"It's another gay disease": an intersectional qualitative approach contextualizing the lived experiences of young gay, bisexual, and other sexual minoritized men in the United States during the mpox outbreak.

BACKGROUND: The U.S. mpox outbreak in 2022 introduced new and exacerbated existing challenges that disproportionately stigmatize gay, bisexual, and other sexual minoritized men (GBSMM). This study contextualizes the perceptions, susceptibility, and lived experiences of the mpox outbreak among GBSMM in the U.S. using an intersectional framework. METHODS: Between September 2022 to February 2023, we conducted 33 semi-structured qualitative interviews with purposively sampled GBSMM in the Northeast and the South region of the United States on various aspects related to their experience during the mpox outbreak. RESULTS: We identified four themes: (1) understanding and conceptualizations of mpox, (2) mpox vaccine availability and accessibility, (3) mpox vaccine hesitancy and mistrust, and (4) call to action and recommendations. GBSMM collectively discussed the elevated mpox stigmatization and homophobic discourse from mainstream social media and news outlets. GBSMM also discussed the lack of availability of mpox vaccines, unclear procedures to receive the vaccine, and continued mistrust in government, non-government, and other institutions of health that were complicit in anti-LGBTQ + narratives related to mpox. However, they expressed that these challenges may be addressed through more LGTBQ + representation and leveraging ways to empower these communities. CONCLUSION: GBSMM have mpox experiences that are distinct and multifaceted. Effectively addressing mpox and mitigating public health emergencies for GBSMM requires prioritizing destigmatizing communication channels and vaccine distribution strategies by centering their stories and lived experiences to advance health equity.

LGBTQ+ Sociopolitical Engagement: Examining the Role of House Ball Community Involvement and LGBTQ+ Community Connection.

Recent events such as the Black Lives Matter movement, COVID-19, and political elections have highlighted the power of a socially and politically engaged society. One under-researched cultural pillar at the core of sociopolitical resistance for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people of color (POC) has been the House Ball Community, a dynamic subculture made up of intricate social networks. This study uses data collected for the Social Justice Sexuality Project (N = 246) to examine LGBTQ+ community connection and House Ball Community involvement as predictors of LGBTQ+ and intersectional LGBTQ+ sociopolitical engagement. Two continuous variables, community connection and sociopolitical engagement (consisting of separate scales about LGBTQ+ individuals and LGBTQ+ POC), were included in the analysis. Multivariate linear regression analyses were performed to examine the relationships between these variables. While community connection was significantly associated with both scales of sociopolitical engagement, House Ball involvement was only associated with intersectional LGBTQ+ sociopolitical engagement. Relative to community connection, House Ball involvement was more strongly associated with intersectional LGBTQ+ sociopolitical engagement. Findings suggest that House Ball involvement may influence behavior for LGBTQ+ POC. Authors discuss implications for intersectionality in social movements and culturally responsive direct, community, and systems-level social work practice within the current U.S. sociopolitical landscape.

Religious Identity Dissonance: Examining the Path of Religious Factors to Depression in Sexual Minority Men in the USA.

Little is known about the religious factors that contribute to religious identity dissonance (ID) for sexual minority men. Our aim was to model the path of religious factors to depression symptoms through ID and internalized stigma (IS). US sexual minority men (N = 168) participated in a survey about religious factors and mental health. Serial mediation of religious factors through ID and IS to depression symptoms was assessed using Hayes PROCESS macro. Results indicate that two religious factors significantly increase depression through ID and IS. Negative parental religious messages about LGBTQ people play a meaningful role in ID and increasing depression.

Young Men Who Have Sex With Men and Substance Use: A Comparison of Venue-Based Sampling and Geosocial Networking Application Sampling.

To compare the demographics, sexual risk behaviors, and substance use characteristics of two probability samples of young men who have sex with men (YMSM): one recruited using a geosocial networking application (GSNA) and one recruited using venues. In 2017 and 2018, a cross-sectional online survey was utilized with a sample of 122 YMSM recruited in Los Angeles, CA. Recruitment procedures included both venue-based (n = 68) and GSNA-based probability sampling (n = 54). Sample substance use, sexual risk behaviors (e.g., unprotected sex at last encounter), and demographics were compared using chi-square tests and t-tests. The samples significantly differed in demographics characteristics (e.g., race, education, employment, outness). Samples did not significantly differ in sexual risk variables. Regressions indicated significant differences (higher in the venue sample) in substance use (marijuana, prescription drugs, alcohol, and poppers) between the two samples. Results indicate that recruitment method impacts demographics and substance use prevalence levels for YMSM. GSNA- based recruitment appears to recruit samples from a broader range of social demographics. GSNA-based methods may be especially applicable to areas in which venues are not readily accessible (e.g., rural areas), allowing social research with the most marginalized sexual minority populations.

Minority stress and sleep: How do stress perception and anxiety symptoms act as mediators for sexual minority men?

OBJECTIVES: Sexual minority men experience worse sleep than heterosexuals. Little is known about how minority stress may account for these differences. Therefore, the aims of this study are to (1) understand the relationship between minority stress and sleep disturbance in a sample of sexual minority men, and (2) test whether these relationships are mediated by generalized anxiety symptoms and perception of stress. METHODS: In 2020, 239 sexual minority men were recruited to complete an online survey. Participants responded to scales assessing minority stress (ie, internalized homophobia, experiences of harassment, microaggressions), perception of stress, generalized anxiety symptoms, and sleep disturbance. Linear regressions were used to test the relationship between minority stress and sleep disturbance and to test generalized anxiety symptoms and perception of stress as mediators. RESULTS: The final model was significant (F = 16.916, p < .001) and accounted for 43.5% of the variance in sleep disturbance. Generalized anxiety symptoms and perception of stress fully mediated the relationships between minority stress and sleep disturbance. CONCLUSIONS: Findings from this study suggest the need for psychological intervention to improve sleep for sexual minority men. Future research should test this model longitudinally, and include objective measures of stress. Future interventions could target stress perception using mindfulness or cognitive-based interventions.

Sexual Assault and Behavioral Health: What Can We Learn From a Probability Sample of Young Sexual Minority Men?

BACKGROUND: Previous research indicates that young sexual minority men (YSMM) are at increased risk of experiencing sexual assault compared to their heterosexual peers. While this increased risk is documented in comparison studies, very little is known about the specific range of sexual assault experiences. The aim of this study was to investigate prevalence of sexual assault experiences and their association with depression and alcohol use for YSMM. METHODS: In 2017 and 2018, 124 YSMM (18-24 year-olds) were recruited to participate in an online study using probability-based sampling methods, in Los Angeles, CA. Participants answered items about lifetime and recent sexual assault experiences (i.e., unwanted touching, oral rape, penetrative rape), characteristics of the coercive behaviors, recent alcohol use, and depression. Analysis of variance (ANOVAs) and multiple linear regressions investigated the relationships between sexual assault experiences and behavioral health. RESULTS: The sample reported a range of lifetime sexual assault experiences: 70% unwanted touching and 28% penetrative rape. Fifty-five percent of the sample reported some type of recent sexual assault, with 17% reporting a recent penetrative rape. ANOVAs of the impact of different forms of sexual assault on behavior health indicated that unwanted touching was associated with higher depression and alcohol use. Further investigation of recent unwanted touching indicated that frequency is associated with depression and binge drinking. Of participants who reported experiences of unwanted touching, 61% reported it occurred while they were intoxicated. DISCUSSION: Findings support previous evidence of high rates of sexual assault among YSMM. Further, the majority of men who reported sexual assault indicated that it occurred while they were intoxicated, suggesting that unwanted touching is occurring while men are drinking alcohol, likely in bars. The culture of gay bars may encourage nonconsensual touching during intoxication and these experiences of sexual assault have consequences (i.e., higher levels of depression and alcohol use).

Depressive symptoms, childhood maltreatment, and allostatic load: The importance of sex differences.

OBJECTIVE: Roughly half the individuals who experience childhood maltreatment also experience depressive symptoms in adulthood; however, many current treatments are ineffective. Allostatic load (AL) offers a method of exploring this relationship through the lens of biometric dysregulation that may explain these increased odds for depressive symptoms in adulthood. We attempted to expand the limited research base on AL, depressive symptoms, and childhood maltreatment by examining how these variables are associated in a U.S. community sample. METHOD: Data were acquired through secondary analysis of the Midlife in the United States Refresher biomarker survey (n = 691). Depression severity, measured by the Center for Epidemiologic Studies Depression Scale, served as the dependent variable, while summed scores for the Childhood Trauma Questionnaire, and a 16 measure AL index served as independent variables. All analyses were stratified by sex (n male = 347, n female = 344). The Perceived Stress Scale was included to control for recent stress. An OLS regression was used to understand the relationship between depression and predictor variables before then being tested for the possible mediating role of AL. RESULTS: Comparison of OLS models yielded notable differences in predicting depressive symptoms between males and females, namely that while maltreatment was significant for both groups, AL was only significant for females. Mediation by allostatic load was not significant for males or females. CONCLUSION: We explored the possible mediation of childhood maltreatment and adulthood depressive symptoms by AL. While our study did not confirm mediation, this was the first known study to explore these relationships in a U.S., community sample. Sex stratification reveals a clear need for accounting for sex differences in predictor variables for future studies.

Religious Identity Dissonance: Understanding How Sexual Minority Adolescents Manage Antihomosexual Religious Messages.

Sexual minority adolescents from religious contexts may be at high risk of mental health issues due to religious identity dissonance. This study investigated the cognitive strategies used to manage antihomosexual religious messages and resolve religious identity dissonance among sexual minority adolescents. In 2014, 46 adolescents were interviewed in Los Angeles, CA. Youths were prompted to discuss experiences with religion, antihomosexual messages, and their strategies for managing these messages. Ninety-one percent of the sample reported hearing antihomosexual religious messages. Messages came from multiple sources (e.g., parents, pastors) and contained three types of content (i.e., creation, sin, and afterlife). A quarter of the sample reported religious identity dissonance. Three primary strategies to manage antihomosexual messages emerged. Findings indicate that all youths, including nonreligious youths, use cognitive strategies to manage negative messages and that these strategies relate to current religious identification.

Bullying Victimization Trajectories for Sexual Minority Adolescents: Stable Victims, Desisters, and Late-Onset Victims.

Sexual minority adolescents are bullied more frequently than heterosexual peers. Research is lacking on their rates of general and sexual orientation bullying victimization. The present study identified (1) the rate, onset, and desistance of general and sexual orientation bullying victimization, (2) the rate of bullying victimization trajectories, and (3) risk and protective factors across trajectories. A life history calendar method and thematic analysis were employed with a sexual minority adolescent sample (N = 52, 14-20 y/o). General bullying began at age 5 and declined after age 12, with sexual orientation bullying increasing throughout adolescence. Late-onset victim (34.6%) was the most common trajectory, followed by stable victim (28.9%), desister (23.1%), and nonvictim (13.5%). Differences in risk and protective factors were found across trajectories.

A developmentally informed adaptation of minority stress for sexual minority adolescents.

Sexual minority adolescents (lesbian, gay, bisexual) experience disparities in behavioral health outcomes compared to their heterosexual peers, generally attributed to minority stress. Although evidence of the applicability of the minority stress model among adolescents exists, it is based on a primarily adult literature. Developmental and generational differences demand further examination of minority stress to confirm its applicability. Forty-eight life history interviews with sexual minority adolescents in California (age 14-19; M = 19.27 SD = 1.38; 39.6% cismale, 35.4% cisfemale, 25% other gender) were completed, recorded, transcribed, and analyzed using thematic analysis in QSR NVivo. Following a consensus model, all transcripts were double coded. Results suggest that minority stress is appropriate for use with adolescents; however, further emphasis should be placed on social context, coping resources, and developmental processes regarding identity development. A conceptual model is provided, as are implications for research and practice.

The Social Context of Depression Symptomology in Sexual Minority Male Youth: Determinants of Depression in a Sample of Grindr Users.

The purpose of this study was to understand which social context factors most influence depression symptomology among sexual minority male youth (SMMY). In 2011, 195 SMMY who use Grindr were recruited to complete an online survey in Los Angeles, California. Items focused on social context variables and depression symptomology. Hierarchical multiple regressions were conducted using an ecological framework. The best fitting model accounted for 29.5% of the variance in depression. Experiences of homophobia, gay community connection, presence of an objecting network member, and emotional support were found to be significant predictors. Past experiences of homophobia continuing to affect youth indicates the need for intervention to reduction of homophobia in youths' social contexts. Interventions that teach youth skills to manage objecting viewpoints or help youth to reorganize their social networks may help to reduce the impact of an objecting network alter.

Religious Conflict, Sexual Identity, and Suicidal Behaviors among LGBT Young Adults.

This is the first known study to explore how religious identity conflict impacts suicidal behaviors among lesbian, gay, bisexual, and transgender (LGBT) young adults and to test internalized homophobia as a mediator. A secondary analysis of 2,949 youth was conducted using a national dataset collected by OutProud in 2000. Three indicators of identity conflict and an internalized-homophobia scale (mediator), were included in logistic regressions with three different suicide variable outcomes. Internalized homophobia fully mediates one conflict indicator and partially mediates the other two indicators' relationship with suicidal thoughts. Internalized homophobia also fully mediates the relationship between one conflict indicator and chronic suicidal thoughts. Two indicators were associated with twice the odds of a suicide attempt. LGBT young adults who mature in religious contexts have higher odds of suicidal thoughts, and more specifically chronic suicidal thoughts, as well as suicide attempt compared to other LGBT young adults. Internalized homophobia only accounts for portions of this conflict.