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1.
J Adolesc Health ; 70(1): 48-56, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1559813

ABSTRACT

PURPOSE: This study characterized the unobserved patterns in crisis response among youth in the U.S. from March to December 2020 and determined the characteristics of vulnerable subgroups who were at increased risk for suicide due to the pandemic. METHODS: A latent class analysis of crisis support-seeking from a national text-based crisis platform, (n = 179,497, aged 24 years or younger) for 11 crisis concerns (e.g., depression, anxiety/stress, suicidal thoughts, isolation, abuse, bereavement, relationships) was performed on three study periods: (1) January 2017 to December 2020, (2) prepandemic: 1 January 2017 to 12 March 2020, and (3) pandemic: 13 March to 20 December 2020. Demographic characteristics (age, race/ethnicity, sexual orientation, and gender identity) were used as predictors for class membership using the three-step method. RESULTS: Four latent classes were identified: (1) depression/isolation/self-harm (D/I/S) (18,694 texters, 10.4%), (2) interpersonal stress/mood-anxiety (I/M) (32,640 texters, 18.2%), (3) suicidal thoughts/depressed (S/D) (34,067, 19.0%), and (4) adjustment/stress (A/S) (94,096 texters, 52.4%). During the pandemic, an increase in suicidal thoughts and active rescues occurred in the D/I/S and S/D higher-risk subclasses. Characteristics of vulnerable groups in higher-risk classes since the pandemic included children, LGBTQ, American Indian, White, Black, Asian, female, and gender-nonconforming youth. CONCLUSIONS: Results identified a strong association with class membership in more severe risk classes during the pandemic and an increase in suicidal help-seeking, particularly among children and LGBTQ youth. Low-cost and targeted crisis text-based platforms for support-seeking in youth may be one potential safety net strategy to address the effects of the COVID-19 pandemic on mental health in youth.


Subject(s)
COVID-19 , Adolescent , Child , Female , Gender Identity , Humans , Latent Class Analysis , Male , Pandemics , SARS-CoV-2 , Suicidal Ideation
2.
Lancet ; 397(10279): 1127-1138, 2021 03 20.
Article in English | MEDLINE | ID: covidwho-1525996

ABSTRACT

In 2010, the US health insurance system underwent one of its most substantial transformations with the passage of the Affordable Care Act, which increased coverage for millions of people in the USA, including those with and at risk of HIV. Even so, the system of HIV care and prevention services in the USA is a complex patchwork of payers, providers, and financing mechanisms. People with HIV are primarily covered by Medicaid, Medicare, private insurance, or a combination of these; many get care through other programmes, particularly the Ryan White HIV/AIDS Program, which serves as the nation's safety net for people with HIV who remain uninsured or underinsured but offers modest to no support for prevention services. While uninsurance has drastically declined over the past decade, the USA trails other high-income countries in key HIV-specific metrics, including rates of viral suppression. In this paper in the Series, we provide an overview of the coverage and financing landscape for HIV treatment and prevention in the USA, discuss how the Affordable Care Act has changed the domestic health-care system, examine the major programmes that provide coverage and services, and identify remaining challenges.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , COVID-19/economics , HIV Infections/drug therapy , HIV Infections/prevention & control , Insurance Coverage/legislation & jurisprudence , Insurance, Health/legislation & jurisprudence , Acquired Immunodeficiency Syndrome/drug therapy , Adult , Aged , Anti-Retroviral Agents/therapeutic use , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Female , Gender Identity , HIV Infections/economics , HIV Infections/epidemiology , Humans , Incidence , Male , Medicaid/statistics & numerical data , Medically Uninsured/statistics & numerical data , Medicare/statistics & numerical data , Middle Aged , Patient Protection and Affordable Care Act , Risk Assessment , SARS-CoV-2/genetics , United States/epidemiology
3.
JMIR Public Health Surveill ; 7(11): e29319, 2021 11 09.
Article in English | MEDLINE | ID: covidwho-1506455

ABSTRACT

BACKGROUND: Substance use is a risk factor for COVID-19 infection and adverse outcomes. However, reasons for elevated risk for COVID-19 in substance users are not well understood. OBJECTIVE: The aim of this study was to evaluate whether alcohol or other drug use is associated with adherence to Centers for Disease Control and Prevention (CDC) guidelines for COVID-19 mitigation. Preregistered analyses tested the hypothesis that greater use of alcohol and other drugs would be associated with lower CDC guideline adherence. A secondary objective was to determine whether substance use was associated with the likelihood of COVID-19 testing or outcome. METHODS: A cross-sectional web-based survey was administered to a convenience sample recruited through Amazon's Mechanical Turk platform from June 18 to July 19, 2020. Individuals aged 18 years or older and residing in Connecticut, Massachusetts, New Jersey, New York, or Rhode Island were eligible to participate. The exposure of interest was past 7-day use of alcohol, cigarettes, electronic cigarettes, cannabis, stimulants, and nonmedical opioids. The primary outcome was CDC guideline adherence measured using a scale developed from behaviors advised to reduce the spread of COVID-19. Secondary outcomes were likelihood of COVID-19 testing and a positive COVID-19 test result. All analyses accounted for the sociodemographic characteristics. RESULTS: The sample consisted of 1084 individuals (mean age 40.9 [SD 13.4] years): 529 (48.8%) men, 543 (50.1%) women, 12 (1.1%) other gender identity, 742 (68.5%) White individuals, 267 (24.6%) Black individuals, and 276 (25.5%) Hispanic individuals. Daily opioid users reported lower CDC guideline adherence than nondaily users (B=-0.24, 95% CI -0.44 to -0.05) and nonusers (B=-0.57, 95% CI -0.76 to -0.38). Daily alcohol drinkers reported lower adherence than nondaily drinkers (B=-0.16, 95% CI -0.30 to -0.02). Nondaily alcohol drinkers reported higher adherence than nondrinkers (B=0.10, 95% CI 0.02-0.17). Daily opioid use was related to greater odds of COVID-19 testing, and daily stimulant use was related to greater odds of a positive COVID-19 test. CONCLUSIONS: In a regionally-specific, racially, and ethnically diverse convenience sample, adults who engaged in daily alcohol or opioid use reported lower CDC guideline adherence for COVID-19 mitigation. Any opioid use was associated with greater odds of COVID-19 testing, and daily stimulant use was associated with greater odds of COVID-19 infection. Cigarettes, electronic cigarettes, cannabis, or stimulant use were not statistically associated with CDC guideline adherence, after accounting for sociodemographic covariates and other substance use variables. Findings support further investigation into whether COVID-19 testing and vaccination should be expanded among individuals with substance-related risk factors.


Subject(s)
COVID-19 , Electronic Nicotine Delivery Systems , Substance-Related Disorders , Adult , COVID-19 Testing , Centers for Disease Control and Prevention, U.S. , Cross-Sectional Studies , Female , Gender Identity , Humans , Internet , Male , SARS-CoV-2 , Substance-Related Disorders/epidemiology , Substance-Related Disorders/prevention & control , United States/epidemiology
4.
Int J Environ Res Public Health ; 18(21)2021 10 28.
Article in English | MEDLINE | ID: covidwho-1488563

ABSTRACT

Previous research has established that gender and sexual minority (2SLGBTQ+) youth experience worse mental health and substance use outcomes than their heterosexual and cisgender counterparts. Research suggests that mental health and substance use concerns have been exacerbated by the COVID-19 pandemic. The current study used self-reported online survey responses from 1404 Canadian 2SLGBTQ+ youth which included, but were not limited to, questions regarding previous mental health experiences, diagnoses, and substance use. Additional questions assessed whether participants had expressed a need for mental health and/or substance use resources since the beginning of the COVID-19 pandemic (March 2020) and whether they had experienced barriers when accessing this care. Bivariate and multinomial logistic regression analyses were conducted to determine associations between variables and expressing a need for resources as well as experiencing barriers to accessing these resources. Bivariate analyses revealed multiple sociodemographic, mental health, and substance use variables significantly associated with both expressing a need for and experiencing barriers to care. Multinomial regression analysis revealed gender identity, sexual orientation, ethnicity, and level of educational attainment to be significantly correlated with both cases. This study supports growing research on the mental health-related harms that have been experienced during the COVID-19 pandemic and could be used to inform tailored intervention plans for the 2SLGBTQ+ youth population.


Subject(s)
COVID-19 , Substance-Related Disorders , Adolescent , Canada/epidemiology , Female , Gender Identity , Humans , Male , Mental Health , Pandemics , SARS-CoV-2 , Substance-Related Disorders/epidemiology
5.
J Med Libr Assoc ; 109(3): 414-421, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1481112

ABSTRACT

Objective: To evaluate the performance of gender detection tools that allow the uploading of files (e.g., Excel or CSV files) containing first names, are usable by researchers without advanced computer skills, and are at least partially free of charge. Methods: The study was conducted using four physician datasets (total number of physicians: 6,131; 50.3% female) from Switzerland, a multilingual country. Four gender detection tools met the inclusion criteria: three partially free (Gender API, NamSor, and genderize.io) and one completely free (Wiki-Gendersort). For each tool, we recorded the number of correct classifications (i.e., correct gender assigned to a name), misclassifications (i.e., wrong gender assigned to a name), and nonclassifications (i.e., no gender assigned). We computed three metrics: the proportion of misclassifications excluding nonclassifications (errorCodedWithoutNA), the proportion of nonclassifications (naCoded), and the proportion of misclassifications and nonclassifications (errorCoded). Results: The proportion of misclassifications was low for all four gender detection tools (errorCodedWithoutNA between 1.5 and 2.2%). By contrast, the proportion of unrecognized names (naCoded) varied: 0% for NamSor, 0.3% for Gender API, 4.5% for Wiki-Gendersort, and 16.4% for genderize.io. Using errorCoded, which penalizes both types of error equally, we obtained the following results: Gender API 1.8%, NamSor 2.0%, Wiki-Gendersort 6.6%, and genderize.io 17.7%. Conclusions: Gender API and NamSor were the most accurate tools. Genderize.io led to a high number of nonclassifications. Wiki-Gendersort may be a good compromise for researchers wishing to use a completely free tool. Other studies would be useful to evaluate the performance of these tools in other populations (e.g., Asian).


Subject(s)
Gender Identity , Information Storage and Retrieval , Databases, Bibliographic , Female , Humans , Male
6.
Int J Environ Res Public Health ; 18(21)2021 Oct 21.
Article in English | MEDLINE | ID: covidwho-1480746

ABSTRACT

The COVID-19 pandemic has negatively impacted the physical and mental health of many and has necessitated widespread societal shifts, including changes to work and family activities. These changes have impacted individuals' identity, including their sexual self-image and body image, yet research on perceptions of these changes is missing. This study reports on quantitative and qualitative data from an electronic survey with adults in the United States (N = 326) to examine these perceptions. Body appreciation did not significantly differ between demographic groups. Themes emerging from the qualitative results included changes in general self-image (becoming more restricted or disempowered), changes in sexual self-image (deepening, becoming more sexy/sexual, or less sexy/sexual), and changes in body image (positive, negative, and neutral). Our findings point to positive, negative, and neutral effects on sexual self-image and body image, implying that nuanced approaches are needed to understand how identity has transformed as a result of the COVID-19 pandemic.


Subject(s)
COVID-19 , Adult , Gender Identity , Humans , Pandemics , SARS-CoV-2 , Sexual Behavior , United States
7.
Gac Sanit ; 35(6): 594-597, 2021.
Article in Spanish | MEDLINE | ID: covidwho-1474573

ABSTRACT

In the current pandemic situation, the literature urges to consider the gender approach to avoid deepening existing inequalities, as already happened in previous epidemics. This field note aims to describe an experience of application of gender analysis to the impact of the pandemic on the public health, carried out by the students and teachers of the Diploma of Gender and Health of the Andalusian School of Public Health-University of Granada. The activity consisted of a review of the literature on caregiving and its impact on health in the context of health crisis, a gender analysis of information and shared reflection and debate. The debate was grouped into around five reflections, in which the care was putted in the center. Every reflection was linked to the need to incorporate the gender approach in measures and specific actions.


Subject(s)
COVID-19 , Pandemics , Gender Identity , Humans , Public Health , SARS-CoV-2
9.
Front Public Health ; 9: 711460, 2021.
Article in English | MEDLINE | ID: covidwho-1468374

ABSTRACT

Objectives: International studies suggest that males may be less likely to adhere to SARS-CoV-2 transmission mitigation efforts than females. However, there is a paucity of research in this field in the United States. The primary aim of this study was to explore the relationship of binary gender identity (female/male) with beliefs, attitudes, and pandemic-related practices in the early stages of the pandemic. Methods: This study is based on a cross-sectional, voluntary response survey. Patients who were tested for SARS-CoV-2 between March 5 and June 7, 2020 were invited to participate. All patients were tested within a large community healthcare system that serves patients through eight hospitals and hundreds of clinics across Washington State. Bivariate associations between gender and various demographics were tested using Chi-squared and Student's t-tests. We examined associations between gender and pandemic-related beliefs, attitudes, and practices using multivariable logistic regression, accounting for potential confounding factors. Results: Females were more likely than males to agree that they (aOR = 1.51, 95% CI 1.14-2.00) or their families (aOR = 1.75, 95% CI 1.31-2.33) were threatened by SARS-CoV-2, or that their own behavior could impact transmission (aOR = 2.17, 95% CI 1.49-3.15). Similarly, females were more likely to agree that social distancing (aOR = 1.72, 95% CI 1.19-2.46), handwashing (aOR = 3.27, 95% CI 2.06-5.21), and masking (aOR = 1.41, 95% CI 1.02-1.94) were necessary to slow SARS-CoV-2 spread. Females were significantly less likely to visit outside of their social distancing circle (aOR = 0.62, 95% CI 0.47-0.81), but among those who did, practices of social distancing (aOR = 1.41, 95% CI 0.89-2.23), remaining outdoors (aOR = 0.89, 95% CI 0.56-1.40), and masking (aOR = 1.19, 95% CI 0.74-1.93) were comparable to males, while females practiced handwashing more than males (aOR = 2.11, 95% CI 1.33-3.34). Conclusions: Our study suggests that gender disparate beliefs, attitudes, and practices existed in the early stages of the SARS-CoV-2 pandemic. Efforts should be tailored to encourage males to engage with mitigation efforts in ongoing pandemic-related public health campaigns.


Subject(s)
COVID-19 , SARS-CoV-2 , Attitude , Cross-Sectional Studies , Female , Gender Identity , Humans , Male , Pandemics , United States/epidemiology
10.
Support Care Cancer ; 29(12): 7195-7207, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1453750

ABSTRACT

PURPOSE: We sought to examine and categorize the current evidence on patient-physician relationships among marginalized patient populations within the context of cancer care using a systemic scoping review approach. METHODS: Web-based discovery services (e.g., Google Scholar) and discipline-specific databases (e.g., PubMed) were queried for articles on the patient-physician relationship among marginalized cancer patients. The marginalized populations of interest included (1) race and ethnicity, (2) gender, (3) sexual orientation and gender identity, (4) age, (5) disability, (6) socioeconomic status, and (7) geography (rural/urban). Study screening and data extraction were facilitated through the Covidence software platform. RESULTS: Of the 397 screened studies, 37 met study criteria-most articles utilized quantitative methodologies (n = 28). The majority of studies focused on racial and ethnic cancer disparities (n = 27) with breast cancer (n = 20) as the most common cancer site. Trust and satisfaction with the provider were the most prevalent issues cited in the patient-physician relationship. Differences in patient-physician communication practices and quality were also frequently discussed. Overall, studies highlighted the need for increased culturally congruent care among providers. CONCLUSION: Results from this review suggest marginalized cancer patients face significant barriers in establishing culturally and linguistically congruent patient-physician relationships. Future studies should focus on the intersectionality of multiple marginalized identities and optimization of the patient-physician relationship.


Subject(s)
Breast Neoplasms , Physicians , Female , Gender Identity , Humans , Male , Physician-Patient Relations , Sexual Behavior
11.
Int J Environ Res Public Health ; 18(19)2021 09 29.
Article in English | MEDLINE | ID: covidwho-1444202

ABSTRACT

There has long been a gender bias in medicine. This qualitative study aims to identify the experience of sexism among frontline female nurses and further explore their expectations and possible strategies to get rid of gender bias. This is a descriptive phenomenological study of 23 female nurses with 11 ± 3.98 years of experience who spent 36 ± 6.50 days at the frontline during the initial COVID-19 outbreak. We employed Colaizzi's phenomenological analysis method to understand the subjective experiences, revealing the following themes: (a) materialization of gender identity; (b) incoordinate relationships; (c) future voice of female nurses. The gender bias experienced by female frontline nurses further challenges their emotional identity and self-identity. Therefore, it is important to require extensive consciousness-raising and policy support to defend female nurses' rights.


Subject(s)
COVID-19 , Nursing Staff, Hospital , China , Female , Gender Identity , Humans , Male , Pandemics , Qualitative Research , SARS-CoV-2 , Sexism
12.
Aging (Albany NY) ; 13(18): 21903-21913, 2021 09 22.
Article in English | MEDLINE | ID: covidwho-1436455

ABSTRACT

The mortality rate of young female COVID-19 patients is reported to be lower than that of young males but no significant difference in mortality was found between female and male COVID-19 patients aged over 65 years, and the underlying mechanism is unknown. We retrospectively analyzed clinical characteristics and outcomes of severely ill pre- and post-menopausal COVID-19 patients and compared with age-matched males. Of the 459 patients included, 141 aged ≤55, among whom 19 died (16 males vs. 3 females, p<0.005). While for patients >55 years (n=318), 115 died (47 females vs. 68 males, p=0.149). In patients ≤55 years old, the levels of NLR, median LDH, median c-reactive protein and procalcitonin were significantly higher while the median lymphocyte count and LCR were lower in male than in female (all p<0.0001). In patients over 55, these biochemical parameters were far away from related normal/reference values in the vast majority of these patients in both genders which were in contrast to that seen in the young group. It is concluded that the mortality of severely ill pre-menopausal but not post-menopausal COVID-19 female patients is lower than age-matched male. Our findings support the notion that estrogen plays a beneficial role in combating COVID-19.


Subject(s)
COVID-19/mortality , Estrogens/metabolism , Menopause , Severity of Illness Index , Adult , Aged , Aged, 80 and over , C-Reactive Protein/metabolism , COVID-19/metabolism , Female , Gender Identity , Humans , Lymphocyte Count , Male , Middle Aged , Neutrophils/metabolism , Postmenopause , Premenopause , Procalcitonin/blood , Retrospective Studies , SARS-CoV-2 , Sex Factors
13.
Pediatr Ann ; 50(9): e366-e370, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1417220

ABSTRACT

The coronavirus disease 2019 pandemic has put strains on transgender and gender expansive (TGE) children and youth, with increased rates of anxiety and depression, lower access to medical and mental health services, and greater exposure to unaccepting home environments. At the same time, for some of these young people, particularly those with supportive living situations, sheltering in place and online schooling has afforded them the opportunity to freely explore and consolidate their gender, protected from the strains of socially induced anxieties, and anticipated or experienced negative, hostile messages from their surrounding environment (ie, school or public meeting places). Culling from emerging data on the psychosocial effects of the pandemic on TGE children and youth, an argument is made for an understanding of these young people's experiences as both stress-inducing and resilience-building, each existing in dialectic tension with the other. Providers are called on to hold both in mind to fortify the biopsychosocial well-being of transgender and gender expansive children and youth. [Pediatr Ann. 2021;50(9):e366-e370.].


Subject(s)
COVID-19 , Physical Distancing , Transgender Persons/psychology , Transsexualism/psychology , Adolescent , Child , Gender Identity , Humans , SARS-CoV-2
14.
BMJ Glob Health ; 6(9)2021 09.
Article in English | MEDLINE | ID: covidwho-1406653

ABSTRACT

BACKGROUND: Testing for COVID-19 and linkage to services is fundamental to successful containment and control of transmission. Yet, knowledge on COVID-19 testing among transgender and non-binary communities remains limited. METHODS: Between October 2020 and November 2020, we examined the prevalence and associations of COVID-19 testing in an online sample of transgender and non-binary people (n=536). Multivariable hierarchical logistic regression analyses examined associations between COVID-19 testing and participants' sociodemographic, mental health, substance use, gender affirmation, economic changes and healthcare experiences. RESULTS: Prevalence of COVID-19 testing in this sample was 35.5% (n=190/536). In the final model, transgender and non-binary participants from upper socioeconomic income background and Europe, who reported having active alcohol use disorder, limited access to gender-affirming surgery, had more than 20% reduction in income, and experienced mistreatment in a health facility due to gender identity had significantly increased odds of COVID-19 testing (all p<0.05); those who reported recent tobacco use had significantly lower odds of COVID-19 testing (p=0.007). CONCLUSIONS: These findings highlight structural disparities in COVID-19 testing and reinforce the importance of increasing testing strategies for transgender and non-binary populations.


Subject(s)
COVID-19 , Transgender Persons , COVID-19 Testing , Cross-Sectional Studies , Female , Gender Identity , Humans , Male , Prevalence , SARS-CoV-2
15.
Int J Environ Res Public Health ; 18(7)2021 03 25.
Article in English | MEDLINE | ID: covidwho-1378230

ABSTRACT

People who identify as trans and gender non-binary experience many challenges in their lives and more interest is being paid to their overall health and wellbeing. However, little is known about their experiences and perceptions regarding their distinct psychosocial needs. The aim of this systematic review is to critically evaluate and synthesize the existing research evidence relating to the unique psychological and social experiences of trans people and identify aspects that may help or hinder access to appropriate psychosocial interventions and supports. The PRISMA procedure was utilized. A search of relevant databases from January 2010 to January 2021 was undertaken. Studies were identified that involved trans people, and addressed issues related to their psychosocial needs. The search yielded 954 papers in total. Following the application of rigorous inclusion and exclusion criteria a total of 18 papers were considered suitable for the systematic review. Quality was assessed using the MMAT instrument. Following analysis, four themes were identified: (i) stigma, discrimination and marginalization (ii) trans affirmative experiences (iii) formal and informal supports, and (iv) healthcare access. The policy, education and practice development implications are highlighted and discussed. Future research opportunities have been identified that will add significantly to the body of evidence that may further the development of appropriate health interventions and supports to this population.


Subject(s)
Gender Identity , Psychosocial Support Systems , Humans , Perception , Qualitative Research , Social Stigma
16.
PLoS One ; 16(8): e0256261, 2021.
Article in English | MEDLINE | ID: covidwho-1367705

ABSTRACT

Evidence suggests that non-binary people have poorer mental and physical health outcomes, compared with people who identify within the gender binomial (man/woman). Research on the impact of the COVID-19 pandemic on mental health has been conducted worldwide in the last few months. It has however overlooked gender diversity. The aim of our study was to explore social and health-related factors associated with mental health (anxiety and depression) among people who do not identify with the man/woman binomial during COVID-19 lockdown in Spain. A cross-sectional study with online survey, aimed at the population residing in Spain during lockdown, was conducted. Data were collected between the 8th of April until the 28th of May 2020, the time period when lockdown was implemented in Spain. Mental health was measured using the Generalised Anxiety Disorder 7-item (GAD-7) scale for anxiety, and the Patient Health Questionnaire (PHQ-9) for depression. The survey included the question: Which sex do you identify with? The options "Man", "Woman", "Non-binary" and "I do not identify" were given. People who answered one of the last two options were selected for this study. Multivariate regression logistic models were constructed to evaluate the associations between sociodemographic, social and health-related factors, anxiety and depression. Out of the 7125 people who participated in the survey, 72 (1%) identified as non-binary or to not identify with another category. People who do not identify with the man/woman binomial (non-binary/I do not identify) presented high proportions of anxiety (41.7%) and depression (30.6%). Poorer mental health was associated with social-employment variables (e.g., not working before the pandemic) and health-related variables (e.g., poor or regular self-rated health). These findings suggest that social inequities, already experienced by non-binary communities before the pandemic, may deepen due to the COVID-19 pandemic.


Subject(s)
COVID-19 , Communicable Disease Control , Mental Health , Adolescent , Adult , Anxiety/epidemiology , Anxiety/psychology , COVID-19/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Depression/epidemiology , Depression/psychology , Female , Gender Identity , Humans , Male , Social Conditions , Spain/epidemiology , Surveys and Questionnaires , Young Adult
17.
J Adolesc Health ; 69(5): 746-753, 2021 11.
Article in English | MEDLINE | ID: covidwho-1364149

ABSTRACT

PURPOSE: The COVID-19 pandemic has exacerbated several existing health disparities in the U.S. Sexual and gender minority (SGM) health disparities may also be widening during the pandemic, though few studies have assessed this question. This study examined SGM young adult disparities in health-related behaviors to cope with isolation during the pandemic. METHODS: Respondents from a prospective cohort of Southern California young adults (N = 2,298) reported whether they engaged in various strategies (e.g., substance use, diet, exercise, relaxation) to cope with isolation during the pandemic (each: yes/no). Differences in coping were assessed across five SGM subgroups: heterosexual men and women, lesbian, gay, bisexual, pansexual, queer (LGBQ) men and women, transgender/nonbinary (TNB) respondents. Negative binomial regressions estimated sexual/gender identity differences in the number of positive or negative behaviors endorsed, adjusting for sociodemographic characteristics and prepandemic health behaviors. Differences were also tested across individual coping behaviors. RESULTS: Heterosexual women (IRR = 1.11 [1.01-1.21]), LGBQ men (IRR = 1.31 [1.12-1.54]), LGBQ women (IRR = 1.33 [1.19-1.49]), and TNB respondents (IRR = 1.29 [1.03-1.61]) engaged in more negative coping behaviors than heterosexual men. LGBQ men (IRR = 1.19 [1.02-1.39]) and LGBQ women (IRR = 1.20 [1.08-1.34]) also reported more negative coping behaviors versus heterosexual women. Generally, LGBQ men reported the highest prevalence of substance use, while LGBQ women and TNB reported the highest prevalence of adverse eating behaviors and self-harm. CONCLUSIONS: SGM young adults may be disproportionately, adversely impacted by the COVID-19 pandemic. Tailored public health and clinical interventions are needed to decrease pandemic-related SGM health disparities.


Subject(s)
COVID-19 , Sexual and Gender Minorities , Adaptation, Psychological , Female , Gender Identity , Humans , Male , Pandemics , Prospective Studies , SARS-CoV-2 , Young Adult
18.
BMJ Open ; 11(7): e050092, 2021 07 30.
Article in English | MEDLINE | ID: covidwho-1334580

ABSTRACT

OBJECTIVE: To systematically review all published and unpublished evidence on the impact of the COVID-19 pandemic on the health and well-being of UK sexual and gender minority (LGBT+; lesbian, gay, bisexual, transgender, non-binary, intersex and queer) people. METHODS: Any relevant studies with or without comparator were included, with outcomes of: COVID-19 incidence, hospitalisation rates, illness severity, death rates, other health and well-being. Six databases (platforms) were searched-CINAHL Plus (Ovid), Cochrane Central (Cochrane Library), Medline (Ovid), Embase (Ovid), Science Citation Index (Web of Science) and Scopus between 2019 and 2020 in December 2020, using synonyms for sexual and gender minorities and COVID-19 search terms. Data extraction and quality assessment (using the relevant Joanna Briggs checklist) were in duplicate with differences resolved through discussion. Results were tabulated and synthesis was through narrative description. RESULTS: No published research was found on any outcomes. Eleven grey literature reports found to be of low quality were included, mostly conducted by small LGBT+ charities. Only four had heterosexual/cisgender comparators. Mental health and well-being, health behaviours, safety, social connectedness and access to routine healthcare all showed poorer or worse outcomes than comparators. CONCLUSIONS: Lack of research gives significant concern, given pre-existing health inequities. Social and structural factors may have contributed to poorer outcomes (mental health, well-being and access to healthcare). Paucity of evidence is driven by lack of routinely collected sexual orientation and gender identity data, possibly resulting from institutional homophobia/transphobia which needs to be addressed. Men are more at risk of serious illness from COVID-19 than women, so using data from trans women and men might have started to answer questions around whether higher rates were due to sex hormone or chromosomal effects. Routine data collection on sexual orientation and gender identity is required to examine the extent to which COVID-19 is widening pre-existing health inequalities. PROSPERO REGISTRATION NUMBER: CRD42020224304.


Subject(s)
COVID-19 , Sexual and Gender Minorities , Female , Gender Identity , Humans , Male , Pandemics , SARS-CoV-2 , Sexual Behavior , United Kingdom/epidemiology
19.
Int J Environ Res Public Health ; 18(14)2021 07 08.
Article in English | MEDLINE | ID: covidwho-1332157

ABSTRACT

(1) Background: The aim of this study was (i) to analyze problems faced by informal caregivers in three areas of their life: health, work and finances, and family and social relationships, (ii) to investigate the main determinants of these problems, and (iii) to explore differences between men and women. (2) Methods: The study population consisted of people aged ≥18 years living in a family home who were providing unpaid care to a dependent person in the same or another home and who were registered as caregivers with the Primary Health Care District of Granada or the Provincial Council of Gipuzkoa. Several logistic regression models were built to analyze the likelihood of caregivers experiencing health, work-related, or social problems as a result of their caregiving responsibilities. (3) Results: Informal female caregivers were more likely to experience problems attributed to caregiving than their male counterparts, particularly in the areas of health and work. Additional factors associated with an increased likelihood of problems were low perceived social support, performance of ungratifying tasks, and fewer years as a caregiver. (4) Conclusions: Informal caregivers in Spain face significant problems as a result of their caregiving duties, and the impact on men and women is different. Policies and interventions to mitigate the negative effects of unpaid caregiving should incorporate differential strategies to meet the specific needs of male and female caregivers in different caregiving contexts.


Subject(s)
Caregivers , Social Support , Adolescent , Adult , Female , Gender Identity , Humans , Male , Social Problems , Spain
20.
Rev. baiana enferm ; 35: e36952, 2021.
Article in Portuguese | LILACS (Americas) | ID: covidwho-1328344

ABSTRACT

Objetivo refletir teórica e criticamente o cenário da situação de saúde de pessoas LGBTI+ frente ao Covid-19 em contexto de pandemia no Brasil. Método Estudo teórico e reflexivo estruturado a partir do arcabouço teórico e analítico de gênero e dos achados empíricos sobre a pandemia do novo Coronavírus, causadora da Covid-19. Realizou-se a decomposição não estruturada dos achados publicados na mídia digital e nas bases de dados científicos sobra a Covid-19, bem como a interseção com a saúde de pessoas LGBTI+, especialmente no Brasil. Resultados Há repercussões negativas geradas pela Covid-19 à saúde de pessoas LGBTI+ que são intensificadas por ações biopolíticas determinantes de exposição humana à vulnerabilidade, negação de direitos, discriminação, violências e iniquidades, que potencializam a degradação da saúde e a condição humana. Conclusão O surgimento da Covid-19 precipita e intensifica as vulnerabilidades e iniquidades em saúde de pessoas LGBTI+, conduzindo-as à marginalização e ao risco expressivo à vida.


Objetivo reflejar teórica y críticamente el escenario de la situación de salud de las personas LGBTI+ frente al Covid-19 en el contexto de una pandemia en el Brasil. Método Un estudio teórico y reflexivo estructurado en el marco teórico y analítico del género y los hallazgos empíricos sobre la pandemia del nuevo Coronavirus, que causa el Covid-19. Se realizó la descomposición no estructurada de los hallazgos publicados en los medios digitales y en las bases de datos científicas sobrantes de Covid-19, así como la intersección con la salud de las personas LGBTI+, especialmente en Brasil. Resultados Hay repercusiones negativas generadas por el Covid-19 en la salud de las personas LGBTI+, que se intensifican por las acciones biopolíticas que determinan la exposición humana a la vulnerabilidad, la negación de derechos, la discriminación, la violencia y las desigualdades, que potencian la degradación de la salud y la condición humana. Conclusión La aparición del Covid-19 precipita e intensifica las vulnerabilidades y desigualdades en la salud de las personas LGBTI+, lo que las lleva a la marginación y a un riesgo significativo para la vida.


Objective to reflect theoretically and critically the scenario of the health situation of LGBTI+ people in face of the Covid-19 in the context of a pandemic in Brazil. Method A theoretical and reflective study structured on the theoretical and analytical framework of gender and empirical findings on the pandemic of the new Coronavirus, causing the Covid-19. It was carried out the unstructured decomposition of findings published in digital media and scientific databases on Covid-19, as well as the intersection with the health of LGBTI+ people, especially in Brazil. Results There are negative repercussions generated by Covid-19 on the health of LGBTI+ people, which are intensified by biopolitical actions that determine human exposure to vulnerability, denial of rights, discrimination, violence and inequalities, which potentialize health degradation and the human condition. Conclusion The appearance of Covid-19 precipitates and intensifies the vulnerabilities and inequities in the health of LGBTI+ people, leading them to marginalization and expressive risk to life.


Subject(s)
Humans , Coronavirus Infections , Vulnerable Populations , Sexual and Gender Minorities , Pandemics , Gender Diversity , Gender Identity
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