Assessing a Syndemic of Discrimination, Material Insecurity, Depression, Substance Use, and Violence Among Sexual and Gender Minorities in Nigeria Using Mixed Methods.

Sexual and gender minority people (SGM) in Nigeria experience disproportionate HIV burden, with an HIV prevalence four to ten times higher than the national average. Better understanding the factors that create HIV vulnerability in this population is important for designing effective interventions, particularly in a context largely hostile to SGM. We assessed a conceptual model describing a syndemic of discrimination, material insecurity, depression, substance use, intimate partner violence, and police and other violence among SGM in Abuja, Nigeria.

Disparities in human papillomavirus vaccination uptake across the intersection of disability and sexual orientation.

Purpose: Although human papillomavirus (HPV) vaccination provides effective primary prevention against cervical cancer, HPV vaccination rates remain low in the U.S. It is unknown whether women with disabilities and/or LGB + women are likely to experience disparities in HPV vaccination uptake.

Examining disparities in cervical cancer diagnosis at the intersection of disability and sexual orientation.

Background: Cervical cancer risk factors are more prevalent among women with disabilities and sexual minorities, yet little is known about how these factors intersect.

Objective: To examine differences in cervical cancer diagnosis at the intersection of disability and sexual orientation.

Methods: Using a nationally representative sample (N = 80,447) obtained from 2014 to 2023 National Health Interview Survey data, we conducted logistic regressions to estimate the odds of cervical cancer diagnosis at the intersection of disability and sexual orientation among women (25-65 years).

"Healthcare Doesn't Care": A Mixed-Methods Study on Healthcare Stigma and PrEP Use Among Black Sexual Minority Men.

BackgroundPre-exposure prophylaxis (PrEP) is a critical tool for HIV-prevention, yet PrEP uptake among Black sexual minority men (BSMM) is relatively low, despite greater HIV vulnerability. Stigma in healthcare settings can be a substantial barrier to PrEP use among BSMM, with implications for the HIV epidemic. We used a sequential explanatory mixed-methods approach to assess quantitative relationships between anticipated healthcare stigma and reduced PrEP use among BSMM, and qualitatively explore stigmatizing experiences within healthcare settings among this population.

Characterisation of a syndemic of STI symptoms, substance use and violence among incarcerated Peruvian women.

Objectives: Despite parallel global trends of increasing incarceration rates and sexually transmitted infections (STIs) among women, STI epidemiological data for this vulnerable at-risk population are limited. The study objective was to characterise patterns of STI symptoms and explore covariates and drivers of indicating STI symptoms using syndemic theory among a population of incarcerated women in Peru.

Methods: In a cross-sectional study, a sample of 249 incarcerated women responded to a questionnaire on substance use, depression, sexual behaviour, STI symptoms and violence, among other variables, between May and July 2015 in Santa Manica Prison (Lima, Peru).

An Integrated Intervention to Reduce HIV Risk Behaviors Among Heterosexual HIV-Negative, African American Couples: Pilot Feasibility, Acceptability, and Usefulness Study.

Synergistic interactions between substance use and violence (SAVA syndemic) are strongly associated with heightened risk for HIV acquisition in the African American population. While couple-based interventions have shown efficacy among at-risk and HIV-positive serodiscordant couples, no interventions have specifically targeted SAVA syndemic risk reduction for HIV-negative, high-risk, heterosexual African American couples in the United States. This pilot study tested the feasibility, safety, and preliminary effects of an integrated sexual risk reduction intervention for African American couples.

PrEP Stigma as a Minority Stressor among Black Sexual Minority Men: A Mixed-Methods Study.

Black sexual minority men (BSMM) remain disproportionately affected by HIV, yet Pre-exposure prophylaxis (PrEP) uptake in this population remains relatively low. Informed by minority stress theory, PrEP stigma may manifest in and exacerbate societal marginalization based on sexuality and race. We used an exploratory sequential mixed-methods approach to determine if PrEP-specific stigma was associated with reduced PrEP uptake among BSMM, and qualitatively explored how PrEP use is stigmatized among BSMM.

Psychometric Validation of the Connectedness to the LGBT Community Scale among Black Sexual Minority Men Living with HIV.

Purpose: LGBTQ + community connectedness is generally a protective health factor for sexual and gender minorities. However, existing scales have not been validated among Black sexual minority men living with HIV (SMMLWH), who face unique marginalized experiences that disproportionately impact several health outcomes compared to the general LGBT + community. We validated the Connectedness to the LGBT Community Scale among Black SMMLWH.

Binge Drinking Disparities by Grade, Race and Ethnicity, Sexual Orientation, and Gender Identity.

Background And Objectives: Binge drinking disparities between sexual and gender minority (SGM) students and their heterosexual, cisgender peers are well-established. Data limitations have precluded understandings of whether the onset and progression of these disparities differ by grade. Additionally, little is known about whether and how SGM-related binge drinking varies across groups of students coincidingly defined by sexual orientation or gender identity (SOGI), race, and ethnicity.

Posttraumatic Stress Disorder Symptoms and Incarceration: The Impact on Sexual Risk-Taking, Sexually Transmitted Infections, and Depression Among Black Sexual Minority Men in HIV Prevention Trials Network (HPTN) 061.

Black men and people belonging to sexual minority groups are disproportionately impacted by criminal legal involvement and sexually transmitted infections (STIs). Traumatic experiences are often associated with later criminal legal involvement, depression symptoms, sexual risk behavior, and STIs. Research on the joint influence of trauma and incarceration on STI risk among racial and/or sexual minority people is limited.

Projected volume of primary total joint arthroplasty in the USA from 2019 to 2060.

Introduction: The global incidence of total joint arthroplasty (TJA) has consistently risen over time, and while various forecasts differ in magnitude, future projections suggest a continued increase in these procedures. Differences in future United States projections may arise from the modeling method selected, the nature of the national arthroplasty registry employed, or the representativeness of the specific hospital discharge records utilized. In addition, many models have not accounted for ambulatory surgery as well as all payer types.

Police Harassment and Psychiatric, Sexual, and Substance Use Risk Among Black Sexual Minority Men and Black Transgender Women in the HIV Prevention Trials 061 Cohort.

Background: Black sexual minority men and Black transgender women (BSMM/BTW) experience disproportionate levels of HIV/STI-related risk factors as well as police harassment (PH). PH is linked to psychiatric risk and could play a role in substance use, sexual risk behavior, and HIV/STI risk.

Methods: We used data from the HIV Prevention Trials Network 061(HPTN 061) study to examine associations between PH and HIV/STI-related outcomes.

Exploring Psychosocial and Structural Syndemic Effects as Predictors of HIV Risk Behaviors Among Black Women (HPTN 064).

Syndemic models have been used in previous studies exploring HIV-related outcomes; however, these models do not fully consider intersecting psychosocial (, substance use, depressive symptoms) and structural factors (unstable housing, concentrated housing vacancy) that influence the lived experiences of women. Therefore, there is a need to explore the syndemic effects of psychosocial and structural factors on HIV risk behaviors to better explain the multilevel factors shaping HIV disparities among black women. This analysis uses baseline data (May 2009-August 2010) from non-Hispanic black women enrolled in the HIV Prevention Trials Network 064 Women's Seroincidence Study (HPTN 064) and the American Community Survey 5-year estimates from 2007 to 2011.

Black Sexual Minority Men's Experiences in MPowerment Interventions: Implications for HIV Prevention.

Background: Black sexual minority men (BSMM) are disproportionately vulnerable to HIV acquisition; the MPowerment model is one community-based framework for preventing HIV in this population. It focuses on developing a supportive network of peers to promote health messaging, reduce stigma, and improve resilience. While these interventions have demonstrated general success, there are important challenges related to race, sexuality, and internalized stigma.

Preliminary Psychometric Evaluation of Novel Measures of Therapist Practice Related to LGBTQ+ Clients.

Background: Culturally competent and equitable mental healthcare for LGBTQ+ people is critical for addressing mental health inequities for this population. Tools to assess therapists' practice with LGBTQ+ clients are needed for research and clinical efforts related to mental healthcare equity goals.

Methods: We conducted a preliminary assessment of the reliability and validity of a novel 28-item self-report measure assessing therapist practice with LGBTQ+ clients.

Latent syndemic profiles among sexual and gender minority college students and psychological distress amid the COVID-19 pandemic.

Sexual and gender minority (SGM) college students experience compounding psychological effects as a result of the COVID-19 pandemic. Using latent profile analysis of cross-sectional data from a sample of SGM students (n=565) we tested for a syndemic of victimization, internalized LGBTQ+ stigma, racism, racialized heterosexism/cisgenderism, family rejection, and isolation associated with psychological distress. We also tested if increases in these factors since the start of the COVID-19 pandemic were associated with greater psychological distress among syndemic profiles.

Age Differences in the Associations Between Incarceration and Subsequent Substance Use, Sexual Risk-Taking, and Incident STI Among Black Sexual Minority Men and Black Transgender Women in the HIV Prevention Trials 061 Cohort.

Incarceration can lead to different risk behaviors often due to increased distress and disruption of social networks. It is not well known, however, how these associations may differ by age. In this study, we measure age differences in longitudinal associations between incarceration and substance use, sex risk, and sexually transmitted infection (STI) among Black sexual minority men and Black transgender women (BSMM/BTW).

Challenges Unique to Transgender Persons in US Correctional Settings: a Scoping Review.

US correctional facilities operate under a binary interpretation of gender, which can yield inherent risks and conflicts for incarcerated transgender people. We conducted a scoping literature review on challenges unique to transgender individuals within US correctional settings. Online databases were searched to identify papers that addressed the challenges of incarcerated transgender adults age 18 + within US correctional institutions.

COVID-19, Vaccine Hesitancy, and HIV Pre-exposure Prophylaxis Among Black Sexual Minority Men.

Background: The COVID-19 pandemic has created substantial and profound barriers to several forms of health care engagement. For Black sexual minority men, this may include engagement with pre-exposure prophylaxis (PrEP) to prevent HIV infection, with significant implications for HIV disparities. Our study explored how the COVID-19 pandemic affected Black sexual minority men, with a focus on relationships between COVID-19 and PrEP engagement.

LGBTQ+ cultural-competence training effectiveness: Mental health organization and therapist survey outcome results from a pilot randomized controlled trial.

Lesbian, gay, bisexual, transgender, queer/questioning and other sexual and gender diverse (LGBTQ+) persons frequently lack access to mental health service organizations (MHOs) and therapists who are competent with LGBTQ+ clients. Existing continuing education programmes to better equip therapists to work with LGBTQ+ clients are often not widely accessible or skills focused, evaluated for effectiveness and inclusive of MHO administrators who can address the organizational climate needed for therapist effectiveness. A virtual, face-to-face, multi-level (administrators and therapists) and multi-strategy (technical assistance, workshop and clinical consultations) LGBTQ+ cultural competence training-the Sexual and Gender Diversity Learning Community (SGDLC)-was tested in a pilot randomized controlled trial.

Associations between police harassment and distrust in and reduced access to healthcare among Black sexual minority men: A longitudinal analysis of HPTN 061.

Objective: Evaluate associations between racialized and homophobia-based police harassment (RHBPH) and healthcare distrust and utilization among Black Sexual Minority Men (BSMM).

Methods: We utilized data from a longitudinal cohort study from HIV Prevention Trials Network (HPTN) 061 with baseline, six and 12 month follow-up assessments. Using multivariable analysis, we evaluated associations between RHBPH and healthcare distrust and utilization reported at the 6 and 12 month visits.

Monkeypox-Related Stigma and Vaccine Challenges as a Barrier to HIV Pre-Exposure Prophylaxis among Black Sexual Minority Men.

Background: The U.S. monkeypox (mpox) outbreak of 2022 was a unique emergent public health crisis disproportionately affecting Black sexual minority men (BSMM).