomedical approaches was cast as an advance over former emphases on psychosocial interventions and attempts to facilitate behaviour change. In contrast to the imaginary of patients who were well-informed and highly compliant with treatment, participants also sought to explain those who were not easily enfolded within modern treatment regimens or who were seen to be overly emotional. These patients, it was said, had some pre-existing psychological problem or perhaps were especially vulnerable to societal pressures. Overall, the imaginary of the public was pervaded by therapeutic optimism, a sense of progress and an invigoration of biomedical themes in overcoming the challenges of delivering services to MSM.

Findings From a Community Survey of Individuals Who Engage in Pup Play.

This study presents findings from a community survey on pup play. Pup play is a kink activity and a form of role play that is growing in popularity internationally, and gaining increasing attention in sexology, yet prior research on pup play has almost entirely employed qualitative methods and primarily involved gay and bisexual men. Using survey data of 733 pup play participants primarily from the US, but also internationally, this study reports on the demographics of participants, how they engage in pup play, its social and sexual elements, and how it relates to social identity and mental health. Unique pup names and identifying with breeds of dogs were used to foster a sense of individuality within pup play, while the majority of participants owned and wore gear when engaging in pup play. We also found significant associations between being younger and identifying as a pup. Most participants reported that pup play improved their mental health. Binary logistic regression analyses indicated that having a mental health diagnosis was associated with identifying with a more social style of pup play and self-reporting the mental health benefits of pup play. We find that the conceptualization of pup play in the existing literature to be accurate to this international sample and highlight areas where further research is needed, alongside limitations of the study.

The COVID-19 Own Risk Appraisal Scale (CORAS): Development and validation in two samples from the United Kingdom.

Perceived risk is an important determinant of the adoption of preventive behaviours. In this article, the psychometric properties of the COVID-19 Own Risk Appraisal Scale (CORAS), including its development and validation in two samples in the United Kingdom, are described. The CORAS is a measure of perceived personal risk of contracting the disease, incorporating primarily intuitive with some analytic risk estimates. Exploratory and confirmatory factor analyses were performed on data from 470 participants in the United Kingdom who completed the CORAS, the Fear of COVID-19 Scale and the COVID-19 Preventive Behaviours Index. Results showed that a unidimensional, six-item model fits the data well, with satisfactory fit indices, internal consistency and high item loadings onto the factor. We found no statistically significant differences by age, gender or ethnicity. The CORAS correlated positively with the Fear of COVID-19 Scale and the COVID-19 Preventive Behaviours Index, suggesting good concurrent validity.

HIV stigma in UK press reporting of a case of intentional HIV transmission.

The UK has set itself the ambitious target of zero new HIV transmissions by 2030. HIV stigma is a significant barrier to achieving this target. Media reporting plays an important role in shaping social representations of HIV and of stigma. Between 2016 and 2018, the media in the UK reported on the Daryll Rowe case - the first criminal prosecution for intentional transmission of HIV in the UK. This article examines the way that UK newspapers reported this case, which may have exacerbated HIV stigma. Using Nexis, 178 UK newspaper articles were extracted and subjected to qualitative thematic analysis through a social constructionist lens. Informed by social representations theory, the analysis yielded three discursive themes: (1) Representing the perpetrator through HIV-focussed metaphors; (2) Constructing volitional ambiguity; and (3) Anchoring the lived experience of HIV to misery and death. UK newspapers constructed an 'evil vs victimhood' dichotomy in relation to Rowe and the men infected with HIV, respectively. This article argues that news coverage of the Rowe story constructs HIV in ways that are inconsistent with public health messaging. Reporting failed to note innovations in HIV treatment and prevention but instead disseminated stigmatising social representations of HIV. This is important because stigma impedes effective HIV prevention, engagement with HIV care and ultimately our ability to achieve the zero-infections target.

Socio-economic inequalities in social network, loneliness and mental health during the COVID-19 pandemic.

BACKGROUND: During the COVID-19 pandemic, a focus on isolation and loneliness is important, especially as social distancing policies (which for some groups involve self-isolation or quarantine) are likely to accentuate these experiences and affect mental health. AIMS: This study focuses on socio-economic inequalities in social network, loneliness and mental health during the COVID-19 pandemic. METHODS: Two-hundred and fourteen residents of Wandsworth, a South West London Borough in the United Kingdom completed an online cross-sectional survey on the impact of COVID-19 on mental health. Data were analysed using independent samples t-tests and multiple regression. RESULTS: Middle-aged people reported a less strong social network and more loneliness, anxiety and depression than younger people. People with a long-term health condition reported a less strong social network, more loneliness, more general practitioner (GP) and hospital visits, and poorer mental health than those with no long-term health conditions. People receiving State financial benefits reported less use of public spaces, a less strong social network, more loneliness, more GP and hospital visits and poorer mental health than those not receiving benefits. Greater neighbourhood identification was associated with a stronger social network and better mental health outcomes. Multiple regression analyses showed that, over and above loneliness, perceived personal risk of COVID-19 constitutes an additional precipitant for both depression and anxiety when controlling for other variables. CONCLUSION: As a novel stressor associated with the pandemic, the situational and involuntary perception of being at risk of COVID-19 may be stimulating anxiety and depressive symptomatology, which will need to be managed effectively as resurgences of the disease are predicted and communicated to the general public under growing mistrust and uncertainty.

Stigma and HIV Concealment Motivation among Gay Men Living with HIV in Finland.

This study explored experiences of HIV stigma among gay men in Finland and the impact of these experiences on decision-making concerning HIV status disclosure. Seventeen gay men living with HIV in Finland participated in a qualitative interview study and the data were analyzed using thematic analysis. The results focus on the following themes: (1) "Social support impedes social stigma;" (2) "Social support and the risk of HIV stigma," which describes how the pursuit of social support can expose some individuals to stigma; and (3) "HIV concealment motivation as a coping strategy," focusing on the motivation to conceal one's HIV status from others to avoid stigma. It is necessary to promote awareness and understanding of HIV in Finnish society, to challenge HIV stigma and, crucially, to facilitate access to social support among those diagnosed with HIV. This is likely to have favorable implications for both psychological and public health.

COVID-19 preventive behaviours in White British and Black, Asian and Minority Ethnic (BAME) people in the UK.

A model of the effects of ethnicity, political trust, trust in science, perceived ingroup power, COVID-19 risk and fear of COVID-19 upon likelihood of COVID-19 preventive behaviour (CPB) is presented. The structural equation model was a good fit for survey data from 478 White British and Black, Asian and Minority Ethnic (BAME) people. Ethnicity had a direct effect on CPB (BAME reported higher CPB) and an indirect effect on it through political trust, ingroup power, COVID-19 risk and trust in science. Ethnicity was not significantly related to COVID-19 fear. COVID-19 fear and trust in science were positively associated with CPB.

Social support, perceived risk and the likelihood of COVID-19 testing and vaccination: cross-sectional data from the United Kingdom.

Two samples of 227 and 214 adults completed surveys of social support, perceived risk of COVID-19 and COVID-19 preventive activity - in Study 1 likelihood of testing was examined and in Study 2 likelihood of both testing and vaccination were examined during the COVID-19 pandemic in the United Kingdom. Path analysis showed, in Study 1, that access to help (as an indicator of social support) had a direct effect on likelihood of testing and indirect effects through self-efficacy, perceived risk and preventive behavior; and, in Study 2, that neighborhood identification (as an indicator of social support) had a direct effect on likelihood of testing and indirect effects on likelihood of both testing and vaccination through the mediators of strength of social network, loneliness, perceived risk of COVID-19, and preventive activity. Both studies suggest that level of social support (conceptualized in different ways) is an important determinant of COVID-19 testing and Study 2 shows it is also a determinant of likelihood of vaccination. As resurgences of COVID-19 occur, it will be necessary to monitor the likelihood of COVID-19 testing and vaccination behaviors and, especially, to promote confidence in the latter in individuals with decreased access to social support.

The Sexual Risk Behaviors Scale (SRBS): Development & Validation in a University Student Sample in the UK.

University students are at risk of poor sexual health outcomes. The aim of this study was to develop and test the psychometric properties of the Sexual Risk Behaviors Scale (SRBS), a novel short tool for measuring engagement in sexual risk behaviors in university students. We developed a pool of six items based on a review of recent literature and tested its properties in 547 undergraduate students in the United Kingdom. We used Exploratory Factor Analysis and Confirmatory Factor Analysis to explore and determine the factor structure and dimensionality of the SRBS. We used Item Response Theory and specifically the Graded Response Model to investigate items' discrimination, information, and differential functioning, respectively, and logistic regression to test whether higher SRBS scores predicted a diagnosis of any sexually transmitted infections in the past 12 months. Results showed that a unidimensional, five-item model fitted the data well, showing satisfactory fit indices and reliability, with all items providing adequate discrimination and information, and no differential item functioning by gender nor by sexual orientation. SRBS total scores significantly predicted the odds of being diagnosed with sexually transmitted infections in the past 12 months. Implications for public health prevention and intervention are discussed.

Identity Threat and Coping Among British South Asian Gay Men During the COVID-19 Lockdown.

This study focuses on the impact of the COVID-19 lockdown on identity, relationships and psychological wellbeing among British South Asian gay men (BSAGM). Interview data from 15 BSAGM were analyzed using qualitative thematic analysis and identity process theory. The analysis yielded the following three themes: (1) Fear of involuntary disclosure of gay identity; (2) Anxiety about relationships; and (3) Coping and casual sexual encounters. BSAGM who returned to the family home during the lockdown reported fear of involuntary disclosure of their sexual identity, exposure to stigma in relation to their sexuality, and anxiety about their relationships with significant others. In order to cope with the resultant threats to identity, some individuals concealed their sexual identity, which could undermine their sense of identity authenticity, and some reported engaging in casual sexual encounters as a means of coping with identity threat. BSAGM may be at high risk of identity threat during the COVID-19 outbreak with limited access to social and psychological support in relation to their sexuality. This in turn may lead to a reliance on ineffective coping strategies, such as sexual risk-taking.

The COVID-19 Preventive Behaviors Index: Development and Validation in Two Samples From the United Kingdom.

Monitoring compliance with, and understanding the factors affecting, COVID-19 preventive behaviors requires a robust index of the level of subjective likelihood that the individual will engage in key COVID-19 preventive behaviors. In this article, the psychometric properties of the COVID-19 Preventive Behaviors Index (CPBI), including its development and validation in two samples in the United Kingdom, are described. Exploratory and confirmatory factor analyses were performed on data from 470 participants in the United Kingdom who provided demographic information and completed the Fear of COVID-19 Scale, the COVID-19 Own Risk Appraisal Scale (CORAS) and the CPBI. Results showed that a unidimensional, 10-item model fits the data well, with satisfactory fit indices, internal consistency and high item loadings onto the factor. The CPBI correlated positively with both fear and perceived risk of COVID-19, suggesting good concurrent validity. The CPBI is a measure of the likelihood of engaging in preventive activity, rather than one of intention or actual action. It is adaptable enough to be used over time as a monitoring instrument by policy makers and a modeling tool by researchers.