A Review of Serious Gaming as an Intervention for HIV Prevention.

PURPOSEOF REVIEW: Young people face the highest number of new HIV infections globally. With today's increasing access to smartphones, serious games have been viewed as an effective means of improving knowledge and behavioral outcomes. This systematic review describes current HIV prevention serious games and their relationship with HIV-related knowledge and behavioral outcomes. RECENT FINDINGS: A search of HIV prevention serious games was conducted using PubMed, CINAL, IEEE, Web of Science, and Google Scholar. A total of 31 papers were identified, which consist of 20 studies and 11 protocols. Results for knowledge, attitudes, intentions, and behaviors were mixed. Two interventions reported improvement in PrEP usage and optimal dosing. Gaming appears to be a viable and engaging method to improve knowledge, attitudes, and behavioral outcomes to promote HIV prevention among diverse groups of adolescents and young adults globally. However, additional research is needed to understand how to implement this modality effectively.

How deep is the cut? The influence of daily microaggressions on bisexual women's health.

Bisexual women experience disproportionately poorer health outcomes in comparison to lesbian and gay groups, and the general population, including inequities related to mental and physical health. Although bisexual-specific health inequities are increasingly well-documented, research examining putative causes of such inequities, as well as research that accounts for differences within bisexual populations - particularly among racial minorities- remains limited. To address these gaps, this paper reports findings from the Women's Daily Experiences Study (WoDES), a multi-method study that explored the relationship between microaggressions and health outcomes among racially/ethnically diverse cisgender, bisexual women in Chicago. Data from 28-day daily e-diaries (N = 2,104 observations; 99 participants, 57% women of color) were analyzed using multilevel modeling to (1) measure the frequency of microaggressions among bisexual women; (2) examine the influence of sexual orientation, racial, and gender microaggressions on mental and physical health; and (3) investigate how race influences relationships between microaggressions and health. Participants reported an average of 8.1 microaggressions in the previous 28 days, and at least one microaggression was reported for more than 42% of days (n = 802). Microaggressions of any type were associated with increased same-day negative affect and somatic complaints. Latina bisexual women experienced worse health outcomes in comparison to Black bisexual women. This study demonstrated the detrimental impact of microaggressions on the health of bisexual women and highlights the critical need for strategies on broader structural changes that could improve the health and well-being of bisexual women.

Sexual minority status, school-based violence, and current tobacco use among youth.

INTRODUCTION: Sexual minority individuals experience elevated risk for smoking and violence due to a combination of general and unique identity-based risk factors. This study examined associations among sexual minority status, school-based violence, and tobacco use, among youth. METHODS: Data for this secondary data analysis consisted of Chicago-specific data from the 2019 Youth Risk Behavior Surveillance System (n=1562). Current use (≥1 day during the previous 30 days) of any tobacco product (cigarettes, e-cigarettes, smokeless tobacco, and cigars) and school-based violence (avoided school because they felt unsafe, were threatened/injured with a weapon, were in a physical fight, and were bullied) were estimated by sexual orientation (heterosexual vs gay, lesbian, bisexual, and unsure). A chi-squared test was used to investigate associations among the variables. Path analysis was employed to examine possible mediation effects of school-based violence. RESULTS: Thirty percent of sexual minority youth and 11.5% of heterosexual youth reported current tobacco use (χ2=55.91; p<0.001). Nearly one-third (31.8%) of youth reported school-based violence, with a higher rate (41.2%) reported by sexual minority youth compared to heterosexual youth (28.1%; χ2=19.48; p<0.001). Path analysis confirmed these associations, controlling for sex, age, and race/ethnicity. The model showed that sexual minority status increased odds of current tobacco use by a factor of 1.8 (95% CI: 1.3-2.6) via its relationship with school-based violence, explaining 33.8% of the total association between sexual minority status and tobacco use. CONCLUSIONS: Tobacco use was higher among sexual minority youth. School-based violence partially mediated the association between sexual minority status and tobacco use. Findings highlight the need for tobacco prevention and treatment efforts for sexual minority youth and school-based interventions to reduce exposure to violence.

Culturally Safe Nursing Care for Black Sex Workers in the Greater Chicago Area, 2020‒2021.

Complex structural and social factors have created health inequities for Black sex workers. Black people, including those engaged in transactional sex, report leaning on spiritual beliefs to guide health-related decision-making, including whether to get the COVID-19 vaccine. Public health nurses can improve the health of Black sex workers through culturally safe care, which may include a community-stated vision of spiritual support. (Am J Public Health. 2022;112(S3):S288-S291. https://doi.org/10.2105/AJPH.2022.306836).

Strategies to address structural and institutional barriers to success among students of color in nursing programs.

The COVID-19 pandemic and the significant disparities experienced by Black, Indigenous, and people of color (BIPOC) in infections, hospitalizations, and deaths associated with the Coronavirus have underscored the imperative to increase the size and diversity of the healthcare workforce, including nursing. Academically focused pipeline development programs have led to some advances in minority recruitment and retention; however, emerging research highlights the importance of extra-academic factors that reduce the sense of belonging and persistence among underrepresented and minority students. The purpose of this manuscript is to describe the diversity, equity, and inclusion goals and activities of a college of nursing located in a minority-serving institution. Here, we emphasize the description of a range of activities aimed at meeting our diversity goals. Further, we highlight the actions initiated in response to emergent "extra-academic" student needs over the past year related to the COVID-19 pandemic and police brutality. The strategies described have implications for improving diversity, equity, and inclusion among higher education institutions in nursing.

The Measurement of Female Early Adolescent Sexual Desire.

We used the developmental systems model to deduce a definition of female early adolescent sexual desire. We evaluated a measure of this phenomenon with a secondary analysis of data from a randomized group sexual health intervention trial involving low-income, English-speaking, seventh grade Latinas enrolled in a Miami-Dade County public school (n = 542). As part of this study, girls completed a four-item early adolescent sexual desire (EASD) measure. Study findings supported internal consistency (Cronbach's alpha = .81 to .82) and stability over a 1-month period (r = .74). Developmental sensitivity was supported by a decline in stability over 12- (r = .66) and 24-month periods (r = .56). Validity was supported by correlations with puberty changes, sexual intentions, sexting, and sexual behavior, and hypothesized mean differences associated with dating and preference for shoes culturally associated with female sexual attractiveness (p < .01). Research implications include validation work with other ethnic/racial groups and using the EASD as a starting point for a measurement continuum tracking development of sexual desire across adolescence and into adulthood. Directions for future research also include measuring the development of sexual desire in boys and transgendered youth across adolescence and into adulthood.

Bullying and suicide risk among sexual minority youth in the United States.

Bullying is associated with increased suicide risk and maladaptive development for sexual minority youth (SMY). The purpose of this study is to determine whether multiple forms of bullying mediate the relationship between biological sex and suicide risk among SMY and to determine whether sexual identity moderates these relationships (i.e., moderated mediation). Data from the 2015-2019 National Youth Risk Behavior Surveillance Survey was analyzed using multiple group structural equation modeling with the 5967 youth that self-identified as Lesbian/Gay, Bisexual, or Not sure of their sexual identity. All forms of bullying were associated with suicide risk. After controlling for bullying, Male SMY reported less suicide risk in comparison to female SMY. Female SMY were more likely to be cyberbullied while male SMY were more likely to be threatened or injured with a weapon. Sexual identity did not moderate these relationships. These finding align with the minority stress theory which posits the victimization experiences are linked to negative mental health outcomes among minority youth. Although sexual identity did not moderate these relationships, this study reveals new mechanistic pathways influencing sex-based suicide risk disparities among SMY. Findings can inform future research and the development of suicide prevention interventions that address the unique needs of SMY occurring at the intersection of sex and sexual identity.

Teen Dating Violence and Suicide Risk Among Bisexual Adolescents.

PURPOSE: Suicide is a public health problem that disproportionately affects bisexual youth more than heterosexual, lesbian/gay, and other sexual minority youth. Teen dating violence (TDV) consists of physically, emotionally, and/or psychologically aggressive behavior in adolescent relationships and has been linked to increased suicidality among sexual minority youth. Although biological sex differences in suicide and TDV have been noted, limited research currently exists regarding the importance of these differences in bisexual youth. METHODS: This study employed a cross-sectional descriptive design to investigate the relationship between biological sex, TDV, and suicide risk among bisexual youth in grades 9-12. This study used structural equation modeling to conduct a secondary analysis of pooled 2015 and 2017 national Youth Risk Behavior Surveillance Survey data that examined whether TDV mediated the relationship between biological sex and suicide risk among bisexual youth. RESULTS: Results indicated that TDV did not mediate the relationship between biological sex and suicide risk among bisexual youth. Biological sex was a significant predictor of suicide risk with male youth reporting lower suicide risk than female youth, when controlling for dating history, TDV, age, and race. TDV predicted suicide risk, with youth reporting TDV having higher suicide risk, when controlling for dating history, biological sex, age, and race. In addition, black and Hispanic youth reported lower suicide risk compared to white youth. CONCLUSION: There is a dire need for research that addresses issues of TDV and suicide among bisexual youth. Understanding factors influencing suicide risk following TDV experiences among bisexual youth will inform interventions to mitigate negative mental health outcomes.

Parent Communication and Bullying Among Hispanic Adolescent Girls.

In this article, we report findings regarding parent communication and daughter's experiences of bullying and victimization in a sample of Hispanic families with seventh-grade daughters. About 57% of daughters reported experiencing any form of victimization and 37% reported engaging in some type of bullying behavior. Overall, the most common type of victimization reported was verbal/emotional bullying (36%). Nearly all parents agreed they had spoken with their daughters about the dangers of bullying perpetration (95%) and how to handle being victimized (96%), but there was no association between the frequency with which parents spoke with their daughters about bullying perpetration and their child's victimization experiences. Additionally, the gap between parent and child acculturation did not appear to moderate this association. The high incidence of self-reported bullying perpetration and victimization experiences underscores the need for school nurses, parents, and school personnel to address bullying behavior.

Waivers of parental consent for sexual minority youth.

The Society for Adolescent Health and Medicine emphasizes the need for research to focus on the health outcomes of sexual minority youth (i.e., lesbian, gay, bisexual, transgender, queer). However, sexual minority youth (SMY) are often less willing to participate in research studies where parental consent is required due to potential victimization and discrimination. This is a major concern given that more research is needed to understand the health needs of this population, especially in terms of suicide, substance use, and HIV prevention. The National Suicide Prevention Strategy classifies SMY as a high-risk group, emphasizing the need to explore suicide risks (along with other health outcomes) among this group. However, this high-risk classification also increases the safeguards necessary to conduct research with this population. Many researchers have argued for waivers of parental consent, but such waivers present with several ethical implications. This article discusses ethical principles, risks, benefits, safeguards, and potential alternative approaches to waivers of parental consent for SMY. We conclude by emphasizing the need for policy changes to allow parental consent waivers for research targeting SMY.