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1.
Int J Behav Med ; 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31925674

RESUMO

BACKGROUND: Sexual and gender minority (SGM) adolescents are more likely than their heterosexual and cisgender peers to smoke cigarettes. Family rejection has been associated with adverse health outcomes; however, few studies have examined whether SGM-specific family rejection is associated with cigarette smoking among SGM adolescents. METHOD: A non-probability sample of 11,005 SGM adolescents (M = 15.58, SD = 1.27) completed an online cross-sectional survey. Bivariate and multivariable analyses were conducted to examine associations between SGM-specific family rejection, sociodemographic variables, and smoking. RESULTS: Approximately 7% of the sample currently smoked cigarettes. Pansexual, asexual, trans boys, and non-binary assigned female at birth adolescents had the highest SGM family rejection scores. In multivariable regression analyses, SGM-specific family rejection was independently associated with smoking after adjusting for covariates (AOR = 1.15, 95% CI 1.04, 1.28). Family support (AOR = 0.80, 95% CI 0.73, 0.88) and experiencing violence (AOR = 1.64, 95% CI 1.49, 1.82) were also associated with smoking in multivariable models. Adolescents who identified as bisexual versus gay/lesbian (AOR = 1.50, 95% CI 1.21, 1.85) and trans boys versus cisgender girls (AOR = 2.05, 95% CI 1.13, 3.71) had an increased odds of smoking. Those who disclosed their sexual orientation identity to most (AOR = 1.95, 95% CI 1.45, 2.63) and all (AOR = 1.60, 95% CI 1.21, 2.11) of their family/parents had increased odds of smoking. CONCLUSION: Our findings underscore the importance of attending to the role of SGM-specific family rejection and distinctions with SGM adolescents in tobacco prevention and smoking cessation efforts.

2.
AIDS Behav ; 24(1): 165-172, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31230176

RESUMO

HIV stigma and future orientations impact the health of adolescents and young adults living with HIV (AYALWH); however, little is known about how these factors may impact tobacco use, and thereby long-term health status. This study examined associations between internalized HIV stigma, future orientations, and smoking behavior using a cross sectional survey of AYALWH ages 18 to 29 (N = 109). Greater levels of stigma were associated with increased odds of smoking, and greater future orientations were associated with a reduced odds of smoking. The interaction was significant, illustrating that stigma was significantly associated with an increased odds of smoking among AYALWH who reported low levels of future orientations, but not for those with high levels of future orientations. Findings underscore the importance of understanding how HIV stigma may undermine future aspirations of AYALWH. Interventions that target HIV stigma and future orientations may be critical for tobacco prevention and cessation.

3.
Arch Sex Behav ; 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31586272

RESUMO

Cisgender men partnered with transgender women are an understudied and hard to engage population in HIV prevention efforts. Relationship stigma-the anticipation of negative treatment based on having a relationship with a member of a stigmatized group-has been linked to adverse health behaviors, but it remains unclear whether different sources of relationship stigma (i.e., family, friends, and the general public) are associated with HIV risk behaviors and whether these associations may vary by men's sexual identities (e.g., gay, bisexual, and heterosexual). The current study examined associations between relationship stigma and HIV risk behaviors and whether these associations were moderated by sexual identity. We recruited a convenience sample of 185 cisgender men in primary partnerships with transgender women to participate in a one-time survey. Gay identified men reported greater levels of relationship stigma from the general public compared with heterosexually identified men. In multivariable models, higher levels of relationship stigma from the public were associated with increased odds of engaging in drug use prior to having condomless sex and receiving an STI diagnosis in the last 30 days. There were significant interaction effects such that higher levels of relationship stigma from the public were associated with both indicators of HIV risk for gay identified men but not for heterosexually identified men. Findings support the importance of HIV prevention approaches accounting for relationship stigma from the general public and the diverse sexual identities of men partnered with transgender women when seeking to increase linkage to and engagement in HIV prevention services, including biomedical prevention strategies.

4.
Child Youth Serv Rev ; 96: 231-236, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31571706

RESUMO

Among the struggles faced by youth currently in or recently exiting foster care, tobacco use remains a low priority for practitioners and researchers, alike. Indeed, despite the dramatically altered landscape of tobacco products on the market, there have been no studies evaluating the use of alternative tobacco products among this vulnerable population. The current study aimed to determine the prevalence of lifetime and current combustible and non-combustible tobacco use among youth exiting foster care, and report on the prevalence of nicotine dependence, motivation to quit, and preferred methods of tobacco cessation. Youth aged 18-24 (M = 20.13, SD = 1.16) who were transitioning from foster care (N = 154) completed a survey of tobacco product use adapted from the Population Assessment of Tobacco and Health Baseline Survey. Most participants (76%) reported lifetime use of combustible cigarettes, while almost half (42%) were current combustible cigarette smokers. Current use of electronic cigarettes was comparable to general population rates. Many participants (76%) reported interest in quitting and willingness to try through patches/gum (56%) and technology-based (61%) approaches. Youth exiting foster care are at high risk for smoking and other tobacco product use, as well as dependence, yet are rarely screened for use or advised to quit. As tobacco use remains among the most preventable causes of mortality and morbidity, future work should involve implementation of screening within child welfare and tailoring interventions to the unique needs of this population. The current results underscore a missed opportunity to promote public health in a vulnerable population.

5.
Ann Behav Med ; 2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31624825

RESUMO

BACKGROUND: Although health goals are recognized as a central feature of health behavior theories, the relational context through which goals are conceptualized is often overlooked. Interdependence theory represents a valuable framework for understanding goals in the adoption of health behaviors, such as pre-exposure prophylaxis (PrEP), among gay and bisexual men in primary relationships. PURPOSE: We examined the content and focus of men's sexual health goals, as well as whether goal content, goal focus, or perceptions of goal congruence with a primary partner were related to PrEP adoption among gay and bisexual men in primary relationships. METHODS: Mixed-methods data were collected from a PrEP demonstration project from 145 HIV-negative gay and bisexual men in primary relationships. Participants reported their sexual health goals and completed measures of perceptions of goal congruence, relationship factors, and sociodemographic factors. RESULTS: Three main goal content categories were identified: prevention, satisfaction, and intimacy. In expressing these goals, participants framed them with either a self-focus or a relationship-focus. Men in serodiscordant relationships reported more intimacy goals and greater perceptions of goal congruence. There were no differences in goal content or focus by sexual agreement. In the multivariable logistic regression model, perceived goal congruence was associated with PrEP adoption, over and above covariates. CONCLUSIONS: Intimate relationships play a significant role in the formation of health-related goals. Goal content, focus, and perceived congruence with partners may represent important targets for HIV prevention interventions for gay and bisexual men in primary relationships, especially in the context of PrEP.

6.
Sex Transm Infect ; 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31511394

RESUMO

OBJECTIVES: Expedited partner therapy (EPT) is an effective strategy to reduce rates of chlamydia and gonorrhoea infection and ensure sexual partners are treated. Currently, EPT is provided to heterosexual patients; however, EPT is not routinely recommended for use with gay, bisexual and other men who have sex with men (GBMSM) because of concerns about HIV coinfection. The objective of the qualitative study was to understand provider and community views on the use of EPT with GBMSM. METHODS: Using convenience sampling methods, we recruited a sample of 18 healthcare providers and 21 GBMSM to participate in in-depth, semistructured interviews. Interviews were conducted over the phone and included questions about knowledge, experiences and potential barriers and facilitators to the use of EPT with GBMSM. RESULTS: Most providers wanted to provide EPT to GBMSM and believed that the potential barriers and concerns to EPT use were not unique to a patient's sexual orientation. Several providers noted that they were currently providing EPT to GBMSM as part of HIV prevention services. Community members were generally unaware of EPT as a service and most indicated that they would only use EPT if they were in a committed relationship. Barriers included partner allergies and resistance, pharmacy protocols, structural concerns (eg, insurance coverage, pharmacists onsite and transportation) and potential disclosure issues. Facilitators included cultural humility and telemedicine with patients' partners to overcome these barriers. CONCLUSIONS: Acceptability of EPT use for both chlamydia and gonorrhoea was high among providers and community members. Barriers to EPT use, including concerns about patients' partners' allergies and resistance, disclosure concerns and linkage to HIV prevention services can be overcome through cultural humility trainings and telemedicine. Changing EPT recommendations at the national level to be inclusive of GBMSM is critical to curtail the rising STI and HIV epidemic.

7.
J Soc Pers Relat ; 36(7): 2180-2201, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31086428

RESUMO

The goals of this study were to: (a) examine associations between interpersonal stigma and psychological distress among a sample of transgender women and their cisgender male partners; and (b) identify whether commitment moderates the association between interpersonal stigma and psychological distress. To address these aims, 191 couples consisting of transgender women and their cisgender male partners completed a one-time survey. Actor-partner interdependence models (APIM) were fit to examine stigma, commitment, and their interaction on psychological distress. More frequent experiences of interpersonal stigma were associated with elevated psychological distress for both partners. For transgender women, higher commitment was associated with lower psychological distress. There was a significant interaction effect such that the association between interpersonal stigma and psychological distress was attenuated by greater commitment for transgender women, but not for their cisgender male partners. Findings provide preliminary support for associations between interpersonal stigma and mental health of both partners, and identify commitment as a potential stress buffer for transgender women.

8.
Subst Use Misuse ; 54(11): 1787-1798, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31094618

RESUMO

Objectives: Substance use is prevalent among young sexual minority men and crime exposure is linked with adverse health behaviors. Guided by the protective model of resilience, we examined the impact of crime exposure and resilience resources on substance use behaviors, and whether resilience moderated associations between crime exposure and substance use behaviors. Methods: A cross-sectional sample of young sexual minority men (n = 720) ages 15-24 participated in a one-time survey conducted in seven cities across the United States. Participants' mean age was 21.2 years; 50% self-identified as Black, and 66% self-identified as gay. Participants self-reported on sociodemographic factors, crime exposure, resilience resources, and substance use behaviors. We fit generalized estimating models to examine associations between crime exposure, resilience resources, and the interaction between crime exposure and resilience resources on substance use behaviors. Results: Overall, 31% reported heavy alcohol use, 54% monthly marijuana use, 14% drug use, and 26% reported being a victim of a crime. Crime exposure was associated with an increased odds of alcohol (AOR = 1.45, 95%CI: 1.02, 2.14), marijuana (AOR = 1.41, 95%CI: 1.07, 2.04), and drug use (AOR = 1.94, 95%CI: 1.14, 2.98). Resilience resources were associated with a reduced odds of alcohol use (AOR = 0.66, 95%CI: 0.47, 0.93), marijuana use (AOR = 0.82, 95%CI: 0.60, 0.98), and drug use (AOR = 0.85, 95%CI: 0.54, 0.96). There was a significant interaction such that resilience resources reduced associations between crime exposure and alcohol and drug use. Conclusions: Findings support the protective effects of resilience resources for young sexual minority men. Results highlight the importance of ensuring the availability of community resources to meet the needs of sexual minority youth.

9.
Cult Health Sex ; : 1-15, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31144598

RESUMO

Few studies have examined the intersection of race/ethnicity and socioeconomic status on the experience of minority stressors among sexual minority adults. We examined whether there are differences in reports of minority stressors by race/ethnicity and socioeconomic status, and whether socioeconomic status moderates the associations between race/ethnicity and minority stressors. We analysed data from Project Stride, a community-based sample of 396 self-identified lesbian, gay and bisexual adults in New York City. We conducted a hierarchical multiple regression analysis to examine the associations between race/ethnicity and socioeconomic status on minority stressors. In adjusted models, African American and Latino sexual minority adults experienced greater anticipated stigma relative to their white counterparts. Socioeconomic status significantly moderated the association of race/ethnicity and enacted stigma. For African Americans, higher socioeconomic status was associated with more enacted stigma, whereas higher socioeconomic status was associated with reduced enacted stigma among whites. Minority stress processes are likely to operate differently for sexual minority people of colour compared with white sexual minority people, and for higher-socioeconomic status versus lower-socioeconomic status sexual minority people. Future research should consider the intersectional axes of identity that contribute to enacted stigma and disparities in mental and physical health, especially for US African American sexual minority adults.

10.
JMIR Res Protoc ; 8(1): e10370, 2019 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-30602433

RESUMO

BACKGROUND: Young gay, bisexual, and other men who have sex with men (YMSM) continue to be the group most heavily impacted by HIV in the United States. Substantial evidence indicates that up to two-thirds of new HIV infections occur in the context of a main partnership. Couples HIV testing and counseling (CHTC) has been shown to be a promising and effective strategy for increasing HIV prevention uptake among male couples; however, YMSM who are new to relationships may not have yet developed the efficacy, negotiation, and communication skills to navigate HIV testing in their relationship and communicate around developing a prevention plan. OBJECTIVE: This study aims to develop and test a relationship skills-focused HIV prevention intervention for YMSM and their partners. The intervention consists of two telehealth-delivered sessions: the first focuses on relationship skills and the second consists of CHTC and prevention planning. Both sessions are attended by both members of the dyad. METHODS: This protocol describes the development of the proposed intervention (We Prevent) and pilot test to examine its feasibility and preliminary efficacy. The intervention will include two motivational interviewing-based sessions: session one is a relationship skills-building session, focused on techniques to explore and build communication skills in a relationship, to help YMSM develop and enhance necessary skills for their current and future relationships; the second session is a CHTC session with YMSM and their partners, to help them develop an HIV prevention plan. Through qualitative data collection and a one-arm pilot with YMSM, we will develop and refine a developmentally appropriate relationship skills session as an addition to the current CHTC intervention. We will then conduct a pilot randomized controlled trial (RCT), comparing the acceptability, feasibility, and preliminary efficacy of the adapted two-session telehealth intervention for YMSM versus a control group receiving one session only-a CHTC session delivered via telehealth. RESULTS: The We Prevent intervention is designed to increase uptake of HIV prevention, shown through self-reported reductions in condomless sex and increases in knowledge and uptake of pre-exposure prophylaxis. In addition, the intervention is designed to increase HIV and sexually transmitted infection (STI) testing. STI incidence is examined as a secondary outcome. A cost-input analysis will examine the costs associated with intervention delivery to inform future scale-up of the intervention. CONCLUSIONS: Drawing on theory and existing CHTC protocols delivered with video-based counseling, this proposed intervention affords the opportunity to empower YMSM with the skills necessary to communicate with their partners and protect themselves from HIV in their current and future relationships. TRIAL REGISTRATION: Clinicaltrials.gov NCT03551938; https://clinicaltrials.gov/ct2/show/NCT03551938 (Archived by WebCite at http://www.webcitation.org/73omJCz1a). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/10370.

11.
J Sex Res ; 56(6): 728-739, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30295545

RESUMO

Despite the implications for human immunodeficiency virus (HIV) prevention and sexual health, little is known about the timing and chronological order of when same-sex male couples disclose their HIV serostatus, establish a sexual agreement, and first engage in condomless anal sex (CAS) in their relationships. Dyadic data from 357 dyads were used to describe when these respective events occurred; whether members of a couple concurred about when the events happened; and the chronological order of these events. For many, disclosure and CAS happened within the first month, whereas an agreement tended to occur much later (if at all). Couples' concordance of when disclosure and agreement formation happened differed by their serostatus, whereas there was little difference by serostatus for CAS. The chronological order of these events revealed interesting patterns and varied substantially. Although two-thirds of partners reported disclosure had occurred first, some reported events happening on the same day. These findings reveal that the first few months in a same-sex male couple's relationship is a critical time period for when information and decisions about sexual health occur. Suggestions are provided for how current and future HIV prevention efforts could assist couples with their sexual health needs.

12.
Int J STD AIDS ; 30(4): 378-385, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30537903

RESUMO

Cisgender men (CM) who report transgender women (TW) as sexual partners are an understudied population in the HIV epidemic in Latin America. The current study sought to characterize this group in a 2012 cross-sectional online survey of Latin American CM who were members of a sexual networking website for men who have sex with men (N = 11,847). Multivariable logistic regression models were fit to estimate demographic, behavioral, and psychosocial correlates of having a TW sexual partner and engaging in condomless sex. Overall, 0.9% (n = 106) reported a TW sexual partner in the last 12 months; of these, 76.4% (n = 81) reported condomless sex in the last three months. Identifying as bisexual or heterosexual compared to gay, and specifying a versatile sexual role preference compared to insertive were associated with reporting a recent TW sex partner (all p < 0.05). HIV-negative serostatus, lifetime STI history, and alcohol dependence were associated with recent condomless sex (all p < 0.05). CM with TW sexual partners have distinct HIV-related vulnerabilities. Future research is needed to understand CM who report TW sexual partners, including their sexual preferences and practices, sexual networks, exposure to stigma, biomedical prevention interest and uptake, and acceptability of integrating alcohol abuse screening into sexual health services.


Assuntos
Infecções por HIV/transmissão , Assunção de Riscos , Comportamento Sexual , Parceiros Sexuais , Sexo sem Proteção/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Heterossexualidade , Humanos , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Rede Social , Pessoas Transgênero , Transexualismo , Adulto Jovem
13.
AIDS Behav ; 23(1): 283-288, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30003506

RESUMO

A substantial number of new HIV infections among gay, bisexual, and other men who have sex with men and transgender women occurs in the context of primary partnerships. Given the diversity of risk reduction needs and various approaches available for reducing risk within couples, condomless sex is no longer the gold standard HIV outcome. We present a novel, comprehensive, and flexible Composite Risk for HIV (CR-HIV) approach for integrating evolving biomedical and behavioral HIV prevention strategies into couples-based HIV prevention intervention and survey research. We provide illustrative examples of the utility of the CR-HIV approach based on couples' HIV status.


Assuntos
Infecções por HIV/prevenção & controle , Promoção da Saúde/métodos , Parceiros Sexuais/psicologia , Minorias Sexuais e de Gênero , Sexo sem Proteção/prevenção & controle , Feminino , Humanos , Masculino , Desenvolvimento de Programas , Comportamento de Redução do Risco , Comportamento Sexual/estatística & dados numéricos
14.
Pers Soc Psychol Bull ; 45(2): 270-283, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29984632

RESUMO

Relational closeness has been positively associated with relationship quality and mental health; however, desire for closeness and intimacy in a relationship may also motivate sexual risk-taking, that is, forgoing condom use. This study examined the impact of desiring more closeness with a primary partner (i.e., motivation for reducing closeness discrepancies) on HIV prevention behavior. Using pre-exposure prophylaxis (PrEP) as a case study, we examined the extent to which closeness discrepancies motivate behavioral intentions (Study 1) and actual behavior (Study 2). In both studies, desiring more closeness and believing that condoms interfere with intimacy were independently positively associated with PrEP adoption. Understanding the relational needs for closeness and intimacy in motivating prevention behavior is critical for social psychology, relationship science, and public health efforts to improve sexual health.

15.
Health Educ Behav ; 46(1): 176-184, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29504469

RESUMO

PURPOSE: Several studies have noted sexual minority disparities in tobacco smoking; however, few studies have examined the role of intimate partners in these different smoking behaviors among sexual minority men and women. Furthermore, few studies distinguish between intermittent and daily smokers. Thus, this study sought to examine whether perceptions of their partner's smoking behaviors were associated with their own smoking behaviors in a sample of sexual minority adults in romantic relationships. METHOD: In total, 898 participants (413 sexual minority females and 485 sexual minority males) completed a one-time online anonymous survey. RESULTS: Approximately one third of the sample reported smoking, with 21.2% daily smokers and 9.8% intermittent smokers. Multinomial regression results revealed that for both sexual minority females and males having a partner who was a daily or intermittent smoker was associated with an increased odds of being a daily smoker, whereas having a partner who was an intermittent smoker was associated with an increased odds of being an intermittent smoker. CONCLUSIONS: These findings provide valuable information on the need to attend to romantic partners and consider tailored programming to account for different smoking patterns and partners' potential role in reinforcing smoking.

16.
AIDS Behav ; 23(2): 366-374, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29936604

RESUMO

Transgender women (TW) are one of the highest risk groups for HIV infection globally; however, the HIV testing needs of their cisgender (non-transgender) male partners remain largely unknown. This study sought to examine the perceived acceptability of couples HIV testing and counseling (CHTC) for TW-male dyads from the perspective of cisgender men who partner with TW. Between September 2016 and June 2017, 19 cisgender men (mean age = 40.1, SD = 12.8) who currently have, or have ever had a TW partner completed an in-depth semi-structured phone interview and brief survey to gather data on acceptability of CHTC, as well as perceived barriers and facilitators to CHTC for TW-male couples. Qualitative data were thematically analyzed and integrated with survey data. Acceptability of CHTC was high in the sample (89.5%) but was complex and largely contingent on: (1) monogamy and commitment as critical precursors to CHTC acceptability; (2) risk perception and level of comfort with CHTC; (3) understandings of sexual agreements; and (4) personal relationships versus other TW-male relationships. Findings have implications for culturally-adapting and implementing CHTC in real-world settings for TW-male couples, as well as for meeting the individual HIV testing needs of cisgender men who partner with TW.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Parceiros Sexuais/psicologia , Pessoas Transgênero/psicologia , Adulto , Atitude do Pessoal de Saúde , Aconselhamento , Feminino , Heterossexualidade/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Pesquisa Qualitativa , Testes Sorológicos
17.
J Subst Abuse Treat ; 92: 27-34, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30032941

RESUMO

BACKGROUND: The technical hypothesis of Motivational Interviewing (MI) proposes that: (a) client talk favoring behavior change, or Change Talk (CT) is associated with better behavior change outcomes, whereas client talk against change, or Sustain Talk (ST) is associated with less favorable outcomes, and (b) specific therapist verbal behaviors influence whether client CT or ST occurs. MI consistent (MICO) therapist behaviors are hypothesized to be positively associated with more client CT and MI inconsistent (MIIN) behaviors with more ST. Previous studies typically examine session-level frequency counts or immediate lag sequential associations between these variables. However, research has found that the strongest determinant of CT or ST is the client's previous CT or ST statement. Therefore, the objective of this paper was to examine the association between therapist MI skills and subsequent client talk, while accounting for prior client talk. METHODS: We analyzed data from a manualized MI intervention targeting both alcohol misuse and sexual risk behavior in 132 adults seen in two hospital emergency departments. Transcripts of encounters were coded using the Motivational Interviewing Skills Code (MISC 2.5) and an additional measure, the Generalized Behavioral Intervention Analysis System (GBIAS). Using these measures, we analyzed the association between client talk following specific classifications of MICO skills, with the client's prior statement as a potential confounder or effect modifier. RESULTS: With closed questions as the reference category, therapist simple reflections and paraphrasing reflections were associated with significantly greater odds of maintaining client talk as CT or ST. Open questions and complex reflections were associated with significantly greater odds of CT following ST, were not associated significantly with more ST following ST, and were associated with more ST following CT (i.e., through an association with less Follow Neutral). CONCLUSIONS: Simple and paraphrasing reflections appear to maintain client CT but are not associated with transitioning client ST to CT. By contrast, complex reflections and open questions appeared to be more strongly associated with clients moving from ST to CT than other techniques. These results suggest that counselors may differentially employ certain MICO technical skills to elicit continued CT and move participants toward ST within the MI dialogue.


Assuntos
Alcoolismo/reabilitação , Competência Clínica , Conselheiros/normas , Entrevista Motivacional/métodos , Adolescente , Adulto , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Entrevista Motivacional/normas , Relações Profissional-Paciente , Assunção de Riscos , Comportamento Sexual , Adulto Jovem
18.
LGBT Health ; 5(5): 320-324, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29979641

RESUMO

PURPOSE: The study purpose was to examine opinions about a single-item assessment of differences of sex development (DSD) to be used in research. METHODS: An online survey was conducted with a convenience sample of 111 adults who self-identified as intersex or having a DSD diagnosis. Participants read and provided feedback on the proposed single-item assessment. RESULTS: The item received general endorsement to represent a population that is often not identified in research; however, participants provided suggestions for improvement. CONCLUSION: This study represents a first step toward identifying people with DSD conditions in surveys to better understand their needs.


Assuntos
Transtornos do Desenvolvimento Sexual , Saúde da População , Projetos de Pesquisa , Inquéritos e Questionários , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
Ethn Health ; : 1-12, 2018 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-29502446

RESUMO

INTRODUCTION: Sexual and behavioral health disparities have been consistently demonstrated between African American and White adults and between sexual minority and heterosexual communities in the United States; however, few studies using nationally representative samples have examined disparities between sexual minority and heterosexual adults within African American populations. The purpose of this study was to examine the prevalence of sexual and behavioral health outcomes between sexual minority and heterosexual African American adults and to examine whether there were different patterns of disparities for African American sexual minority men and women, respectively. METHODS: We analyzed data from 4502 African American adults who participated in the 2001-2015 waves of the National Health and Nutrition Examination Survey. Using multivariable analyses, we examined differences in HIV, sexually transmitted infections, mental health, and substance use among African American sexual minority and heterosexual men and women. RESULTS: After adjusting for sociodemographic variables, African American sexual minority men had significantly higher odds of HIV, sexually transmitted infections, and poor mental health compared to their heterosexual male counterparts, whereas African American sexual minority women had significantly higher odds of Hepatitis C, poor mental health, and substance use compared to their heterosexual female counterparts. CONCLUSIONS: These findings demonstrate notable sexual orientation disparities among African American adults. Disparities persisted beyond the role of sociodemographic factors, suggesting that further research utilizing an intersectional approach is warranted to understand the social determinants of adverse health outcomes among African American sexual minority men and women.

20.
AIDS Behav ; 22(6): 2018-2025, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28951979

RESUMO

Tobacco has been associated with worse HIV disease progression in adult samples of people living with HIV; however, studies have yet to examine these effects in youth living with HIV (YLWH). This study examined the association between tobacco smoking behaviors and sustained viral suppression among a sample of 820 YLWH who were recruited through the Adolescent Medicine Trials Network for HIV Interventions. Participants completed a cross-sectional survey and then staff abstracted viral suppression data from medical records for up to 26 weeks prior to enrollment. Overall, 20.4% of youth reported daily or almost daily tobacco use. In multivariable analyses, older age and daily or almost daily tobacco smoking, and ART adherence remained statistically significant in predicting sustained viral suppression over the study period. These findings underscore the need for tobacco screening and interventions in HIV care settings in order to identify youth in need of additional smoking cessation services.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , HIV/efeitos dos fármacos , Resposta Viral Sustentada , Fumar Tabaco/epidemiologia , Adolescente , Estudos Transversais , Progressão da Doença , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Humanos , Masculino , Programas de Rastreamento , Resultado do Tratamento , Carga Viral , Adulto Jovem
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