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1.
Arch Sex Behav ; 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31897832

RESUMO

Sexual and gender identity have frequently been assessed in public health research as static states. However, a substantial and growing body of evidence indicates that both identities may have greater potential for change over time than once supposed. Despite this evidence, research into adult identity change remains relatively limited. Using longitudinal data from 1553 Black men who have sex with men (BMSM) aged 18-68 years and recruited from study locations in six major cities across the country, we examined changes in sexual and gender identities over a period of 12 months. The results showed that sexual and gender identity did indeed change among adult BMSM. Additionally, we explored internalized homophobia (IH) as a potential driver of identity change and found that IH significantly impacts the degree and direction of change, with individuals who reported higher baseline IH more likely to demonstrate a shift toward a heterosexual/straight identity at 6 and 12 months. The results are discussed in light of what is known and unknown regarding identity change, and potential avenues for future research are explored.

2.
J Stud Alcohol Drugs ; 80(6): 623-630, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31790352

RESUMO

OBJECTIVE: Sexual minority women report more problematic alcohol use and depression than heterosexual women. Despite evidence that sexual identity can change over time, most studies treat it as a static construct. As a result, little is known about the extent to which changes in sexual identity influence alcohol use and depression. The current study examined (a) changes in sexual identity over 36 months, (b) the associations between the number of changes in sexual identity and measures of alcohol use (typical weekly alcohol consumption, peak drinking, and alcohol-related consequences) and depression at the final assessment, and (c) baseline sexual identity as a moderator of the associations. METHOD: The analyses used four waves of data from a national U.S. sample of sexual minority women ages 18-25 (n = 1,057). RESULTS: One third (34%) of participants reported at least one change in sexual identity over the course of the study. The number of changes in sexual identity was positively associated with typical weekly alcohol consumption and depression but was not significantly associated with peak drinking or alcohol-related consequences. None of the associations were moderated by baseline sexual identity. CONCLUSIONS: These findings provide additional evidence that sexual identity continues to change over time for a sizeable proportion of young adult sexual minority women and these changes are relevant to their health and well-being.

3.
Cogn Behav Pract ; 26(2): 254-269, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31787835

RESUMO

Young male couples are at high risk for acquiring human immunodeficiency virus (HIV). However, few HIV prevention programs meet the needs of young male couples that express an interest in how to maintain healthy relationships. As such, we developed 2GETHER, a couple-based program that integrates HIV risk reduction and sexual health information into a relationship education program specific to young male couples. 2GETHER was guided by cognitive-behavioral theories of HIV risk reduction and relationship functioning and was informed by a social-ecological perspective to address factors within and outside the couple that can impact sexual and relationship health. As a micro-level intervention, 2GETHER intervenes directly with couples via psychoeducation and cognitive-behavioral strategies to change couples' communication patterns, sexual health behaviors, and relationship satisfaction. Successful implementation of 2GETHER requires mezzo-level interventions that create an affirming environment of care for sexual-minority individuals and facilitators who are culturally competent in working with young male couples. Although macro-level interventions to change societal acceptance of and policies germane to sexual-minority couples are beyond the scope of 2GETHER, we discuss how clinicians can advocate for systemic changes to improve sexual-minority couples' health, and how 2GETHER addresses the impact of such macro-level factors on the couple's relationship. Our experience developing and testing 2GETHER indicates that HIV prevention programs for young male couples should reflect the unique contexts shaping sexual-minority individuals' relationships and lives, and that programs should intervene within and across multiple levels when possible to improve health for sexual-minority men.

4.
Arch Sex Behav ; 2019 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-31691076

RESUMO

The field of HIV/STI prevention has primarily focused on gay men (or "men who have sex with men" [MSM] as a broad category) with limited attention to bisexual men in particular. Although bisexual men are also at increased risk for HIV and other STI, they are less likely to utilize HIV/STI prevention services than gay men, and very few interventions have been developed to address their unique needs. Further, while biomedical advances are changing the field of HIV prevention, bisexual men are also less likely to use biomedical HIV prevention strategies (e.g., pre-exposure prophylaxis [PrEP]) than gay men. In an effort to advance research on bisexual men and their sexual health needs, the goals of this commentary are: (1) to review the empirical literature on the prevalence of HIV/STI among bisexual men, the few existing HIV/STI prevention interventions developed for bisexual men, and the use of biomedical HIV prevention among bisexual men; (2) to describe the ways in which the field of HIV/STI prevention has largely overlooked bisexual men as a population in need of targeted services; and (3) to discuss how researchers can better address the sexual health needs of bisexual men in the age of biomedical HIV prevention.

5.
Sex Res Social Policy ; 16(3): 385-391, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31692994

RESUMO

Self-identified bisexual men are at increased risk for negative health outcomes, but there are no interventions tailored to their unique needs. In order to develop interventions for this population, it is first necessary to understand their preferences. As part of a larger study, 128 cisgender men who identified as bisexual reported on their preferences for different intervention components. Large proportions of participants prioritized addressing both health (e.g., mental health, HIV/STI) and psychosocial experiences (e.g., dating/relationships, discrimination/victimization). A slightly larger proportion of participants preferred an intervention for gay and bisexual men together compared to an intervention for bisexual men only. However, those who reported more discrimination and recent female sexual partners were more likely to prefer an intervention for bisexual men only. Larger proportions of participants preferred a group intervention compared to an individual intervention and an in-person intervention compared to an online intervention. These findings highlight the importance of addressing both health and psychosocial experiences in tailored interventions for self-identified bisexual men. Further, while in-person and group interventions may appeal to larger proportions of self-identified bisexual men, the appeal of an intervention for gay and bisexual men together compared to an intervention for bisexual men only may depend on individual and social/contextual factors.

6.
J Interpers Violence ; : 886260519888209, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31729280

RESUMO

Bisexual women are more likely to be sexually assaulted and to receive negative reactions to disclosures of sexual assault than heterosexual and lesbian women. However, few studies have examined the extent to which victim sexual orientation and related factors influence perceptions of sexual assault victims and perpetrators. To fill this gap, the current study used an experimental manipulation to examine the influence of victim sexual orientation and coercion type on perceptions of sexual assault victims and perpetrators. Participants (N = 826) were randomly assigned to read one of nine vignettes in which the sexual orientation of the female victim (bisexual, lesbian, heterosexual) and the type of coercion (verbal, physical, alcohol incapacitation) were varied. Then, participants were asked a series of questions about the victim and the perpetrator. Results indicated that bisexual and heterosexual female victims were both perceived as having wanted to have sex with the perpetrator more and as having "led the perpetrator on" more than lesbian victims. In contrast, victim sexual orientation was not associated with explicit ratings of victim or perpetrator responsibility or victim suffering. Bisexual female victims were also perceived as more promiscuous than both lesbian and heterosexual female victims. In turn, perceiving the victim as more promiscuous was associated with perceiving the victim as more responsible, having wanted to have sex with the perpetrator more, having "led the perpetrator on" more, and suffering less, and with perceiving the perpetrator as less responsible. In sum, our findings suggest that efforts to reduce sexual violence toward bisexual women should attend to negative attitudes toward bisexual women, especially the perception of bisexual women as promiscuous.

7.
Clin Psychol Sci ; 7(5): 928-940, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31579559

RESUMO

Stress experienced by either partner in a couple can have a negative impact on each partner's health, but most dyadic research on stress and health focuses on different-sex couples. We examined relationship functioning as a mechanism underlying the longitudinal actor and partner effects of stress on depression and substance use problems among 109 young male same-sex couples. There were significant indirect actor effects of internalized stigma and microaggressions on depression and alcohol use problems through negative relationship interactions. Participants who reported higher levels of internalized stigma and microaggressions reported more negative relationship interactions, which in turn was associated with reporting greater depression and alcohol use problems. In contrast, none of the indirect partner effects were significant. Findings implicate negative relationship interactions as a mechanism linking minority stress to health, but raise questions about the influence of partner stress on individual health among young male same-sex couples.

8.
Arch Sex Behav ; 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286339

RESUMO

Sexual minorities are disproportionately affected by mental health problems (e.g., depression, anxiety, substance use disorders, suicidality). Minority stress theory and the psychological mediation framework have become the predominant conceptual models used to explain these disparities, and they have led to substantial advances in research on stigma-related stress and mental health. However, the field's reliance on these models has limited the extent to which other theories have been considered as potential frameworks for further advancing our understanding of sexual minority mental health. In this article, I discuss how the rejection sensitivity (RS) model can be used to complement and extend minority stress theory and the psychological mediation framework by: (1) emphasizing the role of perception in stigma-related experiences; (2) acknowledging the unique consequences of different anticipatory emotions; (3) describing additional mechanisms linking proximal minority stressors to mental health; and (4) further specifying the temporal order of these processes. I conclude by discussing the importance of attending to developmental processes in research on sexual orientation-related RS and describing important directions for future research.

9.
Arch Sex Behav ; 48(5): 1481, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31165291

RESUMO

The following correction should be noted to the caption of Fig. 1 in this article.

10.
Cogn Behav Pract ; 26(2): 243-253, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31160876

RESUMO

Despite bisexual individuals being at increased risk for mental health and substance use problems, clinicians' ability to provide affirmative and competent care to bisexual clients is limited by their lack of bisexual-specific training. To address this common gap in training, this article provides a brief review of bisexual health disparities and the factors that influence them. Then, we describe a multi-level approach for improving the health and well-being of bisexual individuals. This approach addresses factors that influence health at the micro-level (e.g., strategies that clinicians can use to help bisexual clients cope with stigma-related stressors), mezzo-level (e.g., adaptations to clinical environments and training programs that promote bisexual-affirmative care), and macro-level (e.g., advocating for political change and implementing strategies to reduce prejudice against bisexual individuals at the population-level). Specifically, we describe how clinicians can adapt evidence-based interventions to tailor them to the needs of their bisexual clients. Additionally, we discuss the need for bisexual-affirmative clinical training and provide recommendations for how clinical training can be adapted to prepare clinicians to work effectively with bisexual clients. Finally, we describe how population-level interventions can be used to reduce prejudice against bisexual individuals in order to reduce bisexual health disparities. Given the striking health disparities affecting bisexual individuals, there is a critical need to develop, test, and disseminate interventions to improve the health of this population and to prepare clinicians to provide bisexual-affirmative care.

11.
Arch Sex Behav ; 48(5): 1519-1528, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31123947

RESUMO

Sexual minorities are exposed to various gay-related and general stressors that increase risk of mental and physical health problems. Yet, less attention has been paid to positive factors such as ameliorative coping strategies and social supports that reduce risk of mental health difficulties in this population. The current study sought to address this gap by examining the association between gay community connectedness and internalizing symptoms (i.e., general psychological distress, anxiety, and depression) in a sample of 147 self-identified gay men living in the greater New York City area, as well as the conditions under which gay community connectedness is associated with better mental health. Data were collected between 2013 and 2014. Findings indicated that gay community connectedness was associated with lower levels of internalizing symptoms among gay men, consistent with minority stress theory and other work examining the benefits of community coping resources. This association was strongest for non-White gay men, those whose gay identity was more central to their overall identity, and those with higher levels of femininity. These findings underscore the need to consider multiple aspects of gay men's identity (e.g., race/ethnicity, centrality, femininity) in order to fully understand the factors associated with mental health outcomes in this population.

12.
Arch Sex Behav ; 48(5): 1463-1479, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31123950

RESUMO

Sexual orientation is a multidimensional construct which is increasingly recognized as an important demographic characteristic in population health research. For this study, weighted Youth Risk Behavior Survey data were pooled across 47 jurisdictions biennially from 2005 to 2015, resulting in a national sample of 98 jurisdiction-years (344,815 students). Respondents were a median of 15.5 years, 49.9% male, and 48.8% White. Sexual identity and behavior trends from 2005 to 2015 were assessed with logistic regression analysis. Overall, 13.9% of females and 7.0% of males identified as lesbian, gay, bisexual (LGB), or not sure, while 9.1% of females and 4.2% of males indicated both same-and-different-sex behavior or same-sex behavior. In total, 17.0% of female and 8.5% of male youth reported non-heterosexual (LGB or not sure) sexual identity, same-sex sexual behavior, or both. LGB youth were approximately twice as likely as other youth to report lifetime sexual behavior. White and Asian youth were less likely to report non-heterosexual identity and/or have engaged in same-sex sexual behaviors than youth of other races/ethnicities. Prevalence of non-heterosexual identities increased over time for both sexes, but only female youth reported significantly more same-sex behavior over time. This is the first study to simultaneously assess adolescent sexual identity and behavior over time within a national dataset. These findings are critical for understanding the sexual health needs of adolescents and for informing sexual health policy and practice.

13.
J Lesbian Stud ; 23(4): 439-450, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31134848

RESUMO

This article discusses how sexual orientation-based stigma serves to undermine functioning in female same-sex relationships. We particularly focus on the unique roles of interpersonal stigma (e.g., victimization, microaggressions) and structural stigma (e.g., institutional forms of discrimination), highlighting critical limitations and gaps in this literature and offering suggestions for future studies. We also discuss the need for future work on sexual orientation-related stigma and relationship functioning to consider the unique experiences of bisexual women, intersecting identities, and couple-level perspectives on stigma.

14.
LGBT Health ; 6(4): 174-183, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31033384

RESUMO

Purpose: Sexual minority youth are at increased risk for mental health problems and substance use, and accumulating evidence indicates that bisexual youth are at greatest risk. However, bisexual youth are not a homogenous group and scholars have called for greater attention to the intersections of multiple marginalized identities. As such, we examined racial/ethnic differences in mental health (sadness/hopelessness and suicidal ideation), substance use (cigarette use, binge drinking, marijuana use, and other illicit drug use), and bullying (in-person and electronic) among self-identified bisexual high school-aged youth (overall and by sex). Method: Data from the local versions of the Youth Risk Behavior Survey were pooled across jurisdictions and years (2011-2015), resulting in an analytic sample of 18,515 bisexual youth who were racially/ethnically diverse. Results: Black and Hispanic bisexual youth were less likely to report in-person and electronic bullying than White bisexual youth. In addition, Black bisexual youth were less likely to report sadness/hopelessness and suicidal ideation than White, Hispanic, and Other race/ethnicity bisexual youth. Black bisexual female youth were also less likely to report cigarette use, binge drinking, and other illicit drug use than White bisexual female youth. In contrast to most of our findings, Black bisexual youth were more likely to report marijuana use than White bisexual youth. Most of the significant racial/ethnic differences in mental health and substance use remained significant after controlling for bullying. Conclusion: These findings highlight the heterogeneity of bisexual youth and the need to consider multiple marginalized identities to understand the health disparities affecting this diverse population.

15.
Arch Sex Behav ; 48(1): 175-189, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29611021

RESUMO

Experiencing anti-bisexual discrimination has been linked with numerous negative consequences, such as internalized stigma and symptoms of anxiety and depression. A commonly used measure of anti-bisexual discrimination in research is the Anti-Bisexual Experiences Scale (ABES). While this scale has been instrumental in advancing knowledge about discrimination against bisexual individuals, its length presents challenges to widespread use and it remains unknown if its psychometric properties are consistent across diverse genders and non-monosexual identities. To address these limitations, the current study developed and validated a brief version of the ABES. Using confirmatory factor analysis, we reduced the number of items by more than half, while retaining the full measure's associations with other stigma- and identity-related constructs as well as mental health. Invariance testing indicated that the Brief ABES functioned similarly across diverse genders (i.e., cisgender men, cisgender women, and gender minorities) and sexual identities (i.e., bisexual and other non-monosexual identities). These findings provide initial validation of the Brief ABES and demonstrate that it can be used with bisexual and other non-monosexual (e.g., pansexual, queer) individuals, including cisgender and gender minority individuals.


Assuntos
Bissexualidade/psicologia , Psicometria/métodos , Comportamento Sexual/psicologia , Estigma Social , Adulto , Feminino , Humanos , Masculino , Estudos de Validação como Assunto
16.
Arch Sex Behav ; 48(1): 199-211, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30413988

RESUMO

There are numerous forms of stigma that contribute to the de-legitimization and erasure of bisexual and other non-monosexual identities (collectively referred to as bisexual+ or bi+ identities). To reduce such stigma, efforts are needed to increase bi+ visibility. Little is known, however, about whether bisexual+ individuals attempt to attain greater bi+ visibility (i.e., make their bisexual+ identity visible to others) and, if so, how they do this. Using data from a mixed-method (quantitative and qualitative) internet survey study of 397 individuals reporting attractions to more than one gender, we examined the proportion who attempted to attain greater bi+ visibility, the strategies they used to do so, and factors that distinguished those who made bi+ visibility attempts from those who did not. Results indicated that 58% made bi+ visibility attempts, with the most common being direct verbal communication (e.g., telling others) and visual displays (e.g., wearing bi/pride clothing, jewelry, tattoos). Less common attempts included indirect forms of communication, engagement in LGBT-related activities, and public behavioral displays. Those who made bi+ visibility attempts differed from those who did not on variables related to identity (e.g., centrality, self-affirmation, community connection) and internalized binegativity. Implications for understanding the reasons for and for not making bi+ visibility attempts, as well as the potential consequences of doing so, are discussed.


Assuntos
Bissexualidade/psicologia , Comportamento Sexual/psicologia , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
17.
Arch Sex Behav ; 48(1): 261-275, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29508171

RESUMO

Young men who have sex with men (MSM) are disproportionately affected by HIV, but it remains unclear whether there are differences in HIV risk behaviors between self-identified gay and bisexual young men. To address this, the current study examined differences in condomless sex and substance use before sex with male partners between self-identified gay and bisexual young men who are HIV-negative. Additionally, we examined differences in HIV risk behaviors with male versus female partners among the bisexual men. We used four waves of data spanning 24 months from a cohort of young MSM ages 16-29. At each wave, participants reported on up to four partners, allowing us to examine within-person associations. Compared to gay men, bisexual men reported more insertive condomless anal sex (CAS) with casual partners, they were more likely to report marijuana use before sex, and they were less likely to report lifetime HIV testing and PrEP use. Alcohol and marijuana use before sex were associated with CAS for both gay and bisexual men, but the association between marijuana use and insertive CAS was stronger for bisexual men. Bisexual men reported more condomless sex with female partners compared to male partners, but this was not significant after accounting for alcohol and marijuana use. Bisexual men were more likely to report alcohol and marijuana use with female partners compared to male partners, but both alcohol and marijuana use were associated with condomless sex regardless of partner gender. Findings support the need for tailored HIV prevention for self-identified bisexual men to address their lack of preventive behaviors, their increased engagement in certain risk behaviors with male partners, and their engagement in risk behaviors with female partners.

18.
Arch Sex Behav ; 48(4): 1111-1126, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30519838

RESUMO

Sexual minorities are at increased risk for substance use and mental health problems. Although previous studies have examined the associations between outness and health outcomes, few have used longitudinal designs or examined differences across subgroups of sexual minorities. To address these gaps, the current study examined sexual orientation and gender as moderators of the longitudinal associations between outness and substance use (cigarettes, marijuana, illicit drugs, and alcohol) and mental health (depression and anxiety). Data were from a sample of 169 sexual minority emerging adults (98 women and 71 men) who provided self-report data at four times over 3.5 years. Results indicated that sexual orientation moderated the within-person associations between outness and changes in health. For bisexual individuals, being more out was associated with increases in marijuana use, illicit drug use, and depression. In contrast, for gay/lesbian individuals, being more out was associated with decreases in illicit drug use and it was not significantly associated with changes in marijuana use or depression. Additionally, outness was not significantly associated with changes in cigarette use, alcohol use, or anxiety for gay/lesbian or bisexual individuals, and gender did not moderate any of the associations. In sum, being more open about one's sexual orientation had negative consequences for bisexual individuals but not for gay/lesbian individuals. Professionals who work with sexual minorities need to be aware of the potential risks of being open about one's sexual orientation for bisexual individuals. Interventions are needed to facilitate disclosure decisions and to promote the health of sexual minorities.

19.
Sex Res Social Policy ; 15(2): 172-182, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30505356

RESUMO

Despite high rates of sexually transmitted infections (STIs) among young men who have sex with men (YMSM), little is known about their experiences with diagnosis, treatment, and reinfection. To fill this gap, we interviewed 17 YMSM ages 18-29 who participated in an online HIV prevention trial and tested positive for STIs at both the baseline and three-month follow-up assessments. Participants were asked about their reactions to testing positive, experiences with treatment, disclosure to partners, and changes in thinking and behavior. Reactions were diverse, the most common being surprise and concern. Most participants sought treatment, although type of provider varied (e.g., primary care physician, clinic that specialized in gay/bisexual men's health). Providers tended to re-test participants, but some did so at the incorrect anatomical site. Participants who felt comfortable talking to providers about STIs tended to use their regular provider or one who specialized in gay/bisexual men's health. Most participants described changes in their thinking and behavior (e.g., increased condom use, decreased sex partners, questioning their partners' trust). Most participants disclosed to at least one partner, but some did not remember or were not in contact with partners. Experiences were similar the first and second time participants tested positive for STIs during the study with a few exceptions (e.g., more self-blame and comfort talking to providers the second time). In sum, YMSM have diverse experiences with STI diagnosis and treatment. Implications for public policy and STI prevention are discussed.

20.
J Stud Alcohol Drugs ; 79(5): 741-750, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30422788

RESUMO

OBJECTIVE: Sexual minority women (SMW; e.g., lesbians, bisexual women) are at increased risk for alcohol use disorders and related problems compared with heterosexual women. However, little is known about the social context in which drinking occurs in this high-risk population. This study used latent class analysis to identify subgroups of SMW based on drinking locations and companions and examined whether class membership was associated with consequences, drinking motives, and LGBTQ-related constructs (e.g., outness, discrimination). METHOD: A sample of 670 SMW reported on alcohol use, drinking locations and companions, and related measures as part of a larger study on women's health. RESULTS: Based on SMW's patterns of responding to drinking locations and companions, latent class analysis identified five classes: Infrequent Drinking Contexts (10% of sample, reference class), Private/Intimate Drinking (28%), Convivial Drinking (29%), Alone/Convivial Drinking (20%), and Multiple Drinking Contexts (13%). Greater consequences were associated with greater odds of membership in the Convivial, Alone/Convivial, and Multiple Drinking Contexts classes relative to the Infrequent Drinking Contexts Class. Drinking motives were associated with class membership, although significant group comparisons varied by motive. Higher LGBTQ community involvement was associated with greater odds of membership in the Convivial, Alone/Convivial, and Multiple Drinking Contexts classes. CONCLUSIONS: Drinking classes paralleled those found in the literature on heterosexual individuals (e.g., public versus private contexts). Women in the Alone/Convivial and Multiple Drinking Contexts classes may be at particular risk. The context within which SMW drink may be a useful way to identify women at highest risk for problematic drinking.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Bissexualidade/psicologia , Amigos/psicologia , Homossexualidade Feminina/psicologia , Motivação , Minorias Sexuais e de Gênero/psicologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Feminino , Humanos , Relações Interpessoais , Motivação/fisiologia , Fatores de Risco , Comportamento Sexual/psicologia , Adulto Jovem
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