Search Results (34)

Though previous studies have demonstrated the protective benefits of sports participation against illicit drug use for a general population, how these findings apply to LGBTQ youth remains unknown. This study specifically looks at the relationship between sports participation and prescription drug misuse among sexual and gender minority youth. Using secondary data from the 2019 YRBS, we analyze associations among sports participation, sexual orientation, gender identity, and prescription drug misuse among a representative sample of U.S. high school students in Florida. Our results show that sexual and gender minority youth are at increased risk for prescription drug misuse compared to their heterosexual and cisgender peers. Moreover, sports participation is associated with higher rates of prescription drug misuse among all students, and the nuances of these trends are discussed with particular attention paid to sexual and gender minority youth. These results challenge conventional wisdom about sports participation. Without the addition of new demographic survey questions and LGBTQ youth participation in the YRBS, common myths about sports might have persisted. Our findings point to the meaningful presence of LGBTQ youth in sports, call for research and programming on LGBTQ athletes’ unique needs regarding substance misuse risk, and encourage LGBTQ-inclusive policies and practices within schools and sports programs in particular. Full article

There has been a growing trend of young people coming out as Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) in recent years. Research on the relationship between LGBTQ grandchildren and their grandparents is limited and primarily focuses on the grandchildren’s perspective. This pilot study seeks to understand the relationship between grandparents and their LGBT grandchildren, from the grandparents’ perspective. Six Israeli grandparents were interviewed using a qualitative methodology, guided by a semi-structured interview protocol. Analysis of the interviews revealed three main themes: grandparents’ exposure to the grandchildren’s sexual orientation and their gender identity; the shattering of the grandparents’ dream and concern for the grandchild; and the relations between the grandparents and their LGBT grandchildren. The research findings in this pilot study indicate that the relations remained close and did not change following disclosure of the sexual orientation. However, some grandparents needed time to resume their regular relationship. The insights learned from the research findings regarding the process undergone by the grandparents upon discovering their grandchildren’s sexual orientation can help professionals treat and counsel family members, when necessary, how to bridge the gaps, and rebuild the relations between the grandparent and the grandchild, as these relations are important for the well-being of both. Full article

Despite the availability of pre-exposure prophylaxis (PrEP) in the United Kingdom (UK), uptake among men who have sex with men (MSM) remains inconsistent, signalling a persistent ‘PrEP Gap’. Empirical studies show the important role of psychosocial factors (e.g., stigma, identity, trust in science, and sexual behaviours) in PrEP acceptability and uptake. This study aimed to identify subgroups of MSM in the UK based on psychosocial predictors of PrEP acceptability. A cross-sectional survey of MSM (N = 500) was conducted between June and September 2023. Participants completed validated measures assessing identity resilience, internalised homonegativity, LGBTQ+ connectedness, trust in science, NHS perceptions, HIV stigma, PrEP self-efficacy, condom self-efficacy, sociosexual orientation, perceived HIV risk, and PrEP acceptability. Latent Profile Analysis (LPA) was used to identify distinct subgroups based on these psychosocial dimensions. Four psychosocial profiles were defined: (1) PrEP Ambivalent (15%); (2) PrEP Accepting (36.2%); (3) PrEP Hesitant (37%); and (4) PrEP Rejecting (11.8%). These profiles provide evidence for varied combinations of personal and structural factors influencing PrEP acceptability. PrEP acceptability among MSM in the UK is shaped by distinct psychosocial configurations, influenced by identity, stigma, trust, and perceived risk. These findings highlight the need for differentiated and targeted interventions for enhancing PrEP acceptability based on psychosocial profile. Audience segmentation strategies offer a promising pathway to bridge the awareness-to-engagement gap and address the nuanced barriers facing diverse subgroups within the MSM community. Full article

Background/Objectives: Care-oriented perspectives in the LGBTIQ+ community are essential to ensure adequate and comprehensive health care. This population faces multiple barriers imposed by society, including discrimination in access to healthcare services. This research aims to analyse the perspective of nursing students in relation to the provision of care for people with sexual and gender diversity. Methods: A qualitative phenomenological research-action study was conducted. Data were collected using a semi-structured face-to-face interview consisting of 23 questions. The interviews were transcribed, read thoroughly and analysed. Results: Forty students were interviewed, and four main themes emerged: (1) personal perspective, (2) professional and disciplinary training, (3) nursing education and (4) health implications. The results show that students have mixed perspectives and attitudes towards LGBTQ+ populations, although they are interested in receiving more LGBTQ-focused training. Furthermore, respondents reported that the training received in the degree course and the preparation of lecturers in relation to caring for LGBTQ+ people are lacking. Finally, it emerged that inequalities in access to health services can still be observed and that there is a need for the development of manuals that are at the forefront of comprehensive health in this population. Conclusions: Based on the results, the implementation of Madeleine Leininger’s Sunrise model is suggested. Acceptance of sexual and gender diversity is essential to ensure the elimination of inequalities and make care a transformative process. Finally, education on these aspects needs to be implemented by including activities such as practical training scenarios, workshops and conferences to highlight the specific needs of the LGBTIQ+ population. Full article

The COVID-19 pandemic disrupted the living arrangements of many college students in the United States, potentially impacting their academic development, which plays a critical role in their mental health. At the start of the pandemic, university closures led to an abrupt transition from face-to-face instruction to online instruction, which may have caused significant challenges for college students, particularly lesbian, gay, bisexual, transgender, queer, and others who identify as having a minority sexual orientation and/or gender identity (LGBTQ+). To identify academic challenges and associated protective factors, we examined LGBTQ+ college students’ social support from family and friends, the parent–child relationship quality, and their associations with academic challenges during the first months of the pandemic. The results of online surveys indicated that LGBTQ+ college students (N = 408; Mean Age = 20.4 yrs) who reported less family support and worse relationship quality with their parents perceived that academics had become relatively harder than before the pandemic. In contrast, friend support was unrelated to perceived academic challenges. These findings underscore the potentially protective role of supportive and high-quality relationships with family. The findings also provide insight into how universities could support students’ academic success during other temporary academic breaks and sudden, unplanned disruptions, such as hurricanes or other weather-related events, which is essential in promoting LGBTQ+ college students’ mental health and academic success. Full article

Narrative therapy and expressive writing interventions have been found to improve health and wellbeing among vulnerable populations; however, few have been conducted with young lesbian, gay, bisexual, transgender, and queer people, and those of other diverse sexual orientations and gender identities (LGBTQ+). This study aimed to determine how young LGBTQ+ people in Australia might make meaning of themselves and their experiences through life writing and the implications for health and wellbeing. A study was conducted with 20 LGBTQ+-identifying participants, aged 16 to 20, in or around Melbourne, Australia. The participants attended one of two writing workshops held at a public library in Melbourne in October 2019 and February 2020, where they were taught creative nonfiction writing techniques. They were asked to submit pieces of life writing (“narratives”) and reflections about participating in the study. Fifteen participants submitted one or more narratives in response to a prompt, and 10 participants provided reflections. Thematic analysis was used to code the data and identify themes that emerged. The participants’ processes of meaning-making were analysed using a performativity lens. This article explores the theme “sex and relationships” that emerged and the related sub-themes. The participants’ writing provided insights into sociocultural norms, discourses, and tropes, including those present in school-based sexuality education and in the media, that may impact the developing sexual subjectivities of young LGBTQ+ people in Australia. Engaging in life writing provided an outlet for developing self-knowledge, agency, and subjectivity. The findings can be used to promote the use of creative, youth-centred and queer-affirming practices and interventions for LGBTQ+ youth in school and community settings, including peer support and community health approaches. They indicate the need for de-pathologising the medicalised risk- and prevention-based interventions for LGBTQ+ youth in health and education research and policy, particularly around sexual and mental health. Full article

Background: LGBTQ+ persons with cancer and their families consistently face discriminatory care. In addition, clinicians report inadequate population-specific knowledge and communication skills to effectively promote LGBTQ+ inclusion. To fill this gap, we designed a communication skills training based on extant literature; multidisciplinary perspectives; and patient, family, and clinician expert engagement. Methods: Training content comprised didactic information, including exemplar videos of communication strategies, and experiential learning roleplay opportunities with standardized patient and family member actors. Two training sessions were conducted virtually with invited multidisciplinary clinicians using convenience sampling. Each training was followed by a one-hour, semi-structured focus group to solicit feedback on participants’ experiences and recommendations for improvement. Focus group transcripts were thematically analyzed using a constant comparative approach. Results: Two major themes were identified: key takeaways from the training and recommendations for improvement. Participants reported favorable learning experiences and believed the training would have a positive influence on future clinical interactions. We synthesized recommendations into five discrete pieces of feedback related to (1) the advanced level of training material; (2) diversity throughout the training; (3) complexity of family dynamics; and (4) recovery from communication mistakes; and (5) additional topics for future training. Based on feedback, corresponding changes for each item and a refined communication skills blueprint are provided. Conclusions: Our innovative training on inclusive cancer care for LGBTQ+ patients’ families will provide both knowledge-based and experiential learning opportunities to advance clinicians’ confidence in communicating empathically with members of diverse sexual orientation and gender identities. The training is poised for feasibility and efficacy testing. Full article

Background: The life courses of sexually and gender diverse individuals are shaped by a series of events that include acceptance of one’s own sexual orientation or gender identity, the coming out process and socialization in the LGBTQ+ (for Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, and other sexual orientations and gender identities represented by the plus sign) environment. Generally experienced in a cis-heteronormative context, this process is marked by stigma and discrimination and the social harms they can cause, including a higher-than-average prevalence of alcohol use. Objectives: To profile the alcohol use of sexually and gender diverse (SGD) youth from a life course perspective and to explore individual perceptions regarding the personal, social and cultural factors (including stigmatization and its consequences) modulating their consumption. Methodology: This qualitative descriptive study is grounded in symbolic interactionism. Semi-structured interviews lasting approximately 90 min were conducted with LGBTQ+ youth aged 18 to 30 using alcohol at least once a week. A thematic analysis was performed. Results: A total of 31 individuals aged 18–29 (average age: 25) were interviewed. The average score regarding alcohol use was 14.25 (Standard Deviation -SD-: 4–31), which corresponds to a moderate risk and indicates the need for a brief intervention. Our study documents how the higher alcohol use among LGBTQ+ youth is shaped by individual, community and cultural factors at different points in the queer life course. Among the factors influencing drinking are the emotions experienced when questioning sexual orientation and/or gender identity as well as the feelings resulting from stigma and discrimination. Our findings also indicate the influence of socializing in the queer community and meeting peers and partners, as well as that of LGBTQ+ cultural practices. Discussion: Our study indicates the need for grassroots-level interventions that work to mitigate social pressures in queer socialization contexts. Accordingly, any intervention, whether preventive or therapeutic, must consider the interplay of personal, social, community and cultural factors. Interventions regarding alcohol use must build on the strengths of community and the sense of belonging. Full article

Objectives: In this study, we aimed to investigate (1) the association of tobacco and e-cigarette use with sexual orientation (LGBTQ and heterosexual individuals) and (2) the difference in the association of tobacco and e-cigarette use with self-reported depression by sexual orientation. Methods: The data for this study were obtained from the Health Information National Trends Survey (HINTS 5, Cycle 4). Sample participants included 3583 adults (93.87% heterosexuals). We used multinomial regression to measure the relative risk ratios (RRRs) of being a former and current user versus never a user of tobacco and e-cigarettes and binomial regression to measure the odds ratios of depression between the LGBTQ and heterosexuals. Results: Current smoking prevalence is higher among LGBTQ participants (17.3%) compared to heterosexuals (11.0%). The disparity is even greater for e-cigarette use, with 7.3% of LGBTQ participants being current users versus 2.8% of heterosexuals and 24.5% of LGBTQ participants being former users compared to 9.3% of heterosexuals. Compared to heterosexuals, the relative risk ratio of being a current tobacco user among the LGBTQ participants was about 1.75 times higher [RRR = 1.75, 95%CI = 1.16, 2.64], and that of e-cigarette use was about 2.8 times higher [RRR = 2.81, 95%CI = 1.57, 5.05]. Among current e-cigarette users, heterosexual participants had 1.9 percentage points [risk difference = 1.94, 95%CI = 1.20, 3.13] higher probability of depression, whereas among the LGBTQ participants, the risk was about 3.7 times higher [OR = 3.67, 95%CI = 1.06, 12.74]. Conclusions: Our findings conclude that the LGBTQ are more likely to use tobacco and e-cigarettes compared to heterosexuals and that the risk of depression from e-cigarette smoking is more pronounced among the LGBTQ participants. Full article

People with cancer may suffer negative psychosocial outcomes due to the challenges of cancer. LGBTQ2S+ people routinely experience negative psychosocial outcomes in health care settings, but have showcased resilience in the face of discrimination; however, this has never been studied in a cancer context. Thus, this study aims to assess coping and resilience in LGBTQ2S+-identifying people diagnosed with cancer using a strengths-based approach. A qualitative exploratory design was used. Ten self-identified LGBTQ2S+ people who have completed their cancer treatment were recruited. Participants completed clinical, health, and demographic questionnaires and, subsequently, semi-structured qualitative interviews. Conceptualizations of coping and resilience in the semi-structured interviews were analyzed using interpretative phenomenological analysis (IPA). Participants were members of various gender identities and sexual orientations. In addition to identifying needed LGBTQ2S+-specific resources, four narratives emerged: support networks, regaining control in life, conflicting identities, and traditional coping methods. Most participants’ cancer journeys were characterized by a ‘Second Coming-Out’ phenomenon, where LGBTQ2S+ people with cancer use coping strategies, similar to those used when coming out, to produce resilience throughout their cancer journey. This work provides exploratory insight into LGBTQ2S+ people with cancer, but more research is required with a larger sample. Full article

Background: Equitable access to healthcare is a priority of many healthcare systems, aiming to ensure access is driven by need and not minority groups such as those defined by sexual orientation. However, there are healthcare areas where inequity in access across sexual orientation groups is found that are not justified based on need. Mandated LGBTQ+-specific training of the healthcare workforce may help address some barriers of access for these groups. The study aims to understand the potential economic implications for mandated LGBTQ+-specific healthcare training on the healthcare system in England, UK to inform commissioning of training provision. Methods: Cervical cancer screening was used as an exemplar case where there appears to be inequity in access for different sexual orientation groups. A decision model was developed and analysed that considered the impacts of greater uptake of screening for lesbian and bisexual women due to LGBTQ+ training. Costs took the perspective of the healthcare system and outcomes modelled were cancer cases averted in a timeframe of 5 years. Results: Based on cervical cancer screening alone, where training costs are fully attributed to this service, training would likely result in fewer cancer cases detected in the lesbian and bisexual populations, though this comes at a modest increase in healthcare sector costs, with this increase largely reflecting a greater volume of screens. Training costs do not appear to be a major component of the cost implications. Conclusions: In resource-constrained systems with increasing pressures for efficiency savings, the opportunity cost of delivering training is a realistic component of the commissioning decision. The findings in this paper provide a signal that mandated LGBTQ+ training in healthcare could lead to potentially greater outcomes and in breaking down barriers of access and could also enable the healthcare system to provide more equitable access to healthcare. Full article

We examined online and offline social supports for sexual minority adolescents, underscoring the understudied developmental period of early adolescence and the mental outcome of loneliness. Stemming from a larger study in the northeast U.S., 967 youth participants were 26% sexual minority, 53% female, 45% male, and 2% other/nonbinary (mean age = 13.1, SD = 1.52). LGBTQ+ youth reported significantly higher levels of loneliness compared to their heterosexual counterparts. To understand potential sources of social support while exploring their sexual identities, we compared the experiences of LGBTQ+ youth at both ends of the loneliness spectrum. Gaining knowledge about their sexual orientation from LGBTQ+ organization websites, participating in gender–sexuality alliances, and using TikTok or Instagram were associated with lower levels of loneliness. Providing social support to online friends was associated with lower loneliness; however, receiving online support was not associated with lower loneliness. Furthermore, proactive social media engagement such as posting uplifting content, joining online communities, or raising awareness about social issues were associated with lower levels of loneliness. The results provide guidance on specific youth behaviors and online communities beyond a focus on screen time while highlighting the continued need for social support to ameliorate loneliness, such as gender–sexuality alliance networks. Full article

As the significance of long-term care services for older adults becomes more pronounced in Taiwan, especially considering the intensifying trend of an aging population, there remains a lack of comprehensive attention to the long-term care needs and experiences of older adult individuals within the LGBTQ+ community. The present study examines the long-term care service awareness, needs, and usage intention of older adult male homosexuals in Taiwan and assesses their ideal long-term care service model. This study of five older adult male homosexual subjects aged 66 to 73 years is intended as a preliminary exploration. Interviews were used to collect data. The study determined that the five subjects displayed high awareness of long-term care services, as they possessed actual experience of these services or had even participated in care service staff training to obtain certificates. Some even had experience in applying for home care services and reported problems during use. The subjects perceived that they were very likely to require long-term care services in the future and tended to opt for home care services if they required long-term support. Due to their personal experiences, the subjects displayed negative awareness of long-term care services and expressed worry that long-term care service staff harbored poor attitudes toward homosexuals. The subjects considered the most important aspects of long-term care to be basic medical care and lifestyle care. However, they worried that long-term care staff would delay or refuse to provide such services due to the subjects’ sexual orientation or stereotypes related to it, and they were concerned above all about the “friendly attitude” of long-term care staff. They hoped that long-term care staff were friendly toward homosexuals and did not discriminate against them, feeling that it would be more appropriate for homosexual long-term care staff to provide assistance. In terms of vision, while preferring organizations with homosexual employees, the subjects worried that they would be stigmatized and discriminated against. Regarding ideal long-term care services, while considering institutions with homosexual staff to be ideal, the subjects also worried that these would be labeled as institutions that were dedicated to homosexuals, potentially resulting in discrimination. Therefore, they hoped that the sexuality sensitivity of long-term care staff could be improved and that they would undergo professional continuing education to learn about homosexuals, their situations, and care needs. Full article

Decades of research have enhanced our understanding of the psychological impact of sexual victimization, including risk factors through which post-traumatic stress disorder (PTSD) manifests. Research on sexual assault and PTSD predominately reflects the experience of heterosexual women, yet sexual minorities are both at increased risk of sexual assault and suffer greater negative health outcomes from it. In these cases, PTSD is linked to a clearly identifiable cause, thereby making it possible to identify individuals at risk, enhance interventions immediately following the traumatic event, and offer services to mitigate further harm. This narrative review explores the potential risk factors for PTSS and PTSD among individuals who experience sexual assault and identify as a sexual minority. Knowledge of these compounding risk factors among service providers will assist in obtaining sexual assault disclosures in a sensitive and supportive manner, leading to the provision of early interventions to mitigate the risks of developing PTSD following sexual assault. The findings suggest that empirical investigation is urgently required to develop evidence-informed practices in providing targeted interventions for sexual and gender minorities following a sexual assault and mitigating further adverse health outcomes. Full article

The Infectious and Tropical Diseases Department of the University of Brescia organized free rapid screening tests for HIV and HCV as part of the Fast-Track City commitment. A cross-sectional study was conducted, consisting of an anonymous multiple-choice questionnaire that was administered to individuals who underwent the screening or consultation. The study aimed to compare knowledge and attitudes towards HIV and HCV between age groups (18–40 vs. >40) and sexual orientations (heterosexual vs. LGBTQ+). Overall, 333 questionnaires were completed. Overall, only 107 (32%) of respondents knew how HIV is transmitted. Major differences were shown between different age groups, where people under the age of 40 had a significantly higher correct response rate than people over 40 (n = 101; 39% versus n = 6; 7.8%, p < 0.00001). Similarly, almost half of LGBTQI+ people (n = 28; 44.4%) gave the correct answer, versus 30% (n = 79) of heterosexuals (p = 0.0359). Only 9.6% of the population demonstrated high levels of knowledge for both HIV and HCV. Our study highlights that misconceptions about HIV and HCV should be addressed in prevention and education programs, whose target should also be specific populations. Full article