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1.
South Med J ; 116(12): 923-929, 2023 12.
Article in English | MEDLINE | ID: mdl-38051164

ABSTRACT

OBJECTIVES: Lesbian, gay, and bisexual (LGB) individuals experience stressors distinctively tied to their sexual identities, such as externalized and internalized heterosexism and identity concealment, which are correlated with increased psychological distress, including depression. The present study examined the variance in depression scores resulting from heterosexism, LGB identity concealment, and minority sexual identities, after adjusting for race/ethnicity and interpersonal violence victimization experiences. METHODS: Participants were 277 LGB emerging adults 18 to 29 years old (mean 25.39, standard deviation 2.77; 46 lesbian women, 71 gay men) recruited from an online platform. RESULTS: Nearly 41% reported moderate to severe depression symptoms. A two-step hierarchical regression model examining the effect of sexual minority stressors, heterosexism, LGB identity concealment, and minority sexual identity on depression after controlling for childhood maltreatment and face-to-face intimate partner violence types was significant. Bisexual women (vs gay men), those with greater exposure to heterosexism, and those with a greater degree of identity concealment experienced significantly higher scores on depression. In addition, being a person of color (including identifying as Hispanic), exposure to childhood maltreatment, and experiencing psychological intimate partner violence significantly predicted increases in depression scores. CONCLUSIONS: Findings emphasize the importance of assessing minority stressors and taking them into account when providing clinical interventions to LGB individuals.


Subject(s)
Depression , Sexual and Gender Minorities , Male , Adult , Humans , Female , Adolescent , Young Adult , Depression/epidemiology , Depression/psychology , Bisexuality/psychology , Sexual Behavior , Ethnicity
2.
Child Abuse Negl ; 145: 106433, 2023 11.
Article in English | MEDLINE | ID: mdl-37660426

ABSTRACT

BACKGROUND: Exposure to minority stressors specific to LGBTQ+ individuals, such as heterosexism and cissexism (or cisheterosexism) is not covered under the traditional adverse childhood experiences framework. This is important because childhood identity-related abuse by a parent/caregiver can lead to mental health challenges in later life through the adoption of maladaptive coping mechanisms. OBJECTIVE: The present study aimed to examine the role of cisheterosexism and expressive suppression as serial mediators in the associations between identity-related abuse and depressive symptoms and suicide behavior. PARTICIPANTS AND SETTING: Participants included 563 LGBTQ+ identifying adults between 18 and 64 years (M = 30.02, SD = 9.05) from different regions of Spain and were recruited through social media (e.g., Twitter, Facebook, and Instagram). METHOD: A serial mediation model was conducted with cisheterosexism and expressive suppression as the mediators in the associations between LGBTQ+ identity-related childhood abuse and depressive symptoms and suicide behavior. RESULTS: Findings indicated a positive indirect effect of identity-related abuse on depressive symptoms through cumulative cisheterosexism (B = 0.628, p < .01), and via cumulative cisheterosexism and suppression (B = 0.146, p < .05). No significant indirect effect was found for identity-related abuse on depressive symptoms via suppression (B = 0.086). An indirect effect was found for identity-related abuse on suicide behavior via cumulative cisheterosexism (B = 0.250, p < .01). CONCLUSIONS: Findings reveal that LGBTQ+ identity-related cisheterosexist experiences perpetrated by parents or caregivers are associated with harmful, long-term impacts on symptoms of depression and suicide behavior via experiences of cisheterosexism and expressive suppression.


Subject(s)
Adverse Childhood Experiences , Sexual and Gender Minorities , Adult , Humans , Child , Depression/epidemiology , Adaptation, Psychological , Suicidal Ideation
3.
J Interpers Violence ; 38(19-20): 10514-10541, 2023 10.
Article in English | MEDLINE | ID: mdl-37222535

ABSTRACT

Sexual violence among college students is an enduring issue that can shape adverse outcomes for victim survivors. The gender dynamics of college sexual assault and rape include rates of women overrepresented as victims and men as perpetrators. Dominant cultural frames reinforcing the (hetero)normative gendered sexual scripts of masculinity often preclude men from being considered as legitimate victims of sexual violence, despite evidence documenting their victimization. The present study contributes to knowledge of men's experiences of sexual violence by sharing the narratives of 29 college men survivors and how they make sense of their experiences. Through open and focused thematic qualitative coding, findings revealed how men struggled to understand their victimization experiences within cultural frameworks that exclude men as victims. Participants engaged in complex linguistic processes (i.e., "epiphanies") to process their unwanted sexual encounter, in addition to altering their sexual behavior after experiencing sexual violence. Findings can inform programing and interventions to be more inclusive of supporting men as victims.


Subject(s)
Crime Victims , Rape , Sex Offenses , Male , Humans , Female , Men , Sexual Behavior
4.
J Homosex ; 70(10): 2253-2275, 2023 Aug 24.
Article in English | MEDLINE | ID: mdl-35452368

ABSTRACT

In the absence of adequate measurement efforts, expansive gender and sexual identities will remain underexplored in quantitative social science and health research. We use primary survey data (N = 309) to identify factors associated with U.S.based social and health science faculty's attitudes toward inclusive gender and sexuality measures in participant-based research. Results suggest that political science faculty rated expansive gender and sexuality measures as less important to their own research, relative to psychology, sociology, and health sciences faculty. In addition, cisgender/heterosexual women and LGBTQ+ identifying faculty rate and apply these measures more positively compared to faculy who identify as cisgender/heterosexual men. Finally, faculty engaging in predominantly quantitative research, or in teaching-focused positions, had lower ratings of the importance of gender expansive measurement. Results suggest that while individual characteristics shape faculty's attitudes toward and use of inclusive gender and sexuality measures, disciplinary and academic contexts also matter.


Subject(s)
Sexual and Gender Minorities , Male , Humans , Female , Attitude , Faculty , Sexuality , Surveys and Questionnaires
5.
Sex Res Social Policy ; 20(2): 751-765, 2023.
Article in English | MEDLINE | ID: mdl-35465237

ABSTRACT

Introduction: Lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) people have historically been at the center of contentious political debates in the United States. The pandemic's divisive politicization has created societal stress in both hindering mitigation efforts and exacerbating social marginalization. Research has examined relatively privileged groups' COVID beliefs; however, explorations are needed into ideological processes among those marginalized by COVID, such as LGBTQ+ people, to provide a holistic framework of queer politics. Methods: Data come from in-depth interviews conducted with 43 LGBTQ+ people collected between October 2020 and January 2021. Purposive sampling was used to recruit participants from a larger survey on pandemic experiences. Results: Through the "underdog" framework," LGBTQ+ people held strong convictions to science-informed political beliefs, which informed their critiques of inadequate government leadership. Participants also engaged in ideological resistance to harmful individualistic rhetoric through an emphasis on collectivism. The divisive politicization of the pandemic shaped numerous social stressors that LGBTQ+ people adapted to using various strategies to maintain their mental health. Conclusions: Participants viewed American individualism and Christian nationalism as a public health threat that led to resistance to health and safety measures putting other people at risk. Findings support the underdog theory, with LGBTQ+ people elevating evidence-based science and disadvantaged groups' wellbeing by emphasizing social empathy as a collective good that supports community health. Policy Implications: Findings can inform policies and community programming that promotes equity across all social identities through the depoliticization of public health and centering LGBTQ+ people's capacity for resistance and resilience.

6.
South Med J ; 115(10): 752-759, 2022 10.
Article in English | MEDLINE | ID: mdl-36191911

ABSTRACT

OBJECTIVES: In this study, we explore the role of Coronavirus Disease 2019 pandemic-related stress, social support, and health on unmet healthcare needs during the Coronavirus Disease 2019 pandemic, particularly among lesbian, gay, bisexual, transgender, and queer plus (LGBTQ+) adults. METHODS: We collected data using a self-administered online survey of US adults. Using logistic regression, we modeled potential risk and protective factors for not receiving needed care during the pandemic (forgone care) among LGBTQ+ individuals (n = 121), cisgender and heterosexual-identifying women (n = 235), and cisgender and heterosexual-identifying men (n = 62). Limiting analyses to the LGBTQ+ subsample, we also assessed the unique role of LGBTQ+ discrimination and depressive symptoms. RESULTS: Logistic regression results suggested that social support was associated with lower odds of forgone care (odds ratio [OR] 0.95, P < 0.01). Furthermore, better self-rated health and higher levels of income were associated with lower odds of forgone care (OR 0.56, P < 0.001, and OR 0.92, P < 0.05, respectively). Finally, LGBTQ+ individuals experienced uniquely high levels of forgone care, and LGBTQ+ discrimination (OR 1.03, P < 0.05) and depressive symptoms (OR 1.09, P < 0.01) were associated with higher odds of forgone care among LGBTQ+ participants. CONCLUSIONS: Future research should examine the unique factors shaping the access to health care of LGBTQ+ adults in the United States, and healthcare practitioners should consider strategies to screen for discrimination and leverage the protective benefits of social support.


Subject(s)
COVID-19 , Sexual and Gender Minorities , Adult , COVID-19/epidemiology , Female , Gender Identity , Humans , Male , Pandemics , Social Support , United States/epidemiology
7.
J Interpers Violence ; 37(5-6): NP3293-NP3319, 2022 03.
Article in English | MEDLINE | ID: mdl-32779508

ABSTRACT

Intersecting sources of stigma influence harmful mental health outcomes for lesbian, gay, bisexual, transgender, queer, and Two-Spirit (LGBTQ2S+) young adults (YA) of color as they must manage multiple oppressions. Experiencing both mental health challenges and victimization, LGBTQ2S+ YA of color struggle with distinctive psychological traumas. There is a critical need to determine how certain groups of LGBTQ2S+ YA of color's marginalized social statuses shape trauma understandings. Native LGBTQ2S+ people in general endure diverse forms of oppression and trauma, such as histories of colonialism, contemporary racism, sexism, homophobia, and classism. Understanding the subjective interpretations of violence and trauma among Native LGBTQ2S+ YA is needed to best meet their mental health needs. Through in-depth interviews with 13 Native LGBTQ2S+ YA between 18 and 24 years old, this study delineates processes of how an underrepresented, underserved group of rurally embedded YA conceptualize violent and traumatic life experiences within the context of their mental health. First, participants described their traumatic experiences as shaping persistent harmful mental health outcomes throughout their lives. Second, YA conceptualized trauma as pivotal moments that were profound and influential in their significance as a turning point in their lives. Finally, YA underscored multiple traumas as cumulative and complex in how they interacted to create distinctively harmful mental health challenges. Expansive conceptualizations of trauma can better inform understandings of trauma etiology and promote inclusive health services.


Subject(s)
Homosexuality, Female , Sexual and Gender Minorities , Transgender Persons , Transsexualism , Adolescent , Adult , Bisexuality , Female , Humans , Young Adult
8.
Arch Sex Behav ; 50(7): 3065-3077, 2021 10.
Article in English | MEDLINE | ID: mdl-34647236

ABSTRACT

Health disparities persist for lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+)-identified people, often shaped by minority stress through anti-LGBTQ+ stigma. Resilience and coping are important for LGBTQ+ people widely, especially through social supports, but further examination is needed into more diverse, expansive mental health assets. Companion animals, or pets, have significant positive mental health benefits in the general population, but more understanding is needed to validate LGBTQ+ people's lived experiences of minority stress, mental health challenges, and pet-based sources of resilience. We employ the minority resilience framework to ask: What role do pets play in how LGBTQ+ people navigate and cope with stress? This U.S.-based study centers the voices of 45 LGBTQ+ people's qualitative interview narratives characterizing the diverse coping and resilience-building processes they develop through pet relationships. Findings demonstrate diverse processes surrounding pets as contributing to resilience, as participants emphasized the unique beneficial emotional connections pets provided. Second, pet family members were conceptualized as vital sources of support that promoted thriving. Finally, pet relationships fostered happiness and life enjoyment that augmented participants' life satisfaction. This study delineates more diverse understandings of how LGBTQ+ people manage stress through their pet relationships, which can provide vital information to service providers and policymakers in more holistically attending to marginalized communities' health needs.


Subject(s)
Sexual and Gender Minorities , Transgender Persons , Adaptation, Psychological , Bisexuality , Female , Humans , Mental Health
9.
J Eat Disord ; 9(1): 115, 2021 Sep 16.
Article in English | MEDLINE | ID: mdl-34530927

ABSTRACT

BACKGROUND: In this study, we further explore the role of COVID-19 pandemic-related stress, social support, and resilience on self-reported eating disorder symptoms (using the EDE-QS) and perceived weight gain among lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+ adults) in the US context during the COVID-19 pandemic. METHODS: Employing a convergent mixed method design, we surveyed 411 individuals, and conducted qualitative semi-structured follow-up interviews with 43 LGBTQ+ -identifying survey respondents. Using OLS regression and multinomial logistic regression, we modeled eating disorder symptoms and perceived weight gain among LGBTQ+ individuals (n = 120) and cisgender and heterosexual-identifying women (n = 230), to cisgender and heterosexual-identifying men (n = 61). We also explored complementary interview narratives among LGBTQ+ people by employing selective coding strategies. RESULTS: Study results suggest that LGBTQ+ individuals are likely experiencing uniquely high levels of pandemic-related stress, and secondly, that pandemic-related stress is associated with elevated eating disorder symptoms and higher risk of perceived weight gain. Nearly 1 in 3 participants reported eating disorder symptoms of potentially clinical significance. Social support, but not resilient coping, was found to be protective against increased eating disorder symptoms. Qualitative analyses revealed that LGBTQ+ individuals situated physical exercise constraints, challenging eating patterns, and weight concerns within their pandemic experiences. CONCLUSIONS: Clinicians of diverse specialties should screen for eating disorder symptoms and actively engage patients in conversations about their COVID-19-related weight gain and eating behaviors, particularly with LGBTQ+ -identifying adults.


The COVID-19 pandemic has uniquely shaped the mental health of individuals globally. Adults, particularly those identifying as lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+), may be at risk of engaging in disordered eating behaviors (eating disorder symptoms) due to pandemic-related stress. This study explores correlates of eating disorder symptoms and perceived weight gain among adults during the COVID-19 pandemic. We surveyed 411 US-residents, and engaged in follow-up semi-structured interviews with 43 LGBTQ+ -identifying survey respondents to better establish the unique pandemic-related experiences and mental health challenges of LGBTQ+ adults. We quantitatively found that LGBTQ+ individuals experienced uniquely high levels of pandemic-related stress, and secondly, that pandemic-related stress was associated with increased eating disorder symptoms and perceived weight gain. Qualitative narratives complemented quantative findings and suggested that eating concerns, physical exercise constraints, and weight concerns were important to LGBTQ+ people's perceived health challenges during the pandemic. These findings highlight the need to screen for any persistent eating disorder symptoms or weight concerns, particularly among LGBTQ+ adults.

10.
J Interpers Violence ; 36(9-10): NP4768-NP4787, 2021 05.
Article in English | MEDLINE | ID: mdl-30141722

ABSTRACT

Though rates of bullying among general population youth are high, there is elevated prevalence among certain subgroups, in particular sexual minority homeless youth. Enduring bullying can have devastating consequences, including poor mental health, revictimization, and substance abuse. The current study compares risk factors (i.e., sexual orientation, gender, and child abuse) for being bullied both at school and on the street among homeless youth. We also examine the associations of both contexts of bullying (i.e., at school and on the street) with physical and sexual victimization while on the street, with illicit drug use. From July 2014 to October 2015, we interviewed 150 homeless youth aged 16 to 22 years in shelters and on the streets from two Midwestern cities. Our sample was 51% female and 22% identified as lesbian, gay, or bisexual (LGB). Results revealed that LGB youth experienced more frequent bullying at school and were more likely to have ever used one or more illicit drugs at least a few times compared with heterosexual youth. Moreover, youth who experienced more child abuse prior to leaving home were also victimized more often at school (school bullying) and on the street (street bullying). Young people who experienced more sexual and physical street victimization were more likely to report illicit drug use compared with those who had fewer street victimization experiences. Overall, youth who experience victimization in one context (i.e., home) are at heightened risk for being bullied in additional contexts (i.e., school). These findings have important policy and service intervention implications, such that service providers should attend to homeless youth's multiple social contexts of victimization and the potential for youth's illicit drug use as a coping mechanism.


Subject(s)
Bullying , Crime Victims , Homeless Youth , Adolescent , Child , Female , Humans , Male , Risk Factors , Schools
11.
J Homosex ; 68(2): 269-289, 2021 Jan 28.
Article in English | MEDLINE | ID: mdl-31411539

ABSTRACT

This study examines how social support and perceived discrimination influence depressive symptoms of sexual minorities (including, lesbian, gay, bisexual-identifying individuals, and others with same-sex sexual partners) relative to heterosexual peers, while considering the role of HIV-positive status. We surveyed low-income, predominantly Hispanic/Latino/as residents receiving STI-testing and/or HIV/AIDS care in the lower Rio Grande Valley of southernmost Texas. Respondents aged 18+ took a self-administered survey in English or Spanish in a clinic waiting room (N= 273). Based on OLS regression, HIV-positive status (OLS coefficient = 2.54, p< .01) and social support (OLS coefficient = -0.17, p< .001) were significant predictors of depressive symptoms among sexual minorities, but not those who identified as heterosexual. Perceived discrimination was uniquely associated with increased depressive symptoms among sexual minorities (interaction coefficient = 0.21, p< .05). Clinicians treating sexual minority patients for depression should consider developing and applying resources tailored to individuals' level of social support and ongoing experiences of social discrimination.


Subject(s)
Depression/etiology , HIV Infections/psychology , Homophobia , Sexual and Gender Minorities/psychology , Social Support , Adolescent , Adult , Bisexuality/psychology , Depression/ethnology , Female , Friends , Heterosexuality/psychology , Hispanic or Latino , Homosexuality, Female/psychology , Humans , Longitudinal Studies , Male , Mental Health , Middle Aged , Sexual Behavior/psychology , Texas , Young Adult
12.
Youth Soc ; 52(2): 272-287, 2020 Mar 01.
Article in English | MEDLINE | ID: mdl-34305191

ABSTRACT

We used a life stress framework to examine linkages between distal or primary stressors (e.g., child abuse) and proximal or secondary stressors (e.g., street victimization) and their association with substance use among 150 youth experiencing homelessness in the Midwestern United States. Results revealed that numerous primary stressors such as number of times youth ran from home and number of foster care placements were associated with secondary stressors, such as anxiety, total duration of homelessness, and street victimization. Only street physical victimization (e.g., been beaten up since leaving home) was associated with greater substance use. Our findings provide a more holistic picture of both distal and proximal life stressors that these young people experience and reveal the complexity of issues that service providers must acknowledge when working with this population.

13.
Child Abuse Negl ; 89: 99-110, 2019 03.
Article in English | MEDLINE | ID: mdl-30654290

ABSTRACT

BACKGROUND: Childhood abuse and neglect (CAN) and intimate partner violence victimization (IPV) is prevalent among lesbian, gay, and bisexual individuals (LGB). Identification of distinct patterns of childhood and adult victimization, including technology-mediated and face-to-face IPV, and their cumulative relations to mental/behavioral health challenges, among LGB people is needed to facilitate identification of at-risk individuals. OBJECTIVE: Using latent class analysis, we first sought to identify patterns of lifetime interpersonal victimization, primarily five types of CAN and IPV in LGB emerging adults. Second, we examined if LGB-status and race/ethnicity predicted class-membership; third, we assessed differences between the latent classes on emotion dysregulation, depressive and anxiety symptoms, and alcohol use. PARTICIPANTS: Participants were 288 LGB adults between 18-29 years (M = 25.35, SD = 2.76; 41.7% gay/lesbian) recruited via Amazon MTurk. METHODS AND RESULTS: The 3-step LCA identified five-latent classes: high victimization, childhood emotional abuse and neglect, cybervictimization, adult face-to-face IPV, and lower victimization. People of color (including Hispanics) were more likely to be in the high victimization class, and bisexual individuals, especially bisexual women, in the childhood emotional abuse and neglect class. High victimization and childhood emotional abuse and neglect classes had elevated emotion dysregulation levels and depression and anxiety symptoms, and the high victimization class reported the highest levels of alcohol use. CONCLUSION: Findings suggest a detrimental effect of cumulative interpersonal victimization on emotion dysregulation and the mental/behavioral health of LGB emerging adults, with bisexuals and LGB-people of color at heightened risk of cumulative victimization and of related mental/behavioral health challenges.


Subject(s)
Adult Survivors of Child Abuse/psychology , Child Abuse/psychology , Emotions/physiology , Intimate Partner Violence/psychology , Mental Disorders/psychology , Sexuality/psychology , Adult , Bisexuality/psychology , Bullying/psychology , Child , Crime Victims/psychology , Depressive Disorder/psychology , Ethnicity , Female , Hispanic or Latino/statistics & numerical data , Homosexuality, Female/psychology , Humans , Male , Mental Health , Prevalence , Retrospective Studies , Sexual and Gender Minorities/psychology , Young Adult
14.
J Gay Lesbian Ment Health ; 23(2): 221-243, 2019.
Article in English | MEDLINE | ID: mdl-33897935

ABSTRACT

Sexual minority youth are often described as at-risk for mental health comorbidities, including disordered eating behavior (DEB) and depression. This study assesses differences in late-adolescent DEB and depressive symptoms among gay/lesbian, bisexual, or mostly-heterosexual individuals, and how their symptoms change across early-adulthood. While sexual minority youth were more likely to report DEB and elevated depressive symptoms in late-adolescence relative to exclusively heterosexual peers, gay/lesbian individuals experienced improvement in early-adulthood depressive symptoms. Conversely, bisexual individuals maintained elevated depressive symptoms into early-adulthood, and additional depressive symptoms associated with DEB. DEB may be a unique risk-factor shaping the mental health of bisexual youth.

15.
J Soc Distress Homeless ; 28(2): 115-122, 2019.
Article in English | MEDLINE | ID: mdl-34556970

ABSTRACT

This study examines child physical abuse, social and psychological resources, and street physical victimization among 150 homeless youth from the Midwest. Path analyses results show that males have higher self-efficacy than females, while older youth and those who experienced less child physical abuse reported higher self-esteem. Self-efficacy and self-esteem were positively associated with social support as was being younger and having experienced less child physical abuse. Younger respondents reported fewer difficulties obtaining basic necessities, and those who had less trouble finding these necessities experienced less street physical victimization. Females, younger youth, and those who experienced less child physical abuse reported lower rates of physical victimization. Agencies should be aware that many youth experiencing homelessness have trouble obtaining basic necessities, which increases risk for victimization. Moreover, the ability to obtain necessities appears to override the influential role of social support, further affirming the foundational importance of agencies helping youth meet their basic needs.

16.
Cult Health Sex ; 21(1): 16-30, 2019 01.
Article in English | MEDLINE | ID: mdl-29558249

ABSTRACT

Lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ+) young people of colour are exposed to intersecting dynamics of social prejudice and discrimination related to sexuality and gender as well as race/ethnicity. In particular, Latinx-identifying LGBTQ+ young people face unique challenges in their lives, due to cultural stressors that stigmatise expansive gender and sexual identities. While it is crucial to examine the effects of multiple stressors on the well-being of LGBTQ+ young people of colour, this risk-based focus can overshadow the resilient capacities of multiply marginalised groups. Guided by an intersectional minority stress resilience framework, we asked: how do self-identified LGBTQ+ Latinx young adults manage cultural messages of prejudice and discrimination in relation to their health? Findings underscore how LGBTQ+ Latinx young adults established a strong sense of health autonomy to resist cultural stigma related to their intersecting identities. Young people actively educated themselves on health-related concerns, engaged in health-promoting tactics, and practised cultural negativity management to effectively navigate exposure to prejudice and discrimination.


Subject(s)
Prejudice/psychology , Sexual and Gender Minorities/psychology , Sexuality/psychology , Social Discrimination , Social Stigma , Female , Humans , Male , Self Concept , Young Adult
17.
J Community Health ; 44(1): 127-136, 2019 02.
Article in English | MEDLINE | ID: mdl-30094723

ABSTRACT

U.S.-Mexico border communities are uniquely vulnerable to sexually transmitted infection (STI) transmission given the economic and social challenges these communities face. This study examines how marginalized statuses of U.S. border residents are associated with STI awareness and sexual behaviors. We surveyed low-income residents receiving STI testing and/or HIV/AIDS care in the lower Rio Grande Valley of southernmost Texas. Respondents aged 18+ took a self-administered survey available in English or Spanish in a clinic waiting room (N = 282). Approximately 52% of respondents reported being HIV+, and 32% of respondents reported having a prior STI other than HIV. Although most respondents had heard of HPV (72%), awareness of the HPV vaccine was low across all subgroups (28%), including women (< 35%), reflecting previous findings that border residents are less knowledgeable about the HPV vaccine. Almost half of respondents reported always using a condom (45%), which is higher than elsewhere in the U.S. Male and non-Hispanic respondents had higher estimated prevalence ratios (PR) of lifetime partners [PR 1.39 (95% confidence interval 1.43-3.68), PR 1.88 (1.04-3.41), respectively] and sexual partners met online [PR 3.73 (1.00-14.06), PR 19.98 (5.70-70.10), respectively]. Sexual minority, non-Hispanic, and male respondents had higher adjusted odds ratios (AOR) of utilizing the internet to find sexual partners than their peers [AOR 2.45 (1.60-3.87), AOR 1.52 (1.11-2.07), AOR 1.97 (1.20-3.24), respectively], placing them at greater STI-transmission risk. We found diversity in dimensions of STI awareness and sexual behaviors in our sample. Results can help tailor public health interventions to the unique STI risks of marginalized groups in border communities.


Subject(s)
Hispanic or Latino/statistics & numerical data , Poverty/statistics & numerical data , Sexually Transmitted Diseases/epidemiology , Social Determinants of Health/statistics & numerical data , Adolescent , Adult , Female , HIV Infections/prevention & control , Health Knowledge, Attitudes, Practice , Humans , Male , Mexico , Sexual Behavior/statistics & numerical data , Sexual Partners , Texas , Young Adult
18.
J Womens Health (Larchmt) ; 27(11): 1389-1399, 2018 11.
Article in English | MEDLINE | ID: mdl-29963940

ABSTRACT

BACKGROUND: There is a well-documented link between eating disorders (EDs) and adverse health outcomes, including fertility difficulties. These findings stem largely from clinical data or samples using a clinical measure (e.g., diagnosis) of EDs, which may limit our understanding of how EDs or disordered eating behaviors (DEBs) shape female fertility. METHODS: We compared reproductive outcomes from two longitudinal data sources, clinical and population-based data from the Utah Population Database (UPDB) (N = 6,046), and nonclinical community-based data from the National Longitudinal Study of Adolescent to Young Adult Health (Add Health) (N = 5,951). We examined age at first birth using Cox regression and parity using negative binomial regression. RESULTS: Using the UPDB data, women with diagnosed ED experienced later ages of first birth (hazard rate ratio [HRR] = 0.38; p < 0.01) and lower parity (incidence rate ratio [IRR] = 0.38; p < 0.01) relative to women without EDs. Using the Add Health sample, women who self-reported DEB experienced earlier age of first birth (HRR = 1.16; p < 0.05) and higher parity (IRR = 1.17; p < 0.01) relative to women without DEB. CONCLUSIONS: Conflicting results suggest two sets of mechanisms, physical/biological (sex specific) and social/behavioral (gender specific), may be simultaneously shaping the reproductive outcomes of women with histories of EDs or DEB. Discipline-specific methodology likely shapes Women's Health research outcomes.


Subject(s)
Feeding Behavior , Feeding and Eating Disorders , Fertility , Parity , Reproductive Health/statistics & numerical data , Adolescent , Adult , Feeding Behavior/physiology , Feeding Behavior/psychology , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/psychology , Female , Humans , Longitudinal Studies , Pregnancy , Pregnancy Outcome/epidemiology , Reproduction , Reproductive History , Utah/epidemiology
19.
J Trauma Dissociation ; 19(4): 431-443, 2018.
Article in English | MEDLINE | ID: mdl-29601290

ABSTRACT

Numerous homeless youth experience trauma prior to leaving home and while on the street. Bullying and trading sex (i.e. exchanging sexual favors for survival items such as food) are additional forms of trauma experienced by many homeless youth. Although lesbian, gay, and bisexual (LGB) homeless youth experience higher rates of child abuse compared to their heterosexual counterparts, there is a paucity of research comparing these two groups. As such, we compare whether difficulties finding items of necessity (e.g. food) and different forms of trauma including child sexual abuse, being bullied, trading sex, and street sexual victimization significantly differ for LGB and heterosexual homeless youth. Bivariate results reveal that LGB youth have more trouble finding shelter and are more likely to trade sex compared to heterosexual youth. Logistic regression results show that trading sex is correlated with street sexual victimization. In the second model, we find that being female, experiencing more child sexual abuse, and ever having traded sex are all positively linked with street sexual victimization. LGB youth are over-represented among homeless youth populations and are also more likely to trade sex; therefore, these young people need services that are widely accessible and specific to their needs.


Subject(s)
Bullying , Child Abuse/psychology , Crime Victims/psychology , Homeless Youth/psychology , Sex Work/psychology , Sexuality/psychology , Adolescent , Female , Humans , Interviews as Topic , Male , Risk Factors , Young Adult
20.
J Res Adolesc ; 28(1): 199-210, 2018 03.
Article in English | MEDLINE | ID: mdl-29460358

ABSTRACT

We employ a social stress framework, which examines the influence of multiple stressors (e.g., physical abuse, foster care placement) on an individual's ability to function (e.g., mental well-being), to longitudinally examine the effects of stressful life events on mental health and the role of the social environment in this process among 150 homeless youth. Results revealed that numerous stressors, such as physical abuse and running away from home more frequently, were associated with greater depressive symptoms and elevated anxiety. Having mentors and family and friends from home that youth can rely on resulted in more positive social support, which subsequently lowered the risk for depressive symptoms and anxiety at wave 2.


Subject(s)
Anxiety/psychology , Depression/psychology , Homeless Youth/psychology , Mental Health/standards , Adolescent , Anxiety/epidemiology , Child, Foster/psychology , Depression/epidemiology , Female , Humans , Male , Mental Health/trends , Midwestern United States/epidemiology , Physical Abuse/psychology , Protective Factors , Risk Reduction Behavior , Sexual Behavior/psychology , Social Support , Stress, Psychological/epidemiology , Stress, Psychological/psychology , United States/epidemiology , Young Adult
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