When disability and homoparenting meet: the adoption of children with disability by same sex couples. / Quando a deficiência e a homoparentalidade se encontram: a adoção de crianças com deficiência por casais homoafetivos.

The present theoretical essay is based on six reports concerning same-sex couples and gay and lesbian people in order to interconnect homoparenting and the adoption of children with disabilities, through the lenses of human and social sciences in public health. The reports were interpreted in light of studies on same-sex adoption and the adoption of children with disabilities. Feminist approaches related to care and disability were also included in the interpretative perspective, operating as expressive webs of grammars of ableism. It was found that media approaches endorse the right to family formation and the adoption of children with disabilities by homoparental families, but with little critical depth on the category of disability and without highlighting support for the adoption of all adoptee profiles. Moreover, the intersections between homophobia and ableism increase discriminatory and oppressive logics, with the union of social groups considered to be "undesirable" representing a strategy of governmentality that reveals the complexity of grammars of ableism, applied to the sexual and reproductive rights of LGBTQIA+ adopters and to the fundamental rights of children and adolescents with disabilities who are available for adoption.

O ensaio teórico parte de seis reportagens sobre casais homoafetivos e pessoas gays e lésbicas para interseccionar homoparentalidade e adoção de crianças com deficiência, pelas lentes das ciências humanas e sociais em saúde coletiva. As reportagens foram interpretadas à luz dos estudos sobre adoção homoparental e adoção de crianças com deficiência. Abordagens feministas sobre cuidado e deficiência também compuseram o olhar interpretativo, operando como teias expressivas das gramáticas do capacitismo. Verificou-se que as abordagens midiáticas endossam o direito à constituição familiar e à adoção de crianças com deficiência por famílias homoparentais, sem aprofundar criticamente a categoria deficiência e sem destacar apoio à adoção de todos os perfis de adotandos. E que as intersecções entre homofobia e capacitismo incrementam lógicas discriminatórias e de opressão, sendo a união de grupos considerados "indesejáveis" uma estratégia de governamentalidade que revela a complexidade das gramáticas do capacitismo aplicadas aos direitos sexuais e reprodutivos de adotantes LGBTQIA+ e aos direitos fundamentais de crianças e adolescentes com deficiência disponíveis para adoção.

Sexist, Racist, and Homophobic Violence against Paramedics in a Single Canadian Site.

Violence against paramedics is widely recognized as a serious, but underreported, problem. While injurious physical attacks on paramedics are generally reported, non-physical violence is less likely to be documented. Verbal abuse can be very distressing, particularly if the harassment targets personal or cultural identities, such as race, ethnicity, gender, or sexual orientation. Leveraging a novel, point-of-event reporting process, our objective was to estimate the prevalence of harassment on identity grounds against paramedics in a single paramedic service in Ontario, Canada, and assess its potentially differential impact on emotional distress. In an analysis of 502 reports filed between 1 February 2021 and 28 February 2022, two paramedic supervisors independently coded the free-text narrative descriptions of violent encounters for themes suggestive of sexism, racism, and homophobia. We achieved high inter-rater agreement across the dimensions (k = 0.73-0.83), and after resolving discrepant cases, we found that one in four violent reports documented abuse on at least one of the identity grounds. In these cases, paramedics were 60% more likely to indicate being emotionally distressed than for other forms of violence. Our findings offer unique insight into the type of vitriol paramedics experience over the course of their work and its potential for psychological harm.

Continuing nursing education actions in the face of homophobia: an integrative review.

OBJECTIVES: to analyze continuing nursing education actions in the scientific literature in the face of homophobia. METHODS: an integrative literature review with structured search in June 2022 in eight databases, using the descriptors Nursing Education, Homophobia, Sexual and Gender Minorities. Final sample consisted of six primary studies. RESULTS: continuing nursing education actions are supported by strategies such as use of teaching materials, lectures, case studies and focus groups, addressing content such as gender identity issues and affective-sexual orientation, health disparities and their relationship with homophobia in healthcare settings. FINAL CONSIDERATIONS: carried out in various healthcare settings, continuing education actions proved to be successful in raising nurses' awareness in facing homophobia in health services, however, their expansion is necessary to create health spaces that meet the specific needs of these people.

The Homophobia Course in the Life of Older Gay Men in Brazil: Their Social Representations.

This study aims at understanding the social representations of homophobia among older gay men. A number of 20 older gay men aged between 60 and 75 years old participated of the study; the average age was 63.25 years old (SD = 3.58). In the data collection, a semi-structured interview about homophobia was used; they were analyzed on IRAMUTEQ, which compiles the descendant hierarchical classification. The corpus was divided into three classes of social representations. The first representation comprises images of prejudice within society. The second one presents social representations involving reports of internalized homophobia and the experiencing of prejudice. The third one shows social representations about physical and identity violations. The social representations of homophobia show how the participants lead their actions in society, being based upon risk and protection issues to face the objective and subjective difficulties present in their social representations.

Homophobia in the provision of sexual health care in the UK.

Decision making in the provision of health care is influenced by not only scientific evidence but also by the systems in which decisions are made. We consider national decisions made in the UK related to sexually transmitted infection prevention in gay, bisexual, and other men who have sex with men (GBMSM), with three specific examples-HIV pre-exposure prophylaxis, mpox (formerly known as monkeypox) vaccination, and doxycycline prophylaxis. We suggest that entrenched societal and political homophobia results in unacceptable delays and limitations to accessing highly effective interventions and that these delays result in harm from preventable transmissions of HIV, mpox, and syphilis. GBMSM have been affected disproportionately by HIV, mpox, and bacterial sexually transmitted infections, and there is an ongoing unmet need for effective prevention. Denying access to public health interventions that meet these needs is unethical.

Iatrogenic necropolitics: forced anal examinations and state-sanctioned homophobia.

In 2016, Human Rights Watch, an international human rights organisation, published a report on the use of forced anal examinations to identify and prosecute putative 'homosexuals'. The report provided detailed descriptions and first-person accounts of these examinations in several countries in the Middle East and Africa. Drawing on theories of iatrogenesis and queer necropolitics, this paper uses these accounts and other reports of forced anal examinations to explore the role of medical providers in the 'diagnosis' and prosecution of homosexuality. The goal of these medical examinations is explicitly punitive rather than therapeutic, making them quintessential examples of iatrogenic clinical encounters which harm rather than heal. We argue that these examinations naturalise socioculturally derived beliefs about bodies and gender that construct homosexuality as 'readable' on the body through close medical inspection. These acts of inspection and 'diagnosis' reveal broader hegemonic state narratives of heteronormative gender and sexuality, both within countries as well as internationally as different state actors circulate and share these narratives. This article highlights the entanglement of medical and state actors, as well as contextualises the practice of forced anal examination within its colonial roots. Our analysis offers the potential for advocacy and holding medical professions and states accountable.

Culturally Relevant Africultural Coping Moderates the Association Between Discrimination and Antiretroviral Adherence Among Sexual Minority Black Americans Living with HIV.

Exposure to discrimination has been linked to lower HIV antiretroviral therapy (ART) adherence and poor HIV care outcomes among Black Americans. Coping has been shown to mitigate the harmful effects of discrimination on health behaviors, but the use of cultural relevant Africultural coping strategies is understudied as a moderator of the association between intersectional discrimination and ART adherence among Black Americans. We used adjusted logistic regression to test whether Africultural coping strategies (cognitive/emotional debriefing; collective; spiritual-centered; ritual-centered) moderated associations between multiple forms of discrimination (HIV, sexual orientation, race) and good ART adherence (minimum of 75% or 85% of prescribed doses taken, as measured by electronic monitoring in separate analyses) among 92 sexual minority Black Americans living with HIV. Mean adherence was 66.5% in month 8 after baseline (36% ≥ 85% adherence; 49% ≥ 75% adherence). Ritual-centered coping moderated the relationship between each of the three types of discrimination at baseline and good ART adherence in month 8 (regardless of the minimum threshold for good adherence); when use of ritual coping was low, the association between discrimination and adherence was statistically significant. The other three coping scales each moderated the association between racial discrimination and good ART adherence (defined by the 75% threshold); cognitive/emotional debriefing was also a moderator for both HIV- and race-related discrimination at the 85% adherence threshold. These findings support the benefits of Africultural coping, particularly ritual-centered coping, to help sexual minority Black Americans manage stressors associated with discrimination and to adhere well to ART.

Intimate Partner Violence Perpetration Among Sexual Minority Young Adults: Associations With Alcohol Use, PTSD Symptoms, Internalized Homophobia, and Heterosexist Discrimination.

Lesbian, gay, bisexual, queer, and other sexual minority (LGBQ+) young adults report similar or higher rates of intimate partner violence (IPV) perpetration than their heterosexual peers. Elevated IPV risk among LGBQ+ young adults may be attributable to experiencing heterosexist discrimination and internalized homophobia. In addition, LGBQ+ people report disproportionate posttraumatic stress disorder (PTSD) symptoms, alcohol use, and IPV perpetration in dating relationships. Thus, this study explored which combinations of IPV risk factors (i.e., experiencing heterosexist discrimination, internalized homophobia, PTSD symptoms, alcohol use) related to forms of IPV perpetration, inclusive of psychological, physical, and sexual forms, in a sample of 342 LGBQ+ young adults. Internalized homophobia was related to psychological IPV perpetration at high and medium levels of PTSD symptoms and only high levels of alcohol use. PTSD symptoms and alcohol use interacted to predict psychological IPV perpetration; and PTSD symptoms related to increased psychological IPV perpetration at high and medium, but not low, alcohol use levels. Alcohol use was positively related to physical IPV perpetration. No other risk factors or interactions were significantly related to physical or sexual IPV perpetration. Results were consistent with prior findings that linked internalized homophobia, alcohol use, and PTSD symptoms to IPV perpetration and highlight the interacting nature of these IPV perpetration risk factors. Comprehensive IPV interventions with LGBQ+ young adults should evaluate the impact of simultaneously targeting these multiple IPV risk factors considering their interacting contributions to IPV perpetration risk. More research is needed to examine the temporal relations between minority stress, PTSD symptoms, alcohol use, and IPV perpetration.

Development of a Video-Delivered Serial Drama Designed to Reduce Community Homophobia and HIV Stigma, Decrease Sexual Risk Behavior, and Increase HIV Testing Among Black Youth.

This article describes the development of a video serial drama intervention that was designed to address factors that influence HIV in the United States among Black youth. These include HIV testing, sexual behaviors not protected by condoms, negative attitudes towards sexual minorities, and HIV stigma. Behavior-change principles (social learning theory and education-entertainment) and input from members of the priority audience formed the basis of this 27-episode (3 minutes each) drama for dissemination on multiple platforms, including in public spaces or privately online. The developmental process, specifically involving members of the population of interest and use of behavioral theory, enriched the narrative elements and likely ensured intervention acceptability, enhancing effectiveness. Public health practitioners and prevention programmers may want to consider using this intervention and/or the narrative communication approach when intervening to change behavior.

School Memories about Homophobic Bullying: A Study Based on Cultural-Historical Psychology.

The expression of homophobic violence in schools reveals the urgency of an analytical approach to debate the impact of this phenomenon on students' mental health. This article seeks to debate and better comprehend school memories from young gays, lesbians, and bisexuals, as well as to discuss how homophobic bullying affected their school trajectories. This study is based on cultural-historical psychology in intersection with gender and sexuality studies. In-depth online interviews were conducted with three young subjects who identified themselves as non-heterosexual. The interviews were recorded, transcribed, and analyzed through the analytical discourse tool defined as Nuclei of Meanings. The results were organized in two topics of discussion: (a) the problems associated with non-heterosexual identity in schools; (b) the search for other ways of experiencing sexual identity in school. Throughout the article, reflections were held about the challenges participants had to deal with in order to regularly attend school and be educated, as well as the obstacles they faced in building their own ways of recognizing their sexual identity. The unique ways in which these young subjects took a stand in the face of homophobic situations show new methods to create educational interventions in order to include sexual diversity and openness to different possibilities of being and acting.

Political homophobia and the effect on GBMSM programmes in Kenya: The significance of a community-led rapid agency assessment.

A recent Supreme Court ruling that permitted LGBTQ + rights organisations to officially register as non-governmental organisations has led to rises in political homophobia in Kenya. Community leaders initiated and led a rapid agency assessment to examine the effects of this rising political homophobia on sexual health services access for gay, bisexual and other men who have sex with men (GBMSM). This survey assessment engaged directors and programme managers running 20 community-based organisations (CBOs) representing 19 Kenyan counties, serving the sexual health needs of more than >25,000 GBMSM. In addition to prevalent shutdowns of health services, respondents reported growing religious tensions, fears and threats of attack, withdrawal of local county government support, and rising religious tensions. At a moment when highly oppressive anti-LGBTQ + legislation has been drafted and debated in parliament, in the name of 'family protection', this commentary makes an appeal to allied health officials and global funding partners to make more explicit statements that call attention to the negative consequences of political homophobia on the grounds of public health and human rights.

Everyday Discrimination and HIV Testing Among Partnered Latino/x Sexual Minority Men in the United States: A Stratified Analysis by Birth Location.

We examined the association between everyday discrimination and HIV testing patterns-current (≤ 6 months), recent (7-12 months), and delayed (> 12 months or never tested)-among partnered Latino/x sexual minority men (SMM). Multinomial regression analyses revealed that in the full sample (N = 484) experiencing discrimination based on sexual orientation and race/ethnicity attributions concurrently (vs. no discrimination) was associated with higher odds of delayed (vs. current) HIV testing (AOR = 2.6, 95% CI [1.0, 6.7]). Similarly, in the subset of Latino/x SMM born outside the mainland U.S. (n = 209), experiencing concurrent sexual orientation- and race/ethnicity-based discrimination (vs. no discrimination) was associated with higher odds of recent (AOR = 12.4, 95% CI [1.3, 115.7]) and delayed HIV testing (AOR = 7.3, 95% CI [1.6, 33.0]), compared with current testing. Findings suggest that addressing discrimination may improve HIV testing uptake among partnered Latino/x SMM, particularly those born outside the U.S.

Effects of internalised racism and internalised homophobia on sexual behaviours among black gay and bisexual men in the USA: a systematic review protocol.

INTRODUCTION: Black gay and bisexual men are overburdened by HIV in the USA. While the socioecological model has been applied to understand potential mechanisms of HIV acquisition among black gay and bisexual men, there is mixed evidence on the impact of internalised stigma on HIV risk among this population. This systematic review protocol paper outlines the systematic review being conducted to determine the relationship between internalised racism, internalised homophobia and engagement in sexual behaviour, which puts individuals at risk for HIV infection. METHODS AND ANALYSIS: For the review, we will conduct a systematic review of the literature, summarise and critique published scholarly literature on the associations between forms of internalised stigma and sexual behaviours among black gay and bisexual men. We will conduct a systematic search of published qualitative and quantitative research studies published during and after 1993. The searches will be conducted in Ovid Medline, Ovid APA PsycInfo and EBSCO SocINDEX databases. Studies will be included if they were conducted in the USA, with samples that comprised African American/black cisgender gay, bisexual, queer and other men who have sex with men, measured internalised racism and/or internalised homophobia, and assessed sexual behaviour risk for HIV acquisition. ETHICS AND DISSEMINATION: No ethical approval will be required for this review. We will report our findings using the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Findings of this review may offer new opportunities to study internalised mechanisms impacting outcomes and to identify research gaps and spur additional queries in the group most disproportionately impacted by HIV.

An Experiment Using a Sexual Strategies Explanation to Alleviate Internalized Homophobia Among Men Who Have Sex With Men in China.

Some men who have sex with men (MSM) having more casual sex and sexual partners is interpreted to be a sign of mental disorder and used to justify negative attitudes toward them by some. MSM may internalize this attitude causing internalized homophobia (IH). According to the sexual strategies theory, MSM having more casual sex is the result of differences between men's and women's sexual strategies and is unrelated to sexual orientation. We investigated whether this explanation would reduce IH and improve mental health in MSM. We recruited 255 Chinese MSM online using Wenjuanxing, Douban, Weibo, Tieba, and Blued and divided them using simple randomization into an experimental group (n = 77; sexual strategies explanation provided), an active control group (n = 99; minority stress explanation provided), and a control group (n = 79; no intervention) with pretest (N = 255); a 1 week post-test (n = 195); and a 1 month follow-up test (n = 170) of outcome measures. IH, mental distress (MD), sort-term mating orientation, and risky sexual behaviors were measured online. The data were analyzed by SPSS 28. IH was associated with MD while being married was associated with IH and sexual contact with women with both more IH and MD as were not being masculine and self-identifying as straight. The sexual strategies explanation reduced IH related to pathologizing sexual behaviors and high-risk sexual behaviors while the minority stress explanation reduced MD. Providing a sexual strategies explanation may be used to de-stigmatize casual sex among MSM.

333ª Reunião Ordinária - 18 ago. 2022

Brasília Imperial Hotel - Setor Hoteleiro Sul (SHS), quadra 3, bloco H - Asa Sul - Brasília/DF.

Individual-Level Psychosocial Resiliencies as Mediators of the Relationship Between Internalized Homophobia and Depressive Symptoms Among Middle-Aged and Older Men Living With and Without HIV.

Among sexual minority men (SMM), internalized homophobia (IH) has been consistently associated with increased depression symptoms. However, some SMM experiencing IH demonstrate resilience to buffer against depression symptoms. In this analysis, we used the Stress Process Model (SPM) as a conceptual framework to explore individual-level psychosocial resilience (ILPR) factors serving as a buffer of the IH-depression relationship. To utilize the SPM to explore whether four ILPR factors, including volunteerism, optimism, religiosity/spirituality, and global resiliency measure mediate the relationship between IH and depression symptoms among middle-aged and older SMM living with and without HIV. We used exploratory and confirmatory factor analysis to construct measurement models for the four ILPR factors. We examined whether the four ILPR factors mediated the IH-depression relationship. IH was significantly and positively associated with depression symptoms. There was a partial mediation of the IH-depression association by the four ILPR. Specifically, we found statistically significant indirect effects of optimism and the global resilience measure and supporting buffering effects of the IH-depression association. Although, the indirect effects religiosity/spirituality on the IH-depression relationship was significant, it did not support a buffering of effect. The indirect effects of volunteerism were not statistically significant. Our findings highlight the potential role of ILPR factors in the development of resilience against the negative effects of IH. Implications of these results for future research and practice are discussed.

High School FLASH Sexual Health Education Curriculum: LGBTQ Inclusivity Strategies Reduce Homophobia and Transphobia.

Homophobic and transphobic beliefs that lead to bias-based harassment remain a critical concern for young people in the USA. The aim of the present study was to examine the impact of an inclusive comprehensive sex education program (High School FLASH) on homophobic and transphobic beliefs. Data from this study come from a randomized controlled trial that evaluated the impact of High School FLASH on students' sexual behaviors and related outcomes with 20 schools in two U.S. regions (Midwest and South). Following the baseline survey, the 20 schools were randomly assigned to receive FLASH or a comparison curriculum. Ninth and 10th grade students completed follow-up surveys 3 and 12 months after the instructional period. We examined changes in homophobic beliefs using multilevel linear regression models in the full sample and two sub-groups: straight cisgender young people versus those who identified as not straight or cisgender. Mean scores on the homophobic and transphobic beliefs scale were statistically significantly lower among young people receiving FLASH relative to the comparison at both the 3- and 12-month timepoints (p-values for adjusted mean differences were < 0.01, n = 1357 and 1275, respectively). Specifically, FLASH's positive impact on reducing homophobic and transphobic beliefs was statistically significant for straight and cisgender youth at both survey follow-ups (p < 0.01, n = 1144 and p = 0.05, n = 1078, respectively); the effects for the LGBTQ sub-group reached statistical significance at only the final follow-up (p = 0.01, n = 197). Our results show that carefully designed, inclusive comprehensive sexual health education programs like High School FLASH can play a role in promoting better school climates for all youth by reducing beliefs that may lead to bullying, violence, and victimization.