Impact of COVID-19 on pornography use: Evidence from big data analyses.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has led to radical changes in social distancing awareness and affected social relationships. Owing to large-scale lockdown, home quarantine and social distancing requirements, it was anticipated that sexual activities would be severely impacted. However, retrospective self-report studies showed that pornography use and autoerotism increased during the pandemic. AIM: This study used big-data databases available on the Internet to investigate factors that modulated pornography use during the pandemic. METHODS: Daily relative search volume (RSV) data from Google Trends for the period from 24 February 2020 to 13 July 2020 were extracted. Pornhub traffic data were extracted from the Pornhub Insights website, for the period from 24 February 2020 to 13 July 2020. The parameter was defined as 'percent change in traffic compared to an average day in 2019'. The number of daily new cases of COVID-19 was extracted from the database on Our World in Data. OUTCOME MEASURES: The normality of the data was examined using the Shapiro-Wilk test. All variables included in this study were non-normally distributed. Therefore, non-parametric tests or parametric tests with bootstrapping were adopted where appropriate. RESULTS: According to Google Trends, the RSV for 'pornography' increased after late March 2020, which is close to the date when the World Health Organization declared COVID-19 a global pandemic. The number of daily new cases of COVID-19 was positively correlated with the traffic of Pornhub, a popular pornography website, and the RSV for 'pornography'. Moderation analysis demonstrated a significant main effect of daily new cases of COVID-19 and the RSV for 'social distancing' in predicting Pornhub traffic/RSV for 'pornography'. Furthermore, the RSV for 'social distancing' significantly moderated the relationship between daily new cases and Pornhub traffic/RSV for 'pornography'. A stronger COVID-pornography use association was observed with increased social distancing awareness. CONCLUSION: Increased pornography consumption during the pandemic was observed, and it was associated with the severity of the pandemic. Social distancing awareness could be a key factor influencing interest in and use of pornography. Further studies on the changes in sexual desire and birth-rate control are worthwhile because long-term public health may be affected by the changes in sexual behaviour during the pandemic.

A Minority Stress Response Model of Health Behaviors in Gay and Bisexual Men: Results from a Taiwanese Sample.

Purpose: Health disparities among sexual minority men remain and continue to demand novel interventions. Other than risk reduction, a promising approach is to identify pathways to health-promoting behaviors. In this study, depressive symptoms, internalized homophobia, and sense of community connectedness were hypothesized to result from the experience of harassment and rejection, and in turn either promote or inhibit an individual's tendency toward health-promoting behaviors. We accounted for subgroup differences by examining the hypothesized model in gay and bisexual men separately. Methods: This was a cross-sectional survey study. One thousand three hundred eighty-one gay (81.5%) and bisexual (18.5%) Taiwanese men 18-49 years of age (mean = 26.56, standard deviation = 6) were recruited through a social media advertisement and completed an online survey. Structural equation modeling was employed to simultaneously examine multiple hypothesized paths. Results: Harassment and rejection were associated with greater depressive symptoms, internalized homophobia, and sense of community connectedness, which in turn yielded direct or indirect associations with health-promoting behavior among gay men. For bisexual men, depressive symptoms remained an important mechanism linking harassment and rejection and health-promoting behavior, whereas the roles of internalized homophobia and sense of community connectedness appeared less obvious. Conclusion: These findings cast new light on the behavioral implications of minority stress and elucidate the possible underlying mechanisms. The study suggests that more effort should be invested to understand and promote the drivers of health-promoting behavior to reduce health disparities in this population.

A nationwide cross-sectional study of 15,611 lesbian, gay and bisexual people in China: disclosure of sexual orientation and experiences of negative treatment in health care.

BACKGROUND: Lesbian, gay and bisexual (LGB) people often face individual- and system-level barriers in health care. However, LGB people's experiences of health care in non-European and non-American settings have been scarcely studied. In China, while it has been estimated that there are at least 70 million gender and sexual minorities, there has been no larger-scale study on LGB people's experiences of health care beyond a focus on gay men and HIV. This study is the first larger-scale quantitative study to investigate LGB people's experiences of health care in China, where non-heterosexuality is officially silenced and the needs of non-heterosexual people are largely ignored by service providers. METHODS: An online survey was designed in joint partnership by academic, community groups and the United Nations Development Programme. Targeted and snowball sampling was adopted for participant recruitment. Such unique cross-sectoral partnership made this research possible in the authoritarian state of China where data collection on LGB people is extremely rare. For the analysis in this paper, a sample of 15,611 Chinese LGB people were included. Frequency and descriptive statistics were conducted to describe the LGB respondents' demographic characteristics and their experiences in health care settings. Chi-square tests were conducted to test how experiences vary across LGB people with different demographic characteristics. RESULTS: More than three quarters of the respondents said they would be willing to disclose to their medical care providers their sexual orientation if asked. However, only 5.7% of the respondents said that medical care providers ever asked them about their sexual orientation. About 8.0% of the LGB people surveyed reported having experienced negative treatment in medical care settings. Six percent (5.7%) of the Chinese LGB people said in accessing mental health care services, they were recommended, coaxed into, or provided conversion therapy for sexual orientation, gender identity or gender expression. CONCLUSIONS: There is a strong need to enhance LGB cultural competence among health care providers. Policymakers in China should also formulate laws, policies, regulations, clearly articulated codes of conduct, and transparent procedures and practices to ensure non-discrimination of LGB people in the health care system, with a particular focus on banning conversion therapy.

Filial piety, internalized homonegativity, and depressive symptoms among Taiwanese gay and bisexual men: A mediation analysis.

A theme emerging from the current literature is that Chinese gay and bisexual men are likely to struggle to accept themselves because of the cultural emphasis on filial piety. However, our understanding of this culturally particular process remains partial because most research has operationalized filial piety as either a component of Chinese values or an aggregate construct itself. To pinpoint this mechanism, this study deconstructed filial piety into pragmatic obligations and compassionate reverence to test a mediation model in which internalized homonegativity served as a mediator between filial piety and depressive symptoms among Taiwanese gay and bisexual men. With the aid of Facebook advertisements, a total of 1,381 respondents (Mean age = 26.56, SD = 6) were recruited to complete a web-based survey comprising the Contemporary Filial Piety Scale, the Chinese Internalized Homophobia Scale, and the Patient Health Quesionanire-9. Structural equation modeling was performed to test the mediation paths. Results showed that pragmatic obligations are directly and negatively associated with depressive symptoms without yielding significant correlation with internalized homonegativity. A full mediation path was found in that compassionate reverence is positively correlated with internalized homonegativity and in turn associated with higher depressive symptoms. Whereas filial piety still assumes salience among Taiwanese gay and bisexual men, this study provides novel evidence for the intricate effect of the value of filial piety on Taiwanese gay and bisexual men's self-acceptance and mental health. The results highlight the importance of a relational and cultural focus to address mental health disparities among sexual minorities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Mental Health of Transgender People in Hong Kong: A Community-Driven, Large-Scale Quantitative Study Documenting Demographics and Correlates of Quality of Life and Suicidality.

A community-driven survey of 106 transgender people (the first such survey in Hong Kong) showed that: (1) more than half the sample (50.9%) had a university degree or higher qualification; (2) despite this, 43.4% had a monthly income below HK$6,000 (about USD$775); (3) 66% reported "fair" or "poor" quality of life; (4) 67% of the sample (87.1% of respondents aged 15-24 years) had contemplated suicide; and (5) 20.8% of the sample (35.5% of respondents aged 15-24 years) had attempted suicide. It was found that (1) those who were single, had a lower monthly income, and identified as transgender women reported lower quality of life; and (2) those who were younger and on a lower income expressed higher suicidality. The findings suggest that service providers and policy makers urgently need to address the mental health needs of transgender people, particular younger transgender people.