Social Work Education & Support of Gender Expansive People: A Qualitative Analysis of MSW Student Experiences.

This study examined Master of Social Work (MSW) student experiences with social work education related to support of transgender, nonbinary, queer or other gender expansive people. Sixty-seven students from a sample of thirty-four MSW programs in the United States provided brief qualitative reflections on their educational experiences related to gender identity or expression. Thematic content analysis of these data revealed five primary emergent themes related to; MSW program capacity, persistent bias/tension, safety issues, emotional and academic burden, and lived-experiences external to social work education. Findings suggest there remains a disconnect between the stated intent of social work to support gender expansive communities and the reality of social work education. Specifically, although most students appear to want more from their schools of social work regarding trans-affirming education, most programs reflect persistent discomfort with this domain, or a hesitance or inability to address the topic appropriately and consistently. Examples of how social work education might work to improve its capacity to reflect support of gender expansive people and communities are discussed.

Transgender-Competence in Social Work Education: The Relationship of School Contexts to Student Affirmation of Gender Expansive People.

This study examined the relationship between Master of Social Work program's (MSW) support of lesbian, gay, bisexual, and transgender people (LGBT-competence), and social work student's self-perceived competence to support transgender people (transgender-competence). Thirty-four accredited MSW programs in the United States provided a sample of program directors, faculty members, and students (N = 1385). Hierarchical linear models revealed an MSW program's LGBT-competence was associated with the transgender-competence of its students, and that significant differences exist between organizational LGBT-competence and individual transgender-competence within schools of social work. Specifically, programs with greater LGBT-competence also had students who felt more competent to work with gender minorities. These findings suggest schools of social work provide different levels of support for gender minorities, and that such programs can take substantive action at an organizational level to improve the professional competence of future social workers to serve transgender populations. Implications for social work education are discussed.

A Study of the Longitudinal Patterns of Stimulant and Amyl Nitrite Use and Sexual Behavior Pre- and Post-HIV Seroconversion Among MSM.

The use of stimulant drugs alone or in combination with amyl nitrites (stimulant/nitrites) has been associated with higher rates of risky sexual behavior and predictive of HIV infection among men who have sex with men. However, the temporal pattern of stimulant/nitrite use pre- and post-seroconversion has not been well established. This study assessed changes in stimulant/nitrite use and risky sexual behavior among seroconverting MSM over time. Data were collected in the Baltimore-Washington, DC; Pittsburgh; Chicago; and Los Angeles sites of the Multicenter AIDS Cohort Study (MACS), a longitudinal study of the natural history of HIV infection among MSM. We used propensity scores to select 1044 MSM from 7087 MACS participants composed of 348 seroconverting, 348 seronegative, and 348 seroprevalent participants matched on demographics, recruitment cohort, and study visits. We centered up to four-years of semi-annual data around the seroconversion visit of the seroconverting case within each matched group of participants. Mixed effects regressions estimated the effects of serostatus, recruitment cohort, and time on self-reported stimulant/nitrite use, numbers of male intercourse partners, and numbers of unprotected receptive anal intercourse (URAI) partners. Covariates included demographics, binge drinking, and marijuana use. Seroconverters had the highest odds of stimulant/inhaled nitrite use (AOR 10.3, CI 4.8-22.0), incident rates of intercourse (IRR 1.6, CI 1.3-2.1), and URAI partners (IRR 5.1, CI 3.5-7.3). All participants decreased drug use and sexual risk behavior over time. However, the decreases were largest for seroconverters who nevertheless maintained the highest rates of stimulant/nitrite use and sexual risk. Cohort-related effects were associated with sharp reductions in stimulant/nitrite use and URAI in the early 1990s that rebounded considerably within the first decade of the 2000s. Although all participants decreased risky sexual behavior and stimulant and/or nitrite use over time, seroconverters had the largest decreases. There was no evidence for abrupt or substantial increases in drug use or risky sex post-seroconversion. However, there was substantial variation at the individual level, with the factors underlying this variation not well understood and worth further study. Moreover, stimulant/nitrite use and risky sexual behavior appear to have been strongly influenced by contextual historical and socio-cultural effects. The manner in which contextual factors influence individual behavior is also not well understood and also warrants further study.

LGBT-Competence in Social Work Education: The Relationship of School Contexts to Student Sexual Minority Competence.

This study examined the relationship between master of social work programs' (MSW) support of lesbian, gay, bisexual, and transgender people (LGBT-competence) and the sexual minority competence (LGB-competence) of social work students. Data were gathered from a sample of MSW program directors, faculty members, and students (N = 1385) within 34 MSW programs in the United States. A series of hierarchical linear models tested if a MSW program's LGBT-competence was associated with the LGB-competence of its students. Results showed a significant relationship between organizational LGBT-competence and individual LGB-competence within schools of social work, and that programs with greater LGBT-competence also had students who felt more competent to work with sexual minorities. These findings suggest schools of social work can take substantive action at an organizational level to improve the professional LGB-competence of future social workers. Implications for social work education are discussed.

MSM and drug use: A latent class analysis of drug use and related sexual risk behaviors.

This study examined patterns of drug use among gay men and other men who have sex with men (MSM) to identify sub-categories of men whose drug use and sexual behavior place them at especially high risk for HIV. A latent class analysis of a sample of MSM yielded a four-class model with two distinct high drug use sub-groups: one whose drug use concentrated on "sex-drugs" (SDU); and a distinct polydrug use class that showed higher probabilities of using all other drugs assessed. Comparative follow-up analyses indicated the SDU group was also more likely to engage in particular potentially high-risk sexual behaviors, be older, and to be HIV positive. Implications of distinguishing between patterns of drug use for HIV-risk prevention efforts with MSM are discussed.