"Falling in love with me means that she can never go back": a case study exploring the cumulative costs of multiple migrations.

This case study centers on the narrative accounts of a lesbian couple in a binational relationship (i.e., two women from different countries) who left the United States (U.S.) at a time when immigration laws did not recognize their union. Given that they could not legally stay in the U.S. together, they immigrated to the Netherlands and subsequently to Canada. When DOMA was overturned and the couple was eligible to apply for immigration to the U.S., they opted to remain in Canada, in part due to the strain of multiple migrations. This concept has been described as the complex process that accompanies more than one immigration experience and the cumulative effect that this can have on couples and families over time, particularly when multiple resettlements have taken place. A descriptive case study methodology was employed to investigate the perceptions of multiple migrations of this lesbian binational couple, focusing mainly on their experiences in Canada. Specifically, individual interviews were conducted with each woman to explore their lived experiences of multiple migration and the impact this has had on various aspects of their lives, including those occurring at the intersection of privilege and oppression. A description of each woman is presented, followed by the significant themes that emerged from this study, including immigration difficulties and the centrality of relationship. Implications for psychological training, practice, research, policy were presented.

The APA Guidelines for Psychological Practice With Sexual Minority Persons: An executive summary of the 2021 revision.

This article provides an executive summary of the American Psychological Association (APA)-approved Guidelines for Psychological Practice With Sexual Minority Persons (American Psychological Association, APA Task Force on Psychological Practice with Sexual Minority Persons, 2021). These Guidelines were produced at the request of the APA Society for the Psychology of Sexual Orientation and Gender Diversity (Division 44) and the APA Committee on Sexual Orientation and Gender Diversity (CSOGD) who, in 2018, jointly established a new task force to revise the 2010 Guidelines for Psychological Practice With Lesbian, Gay, and Bisexual Clients. This article provides a summary of the conceptual foundations that influenced these Guidelines, as well as an overview of the complete Guidelines. We highlight major changes in structure and new content areas. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Living in Exile: The Experiences of Individuals in Same-Sex Binational Relationships in Latin America.

While migration is a global phenomenon, laws and policies privilege certain groups of migrants over others. For example, at the time of this study, same-sex couples did not have the right to spousal immigration sponsorship in the U.S. Same-sex binational couples faced numerous legal challenges and some migrated in order to remain together legally. It is likely that where same-sex binational couples are living will have an impact on their well-being and their relationships. Thus, a descriptive phenomenology (n = 6) was employed to examine the following research question: What are the experiences of individuals in same-sex binational relationships who live in Latin America in order to be with their partner? The following predominant structures emerged: (a) differential access to immigration; (b) financial and career impact; (c) lack of social support; (d) laws and policies; (e) emotional impact; (f) impact on relationship; and (g) plans for the future.

Content analysis of psychological research with lesbian, gay, bisexual, and transgender people of color in the United States: 1969-2018.

This article updates previous content analyses that identified a relative paucity of U.S.-based psychological research on lesbian, gay, bisexual, and transgender (LGBT) people of color by extending the period covered to 2018. In addition to documenting how many such studies occurred and when, it considers the research questions asked, funding sources, impact, and journal outlets. This richer description of this research area allowed us to describe historically not only when LGBT people of color in the United States were studied but why they were studied, which journals published this work, and which published studies were most influential. We found that the literature starts in 1988 for LGB people of color and in 2009 for transgender people of color and that a significant shift occurred in 2009, with the majority of the articles being published in the last 10 years. Findings suggest that U.S. federal funding and support for LGBT research as well as divisions of the American Psychological Association focused on minoritized identities and their journals played a role in the recent increase. Half of the studies investigated psychological symptoms, and more than a third of studied experiences and psychological processes related to holding multiple minority statuses, many of which focused on potentially deleterious aspects of these identities. These findings indicate that this literature has a significant focus on pathology. Underrepresented groups included cisgender and transgender women; transgender men; older individuals; Asian Americans, Native Hawaiians, and Pacific Islanders; American Indians and Alaska Natives; and multiracial individuals. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Substance use, gender, and generation status among Asian Indians in the United States.

This study examined substance use (cigarette, alcohol, and illicit drug) among first- and second-generation Asian Indian women and men (n = 1,209; ages 18-34) living in the United States. Participants reported low rates of substance use compared to national averages. First-generation participants reported lower rates of substance use. Men were more likely to have used alcohol and tried cigarettes. Within the first generation, gender differences were only significant for alcohol, but within the second generation, gender differences were significant for all three substances. The findings support the resiliency of immigrants and highlight gender differences that occur among second-generation participants.

Risks for HIV and other sexually transmitted infections among Asian men who have sex with men in Vancouver, British Columbia: a cross-sectional survey.

BACKGROUND: Individuals of Asian heritage represent the largest ethnic minority in Canada. Approximately 10% of the new HIV diagnoses in men in British Columbia occur among Asian-Canadians. However, the HIV risk patterns of Asian men who have sex with men (MSM) have not been extensively studied. METHODS: Participants aged ≥ 19 years were enrolled in a venue-based HIV serobehavioural survey of MSM in Vancouver, Canada. We compared the demographic characteristics, risk behaviours, and prevalence of HIV and other sexual and blood borne infections between Asian and non-Asian MSM using bivariate analysis and logistic regression confounder modelling. RESULTS: Amongst 1132 participants, 110 (9.7%) self-identified as Asian. Asian participants were younger than non-Asian participants (median age 29 vs. 32 years; p < 0.001), but otherwise did not differ from other study participants. HIV prevalence was lower among Asian MSM compared to Non-Asian MSM (3.7% vs 19.0%, p <0.001). Among men who self-reported as HIV negative or unknown we found no differences in unprotected anal intercourse (UAI) with a discordant or unknown serostatus partner in the previous six months (11 vs. 13%; p = 0.503). However, Asian MSM were less likely to report ever using injection drugs (10.8% vs. 19.2%; p = 0.043) or using alcohol before having sex (52% vs. 64.4%; p = 0.017). CONCLUSIONS: Asian MSM in our study reported similar rates of UAI as non-Asian MSM, but had a lower prevalence of HIV infection. Other factors, such as the use of drugs and alcohol, in relation to sex, may partly explain these differences. However this requires further investigation.

Expanding our borders: Cultural Diversity and Ethnic Minority Psychology's special issue on immigration.

Introduces the current special issue of the journal, Cultural Diversity and Ethnic Minority Psychology. This special issue focuses on the topic of immigration and highlights the important within group differences often overlooked when immigrants are conceptualized as a homogeneous group. The articles in this journal consider a variety of microsystems, such as educational settings, ethnic and gay communities, and communities with anti-immigration laws.

"Hard to crack": experiences of community integration among first- and second-generation Asian MSM in Canada.

Asians are the largest racial minority in Canada making up 11% of the population and represented over 60% of new immigrants between 2001 and 2006. We examined the experiences of community integration for first-generation (n = 27) and second-generation (n = 22) Asian Canadian men who have sex with men (MSM) in their ethnic and gay communities. Through focus group interviews, we explored their level of connectedness and the level of discrimination they experienced in the two communities. Findings indicate that Asian MSM in general perceived their ethnic community as homophobic, stemming from a combination of seeing sex as taboo, stereotypes about being gay, and the affiliation with religion. Although the literature indicates that immigrants rely on the support of their ethnic communities, our finding suggest that this is not the case for Asian immigrant MSM, who in our sample reported feeling less connected compared to their second-generation counterparts. For the gay community, our sample reported mixed experiences as some regarded it as welcoming, whereas others described it as racist. However, these experiences did not differ by generational status. Many were aware of explicit messages stating "No Asians" in dating contexts, while at the same time being aware that some older White men were interested in dating Asians exclusively. Barriers to integration in both communities may contribute to feelings of isolation. Theoretical implications are discussed.

Uptake, benefits of and barriers to safer crack use kit (SCUK) distribution programmes in Victoria, Canada--a qualitative exploration.

BACKGROUND: Crack use is prevalent amongst street drug users in Canadian cities, and associated with severe drug use, health and social problems. Whilst few targeted interventions are available for crack use, the common use and sharing of hazardous makeshift paraphernalia are a key concern, as these risks may be associated with oral injury and blood-borne virus (BBV)--e.g., hepatitis C virus (HCV)--transmission amongst users. Recently, distribution programmes of so-called 'safer crack use kits' (SCUKs) have been initiated in select Canadian cities, primarily to reduce the use of unsafe materials and paraphernalia sharing amongst crack users. This study explored uptake and benefits of, barriers to, and possible improvements to two recently implemented SCUK distribution programme in Victoria, Canada. METHODS: N=31 regular crack smokers were recruited through community-based efforts between June and August 2010, and assessed via an interviewer-administered protocol involving quantitative and qualitative data items. Descriptive analyses were completed with the quantitative data, and thematic content analyses were conducted with the qualitative data in order to identify and extract prominent themes and issues. RESULTS: The sample indicated high levels of socio-economic marginalization, poly-substance use, health problems, lengthy crack use histories and common crack paraphernalia sharing. Most participants exclusively utilized the SCUK programme including glass-stems in addition to other paraphernalia materials. Participants described: lesser need to share--or to commit property crimes to obtain resources for--crack to paraphernalia, increased health awareness, and increased personal and community safety as benefits experienced from SCUK use. Limitations in SCUK resources and distribution, shortcomings in materials, and police interference were cited as barriers to current SCUK program delivery. CONCLUSIONS: SCUK distribution in Victoria appears to result in a variety of individual and community health benefits. These benefits could be solidified by addressing current programme limitations, including better resourcing, expanding geographic distributions and eliminating police interference.

Prevalence and characteristics of substance use among Chinese and south Asians in Canada.

This study examines Canadian Alcohol and Drug Use Monitoring Survey data to assess substance use prevalence among Chinese (n = 254), South Asians (n = 245), and Caucasians (n = 14,943). South Asians and Chinese reported less current drinking than Caucasians, and South Asians reported less current drinking than Chinese. South Asians and Chinese reported less cannabis use and any illicit drug use than Caucasians. Compared to Caucasians, Chinese reported less cigarette smoking and South Asians reported less use of any pain relievers. Additional research focusing on immigration and acculturation is warranted to further explore substance use patterns of South Asian and Chinese populations in Canada.

HIV risk profiles among HIV-positive, methamphetamine-using men who have sex with both men and women.

This study examined demographic characteristics, sexual risk behaviors, sexual beliefs, and substance use patterns in HIV-positive, methamphetamine-using men who have sex with both men and women (MSMW) (n = 50) as compared to men who have sex with men only (MSM) (n = 150). Separate logistic regressions were conducted to predict group membership. In the final model, of 12 variables, eight were independently associated with group membership. Factors independently associated with MSMW were acquiring HIV through injection drug use, being an injection drug user, using hallucinogens, using crack, being less likely to have sex at a bathhouse, being less likely to be the receptive partner when high on methamphetamine, having greater intentions to use condoms for oral sex, and having more negative attitudes about HIV disclosure. These results suggest that, among HIV-positive methamphetamine users, MSMW differ significantly from MSM in terms of their HIV risk behaviors. Studies of gay men and HIV often also include bisexual men, grouping them all together as MSM, which may obscure important differences between MSMW and MSM. It is important that future studies consider MSM and MSMW separately in order to expand our knowledge about differential HIV prevention needs for both groups. This study showed that there were important differences in primary and secondary prevention needs of MSM and MSMW. These findings have implications for both primary and secondary HIV prevention among these high-risk populations.

Methamphetamine use, attitudes about condoms, and sexual risk behavior among HIV-positive men who have sex with men.

This study examined attitudes about condoms as a moderator of the relationship between methamphetamine use and sexual risk behavior in a sample of 297 HIV-positive, methamphetamine-using men who have sex with men (MSM). To test for a moderating effect of attitudes towards condoms, an interaction term was included in multiple regression analysis along with age, income, negative condom attitudes, frequency of methamphetamine use, and Beck depression score. A post hoc analysis was conducted to determine the relations between methamphetamine use and unprotected sex for persons with more vs. less negative attitudes toward condoms. These analyses indicated that when individuals had more negative attitudes toward condoms, the relation between methamphetamine frequency and unprotected sex was significant, while among participants with less negative attitudes toward condoms, no significant association was found. Addressing methamphetamine-using MSM's attitudes about condoms can serve as a form of harm reduction for those who are not yet ready or willing to discontinue methamphetamine use.

Assessing the prevalence of nonmedical prescription opioid use in the general Canadian population: methodological issues and questions.

OBJECTIVE: To assess the prevalence of nonmedical prescription opioid use (NMPOU) in the Canadian general adult population in the context of rising overall prescription opioid (PO) consumption and related problems in North America. METHOD: The prevalence of NMPOU was assessed as a multiitem construct in the Canadian Alcohol and Drug Use Monitoring Survey (CADUMS; n = 16 672), an ongoing cross-sectional monthly random digit dialing telephone survey representative of the general Canadian population, aged 15 years and older. CADUMS data were collected between April and December of 2008 with a response rate of 43.5%. RESULTS: About 22% of CADUMS respondents reported PO use in the last year, while 0.5% reported NMPOU during the same time frame. PO use was significantly higher among women than among men, and highest in the group aged 25 to 54 years. NMPOU was similar among men and women, and highest in the group aged 15 to 24 years. CONCLUSIONS: CADUMS data indicate an extremely low rate of NMPOU, especially given the levels of overall PO use, other PO-use related problems, and NMPOU levels estimated in the general US population where NMPOU has been assessed to be 10 times higher than in Canada. NMPOU survey item construction and response rates appear to strongly influence and potentially compromise NMPOU survey data. Existing NMPOU data and survey methods need to be validated for this important indicator in Canada, where increasing PO use and problem levels have been recognized as a significant and rising public health problem.

Changes in and characteristics of admissions to treatment related to problematic prescription opioid use in Ontario, 2004-2009.

BACKGROUND: North America is the region with the world's highest prescription opioid (PO) use. Non-medical use of prescription opioids and PO-related morbidity and mortality have strongly increased in the US in recent years. It is assumed that similar trends are occurring in Canada, but there is less empirical evidence to support this. Treatment demand for problematic PO use is an important indicator of PO-related morbidity. METHODS: Levels and changes related to the caseload of PO-related treatment admissions were assessed using system-level data from the Drug and Alcohol Treatment Information System (DATIS), the reporting system for publicly funded addiction treatment services in the province of Ontario (Canada) for the period April 2004-March 2009 (n=500,217). In addition, basic socio-demographic and clinical characteristics of PO-related treatment admissions in the final year of study (n=10,125) were examined. RESULTS: The number of PO-related treatment admissions in DATIS rose by 60%, and their prevalence in the total caseload increased from 9.4% to 15.7% in the study period. Three-quarters of PO-clients reported other problem substances; the most common co-occurring problem substance was cocaine/crack. The majority of PO-clients were <35 years of age, unemployed, and referred to treatment by others. INTERPRETATION: Demand for treatment for problematic PO use has risen substantially in Ontario in the past five years in the wider context of substantially increased overall PO use and related harms in Canada. The interaction dynamics between these different indicators need to be systematically examined and monitored as the basis for evidence-based interventions.

Experiences of homonegativity and sexual risk behaviour in a sample of Latino gay and bisexual men.

This study examines the relationship between homonegativity, racism and poverty and HIV-risk-related behaviour among an Internet-based sample of 226 Latino gay and bisexual men. Participants had a median level of education at graduate school level or higher and a median monthly income in the US$1600-2400 range. Income and education in this sample are higher than participants in most other studies of Latino gay and bisexual men, providing information about HIV risk in a previously understudied segment of the population. Three negative binomial regressions were used to predict unprotected receptive anal intercourse, unprotected insertive anal intercourse and unprotected sex under the influence of drugs in the past 30 days, with education, Latino acculturation, income, experiences of racism and homonegativity as predictors. Greater experiences of homonegativity, fewer experiences of racism, lower income and higher Latino acculturation predicted unprotected receptive anal intercourse. Only lower Latino acculturation predicted unprotected insertive anal intercourse. Greater experiences of homonegativity, higher income and higher Latino acculturation predicted unprotected sex under the influence of drugs. This suggests that experiences of homonegativity have a detrimental impact on health behaviours. Future research should aim to further understand the relationship between experiencing homonegativity and engaging in risky sexual behaviour.

Methamphetamine initiation among HIV-positive gay and bisexual men.

This study describes factors associated with methamphetamine initiation in a racially diverse sample of 340 methamphetamine-using, HIV-positive gay and bisexual men. A factor analysis was conducted on reasons for initiation, and four factors were identified: to party, to cope, for energy, and to improve self-esteem. Methamphetamine to party accounted for more than one-third of the variance in the factor analysis. Methamphetamine to cope captured almost 9% of the variance, methamphetamine for energy accounted for approximately 8% of the variance, and methamphetamine for self-esteem accounted for approximately 7% of the variance. Regression analyses revealed differential associations between methamphetamine-initiation factors and HIV-risk behaviors. Methamphetamine for self-esteem predicted binge methamphetamine use, while methamphetamine to cope was associated with injecting methamphetamine. Using methamphetamine for energy was associated with number of illicit drugs-used and using methamphetamine to party was associated with having a greater number of sexually transmitted infections. These findings suggest that methamphetamine initiation among gay and bisexual men is multifaceted, which could have implications for intervention development.