Impact of COVID-19 on Sexual and Gender Minority Communities: Focus Group Discussions
Abstract
:1. Introduction
2. Materials and Methods
2.1. Focus Group Recruitment and Procedures
2.2. Focus Group Questions
2.3. Data Analysis
2.4. Ethical Concerns
3. Results
3.1. The Impact of COVID-19 on the Community
3.1.1. Subtheme: Fear, Anxiety, Stress, and Social Isolation
“Having your loved one in the hospital, and you cannot visit. And then when he passes, you cannot have friends over to console you, making it nearly impossible to get through your day.”
“For me, with my addiction and in my recovery, I used to isolate myself a lot. And so, in recovery, I started gaining a lot of friends… And it felt like I lost that again, and so that was almost triggering in a sense, too. So, it definitely did impact my mental health a lot more than I thought it did.”
“She is not fully out to her whole family and now she is just kind of stuck with them and she kind of has to suppress that all down because her dad… says some very nasty things that I could never repeat but you know it is directed towards the LGBT [lesbian, gay, bisexual, transgender] community… She does not have the chance to move out and be herself… Thanks to COVID, she cannot be happy or herself.”
3.1.2. Subtheme: Impacts on Physical Health
“You cannot get around as much... I mean, you can choose to exercise in your house, but… those four walls tend to get smaller and smaller when you try to exercise… And it gets old after a while.”
“I actually prefer all the telehealth. For me, I work Monday to Friday, so business hours for most offices. And it is hard to go before work or after work or even on lunch because it will make me late to anything, so doing it with Zoom or over the phone, I can just go into my car real quick, get it done, [and] go back to work without have to worry about missing hours or having to call in or anything like that.”
3.1.3. Subtheme: Disability and Co-Morbidities as Additional Challenges
“I’m disabled, and it has been really rough to get outside, I cannot go.”
“I am currently battling cancer, and so I am immunocompromised. So being in a pandemic, and battling cancer, and being immunocompromised, is quite an ordeal.”
3.1.4. Subtheme: Economic Challenges
“I’m a dancer so a lot of those opportunities have been shut down, especially for the performers on the [Las Vegas] Strip. I would say [the impact of job loss] has been more so in the creative arts realm.”
3.1.5. Subtheme: Resilience and Adaptation
“I went and got myself a sewing machine and… I am sewing everything now. I am fixing my own clothes, I am making masks… and that is all because of COVID.”
“Instead of doing phone interviews [for my podcast], I do them all via Zoom and record them so it is… on the Facebook page, but then it is also audio. So, it makes it more engaging, and, you know, it gains a… broader audience… [by] bringing it visually instead of just hearing.”
“I am having my first doctor’s appointment on Zoom… so I am excited to try it out.”
3.2. Perceptions of Contact Tracing and Testing
3.2.1. Subtheme: Cultural Attitudes Contributing to Hesitancy to Get Tested
“It is harder for the Black and Hispanic communities to get on board with testing just because there are so many barriers in healthcare and access to healthcare. and when you ask people in those communities about where they receive healthcare, a lot of them are very disjointed. It is kind of random. They only go to the doctor when they are sick…it is going to be really important for the medical community and organizations that serve those communities to reach into those communities and create messages that resonate—not just that it is safe to get vaccinated and they can give them the science behind it, like someone said, but also that it is a safe place to come and get vaccinated where you will not be judged [and] it will not cost you”.
“I am a Mexican–American, OK? And if you are not [from a] Latino family, you know some folks be like… all you got is just a cough, a sneeze, mild indigestion. Just put on some Vicks, and you are good. [LAUGHS] They would be saying stuff like that. And thinking that, oh, it is not COVID, it is just you being you, or your allergies, or something else.”
3.2.2. Subtheme: Histories of Medical Racism Contributing to Hesitancy to Get Tested
“So, you know, historically mentioning the Tuskegee Airmen… Black bodies have been used in medical experiments, Black women, Black men, and… is there anything related to the LGBTQ [lesbian, gay, bisexual, transgender, queer] community that would prevent folks from wanting to get tested or do contact tracing that is kind of related to the same thing?”
“I think it carries over, it is kind of passed down. I know statistically speaking African Americans are the most timid to go to the doctors, they are afraid that they cannot trust the information because of such things that have happened historically. So, I believe it is carried into the LGBTQ community for Black bodies because you cannot separate your Black from your LGBTQ so they kind of go hand in hand, so I think that those cultural beliefs, that have been passed down historically—they are continuing.”
3.2.3. Subtheme: Stigma against Positive Tests and Testing
“I’m scared to get tested. Because if I’m tested, and I get positive, then like everybody in my household is shut down.”
“COVID is also becoming a taboo. And even in the gay community, where, like, they would not want to tell you because they’re ostracized from the community, even if it is 2 weeks or a month.”
“When they first announced that they were doing free COVID testing, you know. I made it publicly known on Facebook that I went and got tested and I received so much backlash. Saying, why did you go get tested?”
3.3. Perceptions of a Potential COVID-19 Vaccine
Subtheme: Political Climate Influences on COVID-19 Vaccine and Informational Hesitancy
“I just wanted to ask [is there] specifically anything from a cultural standpoint from the LGBTQ community that might prevent us from getting the vaccine? Yeah, while Trump is still in the office… I would not think about it [vaccine] now.”
“Everything that I was worried about was kind of what the president was saying, or the ex-president, because he was kind of just like not wanting diverse people to get help, but now that we have a bit of a brighter future. I believe that there should not be as many problems.”
3.4. Decreasing Vaccine Hesitancy
3.4.1. Subtheme: Information Needed to Trust the Vaccine
- How was the vaccine developed so quickly?
- If I am taking hormone treatments, can I still get the vaccine?
- If I have HIV is the vaccine less likely to work?
3.4.2. Subtheme: Trusted Sources of Vaccine-Related Information
- Centers for Disease Control and Prevention
- Family/friends who are health professionals
- World Health Organization
- News on TV or Radio
- Social media influencers
3.4.3. Subtheme: Making the Vaccine Accessible
- Needs to be free
- Need to be offered in a close, convenient location, such as:
- ○
- Clubs
- ○
- Common gathering spaces like recreation centers
- ○
- Places that specifically serve the community
- ○
- The LGBTQ Center
3.4.4. Subtheme: Potential Messages for the Vaccine
- Do not allow anybody to intimidate or force them to do anything; this is a choice
- See friends and family again by getting vaccinated
- Vaccine messaging should be relevant to the SGM culture without stereotyping
“I was thinking it is kind of like the, you know, the PrEP messaging. So, the vaccine … could mean that people could go to clubs and be in crowds and hook up and not worrying about catching COVID so, I would say it gets you back to normal. It gets you back to normal.”
“[The messages] just seem very redundant and stale, so I would just like to see something more creative, expressive, colorful, not stereotypical, do not get me wrong, but something that just encapsulates us, but all different versions of us. Not the same version of us, either.”
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Demographics | Number = 21 |
---|---|
Race/ethnicity | |
Black/African American | 28.5% |
Hispanic | 19.0% |
Native Hawaiian | 5.0% |
White | 33.3% |
Prefer not to Answer | 14.2% |
Age | |
18–30 | 28.6% |
31–50 | 38.1% |
51–64 | 23.8% |
65 or older | 4.8% |
Prefer not to Answer | 4.8% |
Education Level | |
Less than 9th grade | 0.0% |
9th to 12th grade, no diploma | 0.0% |
High School Diploma or GED | 9.5% |
Some college, no degree | 42.9% |
Associate’s Degree | 28.6% |
Bachelor’s Degree | 19.0% |
Graduate/Professional Degree | 0.0% |
Prefer not to Answer | 0.0% |
Gender | |
Male | 71.4% |
Female | 23.8% |
Transgender (MTF) | 4.8% |
Transgender (FTM) | 0.0% |
Gender fluid/Non-binary | 0.0% |
Prefer not to Answer | 0.0% |
Income | |
0 | 4.8% |
<14,999 | 0.0% |
15,000–24,999 | 28.6% |
25,000–39,999 | 9.5% |
40,000–54,999 | 14.3% |
55,000–79,999 | 4.8% |
80,000–109,999 | 9.5% |
110,000+ | 9.5% |
Prefer not to Answer | 19.0% |
Home | |
Rent | 66.7% |
Own | 23.8% |
Prefer not to Answer | 9.5% |
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Share and Cite
Pharr, J.R.; Terry, E.; Wade, A.; Haboush-Deloye, A.; Marquez, E.; Nevada Minority Health and Equity Coalition. Impact of COVID-19 on Sexual and Gender Minority Communities: Focus Group Discussions. Int. J. Environ. Res. Public Health 2023, 20, 50. https://doi.org/10.3390/ijerph20010050
Pharr JR, Terry E, Wade A, Haboush-Deloye A, Marquez E, Nevada Minority Health and Equity Coalition. Impact of COVID-19 on Sexual and Gender Minority Communities: Focus Group Discussions. International Journal of Environmental Research and Public Health. 2023; 20(1):50. https://doi.org/10.3390/ijerph20010050
Chicago/Turabian StylePharr, Jennifer R., Emylia Terry, André Wade, Amanda Haboush-Deloye, Erika Marquez, and Nevada Minority Health and Equity Coalition. 2023. "Impact of COVID-19 on Sexual and Gender Minority Communities: Focus Group Discussions" International Journal of Environmental Research and Public Health 20, no. 1: 50. https://doi.org/10.3390/ijerph20010050