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1.
Artigo em Inglês | MEDLINE | ID: mdl-31939870

RESUMO

BACKGROUND: Despite high efficacy, use of pre-exposure prophylaxis (PrEP) remains low among young men who have sex with men (MSM) and transgender women (TW), primarily due to barriers such as stigma and resource awareness. We evaluated a social marketing campaign known as PrEP4Love that works to eliminate PrEP stigma and awareness gaps via targeted advertising. SETTING: Chicago, Illinois. METHODS: Participants were enrolled within a cohort study of young MSM and TW (RADAR). Data were collected between June 2017 and April 2018 from HIV-negative individuals attending a follow-up visit. Surveys assessed demographics, PrEP attitudes and perceptions, and PrEP4Love campaign awareness. Associations between PrEP4Love awareness and PrEP perceptions, uptake, and behaviors were assessed using multiple logistic regression controlling for age, race/ethnicity, gender, sexual identity, and ever having used PrEP. RESULTS: Of 700 participants, the majority (75.9%) indicated seeing PrEP4Love ads in Chicago. Those who had seen ads were more likely to be out to their providers (OR =1.95; 95% CI: 1.17, 3.23) than those who had not, and those who had conversations were significantly more likely to have initiated the conversation themselves. Individuals who had seen ads were more likely to have taken PrEP in the last six months (OR = 1.87; 95% CI: 1.15, 3.16), and more likely to believe their friends and the general public approved of and used PrEP. CONCLUSION: Social marketing campaigns are promising interventions that have the potential to alleviate barriers to HIV prevention, particularly among MSM and TW. Future research should evaluate the impact of these initiatives at multiple time points.

2.
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.

3.
J Adolesc Health ; 66(2): 202-209, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31607546

RESUMO

PURPOSE: The aim of this study was to identify sex-stratified trends in victimization risk specific to heterosexual, lesbian, gay, bisexual, and questioning youth while considering changes in sexual orientation-disparities from 2009 to 2017. METHODS: Youth Risk Behavior Survey (YRBS) data collected biennially (five waves; 2009-2017) were pooled across 56 jurisdictions and 454,715 students for one of the most nationally representative samples of heterosexual and sexual minority youth to date. We analyzed a seven-item victimization risk assessment using the Centers for Disease Control and Prevention's recommended trend analysis approach. We used logistic regression with year-by-identity interactions to test whether sexual orientation-based disparities widened, narrowed, or were maintained over time. RESULTS: Victimization risk declined significantly for male and female bisexual and questioning youth, lesbian, gay, and heterosexual youth. Disparities narrowed between bisexual, questioning, and lesbian females and heterosexual females and between bisexual and heterosexual males. Nevertheless, sexual orientation-based disparities remained significant for all sexual minority youth in 2017. CONCLUSIONS: Distinct patterns of change in victimization risk for specific groups of sexual minority youth underscore the need to consider variability within sexual minority youth communities; treating them as a singular group could mask nuanced disparities. Some of the relatively small decreases in victimization risk also suggest the need for interventions to address a more comprehensive set of victimization-related risks beyond bullying and needed efforts that are not limited to the immediate school context.

4.
AIDS Behav ; 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31845078

RESUMO

In 2019, the requisite biomedical and behavioral interventions to eliminate new HIV infections exist. "Ending the HIV Epidemic" now becomes primarily a challenge of will and implementation. This review maps the extent to which implementation research (IR) has been integrated into HIV research by reviewing the recent funding portfolio of the NIH. We searched NIH RePORTER for HIV and IR-related research projects funded from January 2013 to March 2018. The 4629 unique studies identified were screened using machine learning and manual methods. 216 abstracts met the eligibility criteria of HIV and IR. Key study characteristics were then abstracted. NIH currently funds HIV studies that are either formally IR (n = 109) or preparatory for IR (n = 107). Few (13%) projects mentioned a guiding implementation model, theory, or framework, and only 56% of all studies explicitly mentioned measuring an implementation outcome. Considering the study aims along an IR continuum, 18 (8%) studies examined barriers and facilitators, 43 (20%) developed implementation strategies, 46 (21%) piloted strategies, 73 (34%) tested a single strategy, and 35 (16%) compared strategies. A higher proportion of formal IR projects involved established interventions (e.g., integrated services) compared to newer interventions (e.g., pre-exposure prophylaxis). Prioritizing HIV-related IR in NIH and other federal funding opportunity announcements and expanded training in implementation science could have a substantial impact on ending the HIV pandemic. This review serves as a baseline by which to compare funding patterns and the sophistication of IR in HIV research over time.

5.
mBio ; 10(6)2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31848288

RESUMO

Mechanisms have evolved to prevent errors in replication, transcription, and translation of genetic material, with translational errors occurring most frequently. Errors in protein synthesis can occur at two steps, during tRNA aminoacylation and ribosome decoding. Recent advances in protein mass spectrometry have indicated that previous reports of translational errors have potentially underestimated the frequency of these events, but also that the majority of translational errors occur during ribosomal decoding, suggesting that aminoacylation errors are evolutionarily less tolerated. Despite that interpretation, there is evidence that some aminoacylation errors may be regulated, and thus provide a benefit to the cell, while others are clearly detrimental. Here, we show that while it has been suggested that regulated Thr-to-Ser substitutions may be beneficial, there is a threshold beyond which these errors are detrimental. In contrast, we show that errors mediated by alanyl-tRNA synthetase (AlaRS) are not well tolerated and induce a global stress response that leads to gross perturbation of the Escherichia coli proteome, with potentially catastrophic effects on fitness and viability. Tolerance for Ala mistranslation appears to be much lower than with other translational errors, consistent with previous reports of multiple proofreading mechanisms targeting mischarged tRNAAla These results demonstrate the essential role of aminoacyl-tRNA proofreading in optimizing cellular fitness and suggest that any potentially beneficial effects of mistranslation may be confined to specific amino acid substitutions.IMPORTANCE Errors in protein synthesis have historically been assumed to be detrimental to the cell. While there are many reports that translational errors are consequential, there is a growing body of evidence that some mistranslation events may be tolerated or even beneficial. Using two models of mistranslation, we compare the direct phenotypic effects of these events in Escherichia coli This work provides insight into the threshold for tolerance of specific mistranslation events that were previously predicted to be broadly neutral to proteome integrity. Furthermore, these data reveal the effects of mistranslation beyond the general unfolded stress response, leading to global translational reprogramming.

6.
LGBT Health ; 6(7): 342-349, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31618165

RESUMO

Purpose: The purpose of this study was to determine the extent to which sexual identity and/or sexual behaviors were associated with pregnancy risk factors (condom use, alcohol or other drug use before sex, and World Health Organization [WHO] Tier 1 [i.e., intrauterine device, implant] or Tier 2 [i.e., injectable, pill, patch, or ring] contraception use) and teen pregnancy among female high school students who reported having a sexual relationship with a male partner. Methods: Data were from the Youth Risk Behavior Survey (YRBS; 2005-2015) (n = 63,313). Logistic regression was used to analyze sexual identity and behavior disparities in pregnancy risk behaviors and teen pregnancy. Interactions between sexual identity and behavior were also tested. All models adjusted for the YRBS complex sampling frame. Results: Girls who reported being unsure of their sexual identity were less likely to use condoms or a WHO Tier 1 or Tier 2 contraceptive method at last sex, and more likely to report alcohol or other drug use at last sex than heterosexual girls. Girls who identified as lesbian were also less likely to use a condom at last sex, and girls who reported both male and female sexual partners were more likely to report alcohol or other drug use and less likely to use condoms at last sex. Girls who identified as bisexual were more likely to report pregnancy during teenage years than girls who identified as heterosexual. Conclusion: Our results support the need to assess both sexual identity and sexual behavior in research on teen pregnancy and pregnancy risk. Furthermore, the finding that girls who were unsure of their sexual identity showed heightened risk highlights the need for additional research that includes this group.

7.
Genome Biol ; 20(1): 221, 2019 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651356

RESUMO

BACKGROUND: Soils are a key component of agricultural productivity, and soil microbiota determine the availability of many essential plant nutrients. Agricultural domestication of soils, that is, the conversion of previously uncultivated soils to a cultivated state, is frequently accompanied by intensive monoculture, especially in the developing world. However, there is limited understanding of how continuous cultivation alters the structure of prokaryotic soil microbiota after soil domestication, including to what extent crop plants impact soil microbiota composition, and how changes in microbiota composition arising from cultivation affect crop performance. RESULTS: We show here that continuous monoculture (> 8 growing seasons) of the major food crop rice under flooded conditions is associated with a pronounced shift in soil bacterial and archaeal microbiota structure towards a more consistent composition, thereby domesticating microbiota of previously uncultivated sites. Aside from the potential effects of agricultural cultivation practices, we provide evidence that rice plants themselves are important drivers of the domestication process, acting through selective enrichment of specific taxa, including methanogenic archaea, in their rhizosphere that differ from those of native plants growing in the same environment. Furthermore, we find that microbiota from soils domesticated by rice cultivation contribute to plant-soil feedback, by imparting a negative effect on rice seedling vigor. CONCLUSIONS: Soil domestication through continuous monoculture cultivation of rice results in compositional changes in the soil microbiota, which are in part driven by the rice plants. The consequences include a negative impact on plant performance and increases in greenhouse gas emitting microbes.

8.
ACS Sens ; 4(10): 2638-2645, 2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31583880

RESUMO

The ability to study bacteria at the single cell level has advanced our insights into microbial physiology and genetics in ways not attainable by studying large populations using more traditional culturing methods. To improve methods to characterize bacteria at the cellular level, we developed a new microfluidic platform that enables cells to be exposed to metabolites in a gradient of concentrations. By designing low-cost, three-dimensional devices with adhesive tapes and tailoring them for bacterial imaging, we avoided the complexities of silicon and polymeric microfabrication. The incorporation of an agarose membrane as the resting substrate, along with a temperature-controlled environmental chamber, allows the culturing of bacterial cells for over 10 h under stable growth or inhibition conditions. Incorporation of an autofocusing module helped the uninterrupted, high-resolution observation of bacteria at the single-cell and at low density population levels. We used the microfluidic platform to record morphological changes in Escherichia coli during ampicillin exposure and to quantify the minimum inhibitory concentration of the antibiotic. We further demonstrated the potential of finely-tuned, incremental gene regulation in a concentration gradient utilizing CRISPR interference (CRISPRi). These low-cost engineering tools, when implemented in combination with genetic approaches such as CRISPRi, should prove useful to uncover new genetic determinants of antibiotic susceptibility and evaluate the long-term effectiveness of antibiotics in bacterial cultures.

9.
LGBT Health ; 6(7): 350-356, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31556791

RESUMO

Purpose: Men who have sex with men (MSM) are affected disproportionately by cancers caused by human papillomavirus (HPV). A safe and effective vaccine is available to prevent HPV infection, yet rates of HPV vaccination among young MSM are low. Guided by the Information, Motivation, and Behavioral Skills model, the purpose of this study was to identify young sexual minority men's perspectives on HPV vaccination. Methods: Men (N = 29) 18-26 years of age, who identified as gay, bisexual, or queer, completed a semistructured interview. Vaccinated (n = 9) and unvaccinated men (n = 20) were interviewed. The interview assessed knowledge, motivation, and behavioral skills related to HPV vaccination as well as relevant contextual factors (e.g., provider recommendation). Interviews were coded for recurring themes. Results: Most participants were aware of HPV and the HPV vaccine; however, misconceptions and knowledge gaps were common with many believing that HPV vaccination was only for women. Motivational factors included perceived advantages (e.g., reducing risk of HPV-related disease) and disadvantages (e.g., stigma) of HPV vaccination, perceived threat of HPV-related disease, and subjective norms for HPV vaccination. Relevant behavioral skills included disclosure of sexual orientation and comfort discussing HPV vaccination. Concerns about vaccine cost, access, and convenience were salient barriers to initiating and completing the series. Encouragement from a health care provider was cited as the primary reason for receiving the HPV vaccine. Conclusion: When developing interventions to increase HPV vaccination among young sexual minority men, it is important to address facilitators and barriers that reflect the unique needs of this population.

10.
Arch Sex Behav ; 2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31549363

RESUMO

Black men who have sex with men (MSM) continue to experience disproportionately high HIV incidence rates relative to their white peers. Yet, Black MSM do not report higher levels of sexual risk behavior, and contextual factors such as access to care and sexual networks only partially explain these disparities. However, risk misclassification could help explain this paradox, if measurement biases systematically underestimate sexual risk behavior among Black MSM relative to their peers. The current study examined variation in sexual partnership corroboration in the RADAR study, a large and diverse cohort of young MSM and transgender women. Network data were elicited regarding all sexual partners in the prior 6 months, including instances where participants reported other participants as sexual partners. Using these data, anal and condomless anal sex partners were separately examined using a series of exponential random graph models to estimate the rate of corroboration of sexual connections between participants and examine whether this parameter varied by race/ethnicity. For both types of behavior, providing separate estimates for corroboration across race/ethnicity groups reduced model fit and did not significantly vary across groups. Accordingly, we found no evidence of measurement bias by race/ethnicity in the current data. However, overall rates of corroboration (41.2-50.3%) were low, suggesting substantial levels of measurement error. Accordingly, it is vital that researchers continue to improve upon methods to measure risk behavior in order to maximize their validity. We discuss the implications of these findings, including potential alternative causes of risk misclassification (e.g., sampling bias) and future directions to reduce measurement error.

11.
J Clin Oncol ; 37(30): 2746-2758, 2019 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-31216228

RESUMO

PURPOSE: The aim of the current study was to report the efficacy of topical and systemic treatments for immune-related cutaneous adverse events (ircAEs) attributed to checkpoint inhibitors in an uncontrolled cohort of patients referred to oncodermatology clinics. METHODS: A retrospective analysis of patients with ircAEs evaluated by dermatologists from January 1, 2014, to December 31, 2017, at three tertiary care hospitals and cancer centers were identified through electronic medical records. Clinicopathologic characteristics, dermatologic therapy outcome, and laboratory data were analyzed. RESULTS: A total of 285 patients (median age, 65 years [range, 17 to 89 years]) with 427 ircAEs were included: pruritus (n = 138; 32%), maculopapular rash (n = 120; 28%), psoriasiform rash (n = 22; 5%), and others (n = 147; 34%). Immune checkpoint inhibitor class was associated with ircAE phenotype (P = .007), where maculopapular rash was predominant in patients who received combination therapy. Severity of ircAEs was significantly reduced (mean Common Terminology Criteria for Adverse Events grade: 1.74 v 0.71; P < .001) with dermatologic interventions, including topical corticosteroids, oral antipruritics, and systemic immunomodulators. A total of 88 ircAEs (20%) were managed with systemic immunomodulators. Of these, 22 (25%) of 88 persisted or worsened. In seven patients with corticosteroid-refractory ircAEs, improvement resulted from targeted biologic immunomodulatory therapies that included rituximab and dupilumab. Serum interleukin-6 (IL-6) was elevated in 34 (52%) of 65 patients; grade 3 or greater ircAEs were associated with increased absolute eosinophils (odds ratio, 4.1; 95% CI, 1.3 to 13.4) and IL-10 (odds ratio, 23.8; 95% CI, 2.1 to 262.5); mean immunoglobulin E serum levels were greater in higher-grade ircAEs: 1,093 kU/L (grade 3), 245 kU/L (grade 2), and 112 kU/L (grade 1; P = .043). CONCLUSION: Most ircAEs responded to symptom- and phenotype-directed dermatologic therapies, whereas biologic therapies were effective in patients with corticosteroid-refractory disease. Increased eosinophils, IL-6, IL-10, and immunoglobulin E were associated with ircAEs, and they may represent actionable therapeutic targets for immune-related skin toxicities.

12.
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.

13.
AIDS Behav ; 23(10): 2749-2760, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31228025

RESUMO

Pre-exposure prophylaxis (PrEP) is one of the best biomedical HIV prevention tools available. However, uptake, particularly in communities of men who have sex with men (MSM) and transgender individuals assigned male at birth (AMAB), remains low. Further, the role of an individual's social support structure on PrEP uptake and adherence remains largely understudied. Understanding MSM and AMAB transgender individuals' perceptions of PrEP use as well as support and patterns of disclosure of (or intent to disclose) their PrEP status may offer key insights into how best to improve uptake in vulnerable communities. Further, the influence of one's social connections on other factors, such as perceptions of and conversations about PrEP deserves attention as well, as these factors may be key to improved knowledge and uptake. Therefore, we assessed perceptions of PrEP use, disclosure of or intent to disclose PrEP status, and social support and associated factors among a cohort of MSM and AMAB transgender individuals in a large Midwestern city. Results demonstrated that, among those not taking PrEP, bisexual participants and those unsure of their sexual identity were less likely to be comfortable with the idea of disclosing PrEP use were they ever to start taking it. Encouragingly however, we found that individuals who reported disclosing their PrEP status had high rates of support among friends and relatives. We also observed that knowing someone else who was on PrEP was associated with increased likelihood of discussing PrEP with one's medical provider, as was increased age. Other findings and implications for research, policy, and practice are discussed within.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Revelação/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/estatística & dados numéricos , Profilaxia Pré-Exposição , Apoio Social , Pessoas Transgênero/estatística & dados numéricos , Adolescente , Adulto , Chicago/epidemiologia , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Homossexualidade Masculina/psicologia , Humanos , Masculino , Sexo Seguro , Comportamento Sexual , Pessoas Transgênero/psicologia , Adulto Jovem
14.
Front Vet Sci ; 6: 114, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31058171

RESUMO

Antibiotics have been used extensively for growth promotion in poultry, along with other food production animals, as well as therapeutically to treat infectious diseases. However, with concerns over selection for drug antibiotic resistant bacteria the practice of using subtherapeutic doses of antibiotics is under increased scrutiny. Consequently, we assessed the impact of the commonly used antibiotic bacitracin methylene disalicylate (BMD) on the gastrointestinal microbiota of chickens. For this we administered therapeutic doses of BMD as a feed additive and 16s rRNA gene amplicon sequencing to measure changes in taxonomic abundance on the distal colon and cecal microbiota of young broiler chickens. While BMD treatment was found to impact the abundance of selected taxa and overall beta diversity, significant changes were, in general, limited to the colon of the treated birds. Selected taxa at the phylum, class, and genus levels that were most impacted were identified. The composition of the cecum remained relatively stable in BMD-treated animals. As poultry production practices seek alternatives to growth promoting antibiotic feed additives, manipulation of the gastrointestinal microbiota holds promise. These results suggest that targeting the cecum may offer a means to promote changes to the microbiota that maximize the benefits for the hosts.

15.
J Pediatr Gastroenterol Nutr ; 69(3): 363-369, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31107796

RESUMO

OBJECTIVES: Gut bacteria play an essential role during infancy and are strongly influenced by the mode of birth and feeding. A primate model was used to investigate the benefits of exposure to the mother or conversely the negative impact of early nursery rearing on microbial colonization. METHOD: Rectal swabs were obtained from rhesus macaques born vaginally and mother-reared (MR, N = 35) or delivered primarily via cesarean-section and human-reared (HR, N = 19). Microbiome composition was determined by rRNA gene amplicon sequencing at 2, 4, and 8 weeks of age and Kyoto Encyclopedia of Genes and Genomes (KEGG) orthologs used to assess influences on functional metabolic pathways in the gut. Growth trajectories and incidence of diarrheic symptoms were evaluated. RESULTS: The microbial community structure was different between MR and HR infants with respect to phylogeny and abundance at all 3 ages. When examining dominant phyla, HR infants had a higher Firmicutes-to-Bacteroidetes ratio. At the genus level, breast milk-dependent commensal taxa and adult-typical genera were more abundant in MR infants. This difference resulted in a corresponding shift in the predicted metabolic effects, specifically for microbial genes associated with metabolism and immune function. HR infants had faster growth trajectories (P < 0.001), but more diarrheic symptoms by 6 months postnatal (P = 0.008). CONCLUSIONS: MR infants acquired adult-typical microbiota more quickly, and had higher levels of several beneficial commensal taxa. Cesarean-delivered and formula-fed infants had different developmental trajectories of bacterial colonization. Establishment of the gut microbiome was associated with an infant's growth trajectory, and implicated in the subsequent vulnerability to Campylobacter infections associated with diarrhea in infant monkeys.

16.
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.

17.
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.

18.
AIDS Care ; 31(10): 1282-1289, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30821480

RESUMO

Young men who have sex with men (YMSM) and transgender youth assigned male at birth (AMAB) bear a disproportionate burden of the HIV epidemic, yet are sub optimally engaged by sexual health service providers and HIV prevention services. To increase sexual health and HIV prevention behaviors and address disparities in HIV incidence and outcomes among YMSM and AMAB transgender youth, it is critical to understand patterns of service utilization and avoidance. This study examined how and why YMSM and AMAB transgender youth use or avoid sexual health services and service providers in a large Midwestern city within a survey administered to 890 participants from a longitudinal cohort study (RADAR). Results demonstrate low overall use of sexual health services and minimal interest in seeking pre-exposure prophylaxis (PrEP), consistent with prior research. Low awareness of available services was associated with how and where YMSM and trans youth AMAB seek care, with 76% of our sample reporting this as their primary reason for not seeking specific sexual health services. Additional associations are discussed, and recommendations are made for how to improve available services and access.

19.
Pediatrics ; 143(4)2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30862728

RESUMO

BACKGROUND: Using a population-based sample of youth, we examined rates of cigarette use and trends in cigarette use disparities between heterosexual youth and 3 subgroups of sexual minority youth (SMY) (ie, lesbian or gay, bisexual, and unsure) from 2005 to 2015. METHODS: Data are from 6 cohorts of the Youth Risk Behavior Survey, a national, biennial, school-based survey of ninth- to 12th-grade students in the United States (n = 404 583). Sex-stratified analyses conducted in 2017 examined trends in 2 cigarette-related behaviors: lifetime cigarette use and heavy cigarette use (20+ days in the past 30). RESULTS: Disparities in lifetime cigarette use between lesbian and heterosexual girls were statistically smaller in 2015 relative to 2005 (adjusted odds ratio [aOR] 0.29; 95% confidence interval [CI] 0.12-0.75; P = .011). Sexual orientation disparities in heavy use were narrower for bisexual boys in 2015 compared with 2005 (aOR 0.39; 95% CI 0.17-0.90; P = .028). Girls and boys unsure of their sexual identity had wider disparities in heavy use in 2015 (aOR 3.85; 95% CI 1.39-11.10; P = .009) relative to 2005 (aOR 2.44; 95% CI 1.22-5.00; P = .012). CONCLUSIONS: SMY remain at greater risk for cigarette-related behaviors despite greater acceptance of lesbian, gay, and bisexual people in the United States. Focused policies and programs aimed at reducing rates of SMY cigarette use are warranted, particularly for youth questioning their sexual identity.


Assuntos
Comportamento do Adolescente , Fumar Cigarros/epidemiologia , Disparidades nos Níveis de Saúde , Heterossexualidade/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adolescente , Estudos Transversais , Bases de Dados Factuais , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , Estudos Retrospectivos , Assunção de Riscos , Estados Unidos
20.
J Am Acad Child Adolesc Psychiatry ; 58(2): 200-210, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30738547

RESUMO

OBJECTIVE: To expand knowledge of co-occurring alcohol use and disordered eating behaviors (DEB) among sexual minority (ie, nonheterosexual) youth. METHOD: Using pooled 2009 to 2015 US Youth Risk Behavior Surveys (322,687 students; 7.3% lesbian, gay, bisexual), multivariable logistic regression models examined the following: (1) associations of age of onset of drinking and past month binge drinking with past year DEB (fasting, diet pill use, purging, steroid use); and (2) effect modification by sexual orientation. RESULTS: Alcohol use and sexual minority identity were independently associated with elevated odds for diet pill use and purging among female adolescents, and with fasting and steroid use among male adolescents. Odds of fasting increased with greater frequency of monthly binge drinking among heterosexual adolescent female youth, and odds of diet pill use increased with greater frequency of monthly binge drinking among heterosexual adolescent male youth. DEB prevalence was particularly pronounced among adolescents who binge drank and who were not sure of their sexual orientation identity. Among male adolescents not sure of their sexual orientation identity, those who binge drank more than 1 day in the past month had 8.63 to 23.62 times the odds of using diet pills relative to those who did not binge drink, and 13.37 to 26.42 times the odds of purging relative to those who did not binge drink. CONCLUSION: More research is needed on psychosocial factors underlying alcohol use and DEB in youth of all sexual orientations.

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