From danger to destination: changes in the language of endemic disease during the COVID-19 pandemic.

At the beginning of 2022, the word 'endemic' became a buzzword, especially in the UK and the USA, and a kernel for the formation of novel social representations of the COVID-19 pandemic. The word normally refers to a disease which is continuously present, whose incidence is relatively stable and is maintained at a baseline level in any given locality. Over time, 'endemic' migrated from scientific discourse into political discourse, where it was mainly used to argue that the pandemic was over and people now had to learn to 'live with' the virus. In this article, we examine the emerging meanings, images and social representations of the term 'endemic' in English language news between 1 March 2020 and 18 January 2022. We observe a change over time, from the representation of 'endemic' as something dangerous and to be avoided to something desirable and to be aspired to. This shift was facilitated by anchoring COVID-19, especially its variant Omicron, to 'just like the flu' and by objectifying it through metaphors depicting a path or journey to normality. However, the new language of hope and aspiration did not go entirely unchallenged. Our analysis suggests that two competing polemic social representations emerged: one of endemicity as hope and aspiration and the other focusing on misguided optimism. We discuss these findings in the context of emerging polarisations in beliefs about the pandemic, politics and disease management.

Findings From a Community Survey of Individuals Who Engage in Pup Play.

This study presents findings from a community survey on pup play. Pup play is a kink activity and a form of role play that is growing in popularity internationally, and gaining increasing attention in sexology, yet prior research on pup play has almost entirely employed qualitative methods and primarily involved gay and bisexual men. Using survey data of 733 pup play participants primarily from the US, but also internationally, this study reports on the demographics of participants, how they engage in pup play, its social and sexual elements, and how it relates to social identity and mental health. Unique pup names and identifying with breeds of dogs were used to foster a sense of individuality within pup play, while the majority of participants owned and wore gear when engaging in pup play. We also found significant associations between being younger and identifying as a pup. Most participants reported that pup play improved their mental health. Binary logistic regression analyses indicated that having a mental health diagnosis was associated with identifying with a more social style of pup play and self-reporting the mental health benefits of pup play. We find that the conceptualization of pup play in the existing literature to be accurate to this international sample and highlight areas where further research is needed, alongside limitations of the study.

Imaginaries of patienthood: Constructions of HIV patients by HIV specialist health professionals.

This paper explores the ways in which HIV specialists based in the United Kingdom (UK) construct, conceptualise and imagine their patient group via the concept of the 'imaginary', a notion encompassing the symbols, concepts and values through which people make sense of their social environment. In discussing their work with men who have sex with men (MSM), practitioners described patients as knowledgeable and highly adherent to treatment, yet apt to pursue hedonistic lives involving sex and recreational drugs. Recent innovations in treatment were formulated in terms of optimism and progress and the ascent of biomedical approaches was cast as an advance over former emphases on psychosocial interventions and attempts to facilitate behaviour change. In contrast to the imaginary of patients who were well-informed and highly compliant with treatment, participants also sought to explain those who were not easily enfolded within modern treatment regimens or who were seen to be overly emotional. These patients, it was said, had some pre-existing psychological problem or perhaps were especially vulnerable to societal pressures. Overall, the imaginary of the public was pervaded by therapeutic optimism, a sense of progress and an invigoration of biomedical themes in overcoming the challenges of delivering services to MSM.

Social support, perceived risk and the likelihood of COVID-19 testing and vaccination: cross-sectional data from the United Kingdom.

Two samples of 227 and 214 adults completed surveys of social support, perceived risk of COVID-19 and COVID-19 preventive activity - in Study 1 likelihood of testing was examined and in Study 2 likelihood of both testing and vaccination were examined during the COVID-19 pandemic in the United Kingdom. Path analysis showed, in Study 1, that access to help (as an indicator of social support) had a direct effect on likelihood of testing and indirect effects through self-efficacy, perceived risk and preventive behavior; and, in Study 2, that neighborhood identification (as an indicator of social support) had a direct effect on likelihood of testing and indirect effects on likelihood of both testing and vaccination through the mediators of strength of social network, loneliness, perceived risk of COVID-19, and preventive activity. Both studies suggest that level of social support (conceptualized in different ways) is an important determinant of COVID-19 testing and Study 2 shows it is also a determinant of likelihood of vaccination. As resurgences of COVID-19 occur, it will be necessary to monitor the likelihood of COVID-19 testing and vaccination behaviors and, especially, to promote confidence in the latter in individuals with decreased access to social support.

Identity Threat and Coping Among British South Asian Gay Men During the COVID-19 Lockdown.

This study focuses on the impact of the COVID-19 lockdown on identity, relationships and psychological wellbeing among British South Asian gay men (BSAGM). Interview data from 15 BSAGM were analyzed using qualitative thematic analysis and identity process theory. The analysis yielded the following three themes: (1) Fear of involuntary disclosure of gay identity; (2) Anxiety about relationships; and (3) Coping and casual sexual encounters. BSAGM who returned to the family home during the lockdown reported fear of involuntary disclosure of their sexual identity, exposure to stigma in relation to their sexuality, and anxiety about their relationships with significant others. In order to cope with the resultant threats to identity, some individuals concealed their sexual identity, which could undermine their sense of identity authenticity, and some reported engaging in casual sexual encounters as a means of coping with identity threat. BSAGM may be at high risk of identity threat during the COVID-19 outbreak with limited access to social and psychological support in relation to their sexuality. This in turn may lead to a reliance on ineffective coping strategies, such as sexual risk-taking.

Discrimination, HIV conspiracy theories and pre-exposure prophylaxis acceptability in gay men.

Background Combination prevention, which includes pre-exposure prophylaxis (PrEP), is essential for achieving the zero HIV infections target in the UK by 2030. It is important to assess attitudes towards PrEP in at-risk populations. This study focuses on the effect of discrimination and HIV conspiracy theorising on attitudes towards PrEP in gay men in the UK. METHODS: In total, 244 White British gay men completed a survey that included demographic questions and measures of sexual health screening, hypervigilance, sexual orientation discrimination, quality of contact with healthcare professionals, belief in conspiracy theories and attitudes towards PrEP. Data were analysed using multiple linear regression and mediation analysis. RESULTS: Discrimination was positively correlated with HIV conspiracy beliefs and negatively correlated with PrEP acceptance. Mediation analyses demonstrated that the relationship between discrimination and attitudes towards PrEP was explained by HIV conspiracy theorising. Gay men who had attended a sexual health screening (vs never attended) reported higher belief in HIV conspiracy theories. A further mediation analysis showed that reported poor contact with a healthcare professional was associated with an increased belief in HIV conspiracy theories, which was associated with negative attitudes towards PrEP. Both perceived discrimination and poor contact with a healthcare professional were exacerbated by hypervigilance. CONCLUSIONS: HIV conspiracy theorising is an important variable in understanding attitudes towards PrEP among gay men. Its roots are in adverse social experiences (e.g. discrimination, poor contact with healthcare professionals) and its consequences may be the rejection of PrEP. HIV prevention and PrEP campaigns must focus on prejudice reduction and on challenging conspiracy beliefs.

Psychological wellbeing facilitates accurate HIV risk appraisal in gay and bisexual men.

Background Accurate HIV risk appraisal is key to effective HIV prevention. This study focuses on the role of psychological wellbeing in determining perceived HIV risk in a sample of gay and bisexual (GBM) in the UK. METHODS: Overall, 191 HIV-negative GBM completed a cross-sectional survey, in which they provided demographic information and completed measures of engagement in actual sexual risk behaviours, diagnosis with a sexually transmissible infection in the past 12 months, frequency of HIV testing, use of post-exposure prophylaxis (PEP), perceived HIV risk, lesbian, gay, bisexual and transgender (LGBT) identity, sexual identity openness and psychological wellbeing. RESULTS: Results showed that there was a correlation between engagement in actual HIV risk behaviours and perceived HIV risk, suggesting relatively accurate HIV risk appraisal in the participant sample. LGBT identity and sexual identity openness were associated with increased psychological wellbeing. Structural equation modelling showed that psychological wellbeing has an effect on perceived HIV risk through the mediator of LGBT identity. CONCLUSIONS: It appears that a state of psychological wellbeing facilitates the construction of a strong and robust LGBT identity, which can be displayed to others, and that a strong LGBT identity in turn facilitates accurate HIV risk appraisal in GBM. In order to achieve our target of zero new HIV infections by 2030, it will be essential to focus on enhancing psychological wellbeing in people at risk of HIV.

HIV knowledge, sexual health and sexual behaviour among Black and minority ethnic men who have sex with men in the UK: a cross-sectional study.

Background Black and minority ethnic (BME) men who have sex with men (MSM) face a major burden in relation to HIV infection. Using a cross-sectional correlational survey design, the present study explored the relationships between HIV knowledge and reported sexual health and sexual behaviour in this population. METHODS: A convenience sample of 538 BME MSM was recruited in London, Leicester and Leeds: 346 (64%) self-identified as South Asian, 88 (16%) self-identified as Latin American, 76 (14%) self-identified as Black, 13 (2%) self-identified as mixed, and 15 (3%) self-identified as other. RESULTS: HIV knowledge was low across the board, and South Asian MSM manifested the lowest scores. Respondents who perceived their HIV risk to be low possessed the least HIV knowledge. There were interethnic differences in the frequency of gay sauna visits, sex-seeking on mobile applications, drug use and attendance at sex parties. Respondents reported a high frequency of racism and discrimination, with Black MSM reporting highest frequency. CONCLUSIONS: There is an urgent need to raise awareness of HIV in BME MSM, and a culturally competent approach to HIV awareness-raising in BME MSM is required. These findings shed light on the contexts in which HIV prevention efforts should be targeted to reach specific ethnic groups, as well as some of the potential syndemics that can increase HIV risk or undermine HIV outcomes in BME MSM patients.

Identity management strategies among HIV-positive Colombian gay men in London.

This study set out to explore the social-psychological aspects of living with HIV among a group of HIV-positive Colombian gay men in London, and the strategies that they deployed to manage ensuing threats to their identities. Focus group and individual interview data were collected from 14 Colombian gay men living with HIV, and were analysed using qualitative thematic analysis and identity process theory. The following themes are discussed: (1) identity struggles and conflicts in Colombia, (2), managing multiple layers of social stigma in England, and (3) changing interpersonal and intergroup dynamics, which highlight the inter-connections between sexual prejudice, sexual risk-taking and HIV stigma. Identity may be chronically threatened due to the multiple layers of stigma, which can limit the coping strategies available to individuals. Findings strongly support the need for action and programmes to highlight and tackle both racism and HIV stigma on the gay scene and to fund more specific resources for sub-communities of gay, bisexual and other men who have sex with men, which employ appropriately trained and culturally competent staff.

Equality in sexual health promotion: a systematic review of effective interventions for black and minority ethnic men who have sex with men.

BACKGROUND: Over the past decade, new diagnoses of HIV have increased eightfold among men who have sex with men (MSM) of other or of mixed ethnicity in the UK. Yet there is little intervention research on HIV among black and minority ethnic (BME) MSM. This article aimed to identify effective HIV and sexual health prevention strategies for BME MSM. METHODS: We searched three databases PubMed, Scopus and PsychInfo using a combination of search terms: MSM or men who have sex with men and women (MSMW); Black and Minority Ethnic; HIV or sexual health; and evaluation, intervention, program* or implementation. We identified a total of 19 studies to include in the review including those which used randomised control, pre/post-test and cross-sectional design; in addition, we included intervention development studies. RESULTS: A total of 12 studies reported statistically significant results in at least one of the behavioural outcomes assessed; one study reported significant increases in HIV knowledge and changes in safer sex practices. In 10 studies, reductions were reported in unprotected anal intercourse (UAI), number of sexual partners, or in both of these measures. Six out of the 13 studies reported reductions in UAI; while seven reported reductions in number of sexual partners. Seven were intervention development studies. CONCLUSIONS: Research into the mechanisms and underpinnings of future sexual health interventions is urgently needed in order to reduce HIV and other sexually transmitted infection (STI) among UK BME MSM. The design of interventions should be informed by the members of these groups for whom they are targeted to ensure the cultural and linguistic sensitivity of the tools and approaches generated.

Fracking in the UK press: threat dynamics in an unfolding debate.

Shale gas is a novel source of fossil fuel which is extracted by induced hydraulic fracturing, or "fracking". This article examines the socio-political dimension of fracking as manifested in the UK press at three key temporal points in the debate on the practice. Three newspaper corpora were analysed qualitatively using Thematic Analysis and Social Representations Theory. Three overarching themes are discussed: "April-May 2011: from Optimism to Scepticism"; "November 2011: (De-) Constructing and Re-Constructing Risk and Danger"; "April 2012: consolidating Social Representations of Fracking". In this article, we examine the emergence of and inter-relations between competing social representations, discuss the dynamics of threat positioning and show how threat can be re-construed in order to serve particular socio-political ends in the debate on fracking.

When climate science became climate politics: British media representations of climate change in 1988.

Climate change has become a pressing environmental concern for scientists, social commentators and politicians. Previous social science research has explored media representations of climate change in various temporal and geographical contexts. Through the lens of Social Representations Theory, this article provides a detailed qualitative thematic analysis of media representations of climate change in the 1988 British broadsheet press, given that this year constitutes an important juncture in this transition of climate change from the domain of science to that of the socio-political sphere. The following themes are outlined: (i) "Climate change: a multi-faceted threat"; (ii) "Collectivisation of threat"; (iii) "Climate change and the attribution of blame"; and (iv) "Speculative solutions to a complex socio-environmental problem." The article provides detailed empirical insights into the "starting-point" for present-day disputes concerning climate change and lays the theoretical foundations for tracking the continuities and discontinuities characterising social representations of climate change in the future.

Identity Processes and Psychological Wellbeing Upon Recall of a Significant "Coming Out" Experience in Lesbian, Gay and Bisexual People.

This study focuses on the relations between minority stressors, protective factors and psychological wellbeing among lesbian, gay and bisexual (LGB) people. Experimental data based on a sample of 156 showed that participants asked to recall a negative coming out experience to somebody significant reported more identity threat and distress and less positive affect compared to those recalling a neutral coming out experience. In the negative recall condition, the effects of the stressors of discrimination and rejection on the variance of distress through the mediation of identity threat were statistically significant but not in the neutral recall condition and the two conditions statistically significantly differed in regards to the relationship between discrimination and distress. Identity resilience-continuity was associated with less identity threat and distress in the negative recall condition only, while social support was negatively associated and LGB stigma sensitivity was positively associated with distress in both conditions. Degree of outness (operating as a coping strategy) was associated with increased positive affect in both the neutral and negative recall conditions. When recalling a negative coming out experience, LGB people may be more susceptible to distress associated with minority stressors but also capitalize on available coping strategies.

Internalized Sexual Orientation Stigma and Mental Health in a Religiously Diverse Sample of Gay and Bisexual Men in Lebanon.

This study explores the correlates of internalized sexual orientation stigma, psychological distress and depression in a religiously diverse sample of gay and bisexual men in Lebanon. A convenience sample of 200 participants completed a cross-sectional survey. Bisexual men reported greater internalized sexual orientation stigma and less outness to their family and were more likely to face family pressure to have a heterosexual marriage than gay men. People of no religion reported more outness than Muslims and Christians but also higher psychological distress and depression. Multiple regression analyses showed that religiosity, outness, family pressure to marry and being bisexual were positively associated with internalized sexual orientation stigma; and that frequency of attending one's place of worship was negatively associated with psychological distress and depression. Individuals may be coping with adversity through engagement with institutionalized religion, which also appears to be a source of negative social representations concerning their sexuality.

Predicting sexual risk and sexual health screening in a sample of university students in Lebanon: a cross-sectional study.

OBJECTIVE: The present study focuses on factors that predict sexual risk behaviors and sexual health screening behaviors in a sample of university students in Lebanon. PARTICIPANTS: A convenience sample of 250 undergraduate students was recruited at a private university in Beirut, Lebanon. METHODS: Students completed measures of religiosity, psychological distress, contraceptives usage, human immunodeficiency virus (HIV)/sexually transmitted infections (STI) screening, and sexual risk behaviors. RESULTS: Religiosity was negatively associated with a range of risky sexual behaviors whereas psychological distress was positively associated with these behaviors. Sex under the influence of alcohol/drugs, discussing methods of contraception, and engaging in sexual activities later regretted had significant effects on having had condomless vaginal sex. Gender (being female) and sex under the influence of alcohol had significant effects on STIs screening. CONCLUSION: Interventions that focus on managing drug and alcohol use in students, unwanted pregnancy, religion, stigma related to screening, and sexual health education are recommended.