A Qualitative Analysis of Shared Values and Motivation for Change Expressed by Sexual Minority Men in Relationships: Use of the Personal Values Card Sort Activity During Motivational Interviewing Sessions Addressing Drug Use and Sexual Health.

The development of tailored interventions that address drug use and sexual risk taking among sexual minority men (SMM) in relationships has garnered increasing interest over the past 20 years. Motivational interviewing (MI) has demonstrated promise in both individual and couples-based applications. The Personal Values Card Sort activity is commonly employed in these interventions; however, relatively little is known about the content of client responses evoked by this intervention task. This study examined how SMM in relationships characterize their values; how their relationship partners influence value attainment; and how they situated drug use and sexual risk taking in the context of their values and primary relationships. A qualitative analysis of intervention transcripts from sessions with 47 SMM aged 18 to 34 was conducted. All respondents were HIV negative and indicated recent (past 30 days) drug use and sexual risk behavior. Participants' high priority values reflected a focus on clarifying personal identity and interpersonal relationships. Values manifested as realized, aspirational, or transformed. Participants described their partners as supporting goal attainment and as a companion with whom they cope with goal-related stressors. Consistent with interdependence theory, participants' responses indicated consideration of their partner and relationship when these aligned with and supported goal-attainment. Conversely, when partners were described as a barrier to realizing their values, participants characterized their relationship as being of lower quality. Implications of this content for the activation of motivation for health behavior are discussed with specific emphasis on applications with SMM in relationships.

Identity and Relationship-Based Discrimination, and Mental Health in a Sample of Sexual Minority Male Couples.

PURPOSE: The study explored the unique associations of individual identity-based discrimination and relationship-based discrimination with mental health among sexual minority male couples. It also examined whether couples' relationship functioning moderated associations between relationship-based discrimination, the experience of one's romantic relationship being devalued, and mental health outcomes. METHODS: Baseline dyadic data drawn from a clinical trial involving 70 couples (N= 140) were analyzed using Actor-Partner Interdependence Modeling. The sample consisted of sexual minority men, of which 54.3% identified as a person of color. Each partner completed the computerized survey independently. Data were collected using the Relationship Marginalization Scale, Dyadic Adjustment Scale, Generalized Anxiety Disorder-7, and Center for Epidemiologic Studies Depression Scale-Revised scales. RESULTS: Dyadic adjustment moderated (i.e., buffered against) the association between relationship-based discrimination and depressive symptoms. The effects appeared to follow an intra-individual pattern (B ACTOR = -0.06, p = .048 and B PARTNER = -0.07, p = .030) indicating the lack of evidence for crossover effects. The interaction terms predicting anxiety yielded non-significant results. CONCLUSIONS: The current research suggests that dyadic functioning buffers against the effects of stigma. These findings point to the potential utility of interventions to improve relationship functioning into interventions addressing stigma among partnered sexual minority men.

Relationships among illness representations and depressive symptom severity in predominantly African-American and Caribbean-American people with epilepsy.

Objective: Depression is the most common psychiatric comorbidity among people with epilepsy (PWE) and tends to be more prevalent among people of color (POC) and those with intractable seizures. However, the extent to which illness-related perceptions are associated with depressive symptom severity among POC with intractable seizures is unclear. Method: This cross-sectional study examined relationships among illness representations and self-rated depressive symptoms in 55 PWE (M Age = 41; 61.8% female) with intractable seizures (M seizures per month = 2) who identified as Black/African-American (52.7%), Black/Caribbean-American (27.3%), and/or Hispanic/Latino (21.8%). Epilepsy-related illness perceptions were assessed with the Illness Perception Questionnaire-Revised and depression was measured via the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Results: Nearly half of the sample (41.8%) scored above the NDDI-E depression cut-off. PWE endorsing more severe depressive symptoms indicated that their epilepsy had more negative consequences, was hard to comprehend, was insufficiently controlled by treatment, and had a negative emotional impact (p's ≤ 0.02). Controlling for sex, these four illness representations accounted for 48% of the variance in depression severity. Interestingly, participants with probable major depressive episodes were more likely to endorse several psychological causes of seizures compared to non-depressed PWE. Conclusions: Worse depression symptom severity was associated with negative illness perceptions and a tendency to attribute one's epilepsy to psychological causes. Future research is needed to understand how the relationship between negative illness perceptions and depression symptoms unfold over time and whether interventions aimed at modifying illness representations reduce psychological distress in diverse PWE.

Perceived Risk, Optimistic Bias, and United Action: A socio-ecological examination of COVID-19 prevention behaviors among sexual minority men.

Sexual minority men (SMM) disproportionately experience psychosocial risk factors and comorbid health concerns (e.g., HIV infection) that increase their vulnerability to COVID-19 infection and distress. The current study applied a socioecological approach to the Health Belief model to understand associations among perceived risk, optimistic bias (a perceived lower risk relative to similar others), united action (perceived community capacity for collective action) and COVID-19 behavioral prevention strategies among COVID-19-negative adult cisgender SMM. Participants (n = 859), recruited via a geo-location-based dating app in May 2020, completed an online survey. Results indicated significant interactions between perceived risk and optimistic bias on social distancing (B = -.03, p < .05), and between perceived risk and united action on number of preventive precautions (B = -.01, p < .01) and number of casual sex partners (B= -.20, p < .05). At low and average levels of perceived risk, socioecological constructs were positively associated with behavioral prevention strategies. At average levels of perceived risk and above, united action was negatively associated with number of casual sex partners, demonstrating evidence of the interaction between perception of interpersonal and community factors and perceptions of one's own risk. These findings may help to inform how to mobilize increased engagement in COVID-19 behavioral prevention strategies among cisgender SMM.

The experience of financial stress among emerging adult cancer survivors.

Objective: The experience of cancer-related financial stress was examined within the developmental context of emerging adulthood.Methodological approach: This study is a secondary analysis of data drawn from two samples of testicular or hematologic cancer survivors. In-depth interviews from 52 emerging adult (EA) cancer survivors, ages 18-29, were coded by combining thematic analysis with an abductive approach.Findings: Emergent themes included some common to most age groups, including worries about medical costs and availability of health insurance, as well as specific age-related concerns, such as fertility preservation. Financial stress appeared to interrupt developmental tasks of emerging adulthood, including completing an education, establishing independence, and managing relationships. Surprisingly, financial stress was experienced as a benefit for some participants.Conclusion: Financial stress affects EA cancer survivors in unique ways. To provide support, health professionals should consider survivors' developmental life stage to understand their financial stress, and ultimately, to improve quality of life.