Bisexual Persons Research Articles

Mind the Gap! LGBTQ + Population’s Perceptions of Discrimination and of Legal Innovation

Abstract Introduction Homosexuality was decriminalized in Portugal in 1982, and several legislative changes have emerged since the beginning of the twenty-first century. However, 2010 marked the beginning of the approval of fundamental laws for the life of LGBTQ + people, such as same-sex marriage, access to parenthood and the right to self-determination of gender identity. Despite these advances, discrimination is still present in Portuguese society. Methods The aim of this investigation is to study the processes and experiences of discrimination of LGBTQ + people in their daily lives, analyzing the perception of the discrepancy between legislation and the experiences of participants. Its aim is also to analyze the strategies suggested by the participants to reduce this discrepancy. To this end, semi-structured interviews were conducted with 21 LGBTQ + participants, of various sexual orientations (six gay men, three lesbian women, six bisexual persons, five pansexual individuals, and one who identified as “other”) and gender identities (six transgender participants, including two trans men, two non-binary persons, one trans woman, and one genderqueer participant). Results Content analysis of these interviews resulted in 828 units of analysis coded in 30 categories. The participants reported that they have gone through multiple experiences of discrimination in different contexts and that they recognize forces of resistance to legal innovation. Conclusion There is a gap between legal advances and the experiences of LGBTQ+ people in Portugal, who still report discrimination experiences in many domains of daily life. Policy Implications Implications for research and public policies are presented, particularly considering the need to inform and provide training to both strategic audiences and stakeholders and to inform the larger population to promote social change.

From the closet to spotlight: the rising tide of lesbian, gay and bisexual political candidacies

ABSTRACT Is there a positive sexuality gap in access to political candidacy and elected office, similar to those found in other forms of political engagement? We utilise validated data on same- and different-sex families from the Swedish administrative registry to descriptively examine long-term trends in access to political candidacy and elected office among Swedish lesbian, gay, and bisexual (LGB) persons. With data covering twenty-four elections and a sample size of nearly seventy million individuals, our findings reveal a gradually emerging positive sexuality gap in access to political candidacy and a declining share of ‘sacrificial lambs’ among LGB candidates. We verify the robustness of these findings with the help of two original representative samples from the Swedish population. By shedding light on the existence and durability of a positive lavender gap in access to political candidacy, this study contributes to existing debates concerning the obstacles to minority political participation and descriptive representation and how they might be overcome.

Binegativity and Social Distance Toward Bisexual Women and Men Among Hispanics Puerto Ricans: A Brief Report

This brief report aimed to geographically describe binegativity and social distance among Hispanic Puerto Ricans, and to explore social determinants related to binegativity and social distance toward bisexual women and men. The team employed secondary research data based on a quantitative, cross-sectional study. Data from a sociodemographic questionnaire, a binegativity scale, and a social distance scale were extracted. Demographic data of a sample of 177 participants were poststratified and divided into binary categories for analysis. Results showed that half of the sample (54.2%) reported high or very high binegativity. Similarly, half of the sample (50.8%) also reported moderate or high social distance toward bisexual individuals. The study also found that participants under 30 years of age and without a religion significantly reported less binegativity. In addition, participants who identify as men, as lesbian/gay, and know a bisexual person significantly reported less social distance. The need for more research is discussed.

Sexual satisfaction, an indicator of sexual health and well-being? Insights from STI/HIV prevention research in European men who have sex with men

IntroductionAlthough sexual health has been holistically defined to include sexual satisfaction, it has been largely absent in health services and sexual and reproductive health and rights programmes in many parts...

The rural side of the rainbow: Mental health and the intersections of geography, sexuality, and partnership.

Lesbian, gay, and bisexual (LGB) persons tend to be geographically concentrated in larger metropolitan areas and research persistently observes LGB persons as a disadvantaged population for mental health outcomes when compared to their heterosexual counterparts. Conflicting evidence suggests that mental health risk exposures are greater for LGB people in rural spaces while other research posits that urban residency is more detrimental for LGB mental health. One positively contributing factor to the mental well-being of LGB persons is their partnership status. To date, no study estimates how partnership may ameliorate unfavourable mental health outcomes for LGB populations in urban and rural areas. Using 10 years of pooled data from the nationally representative Canadian Community Health Survey (CCHS), this study examines mental health and the intersection of sexuality, geographic residency, and partnership. Logistic regression models estimate the intersections of sexuality, geography, and partnership status on mental health, stratified by respondents' gender. Findings show partnered gay men in rural areas experiencing better mental health than their partnered heterosexual counterparts in the largest urban cities. Although not significant, the same pattern is observed for partnered lesbian women who do not experience a significant mental health disadvantage at any geographic level. Regardless of partnership and geographic space, bisexual men, and especially bisexual women, exhibit worse mental health outcomes compared to their heterosexual counterparts.

LGBTI + Persons’ Experiences, Expectations, and Suggestions for Improving LGBTI + Healthcare Services in Turkey: A Qualitative Study

This study aimed to explore the experiences, expectations, and suggestions of LGBTI + persons from the health system in Turkey and their views on what kind of a health system they wish to have. Qualitative descriptive research was used as one of the qualitative research methods. Thirteen LGBTI + persons living in different provinces of Turkey were interviewed. While selecting the participants, the maximum diversity sampling method, one of the purposive sampling methods, was employed. Attention was paid to interview participants from different groups among LGBTI + persons (three gay men, five trans men, two trans women, one queer person, one lesbian person and one bisexual person). Thematic analysis was performed for the analysis of individual in-depth interviews. The expectations of the participants were grouped under three themes: (a) institutional functioning, (b) legal regulations, and (c) healthcare professionals. Each theme and 9 sub-themes demonstrate what kind of a health system LGBTI + persons want to have. Some of the common expectations of the participants are having LGBTI + friendly and free healthcare services, adoption of anti-discrimination laws, and receiving healthcare from professionals with LGBTI+-specific healthcare knowledge. Changes to be made by policy makers, hospital administrators and healthcare professionals in line with the results obtained from the research can improve the experiences of LGBTI + persons in terms of receiving a higher quality healthcare service.

The Experience of Bi-Negativity in Mixed Gender Relationships

Bisexual orientation in the context of long-term relationships comes with a unique set of challenges, especially when that relationship is mixed gender. The cultural belief that bisexual orientation is unstable or temporary paired with the presentation of a partnership that grants heterosexual privilege can be a complex place to exist for bisexual individuals. This experience was examined in semi-structured interviews of 55 bisexual people in a mixed-gender relationship. Participants were an average of 29 years of age and ranged in age from 21 to 48. Reflexive thematic analysis resulted in the identification of three major themes and two subthemes. The major themes were: (1) cultural assumptions of bisexual orientation, (2) bi-negativity/biphobia, and (3) bi-invisibility. These findings highlight the complexity of existing day-to-day as a bisexual person in a mixed-gender relationship. The implications of these findings for individuals, clinicians, and communities and directions for future research are discussed.

Sexual Minorities’ Experiences in Therapy Services in Puerto Rico: A Qualitative Study

Studies have found that lesbian, gay, and bisexual persons (LGB+) find that their therapist does not have the necessary knowledge to work with their sexual orientation, they ignore their sexual orientation, they do not meet their needs, and they even conceptualize it as a problem. The purpose of this study was to explore the experiences of LGB+ people with therapeutic services received. This study was a secondary data analysis of the qualitative results of a mixed method study from a phenomenological exploratory scope. Eighty-seven (87) persons who identified their sexual orientation as LGB+ participated in this study. Thematic analysis was used as an analysis technique. Eight (8) main topics emerged that are exposed and justified in the results: preconceptions about the development of the sexual orientation, feelings about disclosure, signs of understanding or misunderstanding, personal qualities, professional qualities, religious experiences, homophobic and biphobic experiences, and heterosexist experiences. The repercussions of the findings are discussed and the curricular review of the disciplines and the professional acquisition of competencies and skills necessary for therapeutic practice with LGB+ people are recommended, as established by local and national guidelines.

Tobacco Product Use Among Adults – United States, 2021

Commercial cigarette smoking among U.S. adults has declined during the preceding 5 decades (1,2); however, tobacco product use remains the leading cause of preventable disease and death in the United States, and some populations continue to be disproportionately affected by tobacco use (1,2). To assess recent national estimates of commercial tobacco use among U.S. persons aged ≥18 years, CDC, the Food and Drug Administration (FDA), and the National Cancer Institute analyzed 2021 National Health Interview Survey (NHIS) data. In 2021, an estimated 46 million U.S. adults (18.7%) reported currently using any tobacco product, including cigarettes (11.5%), e-cigarettes (4.5%), cigars (3.5%), smokeless tobacco (2.1%), and pipes (including hookah)* (0.9%).† Among those who used tobacco products, 77.5% reported using combustible products (cigarettes, cigars, or pipes), and 18.1% reported using two or more tobacco products.§ The prevalence of current use of any tobacco product use was higher among the following groups: men; persons aged <65 years; persons of non-Hispanic other races; non-Hispanic White (White) persons¶; residents of rural (nonmetropolitan) areas; financially disadvantaged (income-to-poverty ratio=0-1.99); lesbian, gay, or bisexual (LGB) persons; those uninsured or enrolled in Medicaid; adults whose highest level of education was a general educational development (GED) certificate; who had a disability; and who had serious psychological distress. Continued surveillance of tobacco product use, implementation of evidence-based tobacco control strategies (e.g., hard-hitting media campaigns, smoke-free policies, and tobacco price increases), conducting linguistically and culturally appropriate educational campaigns, and FDA regulation of tobacco products will aid in reducing tobacco-related disease, death, and disparities among U.S. adults (3,4).

Dimensions of binegativity differentially predict drinking to cope motivations and alcohol use severity among bisexual women.

Research indicates that bisexual women experience greater stigmatization and discrimination compared to lesbian women. Such oppression is described as binegativity and is associated with alcohol use among bisexual women. Specifically, previous research has suggested that bisexual women may drink to cope in an effort to self-medicate from experiences of binegativity. Although substantial research has been conducted with regard to drinking behaviors among at-risk groups, research has yet to identify which specific types of binegativity may be most predictive of drinking outcomes among bisexual women. Consequently, the present study sought to examine the predictive utility of three dimensions of binegativity: (a) sexual orientation instability (e.g., the perception of bisexuality as an illegitimate sexual orientation), (b) sexual irresponsibility (e.g., the stereotype that bisexual persons are oversexualized or sexually promiscuous), and (c) interpersonal hostility (e.g., the alienation and uncomfortability with bisexual identification), on drinking to cope motivations and alcohol use severity. Participants were 225 self-identified bisexual women between the ages of 18 and 30 years (Mean = 22.77, SD = 3.45) who participated in a larger study about health behaviors among bisexual women. Multiple regressions revealed that, compared to other binegativity dimensions, sexual irresponsibility was the strongest predictor of typical alcohol use, drinking to cope motivations, and alcohol use severity. Thus, bisexual women who are stereotyped to be sexually promiscuous are at particular risk for problematic alcohol use. Prevention and intervention efforts should target stress associated with experiences of oversexualized stigmatizations, in an effort to reduce alcohol-related risk among bisexual women. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PSYCHOSOCIAL AND PSYCHIATRIC CHARACTERISTICS AMONG CROATIAN LESBIAN, GAY, AND BISEXUAL POPULATION

Since there is scarcity of psychological research on lesbian, gay, and bisexual persons (LGB) in Croatia, we aimed to collect first information about the prevalence of psychiatric disorders, psychosocial characteristics and factors related to those issues in LGB adults living there. We focused on bulimia nervosa, binge eating, alcohol abuse, major depressive disorder, other depressive syndromes, panic syndrome, and other anxiety syndromes and somatoform syndrome. Psychosocial information was also gathered and included details about abuse, being out, sexually risky behavior, employment, education, socio-economic status, relationships status and sociodemographic characteristics. According to research, 39% of LGB persons were unemployed and 52.2% were abused. Alcohol abuse is high among all subgroups. Women are prone to somatoform symptoms and alcohol abuse. Since there is insufficient research on the problems of Croatian LGB persons, our results show that there is a real need for regular screening for psychopathology in Croatian homosexual and bisexual persons and for preventive interventions. Keywords: LGBT, mental health, prevalence, psychopathology, assessment, psychiatric disorders, psychosocial problems

Unicorns on the Digital Range: Bisexual Persons’ Experiences of Geo-Social Networking Application Use

Geo-social networking applications (GSNAs) like Tinder and Grindr are popular tools for connecting with people for romance, sex, and other purposes, particularly among sexual minorities. This paper draws on narrative interviews with 13 bisexual persons (5 cisgender men, 6 cisgender women, 2 trans/nonbinary persons) to explore their GSNA use, including motives and gratifications, relational dynamics, and implications for individual identities and cultural understandings of bisexuality. Participants presented complex and ambivalent accounts of their GSNA use, revealing a variety of relational aspirations and experiences. Whatever users’ goals, cultural meanings associated with bisexuality shaped online interactions in ways that impeded their fulfillment, with binegativity routinely preventing relationship formation in the first instance or precipitating relationship dissolution. Despite these challenges, bisexual persons regularly have successful digitally-mediated encounters which can reshape private and collective understandings of bisexuality. GSNAs expose users to new experiences and discourses that help them make sense of their erotic predilections, including partner sex/gender sexuality. They may also play a role in the broader sea change in attitudes toward bisexuality by facilitating the formation of mixed orientation relationships wherein stereotypes are gradually replaced by direct personal experience.

Adverse childhood experiences and mental health problems in a nationally representative study of heterosexual, homosexual and bisexual Danes.

Non-heterosexual persons more often report adverse childhood experiences (ACEs) than heterosexuals, and they generally bear a greater burden of mental health challenges. However, population-based data on this topic are scarce. In a nationally representative study within the Project SEXUS, one of the world's largest cohort studies on sexual health, we used data from 57,479 individuals in Denmark to explore the interplay between ACEs and mental health problems among self-identified heterosexual, homosexual and bisexual persons, and among self-identified heterosexuals with or without same-sex sexual experience. Compared to heterosexuals, non-heterosexual persons were more likely to report most of the studied ACEs, with odds ratios (ORs) for the ACE category "abuse" ranging from 1.38 to 1.75 for homosexual women, from 1.76 to 2.65 for homosexual men, from 2.52 to 3.64 for bisexual women, and from 1.58 to 6.07 for bisexual men. Furthermore, non-heterosexual persons had consistently and statistically significantly higher odds for mental health problems (ORs: 1.50 to 4.63). Combinations of ACEs with a non-heterosexual identity resulted in markedly elevated odds for mental health problems, particularly among bisexual individuals. This included high odds for suicidal thoughts/attempts among bisexual persons with a history of "neglect" (women: OR=12.82; men: OR=35.24) and "abuse" (women: OR=11.81; men: OR=11.65). Among self-identified heterosexuals, combinations of ACEs with same-sex sexual experience were associated with consistently elevated odds for mental health problems (ORs: 2.22 to 12.04). The greater burden of ACEs among self-identified homosexuals and, most notably, bisexuals may account for part of their excess risk of mental health problems. These findings emphasize the public health importance of preventive measures to minimize the burden of ACEs and avert their harmful long-term effects. Moreover, they highlight the need to safeguard the welfare of children and adolescents with non-conforming expressions of sexuality.

Perception of individual and group discrimination among LGB individuals in Puerto Rico: A descriptive study

Background: Discrimination is one or more unjustified negative behaviors towards a person based on one or more characteristics of that person. In the case of lesbian, gay, and bisexual (LGB) persons, they have been constant victims of stereotypes, prejudices, and discrimination around the world. However, few scientific studies explore the experiences of discrimination in Puerto Rico, since most studies have focused on negative attitudes, prejudice, and social distance. Objective: The aims of this brief report are 1) to describe in detail the relative importance of the quality of the items of the Perceived Discrimination in the LGB Community Scale, and 2) to describe the experiences of discrimination both at the individual and group level of an LGB sample according to the order of relative importance found. Method: This research had a quantitative method with a descriptive study design, instrumental type. To meet the objective of this study, the data collected in each item was independently evaluated to examine the experience and perception of each participant in the situation presented by each premise. A non-probability sample of 300 LGB participants was recruited in Puerto Rico. Results: The area with the highest reported experiences of individual discrimination was the relationship category (M=.700), followed by psychological (M=.630), society/environmental (M=.566), family/employment (M=.566) and physical (M=.386) respectively. The area with the highest perceptions of group discrimination reported by the sample was the education/health category (M = .882), followed by culture/society (M=.827), politics (M=.803), maternity/paternity (M=.802) and locality (M=.791) respectively. Conclusion: When analyzing all the items, it was observed that the results of the first 22 positions according to the Relative Importance Index, correspond to the experiences of discrimination in a group way. This means that people perceive greater discrimination as a group than the discrimination they perceive about their own person.

Exploring the Posting of Nude Photographs on Reddit in Relation to Self-Esteem, Perceived Attractiveness, Narcissism, and Sensation Seeking

While many scholars have explored the sharing of nude photographs one-to-one (i.e., sexting), few have examined the sharing of nudity in a one-to-many context. The current study examined the sharing of nude photographs on Reddit, framing the practice as an act of disinhibited online behavior. A survey (n = 628) was conducted to assess whether Redditors levels of sensation seeking, self-esteem, perceived attractiveness, and narcissism would be related to whether or not they posted nude photographs on the site. Results indicated that posting nudity on Reddit was significantly associated with higher perceived attractiveness and narcissism, but not sensation seeking or self-esteem. The role of gender and sexual orientation in the posting of nudity online was also assessed, and an overrepresentation of nude content produced by females and bisexual persons, as well as an underrepresentation of nude content produced by males and heterosexuals, was found. Findings are discussed in relation to self-concept, sexual health, and the online disinhibition effect.

African American Gatekeepers or the Black Church?: Using Modified Grounded Theory to Explore the Debate on Black Homophobia

ABSTRACT In a comparison of attitudes concerning same-sex relationships and inclusive policies for lesbian, gay, bisexual, transgender, and intersex (LGBTI) persons, African Americans are more likely to possess stronger opposition than Whites. The default agent in explaining disapproving attitudes is the Black Church. However, observations from 2017 expert interviews, part of a study on causes of Black homophobia, revealed that varying experts do not affirm the Black Church as the primary actor in sustaining these attitudes. Based on this observation, this study theorizes that attitudes considered homophobic are primarily sustained by actors distinct and separate from the Black Church. This study employs a modified grounded theory to explore themes toward the creation of an expert-driven narrative that disapproval of same-sex relationships and opposition to LGBTI policies are attitudes sustained by Black gatekeepers, as they see same-sex relationships and policy as oppositional to the Black identity and Black sociopolitical progress.

Prescription Drug Insurance and Cost-Related Medication Nonadherence Among Lesbian, Gay, and Bisexual Individuals in Canada.

Purpose: This study estimates the frequency of uninsurance for prescription drugs and cost-related medication nonadherence (CRNA) among lesbian, gay, and bisexual (LGB) persons in Canada, compared with the heterosexual population. Methods: Logistic regression was used to quantify associations between sexual orientation, insurance status, and CRNA within the national probability-based Canadian Community Health Survey, 2015-2016. This sample included 98,413 individuals aged 15-80 years, including 2803 LGB individuals. Results: From our sample of Canadians, 22.2% of LGB respondents reported being uninsured for prescription drugs, compared with 20.0% of heterosexual persons (unadjusted odds ratio [UOR] 1.14, 95% confidence interval [CI] 0.97-1.35). LGB individuals had more than twice the odds of reporting CRNA compared with heterosexual individuals (UOR 2.48, 95% CI 1.99-3.10). This disparity was most pronounced among bisexual respondents, who had over three times the odds of reporting CRNA in comparison to heterosexual respondents (UOR 3.45, 95% CI 2.65-4.51). The odds ratio (OR) for CRNA comparing bisexual with heterosexual individuals remained statistically significant after adjustment for race/ethnicity, gender/sex, and age (OR 2.67, 95% CI 1.97-3.61) and was further attenuated with adjustment for partnership status, employment status, income, educational attainment, prescription drug insurance status, general health status, and immigration status (OR 2.09, 95% CI 1.51-2.89). Conclusion: LGB Canadians reported more CRNA but comparable prescription drug insurance frequencies to heterosexual persons. Factors pertaining to medication access (e.g., income, partnership status) and health needs appear to be the most important contributors to disparities.

Theorizing Agency: New Directions in Research on HIV/AIDS Activism

Theorizing Agency: New Directions in Research on HIV/AIDS Activism Jallicia Jolly (bio) Evidence of Being: The Black Gay Cultural Renaissance and the Politics of Violence. By Darius Bost. Chicago: University of Chicago Press, 2018. 192 pages. $82.50 (cloth). $27.50 (paper). Let the Record Show: A Political History of ACT UP New York, 1987–1993. By Sarah Schulman. New York: Macmillan, 2021. 736 pages. $40.00 (cloth). Remaking a Life: How Women Living with HIV/AIDS Confront Inequality. By Celeste Watkins-Hayes. Berkeley: University of California Press, 2019. 336 pages. $85.00 (cloth). $29.95 (paper). To Make the Wounded Whole: The African American Struggle against HIV/AIDS. By Dan Royles. Chapel Hill: University of North Carolina Press, 2020. 332 pages. $95.00 (cloth). $29.95 (paper). The fourth decade of the HIV/AIDS pandemic on the heels of the COVID-19 outbreak has prompted an undoing of our sense of self and community in relation to illness and inequality. The responses to these two historic pandemics have not only laid bare preexisting racial, gender, sexual, and structural inequities but also illuminated the perennial silences and erasures that have long marked HIV/AIDS in the United States. The initial responses to the pandemic in the 1980s focused on the experiences and needs of white cis-gender gay men, whose influential mobilization was widely documented in mainstream political activism, media, public discourse, and public health interventions. Since then, mainstream HIV/AIDS research has focused heavily on microlevel behavioral risk factors that inform biological susceptibility to HIV transmission, neglecting the histories of marginalization and structural violence that have long facilitated the exposure to social vulnerabilities and slow [End Page 169] death. This emphasis on individualized risk in HIV research and traditional public health interventions coupled with public discourses and media narratives that stigmatize LGBTQ and Black communities as active transmitters of HIV reinforced the homophobia, structural racism, and institutional sexism that has undermined effective approaches to the pandemic. The advent of medication and technology has catalyzed the transition of HIV/AIDS from a “death sentence” to a “chronic illness,” which has produced new social, political, and cultural realities. Of course, for as long as HIV/AIDS has existed, the labor of feminist and queer communities of color to highlight the racial, gendered, and cultural dynamics of disease and state violence have upended linear narratives of HIV/AIDS progress. Alongside the direct action, consciousness raising, and coalitional work of the leading HIV activist group, ACT UP, Black organizers cultivated grassroots collectives to offer communal care for the sick and dying, marshal resources to advocate for their strategic interests, and amplify their overlapping concerns for basic resources, rights, and recognition. In particular, Black feminists and Black gay and lesbian communities—scholars, activists, community leaders, artists—have mounted radical challenges to racism, state violence, and the politics of respectability by foregrounding the humanity, lives, sociality, and political labor of Black people. When we consider the backdrop of this radical activism in Cathy Cohen’s incisive reflections on the HIV/AIDS crisis, neoliberal policies, and conservative ideologies implemented by the Reagan and Clinton administrations, we see a fuller picture of the racial, gendered, sexual, and structural contexts of the pandemic. Cohen’s often-quoted analytic category of “punks, bulldaggers, and welfare queens” describes the historical marginalization of subjects—lesbians, gays, transgender and bisexual persons, single mothers, and state aid recipients.1 As Jafari Allen notes, these subjects are marked not only as “unruly would-be subject citizens, but also as outside cultural boundaries of belonging and care.”2 Decades later, Black, feminist, and queer scholars and organizers continue to build on these intellectual and activist legacies while embracing the radical potentiality of HIV/AIDS activism to transform the HIV/AIDS pandemic and US culture as we know it. The review essay maps this emergent wave of scholarship on the racial, gender, and cultural stories of HIV/AIDS, as well as the political and social dimensions of the evolving landscape of HIV/AIDS activism represented by recent publications from Sarah Schulman, Dan Royles, Darius Bost, and Celeste Watkins-Hayes. These works signal an expansive generation of HIV/AIDS research that foregrounds alternative political and historical...

Evolution of Legislation and Crimes Based on Sexual Identity or Orientation in Spain: A Retrospective Observational Study (2011-2021).

Respect for different sexual options and orientations prevents the occurrence of hate crimes against lesbian, gay, bisexual, trans and intersex (LGTBI) persons for this reason. Our aim was to review the legislation that protects the rights of LGTBI people and to quantify the victimization rates of hate crimes based on sexual identity and orientation. A retrospective observational study was conducted across all regions of Spain from 2011–2021. The laws on LGTBI rights in each region were identified. Hate crime victimization data on sexual identity and orientation were collected in annual rates per 100,000 inhabitants, annual percentage change and average change during the study period to assess the trend. The regulatory development of laws against discrimination against LGTBI individuals is heterogeneous across regions. Overall, in Spain there is an upward trend in the number of hate crime victimizations motivated by sexual identity or orientation. The effectiveness of data collection, thanks to better training and awareness of police forces regarding hate crimes and the processes of data cleansing and consolidation contributes to a greater visibility of hate crimes against LGTBI people.

Syphilis in the era of re-emergence: A 6-year retrospective study from a tertiary care center in South India.

During the last several years, we have observed a rise in the number of patients with syphilis in our center. To find out the trends in the presentation of syphilis to our clinic over a 6-year period and to analyze the clinicoepidemiological features of those patients. A retrospective chart review. We analyzed the case records of all cases of syphilis registered in our sexually transmitted infection (STI) clinic from October 1, 2012, to September 30, 2018. Syphilis was diagnosed based on clinical or serological evidence. We also evaluated these patients for any concomitant STI, including hepatitis B, hepatitis C, and HIV. The data were analyzed using SPSS software (version 20). Chi-square test was done for comparing categorical data, and P < 0.05 was considered statistically significant. During the study period, 215 patients with STI attended our clinic. Of these, 66 (31%) patients had acquired syphilis. Among them, 3 (4.5%) had primary syphilis, 23 (34.8%) had secondary syphilis, and 40 (60.6%) had latent syphilis. Fifteen (22.7%) patients had concomitant HIV infection. A statistically significant rise in the number of cases of syphilis compared with other STIs was noted in the latter half of the study period (P = 0.001). Among the 50 males with acquired syphilis, 29 (58%) were men having sex with men (MSM), including 19 bisexual persons. Among the five antenatal cases, two were detected very late in pregnancy. We observed a marked increase in the number of cases of syphilis during the latter half of the study period. Primary and secondary syphilis were more frequent among MSM, suggesting a need to strengthen targeted intervention programs among them. More rigorous antenatal screening is necessary to prevent congenital syphilis.