Association of positive psychobehavioral factors and structural disadvantage with condomless sex in men who have sex men with childhood sexual abuse histories.

Previous research has highlighted both psychological and structural risk factors as correlates of condomless anal sex, a key pathway to HIV acquisition in men who have sex with men (MSM). Fewer studies have focused on positive psychobehavioral factors, which may be associated with more consistent condom use. This study hypothesized that positive psychobehavioral factors would be associated with more frequent condom use over and above psychological and structural risk factors. MSM with histories of childhood sexual abuse in Boston, MA and Miami, FL (N = 108) completed cross-sectional assessments of psychosocial, structural, and positive psychobehavioral factors. These factors were entered simultaneously in a linear regression model to examine their association with frequency of condomless sex. More recent seroadaptive behavior (B = 0.323, 95% CI = 0.055-0.590, p = .019) and receipt of government benefits to supplement income (B = 0.892, 95% CI = 0.171-1.612, p = .016) were independently associated with higher frequency of condomless sex over and above all other psychosocial, structural, and positive psychobehavioral factors. R2 for the final model was 0.270. Ancillary analyses including participants taking and adherent to biomedical HIV prevention suggested an association between higher distress tolerance and lower frequency of condomless sex. Positive psychobehavioral factors may potentially lower risk for HIV in high-risk MSM; however, left unaddressed, structural disadvantage is a potent influence which may limit potential benefits.

Discrimination experiences, resilience, and cardiovascular disease risk factors among sexual minority women.

Resilience, or the process of adapting to adversity, may protect against the harmful effects of minority-related stressors on the cardiovascular health of sexual minority women (SMW). An online survey was conducted in a sample of cisgender, non-heterosexual women to evaluate resilience as a moderator of the association between discrimination experiences and key cardiovascular disease (CVD) risk factors: stress, tobacco-smoking, hazardous alcohol consumption, poor diet quality, physical inactivity, and sedentary behaviors. Overall, 191 women (mean age = 29.34, SD = 6.92; 84.5% White) completed the survey and met eligibility to be included in the data analysis. White race (b = - 6.71, SE = 2.49) and education (b = - 3.36, SE = 0.56) were each independently associated with fewer discrimination experiences. Latinx ethnicity was associated with more discrimination experiences (b = 9.34, SE = 2.61). Education was associated with greater resilience (b = 4.57, SE = 0.83). Multivariable regression models were adjusted for race, ethnicity, and education. Discrimination was associated with a higher likelihood of smoking in the past month (b = 0.04, SE = 0.02) and drinking at hazardous levels (b = 0.09, SE = 0.02). Resilience was associated with less stress (b = - 0.15, SE = 0.02), a lower likelihood of hazardous alcohol consumption (b = - 0.02, SE = 0.01) and less time spent engaging in sedentary behaviors (b = - 0.02, SE = 0.01). One moderation emerged, such that discrimination was negatively associated with stress for those low in resilience (b = - 1.75, SE = 0.58), and not associated with stress for those high in resilience. These findings may inform the development of CVD-risk reduction interventions for SMW, which could include both strategies to mitigate the effects of discrimination on substance use and coping skills to promote resilience.

Evaluating Food Intake Outcomes Among Sexual Minority Women: A Systematic Review.

Purpose: Sexual minority women (SMW) have a higher prevalence of obesity and weight-related health disparities when compared with heterosexual women that may be explained by differences in food intake. This systematic review had two primary aims: (1) synthesize the results for food intake outcomes among SMW, organized primarily according to the dietary risk assessment; and (2) identify possible theoretically informed moderators and mediators of the association between women's sexual identity and differences in food intake. Methods: The literature search was conducted using the PubMed and PsycInfo databases to identify articles published until March 23, 2021. Inclusion criteria were: (1) included a sample of adult SMW, (2) quantitatively assessed a food intake outcome, and (3) published in an English language peer-reviewed journal in the past 10 years. Thirteen articles were eligible and included in the review. Results: Overall, there were inconsistent findings comparing food intake between SMW and heterosexual women. There was some evidence to suggest that identity characteristics beyond sexual orientation (e.g., race and gender presentation) and place of residence (e.g., urban vs. rural settings) were plausible moderators. Only one variable pertaining to SMW's developmental history, mother's diet quality, was identified as a possible mediator. The main critiques of the literature include the predominance of convenience sampling, cross-sectional data, and inconsistencies in the measurement of sexual orientation and diet. Conclusion: This review highlights that further work is needed to consider additional hypotheses to explain disparities in obesity and weight-related health disparities among SMW to inform comprehensive behavioral intervention strategies.