The Impacts of Stigma Against Sexual Minority Men Within and Between Various Socioecological Levels: Breaking the Vicious Cycle in Zambia.

Sexual minority men (SMM) face persistent stigma in Zambia. From a holistic perspective, we aim to explore its impacts within and between multiple socioecological levels, demonstrating how their interactions create a vicious cycle of barriers to the well-being of SMM. In-depth interviews were conducted with 20 purposively recruited SMM from Lusaka, Zambia. All interviews were audio-recorded, after written consent, transcribed verbatim, and iteratively coded employing inductive (i.e., data-driven) approaches for thematic analysis using NVivo. Results suggest three key themes: (1) interpersonal socially perpetuated sexual minority stigma (SMS); (2) multidirectional interactions between psychosocial well-being and risk-taking behaviors; and (3) institutionally perpetuated SMS as a barrier to seeking and receiving health care. SMS permeates across all levels of the socioecological model to negatively impact the psychosocial well-being of SMM while acting also as a barrier to accessing HIV prevention and care. Our study necessitates structural public health intervention to decrease stigma and discrimination against SMM in Zambia, in efforts to increase their psychosocial well-being as well as their access to and utilization of HIV care by breaking the vicious cycle of SMS that pervades through the intrapersonal, interpersonal, and institutional levels of the socioecological model.

Coping strategies among older adults living with HIV/AIDS with history of childhood sexual abuse.

Background: Childhood sexual abuse (CSA) may be a risk factor for poor mental health in adulthood. Survivors may experience emotions detrimental to their social and mental wellbeing. Some of these emotions may include anger, fear, rage, helplessness, guilt, shame, which may impact their coping strategies. The aim of this study was to determine the association between CSA and coping among older adults living with HIV (OALH). Method: Data were obtained from 91 OALH via convenience sampling. The participants were recruited from an immunology clinic and were at least 50 years or older and living with HIV. CSA was operationalized using questions from the Adverse Childhood Experiences Questionnaire. Coping was assessed using the Brief COPE Inventory. Crude and adjusted linear regression models, controlling for age, sex, race, gender, and income were used to determine the association between CSA and each coping subscale. The analyses were conducted in SAS version 9.4. Results: Crude analyses showed statistically significant associations between CSA and specific coping strategies: humor (ß = 1.244; p = 0.0018), religion (ß = 1.122; p = 0.0291), Self-blame (ß = 1.103; p = 0.0154), planning ß = 1.197; p = 0.0196), venting (ß = 1.218; p = 0.0063), substance use (ß = 0.828; p = 0.0335) and instrumental support (ß = 0.949; p = 0.0416) After adjusting for sociodemographic characteristics, there was a statistically significant association between CSA and humor (ß = 1.321; p = 0.0048) and self-blame (ß = 1.046; p = 0.0382). Conclusion: OALH with a history of CSA were more likely to use humor and self-blame as coping strategies. Trauma-informed interventions should be geared towards decreasing self-blame for OALH who are CSA survivors.

Adverse Childhood Experiences and Subjective Cognitive Decline in the US.

OBJECTIVE: The aim of this study was to determine the association between adverse childhood experiences (ACEs) and subjective cognitive decline (SCD) among a representative sample of the adult US population. METHODS: Data were obtained from the 2019 Behavioral Risk Factor Surveillance System (N = 82,688, ≥45 years). Adverse childhood experiences included sexual, physical/psychological and environmental ACEs, and a score. Multivariable logistic regression was used to determine the association between ACEs and SCD, and SCD-related outcomes. RESULTS: Sexual (adjusted OR (aOR: 2.83; 95% CI: 2.42-3.31)), physical/psychological (aOR: 2.05; 95% CI: 1.83-2.29), and environmental (aOR: 1.94; 95% CI: 1.74-2.16) ACEs were associated with SCD in the past year. There was also a dose-response relationship between ACE score and SCD. CONCLUSION: ACEs were associated with SCD. Interventions to maximize cognitive health in aging and prevent future cognitive impairment should consider the potential role of ACEs among affected populations.

Prevalence of obesity and overweight and associated factors among financial institution workers in Accra Metropolis, Ghana: a cross sectional study.

BACKGROUND: Certain professions are associated with low physical activity. Workers in such professions spend the most part of their adult working lives less engaged in physical activity if they don't consciously exercise outside of working hours. This increases their risk of obesity and its associated diseases. This study determined the prevalence of obesity and overweight and associated factors among workers of a financial institution in Accra Metropolis, Ghana. METHODS: A cross-sectional study was conducted among 180 workers of a financial institution in Accra using the World Health Organization's STEPS (STEPwise approach) instrument for non-communicable disease risk factor surveillance. Relevant sociodemographic information were recorded and BMI was computed for each respondent. RESULTS: The overall prevalence of obesity and overweight among the bank workers was 55.6 % (17.8 % obese and 37.8 % overweight). After adjusting for other variables, physical activity (OR = 0.34, 95 % CI = 0.13-0.89, p = 0.03), alcohol consumption (OR = 3.00, 95 % CI = 1.35, 6.68, p = 0.007), marital status (OR = 2.74, 95 % CI = 0.96-7.85, p = 0.04), sex (OR = 2.78, 95 % CI = 1.23-6.33, p = 0.01), and age (OR = 1.10, 95 % CI = 1.01-1.20, p = 0.036) were significantly associated with obesity and overweight. CONCLUSION: Being physically inactive, consumption of alcohol, being married and a female, in addition to old age, increase the risk of obesity and overweight significantly. These factors should inform policy makers in developing strategies to reduce the burden of obesity and overweight among this category of workers.