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1.
Psychiatr Pol ; 58(1): 183-199, 2024 Feb 28.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-38852188

RESUMO

OBJECTIVES: Some studies suggest that homosexual identity, compared to heterosexual, may be associated with a reduced risk of premature ejaculation (PE). The aim of this study was to test this relationship and to investigate possible underlaying mechanisms. METHODS: The present study drew on a database obtained from a cross-sectional online study of the sexuality of Polish heterosexual (HM; N = 1,121), gay (GM; N = 1,789) and bisexual (BM; N = 743) men. The dependent variable was the PE diagnosis based on the PEDT questionnaire. The explanatory variables were characteristics of sexual and partnership patterns, health and minority stress among GM and BM. Statistical one- and multifactor analyses were performed. RESULTS: Homosexual identity proved to be an independent negative predictor of PE diagnosis. The preference for insertive penetration activity (including vaginal), performance anxiety and financial difficulties increased the risk of PE, while the experience of insertive and receptive forms of oral and anal sex but not vaginal sex, a higher level of education, better general sexual functioning and regular physical activity reduced such risk. The predictive meaning of homosexual identity has not been present in multifactor models for group of men in relationships. CONCLUSIONS: Homosexual identity is associated with a lower risk of PE diagnosis. This may be due to the differences in sexualities of GM and HM, as well as other psychosocial factors.


Assuntos
Ejaculação Precoce , Humanos , Masculino , Ejaculação Precoce/psicologia , Ejaculação Precoce/epidemiologia , Adulto , Estudos Transversais , Polônia , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Adulto Jovem , Parceiros Sexuais/psicologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Fatores de Risco , Heterossexualidade/psicologia , Heterossexualidade/estatística & dados numéricos , Bissexualidade/psicologia , Bissexualidade/estatística & dados numéricos
2.
Eat Behav ; 53: 101884, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38781820

RESUMO

Muscle Dysmorphia (MD) and its psychological impacts on women, especially within sexual minorities, are still relatively understudied. The objective of this study was to compare the relationship of MD symptoms and psychological distress between heterosexual women and lesbian/bisexual women. Our sample consisted of 479 Brazilian cisgender women from the community, aged between 18 and 70 years (M = 32.78; SD = 10.45). Among them, 327 (68.27 %) identified as heterosexual, 134 (27.98 %) as bisexual, and 18 (3.76 %) as lesbian. To ensure there was no bias due to measurement error, the psychometric properties of the instruments in the sample were tested, and invariance between the groups was assessed. t-tests, structural equation modeling, and latent profile analyses were conducted to comprehend the differences between the groups. The results indicated significant differences and a greater severity of MD symptoms and distress for lesbian/bisexual women. The implications of these results are discussed, emphasizing the need for further exploration of MD studies within sexual minorities.


Assuntos
Heterossexualidade , Homossexualidade Feminina , Angústia Psicológica , Humanos , Feminino , Adulto , Heterossexualidade/psicologia , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Homossexualidade Feminina/psicologia , Idoso , Minorias Sexuais e de Gênero/psicologia , Transtornos Dismórficos Corporais/psicologia , Brasil , Bissexualidade/psicologia , Imagem Corporal/psicologia , Psicometria/instrumentação , Inquéritos e Questionários
3.
Hum Reprod ; 39(6): 1323-1335, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38689464

RESUMO

STUDY QUESTION: Does medically assisted reproduction (MAR) use among cisgender women differ among those with same-sex partners or lesbian/bisexual identities compared to peers with different-sex partners or heterosexual identities? SUMMARY ANSWER: Women with same-sex partners or lesbian/bisexual identities are more likely to utilize any MAR but are no more likely to use ART (i.e. IVF, reciprocal IVF, embryo transfer, unspecified ART, ICSI, and gamete or zygote intrafallopian transfer) compared to non-ART MAR (i.e. IUI, ovulation induction, and intravaginal or intracervical insemination) than their different-sex partnered and completely heterosexual peers. WHAT IS KNOWN ALREADY: Sexual minority women (SMW) form families in myriad ways, including through fostering, adoption, genetic, and/or biological routes. Emerging evidence suggests this population increasingly wants to form genetic and/or biological families, yet little is known about their family formation processes and conception needs. STUDY DESIGN, SIZE, DURATION: The Growing Up Today Study is a US-based prospective cohort (n = 27 805). Participants were 9-17 years of age at enrollment (1996 and 2004). Biennial follow-up is ongoing, with data collected through 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS: Cisgender women who met the following criteria were included in this sample: endorsed ever being pregnant; attempted a pregnancy in 2019 or 2021; and endorsed either a male- or female-sex partner OR responded to questions regarding their sexual identity during their conception window. The main outcome was any MAR use including ART (i.e. procedures involving micromanipulation of gametes) and non-ART MAR (i.e. nonmanipulation of gametes). Secondary outcomes included specific MAR procedures, time to conception, and trends across time. We assessed differences in any MAR use using weighted modified Poisson generalized estimating equations. MAIN RESULTS AND THE ROLE OF CHANCE: Among 3519 participants, there were 6935 pregnancies/pregnancy attempts and 19.4% involved MAR. A total of 47 pregnancies or pregnancy attempts were among the same-sex partnered participants, while 91 were among bisexual participants and 37 among lesbian participants. Participants with same-sex, compared to different-sex partners were almost five times as likely to use MAR (risk ratio [95% CI]: 4.78 [4.06, 5.61]). Compared to completely heterosexual participants, there was greater MAR use among lesbian (4.00 [3.10, 5.16]) and bisexual (2.22 [1.60, 3.07]) participants compared to no MAR use; mostly heterosexual participants were also more likely to use ART (1.42 [1.11, 1.82]) compared to non-ART MAR. Among first pregnancies conceived using MAR, conception pathways differed by partnership and sexual identity groups; differences were largest for IUI, intravaginal insemination, and timed intercourse with ovulation induction. From 2002 to 2021, MAR use increased proportionally to total pregnancies/pregnancy attempts; ART use was increasingly common in later years among same-sex partnered and lesbian participants. LIMITATIONS, REASONS FOR CAUTION: Our results are limited by the small number of SMW, the homogenous sample of mostly White, educated participants, the potential misclassification of MAR use when creating conception pathways unique to SMW, and the questionnaire's skip logic, which excluded certain participants from receiving MAR questions. WIDER IMPLICATIONS OF THE FINDINGS: Previous studies on SMW family formation have primarily focused on clinical outcomes from ART procedures and perinatal outcomes by conception method, and have been almost exclusively limited to European, clinical samples that relied on partnership data only. Despite the small sample of SMW within a nonrepresentative study, this is the first study to our knowledge to use a nonclinical sample of cisgender women from across the USA to elucidate family formation pathways by partnership as well as sexual identity, including pathways that may be unique to SMW. This was made possible by our innovative approach to MAR categorization within a large, prospective dataset that collected detailed sexual orientation data. Specifically, lesbian, bisexual, and same-sex partnered participants used both ART and non-ART MAR at similar frequencies compared to heterosexual and different-sex partnered participants. This may signal differential access to conception pathways owing to structural barriers, emerging conception trends as family formation among SMW has increased, and a need for conception support beyond specialized providers and fertility clinics. STUDY FUNDING/COMPETING INTEREST(S): The research reported in this publication was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health (NIH), under award number R01MD015256. Additionally, KRSS is supported by NCI grant T32CA009001, AKH by the NCI T32CA057711, PC by the NHLBI T32HL098048, BM by the Stanford Maternal Child Health Research Institute Clinical Trainee Support Grant and the Diversity Fellowship from the American Society for Reproductive Medicine Research Institute, BGE by NICHD R01HD091405, and SM by the Thomas O. Pyle Fellowship through the Harvard Pilgrim Health Care Foundation and Harvard University, NHLBI T32HL098048, NIMH R01MH112384, and the William T. Grant Foundation grant number 187958. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The first author recently had a leadership role in the not-for-profit program, The Lesbian Health Fund, a research fund focused on improving the health and wellbeing of LGBTQ+ women and girls. The fund did not have any role in this study and the author's relationship with the fund did not bias the findings of this manuscript. TRIAL REGISTRATION NUMBER: N/A.


Assuntos
Técnicas de Reprodução Assistida , Parceiros Sexuais , Minorias Sexuais e de Gênero , Humanos , Feminino , Estudos Prospectivos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Adulto , Parceiros Sexuais/psicologia , Gravidez , Masculino , Heterossexualidade/estatística & dados numéricos , Heterossexualidade/psicologia
4.
Health Promot Chronic Dis Prev Can ; 44(5): 197-207, 2024 May.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-38748477

RESUMO

INTRODUCTION: The goal of this study was to examine potential disparities in positive mental health (PMH) among adults in Canada by sexual orientation and gender modality. METHODS: Using 2019 Canadian Community Health Survey (CCHS) Annual Component data (N = 57 034), we compared mean life satisfaction and the prevalence of high self-rated mental health (SRMH), happiness and community belonging between heterosexual and sexual minority adults, and between cisgender and gender minority adults. We used 2019 CCHS Rapid Response on PMH data (N = 11 486) to compare the prevalence of high psychological well-being between heterosexual and sexual minority adults. Linear and logistic regression analyses examined the between-group differences in mean life satisfaction and the other PMH outcomes, respectively. RESULTS: Sexual minority (vs. heterosexual) adults reported lower mean life satisfaction (B = -0.7, 95% CI: -0.8, -0.5) and were less likely to report high SRMH (OR = 0.4, 95% CI: 0.3, 0.5), happiness (OR = 0.4, 95% CI: 0.3, 0.5), community belonging (OR = 0.6, 95% CI: 0.5, 0.7) and psychological well-being (OR = 0.4, 95% CI: 0.3, 0.6). Differences were not always significant for specific sexual minority groups in sexstratified analyses. Gender minority adults reported lower mean life satisfaction and were less likely to report high SRMH and happiness than cisgender adults. CONCLUSION: Future research could investigate how these PMH disparities arise, risk and protective factors in these populations, how other sociodemographic factors interact with sexual orientation and gender identity to influence PMH and changes in disparities over time.


Assuntos
Saúde Mental , Minorias Sexuais e de Gênero , Humanos , Masculino , Feminino , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Canadá/epidemiologia , Adulto , Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Satisfação Pessoal , Disparidades nos Níveis de Saúde , Inquéritos Epidemiológicos , Felicidade , Adulto Jovem , Heterossexualidade/estatística & dados numéricos , Heterossexualidade/psicologia , Adolescente , Idoso
5.
J Int AIDS Soc ; 27(5): e26249, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38695102

RESUMO

INTRODUCTION: South African men face a substantial burden of HIV and are less likely to test for HIV and initiate antiretroviral therapy if tested positive and more likely to die from AIDS-related causes than women. In addition to condoms and circumcision, guidelines provide for the use of daily oral pre-exposure prophylaxis (PrEP) as an HIV prevention intervention for any men who recognize their need and request PrEP. However, heterosexual men have not been a focus of PrEP programmes, and since its introduction, there is limited literature on PrEP use among men in South Africa. This study explores the experiences, motivators and barriers to oral PrEP use among heterosexual men accessing primary healthcare services in South Africa. METHODS: This study forms part of a mixed-methods implementation science study aimed at generating evidence for oral PrEP introduction and conducted in primary healthcare clinics in South Africa since 2018. Men aged ≥15 years who initiated oral PrEP and enrolled in a parent cohort study were purposefully invited to participate in an in-depth interview (IDI). Between March 2020 and May 2022, 30 men participated in IDIs exploring their motivators for PrEP use, and experiences with accessing health services. Interviews were audio recorded, transcribed and analysed thematically. RESULTS: The final analysis included 28 heterosexual men (18-56 years old). Motivations to initiate PrEP included fear of acquiring HIV, self-perceived vulnerability to HIV and mistrust in relationships; health systems factors which motivated PrEP use included the influence of healthcare providers, educational materials and mobile services. Perceived reduction in HIV vulnerability and changing proximity to partners were reasons for PrEP discontinuation. Side effects, daily-pill burden and stigma were noted as challenges to PrEP use. Health system barriers to PrEP use included limited PrEP availability, school and work demands, and inconsistent mobile clinic schedules. CONCLUSIONS: Our study reports on the experiences of heterosexual men accessing oral PrEP in real-world settings and contributes to the limited literature among this population. We highlight multiple levels which could be strengthened to improve men's PrEP use, including individual support, education among partners and communities, and addressing health system barriers to access.


Assuntos
Infecções por HIV , Heterossexualidade , Profilaxia Pré-Exposição , Pesquisa Qualitativa , Humanos , Masculino , Profilaxia Pré-Exposição/métodos , África do Sul , Adulto , Infecções por HIV/prevenção & controle , Adulto Jovem , Adolescente , Pessoa de Meia-Idade , Serviços de Saúde Reprodutiva , Fármacos Anti-HIV/uso terapêutico , Fármacos Anti-HIV/administração & dosagem , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Administração Oral , Entrevistas como Assunto , Acessibilidade aos Serviços de Saúde , Motivação
6.
JAMA ; 331(19): 1638-1645, 2024 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-38662342

RESUMO

Importance: Extensive evidence documents health disparities for lesbian, gay, and bisexual (LGB) women, including worse physical, mental, and behavioral health than heterosexual women. These factors have been linked to premature mortality, yet few studies have investigated premature mortality disparities among LGB women and whether they differ by lesbian or bisexual identity. Objective: To examine differences in mortality by sexual orientation. Design, Setting, and Participants: This prospective cohort study examined differences in time to mortality across sexual orientation, adjusting for birth cohort. Participants were female nurses born between 1945 and 1964, initially recruited in the US in 1989 for the Nurses' Health Study II, and followed up through April 2022. Exposures: Sexual orientation (lesbian, bisexual, or heterosexual) assessed in 1995. Main Outcome and Measure: Time to all-cause mortality from assessment of exposure analyzed using accelerated failure time models. Results: Among 116 149 eligible participants, 90 833 (78%) had valid sexual orientation data. Of these 90 833 participants, 89 821 (98.9%) identified as heterosexual, 694 (0.8%) identified as lesbian, and 318 (0.4%) identified as bisexual. Of the 4227 deaths reported, the majority were among heterosexual participants (n = 4146; cumulative mortality of 4.6%), followed by lesbian participants (n = 49; cumulative mortality of 7.0%) and bisexual participants (n = 32; cumulative mortality of 10.1%). Compared with heterosexual participants, LGB participants had earlier mortality (adjusted acceleration factor, 0.74 [95% CI, 0.64-0.84]). These differences were greatest among bisexual participants (adjusted acceleration factor, 0.63 [95% CI, 0.51-0.78]) followed by lesbian participants (adjusted acceleration factor, 0.80 [95% CI, 0.68-0.95]). Conclusions and Relevance: In an otherwise largely homogeneous sample of female nurses, participants identifying as lesbian or bisexual had markedly earlier mortality during the study period compared with heterosexual women. These differences in mortality timing highlight the urgency of addressing modifiable risks and upstream social forces that propagate and perpetuate disparities.


Assuntos
Disparidades nos Níveis de Saúde , Mortalidade Prematura , Enfermeiras e Enfermeiros , Minorias Sexuais e de Gênero , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Bissexualidade/estatística & dados numéricos , Heterossexualidade/estatística & dados numéricos , Homossexualidade Feminina/estatística & dados numéricos , Mortalidade/tendências , Enfermeiras e Enfermeiros/estatística & dados numéricos , Estudos Prospectivos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Comportamento Sexual , Estados Unidos/epidemiologia
7.
J Affect Disord ; 356: 137-144, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38593941

RESUMO

BACKGROUND: This study aims to understand the mechanisms contributing to the elevated risk of depression among sexual minority older adults compared to heterosexuals. Specifically, the role of loneliness as a potential mediator is investigated to inform targeted interventions for preventing depression in sexual minority populations. METHODS: Data from the English Longitudinal Study of Ageing, focusing on adults aged over 50, were analysed. Sexual orientation (sexual minority or heterosexual) and loneliness scores (UCLA scale) were assessed at wave six (2010-2011), while depressive symptoms (CESD) were assessed at wave seven (2013-14). Linear regression models and mediation analyses, using g-computation formula and adjusted for confounders, were conducted. RESULTS: The sample included 6794 participants, with 478 (7.0 %) identifying as sexual minorities. After adjustments, sexual minorities scored higher on depressive symptoms at wave seven (mean difference): 0.23, 95 % CI 0.07 to 0.39) and loneliness at wave six (MD: 0.27, 95 % CI 0.08 to 0.46). Loneliness was positively associated with depressive symptoms (coefficient: 0.27, 95 % CI 0.26 to 0.29). In mediation analyses, loneliness explained 15 % of the association between sexual orientation and subsequent depressive symptoms. LIMITATIONS: The dataset used sexual behaviour rather than desire and identity, potentially skewing representation of sexual minorities. Additionally, transgender older adults were not included due to limited gender diversity reported within the ELSA dataset. CONCLUSIONS: Loneliness appears to be a significant modifiable mechanism contributing to the heightened risk of depressive symptoms in sexual minority older adults compared with their heterosexual counterparts.


Assuntos
Depressão , Solidão , Minorias Sexuais e de Gênero , Humanos , Solidão/psicologia , Masculino , Feminino , Idoso , Depressão/psicologia , Depressão/epidemiologia , Estudos Prospectivos , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Pessoa de Meia-Idade , Estudos Longitudinais , Comportamento Sexual/psicologia , Heterossexualidade/psicologia , Heterossexualidade/estatística & dados numéricos , Inglaterra , Idoso de 80 Anos ou mais
8.
J Sex Marital Ther ; 50(4): 527-541, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38567544

RESUMO

This study examines dyadic data from 299 married and 242 cohabiting Black heterosexual couples in the United States (an understudied cross-section of the population) and assesses individual (actor) effects as well as couple (partner) effects of sexual sanctification and relationship satisfaction. Higher levels of sexual sanctification were associated with higher levels of relationship satisfaction for women and men in the actor effects, but no significant associations were found in the partner effects for couples. Additionally, initial findings suggest that sexual sanctification may act as a relational protective factor for Black married and cohabiting couples. Implications for further research as well as practical applications for clergy, therapists, and practitioners working with Black heterosexual couples in sexual relationships are also discussed.


Assuntos
Negro ou Afro-Americano , Heterossexualidade , Satisfação Pessoal , Parceiros Sexuais , Humanos , Masculino , Feminino , Heterossexualidade/psicologia , Adulto , Negro ou Afro-Americano/psicologia , Parceiros Sexuais/psicologia , Estados Unidos , Relações Interpessoais , Comportamento Sexual/psicologia , Pessoa de Meia-Idade , Cônjuges/psicologia , Casamento/psicologia
9.
Hum Reprod ; 39(6): 1247-1255, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38593421

RESUMO

STUDY QUESTION: Can the application of the theory of planned behavior (TPB) help predict heterosexual parents' disclosure of donor conception to their children? SUMMARY ANSWER: Parents with a stronger will to act in accordance with social norms favoring disclosure were more likely to start the disclosure process within the next 5-9 years. WHAT IS KNOWN ALREADY: In contrast to single mothers by choice and same-sex couples, heterosexual couples need to make an active decision to disclose their use of donor conception to their child. While disclosure at an early age is encouraged by international guidelines, many heterosexual-couple parents struggle with this. A previous study has found an association between parental scores of TPB factors and disclosure intention, but so far, no study has applied the TPB to predict parents' disclosure behavior. STUDY DESIGN, SIZE, DURATION: The present study is based on the fourth and fifth waves of data collection (T4 and T5) in a nation-wide longitudinal study. Participating parents had conceived through identity-release oocyte donation (n = 68, response rate 65%) and sperm donation (n = 62, response rate 56%) as part of a heterosexual couple. PARTICIPANTS/MATERIALS, SETTING, METHODS: The present study is part of the prospective longitudinal Swedish Study on Gamete Donation (SSGD). Consecutive recruitment of couples starting oocyte or sperm donation treatment was conducted at all seven fertility clinics providing gamete donation in Sweden during a 3-year period (2005-2008). Participants were requested to complete postal surveys at five time points. The present study includes heterosexual-couple parents following oocyte or sperm donation who participated at the two latest time points when their children were 7-8 years old (T4), and 13-17 years old (T5). At T4, participants completed the study-specific TPB Disclosure Questionnaire (TPB-DQ) measuring attitudes and intentions to disclose the donor conception to the child, and disclosure behavior was assessed at both T4 and T5. Data from those participants who had not yet disclosed at T4 were analyzed using survival analysis with Cox regressions. MAIN RESULTS AND THE ROLE OF CHANCE: Forty participants had not disclosed the donor conception to their children at T4 and, out of these, 13 had still not disclosed at T5. We found a significant association between scores of the TPB factor Subjective norms at T4 and their subsequent disclosure behavior at T5 (HR = 2.019; 95% CI: 1.36-3.01). None of the other factors were significantly associated with disclosure behavior. LIMITATIONS, REASONS FOR CAUTION: The present study concerns heterosexual-couple parents with children conceived following treatment with gametes from open-identity donors, which limits the generalizability of our findings to other groups and contexts. Other limitations include the risk of systematic attrition due to the longitudinal study design and decreased statistical power due to few participants. WIDER IMPLICATIONS OF THE FINDINGS: Our findings highlight the importance of perceived subjective norms for parents' disclosure behavior and indicate that the co-parent's opinion about disclosure is of particular relevance in this regard. Counselors should focus on supporting prospective parents to initiate and maintain a healthy and open dialogue about concerns around building a family with donor conception. STUDY FUNDING/COMPETING INTEREST(S): The study was funded by the Swedish Research Council. The authors have no competing interests to declare. TRIAL REGISTRATION NUMBER: N/A.


Assuntos
Concepção por Doadores , Pais , Humanos , Feminino , Masculino , Estudos Longitudinais , Concepção por Doadores/psicologia , Adulto , Criança , Pais/psicologia , Relações Pais-Filho , Doação de Oócitos/psicologia , Suécia , Revelação , Inseminação Artificial Heteróloga/psicologia , Estudos Prospectivos , Heterossexualidade/psicologia , Teoria do Comportamento Planejado
10.
Am J Public Health ; 114(5): 511-522, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38598758

RESUMO

Objectives. To describe longitudinal trends in the prevalence of mental distress across the first year of the COVID-19 pandemic (April 2020‒April 2021) among US women at the intersection of sexual orientation and racialized group. Methods. Participants included 49 805 cisgender women and female-identified people from the COVID-19 Sub-Study, a cohort of US adults embedded within the Nurses' Health Studies 2 and 3 and the Growing Up Today Study. We fit generalized estimating equation Poisson models to estimate trends in depressive and anxiety symptoms by sexual orientation (gay or lesbian, bisexual, mostly heterosexual, completely heterosexual); subsequent models explored further differences by racialized group (Asian, Black, Latine, White, other or unlisted). Results. Relative to completely heterosexual peers, gay or lesbian, bisexual, and mostly heterosexual women had a higher prevalence of depressive and anxiety symptoms at each study wave and experienced widening inequities over time. Inequities were largest for sexual minority women of color, although confidence intervals were wide. Conclusions. The COVID-19 pandemic may have exacerbated already-glaring mental health inequities affecting sexual minority women, especially those belonging to marginalized racialized groups. Future research should investigate structural drivers of these patterns to inform policy-oriented interventions. (Am J Public Health. 2024;114(5):511-522. https://doi.org/10.2105/AJPH.2024.307601).


Assuntos
COVID-19 , Transtornos Mentais , Minorias Sexuais e de Gênero , Adulto , Feminino , Humanos , Masculino , Pandemias , COVID-19/epidemiologia , Comportamento Sexual/psicologia , Heterossexualidade/psicologia
11.
JAMA Netw Open ; 7(4): e246448, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38607622

RESUMO

Importance: Nonheterosexual and gender-nonconforming (GNC) individuals tend to report adverse childhood experiences (ACEs) more frequently compared with heterosexual and gender-conforming individuals, and individuals who have experienced ACEs, identify as nonheterosexual, or exhibit moderate to high levels of GNC are more prone to engaging in problematic smartphone use (PSU). However, there is limited school-based data among adolescents regarding this matter. Objectives: To explore the associations between ACEs and PSU among adolescents across different sexual orientation and gender expression groups. Design, setting, and participants: Using data from the 2021 School-Based Chinese Adolescents Health Survey, this cross-sectional study includes participants from 288 public high schools across 8 provinces in China. Statistical analysis was performed from October 2023 to February 2024. Exposures: Data on ACEs, sexual orientations, and gender expressions (high, moderate, and low GNC) were collected. Main outcomes and measures: PSU was assessed using the 10-item Smartphone Addiction Scale-Short Version (SAS-SV). Weighted linear, logistic, or Poisson regression models were used. Results: Among the 85 064 adolescents included (mean [SD] age, 14.92 [1.77] years), 42 632 (50.1%) were female, 70 157 (83.2%) identified as Han Chinese, and 14 208 (16.8) identified as other ethnicities (Miao, Hui, Yi, Dai, and other ethnic groups). The prevalence of PSU among participants was 35.4%. Weighted Poisson regression models indicated that the interaction between GNC and ACE was significant (adjusted prevalence ratio [APR], 0.98; 95% CI, 0.97-0.99). Further stratified analysis demonstrated homosexual adolescents who experienced 4 or more ACEs showed a significantly increased prevalence of PSU (APR, 1.79; 95% CI, 1.64-1.96). Similarly, a markedly higher prevalence of PSU was observed among bisexual individuals with 4 or more ACEs (APR, 1.60; 95% CI, 1.41-1.80). Regarding gender expression categories, a significantly higher prevalence of PSU was noted among high GNC adolescents with 4 or more ACEs (APR, 1.78; 95% CI, 1.60-1.98) compared with low GNC adolescents without ACEs. Furthermore, experiencing any 3 ACE categories (abuse, neglect, and household dysfunction) was associated with an increased prevalence of PSU across different sexual orientation and gender expression subgroups. Conclusions and relevance: In this cross-sectional study, the amalgamation of elevated ACE scores with nonheterosexual orientations or GNC identities was significantly associated with increased PSU prevalence. These findings underscore that preventing ACEs may be beneficial in mitigating PSU among adolescents, particularly for nonheterosexual adolescents and those with high levels of GNC.


Assuntos
Experiências Adversas da Infância , Feminino , Adolescente , Humanos , Criança , Masculino , Estudos Transversais , Smartphone , Heterossexualidade , Homossexualidade
12.
Subst Use Addctn J ; 45(3): 515-522, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38477014

RESUMO

INTRODUCTION: Despite elevated rates of e-cigarette use among sexual minority versus heterosexual young adults, limited research has examined sexual identity in relation to transitions from e-cigarette use to other tobacco use patterns. METHODS: We analyzed data from 608 US young adults in a 2-year study (2018-2020) who reported using e-cigarettes in the past 6 months (time period between assessments) but no other tobacco product at baseline (Fall 2018). Multinomial logistic regressions among women and men, separately, examined associations between sexual identity and past 6-month tobacco use in Fall 2020 (nonuse [referent group] vs e-cigarette only, other tobacco product only, e-cigarette and other tobacco product dual use), controlling for age and race/ethnicity. RESULTS: Among women (n = 340; mean [M]age = 23.42; n = 147 [43.4%] sexual minority; 29.4% racial/ethnic minority), 34.4% reported nonuse at follow-up, 26.8% e-cigarette only, 10.3% other tobacco product only, and 28.5% e-cigarette and other tobacco product dual use. Sexual minority (vs heterosexual) women displayed greater odds of e-cigarette-only use, as well as dual use relative to nonuse at follow-up. Among men (n = 244; Mage = 24.30; n = 51 [20.9%] sexual minority; 36.1% racial/ethnic minority), 25.4% reported no use, 20.9% e-cigarette only, 17.2% other tobacco product only, and 36.5% dual use at follow-up. Sexual minority (vs heterosexual) men displayed lower odds of e-cigarette only, other tobacco product only, and dual use relative to nonuse at follow-up. CONCLUSIONS: Research is needed to assess and intervene on tobacco/nicotine product perceptions (eg, harm, social acceptability) and reasons for use (eg, mood regulation) associated with high-risk tobacco use patterns and trajectories, particularly among sexual minority young adult women who may have distinct profiles and risks associated with use.


Assuntos
Heterossexualidade , Minorias Sexuais e de Gênero , Uso de Tabaco , Vaping , Humanos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Heterossexualidade/estatística & dados numéricos , Feminino , Estados Unidos/epidemiologia , Masculino , Adulto Jovem , Adulto , Vaping/epidemiologia , Uso de Tabaco/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Adolescente
13.
Body Image ; 49: 101687, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38471234

RESUMO

Body dysmorphic disorder (BDD) is a common disorder associated with substantial comorbidity, impairment, and poor quality of life. Research on subcultural variations of BDD is limited but may impact assessment and treatment of the disorder. The current study examined clinical features in a sample of sexual minority (SM; n = 43) and heterosexual (n = 155) women with diagnosed BDD. Participants completed self-report and clinician-administered measures of demographic and clinical characteristics. Results indicated largely similar clinical features across groups with some exceptions: compared to non-SM women, SM women were younger (M = 25.50 vs 31.96 years, p < .001), had better BDD-related insight (M = 14.51 vs 16.26, p = .01), endorsed a greater number of disliked body parts, and were more likely to express preoccupation with body build (OR = 4.6, 95% CI [2.0, 10.9]), chin/jaw (OR = 4.7, 95% CI [2.1, 10.3]), and shoulders (OR = 10.1, 95% CI [2.7, 37.9]), possibly reflecting nuanced beauty ideals within the SM community. There were no significant group differences in other body parts of concern, BDD severity, or depression. Future studies are needed in larger, more inclusive samples to explore the relationship between diverse identities on BDD and its associated features.


Assuntos
Transtornos Dismórficos Corporais , Imagem Corporal , Heterossexualidade , Minorias Sexuais e de Gênero , Humanos , Feminino , Transtornos Dismórficos Corporais/psicologia , Adulto , Heterossexualidade/psicologia , Heterossexualidade/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Imagem Corporal/psicologia , Adulto Jovem
14.
J Subst Use Addict Treat ; 161: 209340, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38494052

RESUMO

INTRODUCTION: Research indicates that sexual minority (SM) individuals with alcohol and other drug use disorders may underutilize recovery resources generally but be more likely to use recovery community centers (RCCs). To inform recovery supports, this study characterized SM and heterosexual RCC members by demographics and clinical and recovery support service utilization. METHODS: Cross-sectional secondary analyses compared SM and heterosexual RCC members in the northeastern U.S. (n = 337). Qualitative analyses coded the top three recovery facilitators. RESULTS: Of the 337 participants (Meanage[SD] = 40.98[12.38], 51.8 % female), SM RCC members were more likely than heterosexuals to endorse lifetime psychiatric diagnoses and emergency department mental health treatment (p < .01). RCC service utilization and qualitatively derived recovery facilitators were mostly consistent across groups. CONCLUSIONS: RCCs engaged SM individuals in recovery in ways consistent with heterosexuals. Despite otherwise vastly similar demographic characteristics across sexual identity, findings suggest a need for additional mental health resources for SM individuals in recovery.


Assuntos
Heterossexualidade , Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias , Humanos , Feminino , Masculino , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto , Estudos Transversais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Heterossexualidade/psicologia , Heterossexualidade/estatística & dados numéricos , Pessoa de Meia-Idade , Transtornos Mentais/terapia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , New England , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/psicologia
15.
Body Image ; 49: 101696, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38492460

RESUMO

A growing body of research suggests that sexual minority men (SMM) experience greater body image concerns including body shame, body surveillance, drive for muscularity and drive for thinness than heterosexual men. However, little is known regarding the potential factors that can buffer these relationships. The aim of the present study was to examine the role that both self-compassion and relationship status may play in decreasing the strength of the relationship between sexual minority status and body image concerns. A sample of n = 106 SMM and n = 145 heterosexual men completed an online survey assessing body image concerns, self-compassion, and relationship status. Findings revealed that SMM reported higher levels of body image concerns (on all measures, except drive for muscularity) as compared to heterosexual men. Self-compassion moderated the link between sexual orientation and drive for muscularity: in men with higher levels of self-compassion, sexual orientation was no longer associated with drive for muscularity. But, among men with less self-compassion, SMM reported higher drive for muscularity than heterosexual men. Moreover, relationship status moderated the relationship between sexual orientation and body shame and drive for thinness, such that, among SMM only, being in a relationship was associated with lower levels of these concerns.


Assuntos
Imagem Corporal , Empatia , Heterossexualidade , Autoimagem , Minorias Sexuais e de Gênero , Vergonha , Humanos , Masculino , Imagem Corporal/psicologia , Minorias Sexuais e de Gênero/psicologia , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto , Adulto Jovem , Heterossexualidade/psicologia , Adolescente , Pessoa de Meia-Idade , Inquéritos e Questionários
16.
Arch Sex Behav ; 53(5): 1747-1761, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38472605

RESUMO

One proposal for the persistence of homosexuality in the human population is the sexually antagonistic gene hypothesis, which suggests that the lower fertility of homosexual individuals, especially men, may be compensated by higher fertility of their relatives of the opposite sex. To test this hypothesis, we have collected data from 7,312 heterosexual men, 459 gay men, 3,352 heterosexual women, and 79 lesbian women mainly from Czechia. In an online survey, participants answered questions regarding their own as well as their parents' and grandparents' fertility. For men, we obtained no significant results except for higher fertility of gay men's paternal grandmothers, but the magnitude of this effect was very small. For the female sample, we recorded lower fertility of lesbian women's mothers and fathers. In line with our expectations, both gay men and lesbian women had lower fertility rates than their heterosexual counterparts. Our results are consistent with recent studies which likewise do not support the sexually antagonistic gene hypothesis.


Assuntos
Fertilidade , Heterossexualidade , Homossexualidade Feminina , Homossexualidade Masculina , Humanos , Masculino , Feminino , República Tcheca , Adulto , Homossexualidade Feminina/genética , Homossexualidade Feminina/psicologia , Homossexualidade Masculina/genética , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Fertilidade/genética , Heterossexualidade/psicologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
17.
Brain Behav Immun ; 119: 211-219, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38548185

RESUMO

Sexual minority individuals have a markedly elevated risk of depression compared to heterosexuals. We examined early threats to social safety and chronically elevated inflammation as mechanisms contributing to this disparity in depression symptoms, and compared the relative strength of the co-occurrence between chronic inflammation and depression symptoms for sexual minorities versus heterosexuals. To do so, we analyzed data from a prospective cohort of sexual minority and heterosexual young adults (n = 595), recruited from a nationally representative sample, that included assessments of early threats to social safety in the form of adverse childhood interpersonal events, three biomarkers of inflammation (i.e., CRP, IL-6, TNF-α) measured at two time points, and depression symptoms over four years. In pre-registered analyses, we found that sexual minorities experienced more adverse childhood interpersonal events, were more likely to display chronically elevated inflammation, and reported more severe depression symptoms than heterosexuals. Adverse childhood interpersonal events and chronically elevated inflammation explained approximately 23 % of the total effect of the association between sexual orientation and depression symptom severity. Further, there was an increased coupling of chronically elevated inflammation and depression symptoms among sexual minorities compared to heterosexuals. These results provide novel longitudinal, population-based evidence for the role of chronically elevated inflammation in linking threats to social safety during childhood with depression symptom severity in young adulthood, consistent with the primary tenets of the social signal transduction theory of depression. Our study extends this theory to the population level by finding that members of a stigmatized population (i.e., sexual minorities) experience a greater risk of depression because of their greater exposure to adverse childhood interpersonal events and the subsequent link to chronic inflammation, highlighting potential biopsychosocial intervention targets.


Assuntos
Depressão , Heterossexualidade , Inflamação , Minorias Sexuais e de Gênero , Humanos , Masculino , Feminino , Estudos Prospectivos , Minorias Sexuais e de Gênero/psicologia , Adulto Jovem , Adulto , Comportamento Sexual/fisiologia , Comportamento Sexual/psicologia , Interleucina-6/sangue , Biomarcadores/sangue , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/metabolismo , Experiências Adversas da Infância , Adolescente
18.
J Infect ; 88(4): 106128, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38452934

RESUMO

INTRODUCTION: Many sexual health services are overwhelmed and cannot cater for all the individuals who present with sexually transmitted infections (STIs). Digital health software that separates STIs from non-STIs could improve the efficiency of clinical services. We developed and evaluated a machine learning model that predicts whether patients have an STI based on their clinical features. METHODS: We manually extracted 25 demographic features and clinical features from 1315 clinical records in the electronic health record system at Melbourne Sexual Health Center. We examined 16 machine learning models to predict a binary outcome of an STI or a non-STI diagnosis. We evaluated the models' performance with the area under the ROC curve (AUC), accuracy and F1-scores. RESULTS: Our study included 1315 consultations, of which 36.8% (484/1315) were diagnosed with STIs and 63.2% (831/1315) had non-STI conditions. The study population predominantly consisted of heterosexual men (49.5%, 651/1315), followed by gay, bisexual and other men who have sex with men (GBMSM) (25.7%), women (21.6%) and unknown gender (3.2%). The median age was 31 years (intra-quartile range (IQR) 26-39). The top 5 performing models were CatBoost (AUC 0.912), Random Forest (AUC 0.917), LightGBM (AUC 0.907), Gradient Boosting (AUC 0.905) and XGBoost (AUC 0.900). The best model, CatBoost, achieved an accuracy of 0.837, sensitivity of 0.776, specificity of 0.831, precision of 0.782 and F1-score of 0.778. The key important features were lesion duration, type of skin lesions, age, gender, history of skin disorders, number of lesions, dysuria duration, anorectal pain and itchiness. CONCLUSIONS: Our best model demonstrates a reasonable performance in distinguishing STIs from non-STIs. However, to be clinically useful, more detailed information such as clinical images, may be required to reach sufficient accuracy.


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Masculino , Humanos , Feminino , Adulto , Homossexualidade Masculina , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/epidemiologia , Comportamento Sexual , Heterossexualidade , Infecções por HIV/epidemiologia
19.
Sci Rep ; 14(1): 5306, 2024 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-38438415

RESUMO

Men and women respond differently when presented with sexual stimuli. Men's reaction is gender-specific, and women's reaction is gender-nonspecific. This might be a result of differential cognitive processing of sexual cues, namely copulatory movement (CM), which is present in almost every dynamic erotic stimulus. A novelty eye-tracking procedure was developed to assess the saliency of short film clips containing CM or non-CM sexual activities. Results from 29 gynephilic men and 31 androphilic women showed only small and insignificant effects in attention bias and no effects in attentional capture. Our results suggest that CM is not processed differently in men and women and, therefore, is not the reason behind gender-nonspecific sexual responses in women.


Assuntos
Viés de Atenção , Heterossexualidade , Masculino , Animais , Humanos , Feminino , Tecnologia de Rastreamento Ocular , Comportamento Sexual , Copulação
20.
BMC Womens Health ; 24(1): 174, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38481251

RESUMO

BACKGROUND: Morbid Obesity (MO) is a public health problem that affects a person's physical, psychological and sexual well-being. Women with MO are affected by their body image and self-concept, and obesity stigma may affect women in social and sexual relationships. OBJECTIVE: To describe and understand the experiences of morbidly obese heterosexual women (who are sexually attracted to men) in relation to their body image and sexuality after bariatric surgery. METHODOLOGY: Qualitative study using Merleau-Ponty's hermeneutic phenomenology as a philosophical framework. Data collection took place between 2020 and 2021 in a southern Spanish province. A total of 22 in-depth interviews were conducted using open-ended questions until data saturation was reached. RESULTS: Two main themes were identified: (1) "Escaping from a cruel environment": weight loss to increase self-esteem; with the sub-themes: 'I love myself now', and 'Body image and social relationships; a vicious circle; (2) "Now, I am truly me": accepting my body to reclaim my sexuality, with the sub-themes: 'The body as the focal point of sexuality', and 'When regaining your sex drive reignites your sex life and relationship'. CONCLUSION: Weight loss and body acceptance radically change morbidly obese women's sex lives after bariatric surgery. They rediscover their bodies, have increased self-esteem, and see improvements in their social relationships and sexuality. These women feel seen, loved and desired, and now value their body image and femininity. As they go through continuous improvements following bariatric surgery, they gradually regain self-esteem, acceptance of their bodies and control over their sex life. Even though the women's partners benefit from these improvements, they seem to be afraid of being left.


Obesity is a problem that affects women's physical, psychological and sexual well-being, as well as their social relationships. It is important to explore and understand the experiences of heterosexual women regarding their body and sexuality. After other treatments, women undergo surgery to reduce their obesity. After bariatric surgery women feel happier about themselves, experience less stigma and progressively recover their social and sex lives.


Assuntos
Cirurgia Bariátrica , Obesidade Mórbida , Masculino , Humanos , Feminino , Obesidade Mórbida/cirurgia , Obesidade Mórbida/psicologia , Sexualidade/psicologia , Cirurgia Bariátrica/métodos , Heterossexualidade , Inquéritos e Questionários , Redução de Peso
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