Several Common Bonds: Addressing the Needs of Gay and Bisexual Men in LGBT-Specific Recovery Housing

ABSTRACT

Recovery housing is a promising way to augment the substance use continuum of care, but we know little about the experiences of members of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community who live in them or about residences specifically for them. Within the LGBTQ community, gay, bisexual, and other men who have sex with men (MSM) often experience co-occurring syndemic conditions (e.g., trauma, depression, HIV) that present unique recovery challenges. Using qualitative data gathered from residents living in a recovery residence specifically for gay and bisexual men and from community key informants, we examine the experiences of men living in the home and factors that facilitate operating it. Findings highlight the need for residences that can address syndemic burden among gay and bisexual men in recovery and identify programmatic and community-level factors critical to operating residences for this population.     

Is the Lack of Specific Lesbian,Gay, Bisexual,Transgender and Queer/Questioning (LGBTQ) Health Care Education in Medical School a Cause for Concern? Evidence From a Survey of Knowledge and Practice Among UK Medical Students

Lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) people frequently report negative health care encounters. Medical professionals may inadequately manage LGBTQ persons’ health if they have not received training in this area. An anonymous survey measuring efficacy in health situations among LGBTQ persons was answered by 166 medical students across all years of a UK university. Results show that 84.9% of participants reported a lack of LGBTQ health care education, with deficits in confidence clarifying unfamiliar sexual and gender terms, deciding the ward in which to nurse transgender patients, finding support resources, and discussing domestic abuse with LGBTQ patients. Most participants reported that they would not clarify gender pronouns or ask about gender or sexual identity in mental health or reproductive health settings. Participants reported infrequently observing doctors making similar inquiries. Participants held positive attitudes toward LGBTQ patients, with attitude scores positively correlating with LGBTQ terminology knowledge scores (r_s = 0.5052, p < .01). Addressing gender identity and sexuality issues within medical curricula may remove barriers to accessing health care and improve encounters for LGBTQ patients.     

Health Needs and Experiences of a LGBT Population in Georgia and South Carolina

ABSTRACT

The 2016 Municipal Equality Index rated Augusta, the largest city in the Central Savannah River Area (CSRA), as one of the least lesbian, gay, bisexual, and transgender (LGBT) friendly cities in America. To understand the context of our region in relation to LGBT wellness, we conducted the first LGBT health needs assessment of the CSRA, assessing physical and mental health status and health care needs and experiences in the community. Participants (N = 436) were recruited using venue and snowball sampling and completed an anonymous online survey. Overall, the health problems experienced (i.e., obesity, depression) were not uniformly experienced across sexual orientation and gender identity; some groups experienced significantly higher rates of these conditions than others. Similarly, transgender individuals in particular reported higher rates of negative experiences with health care providers. Regional and national dissemination of these findings is critical to reducing health disparities and improving wellness of our local LGBT community.     

Health Care Needs and Care Utilization Among Lesbian,Gay, Bisexual,and Transgender Populations in New Jersey

The purpose of this study was to explore prevalent health issues, perceived barriers to seeking health care, and utilization of health care among lesbian, gay, bisexual, and transgender (LGBT) populations in New Jersey. A cross-sectional online survey was administered to 438 self-identified LGBT people. Results identified health needs, which included management of chronic diseases, preventive care for risky behaviors, mental health issues, and issues related to interpersonal violence. Barriers to seeking health care included scarceness of health professionals competent in LGBT health, inadequate health insurance coverage and lack of personal finances, and widely dispersed LGBT inclusive practices making transportation difficult. There is a need for better preparation of health care professionals who care for LGBT patients, to strengthen social services to improve access and for better integration of medical and social services.     

LGBT Health in the Midlands: A Rural/Urban Comparison of Basic Health Indicators

Research into the health and wellbeing of rural lesbian, gay, bisexual, and transgender (LGBT) populations is limited. A community-based participatory research (CBPR) approach was used to develop an online survey for LGBT Nebraskans. The 770 participants replied to an array of questions on social determinants of health and basic health outcomes. Only significant differences in having health insurance were found between urban and rural participants. Social determinants of health were explored. Results of this study suggest that regional culture may be more salient to health for lesbian, gay, bisexual, and transgender persons living in the Midwest than rural or urban residence.     

The Interrelations Between Internalized Homophobia,Depressive Symptoms,and Suicidal Ideation Among Australian Gay Men,Lesbians, and Bisexual Women

ABSTRACT

Internalized homophobia has been linked to depression among gay men, lesbians, and bisexuals. Relatively little research has investigated the link between internalized homophobia and suicidal thoughts and behaviors. The current research investigated the interrelations among internalized homophobia, depressive symptoms, and suicidal ideation by testing additive, mediation, and moderation models. Self-identified Australian gay men (n = 360), lesbians (n = 444), and bisexual women (n = 114) completed the Internalized Homophobia Scale, the Center for Epidemiological Studies Depression Scale, and the suicide subscale of the General Health Questionnaire. Results supported the additive and partial mediation models for gay men and the mediation and moderation models for lesbians. None of the models were supported for bisexual women. The findings imply that clinicians should focus on reducing internalized homophobia and depressive symptoms among gay men and lesbians, and depressive symptoms among bisexual women, to reduce suicidal ideation.     

Suicidality and Associated Factors Among Men Who Have Sex With Men in Estonia

Many studies over the last decade provide strong evidence of elevated rates of suicidality among lesbian, gay, bisexual, and transgender populations compared to heterosexual populations. The aim of the current study was to investigate suicidal ideation and attempts and related factors among men who have sex with men (MSM) in Estonia. We conducted a nationwide Internet-based study among MSM with 265 eligible participants. Our results reveal high rates of self-reported suicidal ideation (lifetime prevalence 45%) and attempts (lifetime prevalence 11%) as well as a high rate of problem drinking (33%) and depressive symptoms (32%) among MSM. Recent suicidal ideation (14% had thought about suicide in the last 12 months) was related to depressive symptoms and lower socioeconomic situation. There is a need to develop specific interventions to address these issues among MSM and to provide gay-friendly mental health services.     

Health Care Issues Among Lesbian,Gay, Bisexual,Transgender and Intersex (LGBTI) Populations in the United States: Introduction

ABSTRACT

This supplemental issue of the Journal of Homosexuality presents research that explores a variety of health care issues encountered by lesbian, gay, bisexual, transgender and intersex (LGBTI) population groups in the United States over the 10-year period from 1993 to 2002.

Topics include access to health care, utilization of care, training of medical and mental health providers, and the appropriate preparation of clinical offices and waiting areas. Authors used a variety of community-based public health research methods, including participant and provider surveys and retrospective chart reviews of patients, to develop this body of research, providing a recent-historical perspective on the complex health care and health-related needs of sexual and gender minorities. Particularly for transgender and intersex populations, the state of research describing their health care needs is in its infancy, and much remains to be done to design effective medical and mental health programs and interventions.     

Internalized Homophobia,Coping, and Quality of Life Among Nigerian Gay and Bisexual Men

ABSTRACT

Despite high levels of homophobia in Nigeria, no studies have investigated the quality of life (QOL) of Nigerian gay and bisexual (GB) men. The associations between QOL and minority stress may differ from those reported in developed countries and may indicate alternative interventions. This study investigated internalized homophobia (IH) and coping strategies among gay and bisexual men in Nigeria and the relationships with overall QOL. Eighty-nine GB men were recruited with a snowball sampling technique. QOL (outcome), IH (predictor) and coping strategies (covariates) were assessed using standardized questionnaires. Relationships were investigated using linear regression analyses. Participants used adaptive more frequently than maladaptive coping strategies. The relationship between IH and QOL was nonlinear (β = ?0.27, 95% CI = ?0.48, ?0.06), and the positive component was attenuated by adaptive coping strategies. Adaptive strategies can be reinforced as a therapeutic intervention to improve wellbeing among gay and bisexual men in Nigeria.     

Health care issues among lesbian, gay, bisexual, transgender and intersex (LGBTI) populations in the United States: Introduction

This supplemental issue of the Journal of Homosexuality presents research that explores a variety of health care issues encountered by lesbian, gay, bisexual, transgender and intersex (LGBTI) population groups in the United States over the 10-year period from 1993 to 2002. Topics include access to health care, utilization of care, training of medical and mental health providers, and the appropriate preparation of clinical offices and waiting areas. Authors used a variety of community-based public health research methods, including participant and provider surveys and retrospective chart reviews of patients, to develop this body of research, providing a recent-historical perspective on the complex health care and health-related needs of sexual and gender minorities. Particularly for transgender and intersex populations, the state of research describing their health care needs is in its infancy, and much remains to be done to design effective medical and mental health programs and interventions.     

Intimate Partner Violence Among Sexual Minorities in Japan: Exploring Perceptions and Experiences

Using qualitative interviews (n = 39) and participant observation (n = 54), this study documents perceptions and experiences of violence between lesbian, gay, bisexual, transgender, and intersex intimate partners in Japan, thereby providing exploratory, formative data on a previously unexamined issue. Results indicate that intimate partner violence (IPV) is experienced physically, sexually, and psychologically in all sexual minority groups. Participants perceived the violence to be: a) very similar to heterosexual IPV against women; b) more likely perpetrated and experienced by lesbians, bisexual women, and transgender persons compared to gay and bisexual men and intersex persons; c) the cause of several negative physical and mental health outcomes; and d) largely unrecognized in both sexual minority communities and broader Japanese society.     

“All of My Lovers Fit Into This Scale”: Sexual Minority Individuals’ Responses to Two Novel Measures of Sexual Orientation

Previous qualitative research on traditional measures of sexual orientation raise concerns regarding how well these scales capture sexual minority individuals’ experience of sexuality. The present research focused on the critique of two novel scales developed to better capture the way sexual and gender minority individuals conceptualize sexuality. Participants were 179 sexual minority (i.e., gay, lesbian, bisexual, pansexual, queer, asexual) individuals who identified as cisgender (n = 122) and transgender (n = 57). Participants first completed the new scales, then provided qualitative responses regarding how well each scale captured their sexuality. The Sexual-Romantic Scale enabled the measurement of sexual and romantic attraction to each sex independently (same-sex and other-sex). Participants resonated with the way the Sexual-Romantic scale disaggregated sexual and romantic attraction. Although cisgender monosexual (lesbian/gay) individuals positively responded to the separation of same- and other-sex attraction, individuals with either plurisexual (bisexual, pansexual, or fluid) or transgender identities found the binary conceptualization of sex/gender problematic. The Gender-Inclusive Scale incorporated same- and other-sex attraction as well as dimensions of attraction beyond those based on sex (attraction to masculine, feminine, androgynous, and gender non-conforming individuals). The incorporation of dimensions of sexual attraction outside of sex in the Gender-Inclusive Scale was positively regarded by participants of all identities. Findings indicate that the Sexual-Romantic and Gender-Inclusive scales appear to address some of the concerns raised in previous research regarding the measurement of sexual orientation among sexual minority individuals.     

PrEP Awareness in the Context of HIV/AIDS Conspiracy Beliefs Among Black/African American and Hispanic/Latino MSM in Three Urban US Cities

ABSTRACT

We examined HIV conspiracy beliefs and PrEP awareness in a convenience sample of minority MSM. Participants in three cities completed a behavioral self-assessment on sociodemographics, PrEP awareness, and HIV/AIDS conspiracy beliefs. HIV/AIDS conspiracy beliefs were more common among Black than Latino MSM (58% vs. 42%, p < .05), and among younger men than older men (age 18–29 (50%), 30–39 (22%), 40+ (28%); p < .05). PrEP awareness co-occurred with conspiracy belief less (37%) than with non-belief (63%, p < .05), persisting in multivariable regression (aOR = 0.52, 95% CI = 0.38–0.71). This relationship suggests that current HIV care and prevention messaging is either inaccessible or not credible to some minority subpopulations.     

LGBT-Competence in Social Work Education: The Relationship of School Contexts to Student Sexual Minority Competence

This study examined the relationship between master of social work programs’ (MSW) support of lesbian, gay, bisexual, and transgender people (LGBT-competence) and the sexual minority competence (LGB-competence) of social work students. Data were gathered from a sample of MSW program directors, faculty members, and students (N = 1385) within 34 MSW programs in the United States. A series of hierarchical linear models tested if a MSW program’s LGBT-competence was associated with the LGB-competence of its students. Results showed a significant relationship between organizational LGBT-competence and individual LGB-competence within schools of social work, and that programs with greater LGBT-competence also had students who felt more competent to work with sexual minorities. These findings suggest schools of social work can take substantive action at an organizational level to improve the professional LGB-competence of future social workers. Implications for social work education are discussed.     

Left Out? Lesbian,Gay, and Bisexual Poverty in the U.S.

This paper analyzes the risk of poverty for self-identified lesbian, gay, and bisexual (LGB) people from mid-2013 through 2016 in the National Health Interview Survey, a nationally representative survey of households that includes a sexual orientation question based on identity (n = 112,143). The study tests the role of family structure—living with a spouse or partner and having children—on the risk of poverty for LGB and heterosexual respondents. After controlling for education, demographic, and health measures in a probit model, lesbians and gay men are as likely to be poor as similar heterosexuals, but bisexual women and men are significantly more likely to be poor, regardless of relationship status. Single and childless gay men are also more likely to be poor than single heterosexual men. Being in a relationship reduces the likelihood of poverty for people of all sexual orientations, but the data show evidence of a gender composition effect: married male same-sex couples are less likely and unmarried female same-sex couples more likely to be poor than their married counterparts. Marriage reduces gay men’s poverty risk more and children increase their poverty risk less than for heterosexual men.     

Seroadaptive Strategies of Vancouver Gay and Bisexual Men in a Treatment as Prevention Environment

British Columbia’s treatment as prevention policy has provided free access to highly active antiretroviral therapy (HAART) to all HIV-positive provincial residents since 1996. One outcome is an increase in HIV-positive gay and bisexual men (GBM) with suppressed viral loads. Previous cross-sectional analyses indicated that some Vancouver GBM now recognize condomless anal sex with men on HAART who report a suppressed viral load as a seroadaptive strategy. To test the hypothesis that this new strategy, termed viral load sorting (VLS), is recognized and used among by GBM in the Momentum Health Study, we analyzed longitudinal data for HIV-negative/unknown (n = 556) and HIV-positive (n = 218) serostatus participants. Analyses indicated that both groups reported VLS, and that serostatus and Treatment Optimism Scale scores were significant determinants in frequency and use. Results exemplify the medicalization of sex and Rogers’ Diffusion Of Preventative Innovations Model, and they have important implications for HIV research and GBM sexual decision-making.     

Factors Influencing the Career and Academic Choices of Lesbian,Gay, Bisexual,and Transgender People

This is an empirical study of academic and career choices for 119 lesbian, gay, bisexual, and transgender (LGBT) students using a questionnaire. Respondents who reported that their sexual orientation influenced their choices a great deal indicated that the influences were both positive and negative. This group was most likely to have experienced anti-LGBT discrimination in the past. In comparing lesbian, bisexual people, and gay males, gay males and respondents from visible minorities were the most likely to feel a negative impact, while bisexual respondents were the least likely. There were too few transgender respondents to include in these statistical comparisons; however, frequencies suggest that transgender people may be the most vulnerable of all. Results suggest that counselors need to take sexual orientation issues, particularly past experiences of discrimination, when working with LGBT clients.     

Factors influencing the career and academic choices of lesbian, gay, bisexual, and transgender people

This is an empirical study of academic and career choices for 119 lesbian, gay, bisexual, and transgender (LGBT) students using a questionnaire. Respondents who reported that their sexual orientation influenced their choices a great deal indicated that the influences were both positive and negative. This group was most likely to have experienced anti-LGBT discrimination in the past. In comparing lesbian, bisexual people, and gay males, gay males and respondents from visible minorities were the most likely to feel a negative impact, while bisexual respondents were the least likely. There were too few transgender respondents to include in these statistical comparisons; however, frequencies suggest that transgender people may be the most vulnerable of all. Results suggest that counselors need to take sexual orientation issues, particularly past experiences of discrimination, when working with LGBT clients.     

Difference in Condom Use Between Bear Concordant and Discordant Dyads During the Last Anal Sex Event

The purpose of this study was to understand how bear identity influenced condom use during the last anal sex event. Participants were recruited to complete an online, anonymous self-report survey through bear-related sexual and social networking websites. A total of 1,080 men who identified as gay or bisexual and as a member of the bear community and were 18 years or older completed the survey. Overall, fewer than a third of men reported condom use during the most recent receptive (28%) and insertive (30%) anal sex event. Men in bear concordant pairings were less likely to use a condom during receptive and insertive anal sex compared to those is discordant pairings (p < .05). Findings suggest that bear identity concordance influences condom use during anal sex after accounting for an individual’s relationship to their most recent partner as well as other confounding variables.     

Identifying the Needs of LGBTQ Immigrants and Refugees in Southern Arizona

This article reports on the results of a needs assessment conducted for lesbian, gay, bisexual, transgender, and queer (LGBTQ) immigrants, asylees, refugees, and their allies in Southern Arizona, and it is the first study of its kind in the United States. Utilizing interview data collected with migrants, allies, and service providers in Tucson, Arizona, this article presents findings on the quality of service provision provided to this very underserved community pertaining to health care, housing, and legal services. The assessment shows that no services are provided specifically for LGBTQ migrants, and most LGBTQ migrants turn to family and friends when they have needs. The most significant result of this study pertains to the lack of cultural competence and an overall deficiency in terms of cultural awareness when it comes to the specific needs of LGBTQ migrants.