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Background: The COVID-19 pandemic, together with the cost-of- living crisis, have shone a light on health inequalities running through our society - not least in UK lung cancer. Lung cancer has the widest deprivation gap of all cancers. Despite published data about socio-economic factors, the amount of evidence available about other health inequalities is poor. Method(s): The Bridging the Gap report is the output from a Health Inequalities focus-group meeting of the UKLCC's Clinical Advisory Group in June 2022. These opinions were supplemented by views and information gathered from 15 interviews with leading lung cancer and health inequalities experts, from across the four UK nations in August/September 2022. Further desk research and literature reviews were carried out over the same period. Result(s): The report calls for a 'comprehensive' approach to data collection on health inequalities - to bridge gaps in current knowledge, improve outcomes and ensure people with lung cancer have equitable access to diagnosis, treatment, and care - wherever they live and from whatever background. Key recommendations include: * Extending the remit of the National Lung Cancer Audit (NLCA) to collect more data on ethnicity, LGBTQ+ and other health inequality factors - such as gender, religion and disability. * Establishing a single, coordinated data strategy, compiling evidence on health inequalities at local, regional and national levels. * Introducing a Personal Care and Access Card scheme, carried by the patient, combining their Holistic Needs Assessment information with their personal treatment and care plan to facilitate transfer of information between hospitals and specialists. * Disease awareness campaigns targeted to address local needs and communities. Conclusion(s): The UKLCC believes that - with the implementation of these recommendations and support from policy makers, commissioners and clinicians - we can successfully mitigate health inequalities in lung cancer and have further impact on lung cancer outcomes. Report accessible here: www.uklcc.org.uk/our-reports Disclosure: No significant relationships.Copyright © 2023 Elsevier B.V.
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Este artigo objetiva analisar os impactos da pandemia de Covid-19 na comunidade LGBTQIA+, em específico a situação das travestis e mulheres trans. Nessa direção, este texto privilegia a análise secundária em uma pesquisa direcionada à população nacional LGBTQIA+ e outra pesquisa direcionada às travestis e mulheres trans da cidade de São Paulo, bem como a revisão bibliográfica do tema proposto. Para tanto, nos apropriamos das categorias que perpassam e vão além da questão de gênero e incorporam a diversidade humana, contemplando as relações sociais de sexo, raça e classe social, bem como aquelas que determinam as mutações do mundo do trabalho no contexto do "capitalismo pandêmico”.Alternate :This article aims to analyze the impact of pandemic the new coronavirus of Covid-19 on the LGBTQIA+ community, particularly the situation of transvestites and transgender women. With this in mind, this text advocates a secondary analysis in one research aimed at the national LGBTQIA+ population and another research aimed at transvestites and transgender women in the city of São Paulo, as well as the bibliographical review of the proposed. To this end, we use the categories that permeate and go beyond gender and include human diversity, taking into account the social relationships of gender, race and social class, as well as those that determine the changes in the world of work in the context of "pandemic capitalism”.
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The coronavirus pandemic and responses have had uneven impacts on different segments of societies. We analysed experiences of LGBTQIA+ people during COVID-19, based on interviews in the UK and Brazil in 2020. The UK and Brazil are instructive cases, with the same crisis impacting these two different social, cultural, economic, and political contexts. Pre-existing marginalisation shaped COVID-19 experiences in both contexts, influencing challenges faced, such as isolation or disruption to transgender healthcare, and coping strategies, including the important role of LGBTQIA+ volunteer and mutual-aid groups. We argue that despite commonalities, there is no single LGBTQIA+ experience, and that disaster strategies will be ineffective until they recognise intersectionality and support the diversity of LGBTQIA+ populations. We conclude with a call to action for more inclusive disaster research, policy, and practice, which requires scrutinising dominant cisgender-heteronormative structures that produce and reproduce LGBTQIA+ marginalisation.
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Background: In mid-2022, New York City (NYC) became the epicenter of the US mpox epidemic. Health authorities were in need of forecasts to anticipate the timing and magnitude of the outbreak. We provided mathematical modelbased projections with methodologies that evolved alongside the epidemic. Here, we retrospectively evaluate our mpox case projections and reflect on potential reasons for accuracies and inaccuracies. Method(s): Early in the outbreak (July 1 - 15, 2022), when the size of the at-risk population was unknown, we performed short-term (2-week) forecasting using exponential regression. Once epidemic growth was no longer exponential (July 15 - Aug. 9), we consulted with the NYC Department of Health and Mental Hygiene regarding populations most-at-risk of mpox based on available epidemiological data. Modelers and epidemiologists collaboratively developed an estimate of 70,180 people at risk, informed by estimates of LGBTQ adults with male sex at birth who had 2+ partners in the last 3 months. We combined this with NYC case count data, NYC vaccination data, and global mpox natural history data to develop a Susceptible-Exposed-Infected-Recovered (SEIR) model, taking into account immunity accrued through vaccination and prior exposure, for longer-term forecasting. Result(s): Initial exponential forecasts of the NYC mpox outbreak were only accurate for very short-term predictions (< 2 weeks) (Figure, top panel). Forecasts were more accurate after 1 week (mean absolute error: 83.0 cases/ wk) than after 2 weeks (mean absolute error: 351.4 cases/wk). In contrast, the SEIR model accurately predicted the decline in cases through the end of Sept. 2022, when cases fell to < 70/wk. Over the period from Aug. 10 to Sept. 24 2022, the mean absolute error of the SEIR-based projection was 8.2 cases per week (Figure, bottom panel). Conclusion(s): Model-based NYC mpox projections provided only short-term accuracy in the early epidemic, but long-term accuracy once the epidemic exited exponential growth and an SEIR model was developed. Cumulative cases and vaccinations when exiting exponential growth, and the epidemiology of those most-at-risk, provided evidence for the likely size of the most-at-risk population - a crucial input for an accurate SEIR model. The ability of the SEIR model to accurately forecast mpox cases was in part attributable to lack of vaccine or immune escape by mpox, in contrast to more rapidly-evolving viruses such as SARS-CoV-2.
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Medical misinformation is more pervasive today because of widespread and near instantaneous dissemination of information via the internet and social media platforms. Consequences of medical misinformation may include decreased uptake of needed health care resources, delays in seeking care, vaccine hesitancy, medication non-compliance, increased disease outbreaks and/or burden, and increased hospitalization and mortality. It disproportionately impacts underserved populations, including Black patients, those who identify as LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and more), and patients with reduced health literacy skills or who are digitally disadvantaged. Medical misinformation challenges health care professionals not only to provide the best care possible, but to assist patients in finding accurate information. Preprint publications, although potentially beneficial in rapidly disseminating new scientific discoveries, often have not undergone peer review and may contribute to the widespread propagation of inaccurate or overstated results, thereby perpetuating the spread of medical misinformation when it exists. The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of practicing evidence-based medicine and the need for cautious review of preprint publications and articles from predatory publishers in addition to usual and customary literature evaluation techniques. Everyone plays a role in preventing the spread of medical misinformation, with pharmacists uniquely positioned as trusted and highly accessible professionals who may help combat its spread. The goal of this article is to define medical misinformation and related terms, outline mechanisms by which it is spread, describe its clinical impact, highlight how it disproportionately impacts underserved populations, provide actionable strategies to prevent its spread, and give examples of practical tactics to help identify, correct, and alert individuals about the possible presence of medical misinformation.Copyright © 2023 Pharmacotherapy Publications, Inc.
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It is important to understand the differential impact of COVID-19 on the health of older lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and people with other sexual orientations and forms of gender expression (LGBTQIA+). The objective of this study is to systematically review the impact of COVID-19 on LGBTQIA+ older adults' health including risk and protective factors. We reviewed a total of 167 records including LGBTQIA+ older adults published since 2019. Two independent reviewers screened titles and abstracts and extracted information of 21 full-text records meeting inclusion criteria using COVIDENCE software. The results show that the negative health consequences are exacerbated by personal risk (e.g., perceived homo/transphobia and ageism in LGBTQIA+ communities) and environmental factors (e.g., heterosexism within health services). The negative impact seems to be reduced by personal protective (e.g., resilience, spirituality, and hobbies) and environmental factors (e.g., technology use to increase social participation and social rituals). In conclusion, the health of LGBTQIA+ older adults has been disproportionately affected during the pandemic associated to the latest coronavirus (COVID-19). The experiences of LGBTQIA+ older adults during the pandemic are integrated in a Model of Health and Disease for LGBTQIA+ older adults. Specific strategies to promote health and well-being in this community are provided.
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Purpose: While Pre-Exposure Prophylaxis (PrEP) is highly effective at preventing HIV, uptake is low among adolescents. In low- and middle-income countries (LMIC), peer mentors (PMs) are considered best practice to increase PrEP acceptability and uptake. Globally, COVID19 has shifted much education and training to virtual formats. Most young people in LMIC have cell phones. Our objective is to describe our experiences developing and delivering a mixed virtual/physical curriculum for training PrEP PMs. Methods: IRB and local research ethics committee approval was obtained. A literature search (PubMed, EBSCO, USAID website, and MedEd Portal) yielded one published curriculum for PrEP PMs. This curriculum was combined with locally developed HIV PM education modules to create a new curriculum, with planned virtual and physical sessions. Curriculum materials were reviewed and agreed upon by all authors. All sessions were delivered by authors, with the majority delivered by Americans. The first 4 hours were done virtually via Zoom, covering the basics of HIV, detailed information on PrEP, adolescent development, and confidentiality. The remaining sessions were held in person and covered expectations of PMs, basic family planning, research ethics, action planning, role playing, and a review of virtual topics. Feedback was solicited from the PMs after virtual training. A debriefing session was held with the five facilitators involved in training: 1 research staff and 1 physician investigator from Kenya, 1 research staff and 2 physician investigators from the US - all female. Results: All five PMs (aged 21 – 27) participated. One identified as female, and one as LGBTQ. Feedback was solicited via anonymous survey (n=3) after the virtual sessions and debriefing with Kenyan research staff. Respondents strongly agreed that the virtual training was worth their time. Although PMs felt they were able to learn in the virtual format, facilitators noted more engagement during in-person sessions. Facilitators noted the importance of introductions and challenges of building cohesiveness for virtual sessions, particularly with sensitive content and internet limitations restricting video use (eg. low bandwidth, use of cell phones). Kenyan investigators noted that the Kenyan educational system is hierarchical, with students largely learning passively. They felt that this, combined with the newness of virtual learning and minimal dedicated time for introductions, may have hampered active virtual participation. While no PMs pointed to race or accent as limitations, facilitators noted differences between American and Kenyan English idioms, cadence, speed, and pronunciation that may have caused difficulty. Given Kenya's history of colonialism, all raised concerns that PMs may have been more deferential to light-skinned, foreign facilitators. Facilitators who observed both virtual and in-person sessions felt it was easier to break barriers of colonialism and assess for differences in spoken English in person. Facilitators felt that if virtual training were to be used in the future, it would be beneficial to have physical sessions first to set an interactive, educational tone and allow participants to build rapport. Conclusions: Virtual delivery of PM educator training in a LMIC setting is difficult and requires careful consideration or technological limitations and culture. Sources of Support: Indiana CTSI;Grant Number UL1RR025761-01.
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Purpose: Rates of suicidal ideation and attempts among adolescents, especially young sexual and gender minority (SGM) adolescents, have been on the rise over the last several years. The COVID-19 pandemic has only exacerbated risk factors for suicidality and introduced additional barriers to accessing needed medical care and other help-seeking resources. This study sought to estimate the prevalence of suicidal thoughts, plans, and attempts among young SGM adolescents residing in the South, a geographic region with high unmet health needs, greater multi-level experiences of discrimination, and a hostile policy landscape marked by numerous anti-LGBTQ bills and few protections on the basis of sexual and gender identity. Methods: Tailored social media advertising was used between July 2021 and April 2022 to recruit and enroll 384 SGM adolescents aged 13-17 years residing in eight southeastern states (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, and Tennessee). Study staff used multiple authentication procedures to verify the uniqueness and validity of each enrollment. Respondents completed an online cross-sectional survey that assessed prior suicidality (thoughts, plans, attempts). Respondents were provided a number of help-seeking resources at the conclusion of the survey. The mean respondent age was 16.1 years (SD = 1.0), and respondents were primarily female (45.6%, n=175), bisexual (38.0%, n=146), and non-Hispanic White (52.6%, n=202). We used unadjusted and adjusted logistic regression analyses to identify sociodemographic, health, and relationship correlates of prior suicidal ideation and attempts. Results: Overall, 70.6% (n=271) of SGM adolescents reported ever having serious suicidal thoughts. Of these respondents, 74.9% (n=203) had planned and 43.9% (n=119) had attempted suicide. Adjusted analyses showed that the likelihood of prior suicidal ideation was higher among respondents who identified as Hispanic (AOR: 2.7;95% CI: 1.1, 7.0), non-Hispanic Multiracial (AOR: 4.1;95% CI: 1.2, 13.9), and non-Hispanic White (AOR: 3.0;95% CI: 1.4, 6.3) as compared to non-Hispanic Black, and was twice as high among respondents 17 years of age (AOR: 2.3;95% CI: 1.1, 5.0) compared to those 15 years of age. Having a diagnosed disability (AOR: 3.4;95% CI: 1.9, 6.1) and poor parental relationship quality (AOR: 2.3;95% CI: 1.2, 4.1) were also associated with an increased likelihood of prior suicidal ideation. The likelihood of prior attempted suicide was significantly greater among SGM adolescents who reported poor parental relationship quality (AOR: 2.0;95% CI: 1.1, 3.6), a diagnosed disability (AOR: 2.1;95% CI: 1.1, 4.0), and a chronic health condition (AOR: 2.5;95% CI: 1.4, 4.7). Conclusions: The prevalence of lifetime suicidality was quite high among SGM adolescents in the South, even higher than estimates reported by national studies among similarly aged adolescents. The findings suggest the immediate need for tailored efforts to prevent and address suicidality among SGM adolescents, especially given the compounding effects of the COVID-19 pandemic on adolescents' health. The findings also suggest the need to intervene with the parents of SGM adolescents or increase acceptance and connectedness in other close relationships. Sources of Support: This study was funded by the Centers for Disease Control and Prevention's National Center for Injury Prevention and Control (K01CE003226).
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BACKGROUND: People who identify as sexual and gender minorities (SGM) experienced disproportionate economic and mental health issues related to COVID-19 when compared to the general population. The purpose of this study was to better understand how COVID-19 has impacted the SGM community and ways to address vaccine hesitancy. METHODS: Three focus groups were conducted with 21 members of the SGM community between 5 November and 10 December 2020. A thematic analysis using the reflexive approach was applied to the transcripts of the focus groups. RESULTS: Four themes emerged: (1) Impact of COVID-19 on the Community, (2) Perceptions of Contact Tracing and Testing, (3) Perceptions of a Potential COVID-19 Vaccine, and (4) Decreasing Vaccine Hesitancy. The most relevant subthemes were that social isolation led to anxiety, stress, and fear in the SGM community during COVID-19; resilience and adaptation were positive outcomes of the pandemic; histories of medical racism contributed to hesitancy to get tested; and specific messaging from trusted messengers may be needed to encourage SGM communities to get vaccinated. These findings support other COVID-19 research on the SGM community during the start of the pandemic. CONCLUSIONS: This study provides insight into the impact of the early stages of COVID-19 on the SGM community, highlighting the unique hurdles faced by SGM individuals with regard to contact tracing and vaccine hesitancy.
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COVID-19 , Sexual and Gender Minorities , Humans , Focus Groups , COVID-19 Vaccines , COVID-19/epidemiology , Sexual Behavior , Gender IdentityABSTRACT
Objective:Offering comprehensive lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual (LGBTQIA+) friendly and sex-positive student health centers are central to institutions of higher education being able to retain and support students. Positive sexual experiences for LGBTQIA + students can have an impact on academic success but many LGBTQIA + students are discriminated against and are often victims of microaggressions. Participants: Twenty undergraduate students enrolled in a LGBTQIA+ health course. Methods: Students in an LGBTQIA + Health undergraduate course at a private Northeastern university assessed what mattered most to them when it came to creating a sex-positive healthcare environment that promotes LGBTQIA + inclusiveness and removes perceived barriers. Results:The themes included expanding mental health care, greater involvement of culturally-competent provider, establishing a stigma-free clinical environment, re-imagining the clinic waiting room, and facilitating sexual health advocacy. Conclusion: Re-envisioning the role of student health centers is critical for ensuring every student has a fair and just opportunity to achieve their full health potential.
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Compared to youth a decade ago, today's youth experience increased rates of mental health concerns as well as greater severity of mental health issues. Prior to the COVID-19 pandemic in 2020, over a third of youth reported feeling sad and hopeless and one in five reported having seriously considered suicide. With this grim reality, schools and communities are no longer able to ignore how mental health affects the daily lives, social and emotional development, and identify formation of their youth. When schools implement mental health promotion programs and policies, they not only promote academic success but also increase protective factors that establish an environment supportive of help-seeking behaviors. Active Minds is committed to improving mental health outcomes for youth, specifically LGBTQIA2S+ students, enrolled in K-12 schools across the United States. These recommendations, grounded in evidence-based best practices, provide support for schools as they work to improve student mental health. These recommendations include the following:Implementing the Whole School, Whole Child, Whole Community (WSCC) model;Centering youth voices in mental health promotion;Participating in surveillance efforts;Ensuring mental health support for students with diverse identities and needs;Providing space to address individual biases and stigma;Developing and aligning policies and culture to support youth mental health.
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COVID-19 , Mental Health , Child , Humans , Adolescent , United States , Pandemics/prevention & control , COVID-19/prevention & control , Schools , StudentsABSTRACT
In assessing the occurrence of an unexpected medical adverse event following pharmaceutical,medical, or surgical treatment, the causal or contributory roles played by bias, systemic racism, and social determinants of health should be investigated. Up to 80% of clinical outcomes are estimated to be driven by social determinants including the environments in which patients live, work, learn, worship, and play. Among women, there are racial health disparities in sterilization procedures, method of hysterectomy, cesarean birth rates, preterm birth rates, and, most recently, the rates of COVID-19 death and hospitalizations. At the same time, there is little specific guidance of how to investigate social determinants of health that affect patient outcomes. Differences in health equity-related factors affect the quality of gynecologic care. There is immeasurable potential for bias in patient characteristics: race;ethnicity;persons with obesity;LGBTQ+ (lesbian, gay, bisexual, transgender, queer+) persons;socioeconomic factors;and young and old age. Within existing models for patient safety, inclusion of equity-related aspects of care may improve the current understanding of the causes of medical adverse events. It is critical to consider social determinants of health, structural racism, and both overt and implicit bias. The aim of this studywas to establish a sustainable and trackable process to determine the role of social determinants of health, bias, and racism in adverse gynecologic events. Each adverse event case is assessed for preventability, harm, and standards of care. Cases are identified for review utilizing existing hospital event-reporting systems (RLDatix) and enhanced by resident and attending physician self-reporting. The following equity-focused process was used: (1) creating a standardized health equity checklist;(2) applying the checklist to each gynecologic adverse event beginning on September 1, 2020;(3) collecting event review data in a secure central digital repository;(4) reviewing each adverse case to understand apparent causes of the event;(5) exploring areas for improvement using standard fields;and (6) identifying specific ideas for improvement. Within 15 months (between September 1, 2020, and November 30, 2021), 46 safety cases were identified using standard criteria. Twenty-four of these were deemed preventable.Of the 24 cases, 12 cases were identified inwhich social determinants of health, bias, or both had a role. Delays in diagnosis and care were attributed to social determinants of health and implicit bias. This process has mapped areas of infrastructure as well as the need for culture improvement and restorative work to address implicit bias and improve approaches to shared decision-making. These findings show that with use of a health equity checklist, it is feasible to create a systematic and trackable process to begin delineating the role of social determinants of health, bias, and racism in adverse gynecologic events. Copyright © 2023 Lippincott Williams and Wilkins. All rights reserved.
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Background: LGBTQ adults experience higher rates of dementia and rely more heavily on informal social support to meet care needs compared to cisgender, heterosexual peers. As dementia progresses and they enter new systems of care, LGBTQ adults must make important choices not only about health promoting behaviors and care plans generally, but also about identity disclosure, building and maintaining a care team with families of choice, and navigating potential discrimination specific to their identities as sexual and gender minorities. A culturally relevant intervention is urgently needed to protect self-determination and meet their unique care needs. Method(s): Using findings from a longitudinal study of LGBTQ adults, a team of interventionist researchers adapted Reducing Disabilities in Alzheimer's Disease (RDAD) by integrating culturally relevant modifications and enhanced empowerment strategies through motivational interviewing (MI). The team developed and implemented a training protocol for study interventionists called "coaches," trialed the intervention with 150 dyads of adults with dementia and care providers in the LGBTQ community, and collected case reports from coaches and qualitative data from trial participants to inform intervention adaptations. Result(s): MI added unique theoretical and practical contributions, resulting in a culturally relevant, efficacious intervention (Aging with Pride: IDEA), designed for adults with dementia and care providers in the LGBTQ community and adapted for online delivery during the COVID pandemic. Qualitative data from the trial demonstrates that participants discovered "new possibilities for managing changes" as dementia progressed and finished feeling "empowered rather than stuck.". Conclusion(s): MI uniquely supported trial participants' self-determination to develop and implement strategies for dementia care and coping. Practice examples are included to illustrate applications of MI and relevant theory to promote self-determination and implementation of strategies to navigate dementia for LGBTQ adults. Copyright © 2022 the Alzheimer's Association.
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BACKGROUND: The ramifications of the existing crisis caused by the coronavirus pandemic are sensed in all walks of life. Among the various efforts made to curb the spread of this novel infection, the development of COVID-19 vaccines had a profound role in flattening the pandemic curve. Even though the rapid vaccine drive received a highly welcoming response among people, the reluctance and ignorance of a part of the population towards available safe vaccines stand as impediments to achieving the desired outcome. The LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual) communities are the least studied groups in this regard. OBJECTIVE: The purpose of this study is to extensively review and report on COVID-19 vaccine uptake and refusal among the LGBTQIA+ population and enumerate the factors contributing to vaccine hesitancy. The study extends further to outline a conceptual framework for interventions to enhance COVID-19 vaccine acceptance among the LGBTQIA+ population. METHODS: We performed a systematic search using key terms on Google Scholar and PubMed. The obtained results were filtered using the eligibility criteria framed for this study. The initial search provided an extensive result of 4510 articles which were later screened at various levels to arrive at the final inclusive collection of manuscripts adding to 17. The studies were analyzed by the authors individually, and the data were categorized using variables. The results are interpreted using charts and graphs. The whole manuscript has been structured in accordance with the PRISMA extension for scoping reviews. RESULT: The comprehensive search yielded 17 eligible articles for this review. Most of the studies were conducted in the United States (n = 17), and predominantly cross-sectional studies have been conducted. The major comparative factor was the HIV status of the LGBTQIA+ population. HIV-affected patients were more willing to take up COVID-19 vaccination. However, social stigma, discrimination, lack of access and non-prioritization in vaccine drives were found to be the major factors contributing to vaccine hesitancy among this population. CONCLUSION: The invention of the COVID-19 vaccination revolutionized the healthcare systems burdened with COVID-19. Although this is a breakthrough scientific contribution, many factors are associated with the rate of vaccine acceptance, especially among sexual and gender minorities. The reviewed studies have revealed numerous factors that influence vaccine uptake and refusal with the commonest being concerns on discrimination, social stigma, inequitable access to healthcare, vaccine safety, efficacy, potency, side effects and lack of trust in medical workers. These impediments in vaccine coverage should be meticulously addressed to ensure optimum LGBTQIA+ physical and mental health as well as for providing non-discriminative, equitable and quality healthcare service regardless of the gender or sexual orientation of individuals.
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The COVID-19 pandemic caused unprecedented global disruption. When we reflect on the past two years and the severe effects of the pandemic that continues to this day, it is clear that education was one of the most affected sectors. Both the general public and educational establishments were ill-prepared to accept the sudden shift to various platforms. Empirical evidence on the impact of COVID-19-related school closures on academic achievement has been the recent trend in the field of academic research. The present work aimed to determine the level of cognitive skill of Junior High school students in one of the public schools in the Philippines. Employing a quantitative descriptive correlational design, respondents were also chosen using total enumeration sampling. Results indicate that the students are satisfactory in terms of their academic performances. Moreover, a very weak relationship exists between their cognitive skill and their gender where males and LGBTQ were found to be different from each other. Copyright © 2022, Anka Publishers. All rights reserved.
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In March 2020, the World Health Organization declared a global pandemic due to the rapid spread of COVID-19. Two years into the pandemic, there have been over one million COVID-19 deaths in the United States alone. While the pandemic has impacted everyone, the most extreme impacts have been experienced by marginalized communities, including those who identify as LGBTQIA+. Although LGBTQIA+ people have faced the negative impacts of the pandemic, the LGBTQIA+ community may be well equipped to navigate the COVID-19 pandemic due to the historic and current societal oppression this community has endured. Using both a resilience and resistance framework, the present study explores the resilience and resistance strategies employed by LGBTQIA+ adults in the Southeast U.S. during the COVID-19 pandemic through the collection and analysis of monthly diary entries and video interviews. Findings show that resilience and resistance build on the knowledge base and histories of LGBTQIA+ people, and resilience and resistance have been re-imagined for this community during the COVID-19 pandemic. As a result of the pandemic, many LGBTQIA+ people are dreaming of and re-imagining a better future, a future that social work educators and practitioners can help co-create. [ FROM AUTHOR]
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Public health crises alter political landscapes. This article investigates social movement strategies during and between the HIV and COVID-19 pandemics. We conducted a set of eighteen in-depth interviews with eleven leaders of organisations working with sex workers, sexual minorities, and transgender people around India, all of whom had been actively involved in HIV prevention programs, before and after the arrival of COVID-19 in India. First HIV, and then COVID-19, altered the political landscape for these groups in relation to three types of institutions: (1) donors (by creating dramatic increases and decreases in the amount, type, and conditions of global funding and deepening inequalities among organisations) (2) the state (by shifting the balance of advocacy and human rights work toward immediate relief); and (3) other social movements (by expanding solidarities across groups but also placing them in competition for limited resources). We argue that, to weather these dramatic shifts, organisations relied on internal alliances and resources built in and after periods of crisis. In this way, despite the differences between the two pandemics, the legacies of HIV shaped the response to COVID-19. Though responses to COVID-19 seem improvised and temporary, they build on a longer-term social movement infrastructure.
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BACKGROUND: There are over 20,000 individuals imprisoned by Immigration and Customs Enforcement (ICE) daily, with nearly half a million detained annually. Numerous reports have documented human rights abuses in immigration detention, yet little is known about its health impacts. METHODS: From July 2020 - February 2021, we conducted a qualitative study of adults who had been detained by ICE in New York and New Jersey and who were clients of local legal and community-based organizations. Eligibility included: release from immigration detention in the past two years, detained for >30 days. Two interviewers conducted anonymous, individual, semi-structured interviews in English or Spanish. Interviews explored participants' experiences trying tomeet physical and mental health needs while in detention. We continued interviews until reaching thematic saturation and conducted analysis concurrently using a modified grounded theory approach. RESULTS: Of 16 participants, 13 identified as men, 5 as LGBTQ, and 4 as Black;they were from 9 countries and had spent a median of 11 months in detention. Four themes emerged from our analysis: (1) Participants attributed new medical problems or worsening of chronic conditions to inhumane treatment and poor physical conditions: “They detected I had high blood sugar and cholesterol level, but that's due to the food they give you there.” (2) Structural barriers prevented access to needed care and led to delays in medical attention: “You could literally be dying in there and it's like they need to see you dead in order for them to get you help.” (3) A pervasive sense of injustice exacerbated emotional distress. Participants felt detention was designed to break one down: “It harms you morally, psychologically, physically, what immigration officials do to you. if you didn't commit a crime that put others at risk why do they detain you there?” (4)Worsening conditions during the COVID-19 pandemic. The pandemic worsened isolation and desperation;participants feared for their lives as COVID-19 spread in their facilities and they remained unprotected: “They didn't come and ask people, ?Hey, do you feel any symptoms? Are you okay, do you want to get tested?' There was no proper tools given like hand sanitizer, Clorox. no measurements being taken, masks given out or gloves given out? we barely had toilet paper and soap.” CONCLUSIONS: These interviews demonstrate how structural features of immigration detention erode health while creating barriers to accessing needed medical care. Underlying the participants' experiences of the immigration detention enterprise is a sense of arbitrariness and injustice that further contributes to its psychological toll. Clinicians caring for immigrant communities must be cognizant of these health impacts. As COVID-19 continues to disproportionately affect incarcerated individuals, community-based alternatives to immigration detention should be urgently prioritized.
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Introduction In attempts to further promote awareness and availability of HIV Pre-Exposure Prophylaxis (PrEP) within local LGBTQ+ communities a pop-up clinic was held at the 2021 Bournemouth Pride event. Patients were educated about PrEP, Point-of-Care tested for HIV and Syphilis and given the option of starting an event-based regimen to cover for risk over the Pride weekend. Methods Event-based PrEP was initiated in patients undertaking a self-completion triage form, consultation and pointof- care testing. Patients took the first dose immediately and left the consultation with two follow-up doses of PrEP with text reminders scheduled to promote adherence. All patients were offered a follow-up appointment, given access to STI screening and further information about chemsex harm minimisation. Results 8 patients were given event-based PrEP during the event. All patients were cis-male and identified as men who have sex with men. None of them reported previous PrEP use. All patients made follow-up appointments for continuation PrEP whilst at the event and all patients attended this and continued PrEP. At this follow up visit, all patients disclosed HIV risk at the event. No patients required further 'emergency' dosing after the event. 3 patients self-sourcing PrEP asked to be 'converted' to NHS supply and were booked into follow up clinics at the event. Discussion Owing to the successful local rollout of PrEP since November 2020, many of the event attendees were already accessing PrEP. However, presence at a community LGBTQ+ event helped to further promote awareness of PrEP and encouraged high risk patients to attend mainstream services.