Search Results (47)

HIV disproportionately affects key populations (MSM, transgender people, sex workers and psychoactive substance users), who face greater social vulnerability and limited healthcare access. This study aimed at analyzing sexual orientation and gender identity and their association with sexual practices, sexually transmitted infections and psychoactive substance use among PrEP users. Method: A cross-sectional study was conducted between January 2018 and June 2021 with 736 Brazilian PrEP users from a health service in São Paulo. Sociodemographic data, sexual behaviors, STI history (past 3 months) and psychoactive substances use (past 3 months) were extracted from clinical records. The associations were analyzed using binomial logistic regression (p < 0.05). Results: Most of the participants were cisgender men (93.4%) and homosexual (84.8%), with a mean age of 34.9 years old. Condomless sex was reported by 98.5%, and 18.4% had some recent sexually transmitted infection, mainly syphilis. Psychoactive substance use was reported by 55.4%, especially marijuana, club drugs, erectile stimulants and poppers. Transgender and cisgender women were more likely to report sex work and crack use. Homosexual and bisexual participants had higher odds of using erectile stimulants. Conclusions: The study reveals key links between gender, sexual orientation and risk behaviors, highlighting the need for inclusive, targeted prevention. Full article

Background: Loneliness is both a social and a health-related problem, and among LGBT people, feelings of loneliness are often exacerbated. According to the minority stress theory, stress and loneliness can be directly related to the discrimination and stigma that are experienced over time in a heteronormative society. Exposure to social stigma causes mental health problems, stress, and loneliness, coupled with increased social and economic vulnerability. Method: The aim of this study was to conduct an exploratory analysis of homosexual men’s feelings of loneliness and their relationship with experiences of discrimination throughout their life. A qualitative methodology involving focus groups and individual interviews was utilized. Results: The results show the double or overlapping discriminations that gay men experience as a result of their age and sexual orientation and, in some cases, their HIV status, and the relationship between said discrimination and the feeling of unwanted loneliness. Exposure to such intolerance is more common among those with a reduced social network, which limits their social participation and has a negative impact on their well-being. Conclusion. The aging process of LGBT people implies a new context of intervention and research that must be addressed to prevent episodes of unwanted loneliness that negatively affect the quality of life among this demographic. Full article

The global impact of HIV is especially significant when diagnoses are made in advanced stages. While strategies exist to mitigate late presentations, Ecuador’s 2018–2022 strategic plan has not yet been evaluated. This study assesses the prevalence and implications of late and advanced HIV presentations in Ecuador, using data from a reference hospital in Quito. A cross-sectional analysis of 436 medical records of people living with HIV from the “Hospital de Especialidades Eugenio Espejo” was conducted between November 2015 and February 2020. The data were divided into “Pre-Plan” and “Post-Plan” periods for comparative analysis. The mean CD4 T count showed a non-statistically significant increase in the post-plan period (January 2018–February 2020). Notably, 65.1% of patients presented late, and 39.4% had advanced disease. Demographic data indicated that 89.9% were men, and 54.1% were under 30 years of age. No characteristics were identified that were associated with advanced late presentation of HIV infection. Sexual orientation data revealed that 69.1% identified as homosexual or bisexual. A predominance of late and advanced presenters was identified in the post-plan period, associated with being employed (p < 0.05) and being drug users (p < 0.001). There was also a greater incidence of late presenters among immigrants in the post-plan period (p = 0.045). Despite the implementation of Ecuador’s 2018–2022 strategic plan for HIV, substantial challenges in reducing late presentations remain. This study suggests that early diagnoses have not significantly improved. Employed patients and drug users were more likely to present late, with drug users also accounting for many advanced cases. This study highlights the need for more focused and targeted strategies to supplement the existing plan. Full article

Few things can potentially divide (and are dividing) Christians like the LGBTIQ+ issue. Conservative churches argue that sexuality forms an integral part of the human being and, hence, that sexual sin falls in a category of its own in any catalogue of sins. It is sin committed in the human body that radically affects one’s participation in Christ’s earthly body. To act on the realisation of same-sex lust is in itself sinful. Same-sex practices are viewed as sexual sin and all practitioners are condemned. On the other hand, there are Christians who accept that a homosexual orientation can be a biological given that needs to be accepted but that God views homosexual practice as an evil that should be avoided at all costs. Then there are also Christians who accept that a homosexual orientation is integral to some people’s humanity and accept same-sex behaviour as a regular expression of sexuality. Romans 1 plays a key role in the church’s discussion of the issue. The article reconsiders the textual evidence, using an exegetical model based on the historical–critical method combined with biblical theology. The conclusion is that Romans 1:24–29 refers to same-sex behaviour within the context of the Gentile world of idolatry that engages in wilful transgression of God’s bounds, resulting in degeneration in the lives of offenders. Full article

The beginning of the COVID-19 pandemic was marked by a sharp decline in syphilis infections in many countries worldwide, including Greece. However, a resurgence of positive cases started to appear in the second half of 2020. The aim of this study was to explore the impact of the pandemic on the incidence of new syphilis infections and reinfections and analyze the sociodemographic characteristics associated with recurrent episodes. We analyzed medical records from a 14-month period after the beginning of the pandemic and compared them with the respective period before the start of the pandemic. Our participants consisted mainly of men, with a median age of 43 years, homosexual orientation, and higher education. During COVID-19, more HIV patients presented for syphilis testing (38.0% vs. 34.6%, p = 0.025). Overall, we observed almost a two-fold increase in positive syphilis cases during COVID-19 (21.1% vs. 12.4%, p < 0.001), with new infections rising from 8.4% to 13.2% and reinfections from 4.0% to 7.9%. Multivariable logistic regression analysis revealed that the COVID-19 pandemic, among different parameters (such as age, gender, sexual orientation, HIV status, and educational level), was the only factor associated with higher positive syphilis rates (OR 1.47, 95% CI: 1.07–2.01, p = 0.003). Our results highlight the need to ensure enhanced prevention and undisrupted healthcare services, with a focus on future pandemics. Full article

Recent studies suggest that traditional bullying, cyberbullying, and homophobic bullying lead to a low health-related quality of life (HRQoL) in adolescents. The present study aims to analyze this, paying particular attention to homophobic bullying, based on the sexual orientation of 815 adolescents who were asked to fill in a self-report questionnaire. In heterosexuals, both homophobic victimization and victimization were inversely related to different dimensions of HRQoL (moods and emotions, and school environment, respectively). In adolescents who were uncertain about their sexual orientation, there were inverse relationships between homophobic victimization and mood and social acceptance, and there was also a positive relationship between homophobic aggression and physical well-being. In homosexuals and bisexuals, homophobic victimization was inversely related to social acceptance, economic resources, and autonomy, while homophobic aggression was not related to HRQoL. The results obtained offer new insights, thanks to the use of a specific and validated instrument to record homophobic bullying that covers both homophobic victimization and homophobic aggression. In addition, the need to intervene in a holistic manner, involving political and social agents, as well as all actors implicated in the school environment, is discussed with a view to protecting adolescent health and promoting inclusive education. Full article

Homosexual (lesbian or gay) and bisexual (i.e., LGB) people tend to suffer from social exclusion and thus distress. To prevent or relieve distress, the people’s assertiveness about justice and rights is an advocated means, but its effectiveness is uncertain, considering possible conflict with social exclusion. To clarify the effectiveness, this study analyzed data collected from 189 Chinese LGB adults in Hong Kong, which is a special administrative region of China generally Westernized and liberal to sexual orientation. Controlling for prior distress reported, the analysis showed that distress was lower when assertiveness was higher or social exclusion experienced was lower. However, distress was higher when both assertiveness and social exclusion experienced were higher. The higher distress implies a conflict between assertiveness and social exclusion to raise distress. It also implies the need to avoid conflict when promoting assertiveness and eliminating social exclusion to prevent distress in LGB people. Full article

Although several studies have found disparities in health outcomes between heterosexual and lesbian, gay, and bisexual (LGB)-identifying individuals, few studies have focused on subjective well-being and protective factors for health and well-being. The purpose of this work is twofold: (1) to examine the relevance of sexual orientation to health and well-being in women and men; (2) to identify protective and risk factors for psychological distress, self-rated health, and well-being for gay men, lesbian women, bisexual women and men, and heterosexual women and men. The sample consisted of 908 women and 586 men from the general Spanish population aged 16–64, half of whom identified themselves as LGB and half as heterosexual. All were assessed using eight questionnaires and inventories. The results showed that differences varied depending on the health indicator considered. In general, bisexuals had the poorest health, with lower self-rated health and lower self-esteem. In all groups, self-esteem was a protective factor against psychological distress and was associated with better health and well-being. To a lesser extent, social support served as a protective factor against psychological distress and was associated with greater well-being in all groups. It is concluded that although sexual orientation is relevant to the health and well-being of individuals, there are differences among sexual minorities, with bisexuals having lower self-esteem than homosexuals. Full article

Background: The incidence of syphilis has increased in high-income countries in the past few decades, especially among men who have sex with men. In the present study, we aimed to analyze the correlations between atypical syphilis manifestations and the demographic, clinical, and laboratory features of patients and to review unusual presentations of syphilis reported in the literature. Methods: We conducted a retrospective analysis of 307 patients with syphilis diagnosed between 1 January 2013 and 31 October 2023 at the sexually transmitted infection (STI) centers of the University of Genoa and University of Foggia with both typical and atypical manifestations of disease. Results: In our series, atypical manifestations were detected in 25.8% of the patients, especially in the secondary stage of the disease. Lesions with annular morphology and lesions presenting as itchy erythematous scaly plaques with a psoriasiform appearance were the most common atypical presentations of secondary syphilis. A statistical analysis revealed that homosexual orientation, syphilis reinfection, and venereal disease research laboratory (VDRL) titers > 1:32 were correlated with atypical manifestations. Conclusions: Our study demonstrates that the spectrum of syphilis manifestations, in all the stages of the disease, is wide; atypical manifestations often pose diagnostic challenges, may delay the provision of appropriate treatment, and facilitate the spread of the infection. 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

The interplay between disordered eating, depressive symptoms and self-objectification differs between genders and sexual orientations, and merits further study in homosexual and heterosexual men. We examined disordered eating, depressive symptoms and self-objectification in a sample of Israeli heterosexual and homosexual men. Participants were 215 men aged 19–65, 108 of whom were classified by the Kinsey scale as being heterosexual and 107 as homosexual. They completed online measures of self-objectification, disordered eating and depressive symptoms. Heterosexual men reported lower levels of disordered eating and self-objectification than homosexual men, however the difference in depressive symptoms was not statistically significant. Correlations between disordered eating, self-objectification and depressive symptoms when controlling for age, BMI and number of children were all significant, with similar patterns of association for heterosexual and homosexual men. Self-objectification partially mediated the association between sexual orientation and disordered eating. However, contrary to our hypothesis, sexual orientation (homosexual/heterosexual) did not moderate the association between disordered eating and self-objectification. The tendency of homosexual men towards self-objectification is linked to unhealthy eating habits. Self-objectification helps explain the propensity of homosexual versus heterosexual men to develop disordered eating and possibly eating disorders. It should therefore be targeted in prevention and in therapy. Full article

The Interpersonal Exchange Model of Sexual Satisfaction proposes that sexual satisfaction can be explained by the balance of sexual rewards or costs exchange. The Interpersonal Exchange Model of Sexual Satisfaction Questionnaire (IEMSSQ) was developed from this model. The IEMSSQ includes the Reward/Costs Checklist (RCC). The RCC assesses different sexual exchanges that are categorized into sexual rewards and/or costs. Analyses and comparisons of sexual rewards and costs in the Hispanic cisgender population based on gender (man or woman) and sexual orientation (heterosexual and homosexual) with this measure have not been conducted. The main goal was to analyze and rank the sexual rewards, costs, and both, indicated by a sample of 1996 Hispanic partnered participants (heterosexual men, gay men, heterosexual women, and lesbians). The predominant sexual exchanges that were reported involved emotional aspects, both as rewards and costs. When participants indicated that the exchange was both a reward and a cost, they were referring to aspects specifically related to the sexual relationship itself. Heterosexual men and women had greater rewards and higher costs, respectively. Gay men obtained a greater number of items reported as rewards and costs. The results provide further insight into sexual satisfaction related to gender and sexual orientation. Full article

Research has revealed that homosexual and bisexual people are at higher risk of mental health problems than heterosexual people. However, most studies have focused on differences in disorders and have not examined the intersection of gender and sexual orientation. The main aim of this study is to investigate the relevance of sexual orientation in women’s and men’s mental symptoms, life satisfaction, and self-esteem. A cross-sectional study was conducted with 309 women and men who were homosexual or bisexual and 309 women and men who were heterosexual, aged between 17 and 54. All participants were assessed by four self-reports measuring mental symptoms, life satisfaction, self-esteem, masculine/instrumental and feminine/expressive traits, and traditional gender role attitudes. Results showed an interaction between sexual orientation and gender, with lesbian or bisexual women scoring higher in severe depression symptoms and lower in life satisfaction than heterosexual women. Homosexual and bisexual people scored higher than heterosexuals in somatic symptoms, social dysfunction, and lower in self-esteem. Women scored higher than men in somatic, anxiety, and insomnia symptoms and in feminine/expressive traits, whereas men scored higher than women in traditional gender role attitudes. We conclude that sexual orientation and gender are relevant to the mental health and well-being of people. Full article

Vaccination is a crucial preventive measure against COVID-19. However, limited research has focused on identifying the factors predicting motivation to get vaccinated against COVID-19 (MoVAC-19) among lesbian, gay, and bisexual (LGB) individuals. This study examined the predictive effects of depression and sexual stigma (i.e., perceived sexual stigma from family members, perceived sexual orientation microaggression, and internalized sexual stigma) before the COVID-19 pandemic on MoVAC-19 among LGB individuals 4 years later during the COVID-19 pandemic in Taiwan. Baseline data related to depression and sexual stigma were collected in 2018 and 2019. Depression was assessed using the 20-item Mandarin Chinese version of the Center for Epidemiologic Studies Depression Scale. Perceived sexual stigma from family members was assessed using the Homosexuality-Related Stigma Scale. Internalized sexual stigma was assessed using the Measure of Internalized Sexual Stigma for Lesbians and Gay Men. Perceived sexual orientation microaggression was assessed using the Sexual Orientation Microaggression Inventory. Participant MoVAC-19 during the pandemic was assessed using the nine-item Motors of COVID-19 Vaccination Acceptance Scale. The associations of depression and sexual stigma at baseline with MoVAC-19 at follow-up were examined through multivariate linear regression analysis. Internalized sexual stigma was negatively associated with MoVAC-19, whereas perceived sexual orientation microaggression was positively associated with MoVAC-19. Depression and perceived sexual stigma from family members were not significantly associated with MoVAC-19. Although male sex and older age were positively associated with increased MoVAC-19, sex and age did not moderate the relationship between sexual stigma and motivation to get vaccinated. Among LGB individuals, sexual stigma experiences should be considered when developing intervention strategies aimed at enhancing MoVAC-19. Full article

Aim: This study aimed to analyze the reliability and validity of a Korean version of the Nursing Student Attitudes and Knowledge Toward Lesbian, Gay, Bisexual, and Transgender Patients (K-NAKL) Scale, which measures health and heterosexual attitudes toward LGBT individuals. Background: Lesbian, gay, bisexual, and transgender (LGBT) individuals often face discrimination and a lack of care experience on the part of healthcare professionals. Introduction: In South Korea, the current knowledge and attitude measurement tools for medical staff regarding LGBT individuals are limited, as they only focus on homosexuality and do not account for different sexual orientations. Methods: The participants were 217 nursing college students aged 18–25. The item–total correlations method and Cronbach’s alpha coefficient were used to analyze internal consistency reliability. Face validity, content validity, construct validity, and criterion validity testing were conducted to establish scale validity. We made sure to follow STROBE guidelines when carrying out this research. Results: The K-NAKL is a culturally appropriate instrument used to measure the attitudes and knowledge of Korean nursing students when it comes to LGBT health. Discussion: As LGBT health is increasingly gaining social interest, the nursing education curriculum needs to produce culturally competent graduates to meet the health needs of this vulnerable and marginalized population. The current study contributes to that goal. Conclusion: The K-NAKL is a valid and reliable tool with which to measure attitudes and knowledge regarding LGBT health among Korean nursing students. Implications for nursing: The K-NAKL can enable Korean nursing students to increase their knowledge and improve their attitudes when caring for the LGBT population. Implications for nursing policy and health policy: The study highlights the importance of incorporating LGBT-related health education into nursing curricula and developing inclusive policies to improve the quality of care and health outcomes for LGBT individuals. Full article