Gender Minority Individuals Research Articles

Victimization of Sexual and Gender Minorities: A Narrative Review of Prevalence Rates, Adverse Outcomes, Protective Factors, and Suggestions for Future Research.

Victimization is a common but unfortunate reality, with sexual and gender minority (SGM) individuals at an increased risk of various forms of victimization compared with the heterosexual and cisgender counterparts. This disproportionate victimization of SGMs increases the likelihood that these individuals will experience adverse mental, physical, and educational outcomes. Some scholars have explored potential protective factors, specific to SGMs, that may be associated with a decreased risk of victimization and/or subsequent adverse outcomes. The present article provides readers with a narrative review of the relevant literature on these topics by examining prevalence rates of SGM victimization, common adverse consequences experienced by SGMs, and empirically examined protective factors for SGMs that show some evidence of effectiveness. The article ends with a discussion of suggestions for future research.

Engagement and Factors Associated With Annual Anal Human Papillomavirus Screening Among Sexual and Gender Minority Individuals.

Although self-sampling could help address anal cancer screening barriers, no studies have investigated annual engagement with this method or compared it with annual screening with a provider. Building on our baseline article, we compared annual anal screening engagement between home-based self-sampling and clinic-based clinician sampling. The Prevent Anal Cancer Self-Swab Study recruited and randomized sexual and gender minority individuals 25 years and older who have sex with men to a home or clinic arm. Home-based participants were mailed an anal human papillomavirus self-sampling kit at baseline and 12 months, whereas clinic-based participants were asked to schedule and attend 1 of 5 participating clinics at baseline and 12 months. Using Poisson regression, we conducted an intention-to-treat analysis of 240 randomized participants who were invited to screen at both timepoints. More than half (58.8%) of participants completed annual (median = 370 days) anal screening. In the home arm, 65.0% of participants engaged in annual screening compared with 52.5% of clinic-based participants ( P = 0.049). When stratified by HIV status, persons living with HIV had a higher proportion of home (71.1%) versus clinic (22.2%) annual screening ( P < 0.001). Non-Hispanic Black participants participated more in home-based annual anal screening (73.1%) than annual clinic screening (31.6%; P = 0.01). Overall, annual screening engagement was significantly higher among participants who had heard of anal cancer from an LGBTQ organization, reported "some" prior anal cancer knowledge, preferred an insertive anal sex position, and reported any prior cancer diagnosis. Annual screening engagement among those at disproportionate anal cancer risk was higher in the home arm.

Microcosting the Optimization of Prep Implementation Among Sexual and Gender Minority Individuals With a Substance Use Disorder (SUD)

Microcosting the Optimization of Prep Implementation Among Sexual and Gender Minority Individuals With a Substance Use Disorder (SUD)

Adolescent Youth Survey on HIV Prevention and Sexual Health Education in Alabama: Protocol for a Web-Based Survey With Fraud Protection Study.

In Alabama, the undiagnosed HIV rate is over 20%; youth and young adults, particularly those who identify as sexual and gender minority individuals, are at elevated risk for HIV acquisition and are the only demographic group in the United States with rising rates of new infections. Adolescence is a period marked by exploration, risk taking, and learning, making comprehensive sexual health education a high-priority prevention strategy for HIV and sexually transmitted infections. However, in Alabama, school-based sexual health and HIV prevention education is strictly regulated and does not address the unique needs of sexual and gender minority teenagers. To understand knowledge gaps related to sexual health, HIV prevention, and pre-exposure prophylaxis (PrEP), we conducted the Alabama Youth Survey with individuals aged 14-17 years. In the survey, we also evaluated young sexual and gender minority individuals' preferences related to prevention modalities and trusted sources of health information. Between September 2023 and March 2024, we conducted a web-based survey with 14- to 17-year-olds who are assigned male at birth, are sexually attracted to male youth, and lived in Alabama. Half of the study's participants were recruited through community partners, the Magic City Acceptance Academy and Magic City Acceptance Center. The other half were recruited on the web via social media. A 7-step fraud and bot detection protocol was implemented and applied to web-based recruitment to reduce the likelihood of collecting false information. Once data are ready, we will compute frequencies for each measure and construct summary scores of scales, such as HIV and PrEP knowledge, to determine internal consistency. Using multivariable logistic regression, we will examine associations between personal characteristics of survey respondents and key constructs using SPSS 29 (IBM Corp) or SAS 9.4 (SAS Institute). Analyses are ongoing (N=206) and will conclude in June 2025. Preliminary results include a sample mean age of 16.21 (SD 0.88) years; about a quarter identified as transgender or gender nonconforming, with 6% stating their gender as a transgender woman. A total of 30% self-reported their race as African American or Black; 12% were Hispanic or Latinx. More than half reported being sexually active in the past 6 months. Primary data analyses will be completed in mid-2025. If findings are promising, results will be used as preliminary data to support the development of an intervention to address knowledge gaps and prevention preferences. If the study is successful, it will yield information on HIV knowledge, PrEP awareness, PrEP preferences, and related outcomes among sexual and gender minority teenagers in Alabama, an underserved, hard-to-reach, but also high-priority population for public health efforts to Ending the HIV Epidemic. DERR1-10.2196/63114.

P-484. Community Food Pantries Provide Unique Opportunities for Linkage to HIV Care in Newly Diagnosed Individuals

Abstract Background Food insecurity has been associated with sexual risk behavior that increases Human Immunodeficiency Virus (HIV) risk in cis women and sexual and gender minority (SGM) individuals such as transactional sex for money or food and multiple sexual partners. SGM people and cis women experiencing insecure immigration status also often face financial and housing instability, stigma, discrimination, lack of social support as well as food insecurity. North Jersey Community Research Initiative (NJCRI) is a non- profit organization in Newark, NJ that provides medical care and support services for highly vulnerable and hard to reach patient populations including unhoused individuals, people living with HIV/AIDS, LGBQTIA community members, people who use drugs and new immigrants. In 2023, NJCRI expanded food pantry status neutral services to the community and offered onsite HIV counselling and testing to pantry visitors. Methods From April 2023 to April 2024, NJCRI provided HIV testing for 3630 individuals with 1025 being tested at the pantry. Results There were 63 total positive tests with 13 diagnosed at the pantry. Of those diagnosed at the pantry, 2/3 (9) identified as SGM and 1/3 (4) as cis women. All the SGM individuals were Latinx. All reported to be new migrants. All diagnosed were linked to care and services and started on ART on the day of diagnosis.OrganizationTotal Test (Statewide)NJCRI Pantry TotalTotal (+) - StatewideNJCRI Pantry - (+)NJCRI363010256313Self-IdentificationSGMn/ax429Cis-Womenn/ax94EthnicityLatinxn/an/a4213Blackn/an/a170Othern/an/a40 Conclusion Migrant individuals from known groups for higher HIV associated risk experiencing food insecurity benefit from HIV testing at nontraditional testing sites. Food pantries run by trusted community partners who provide integrated HIV care and prevention services can serve as entry points for HIV care for new immigrants. Community organizations serving this community should be aware of the opportunity to engage individuals in HIV care and prevention services and link to care. Disclosures All Authors: No reported disclosures

STEP 1: The Scottish Trauma & Orthopaedics Equality Project.

Trauma & Orthopaedic (T&O) surgery has come under scrutiny for lagging behind other medical specialties in promoting gender and cultural equity and diversity within their workforce. The proportions of female, ethnic minority, and sexual and gender minority individuals within orthopaedic membership bodies are disproportionate to the populations they serve. The aim of this study is to report the findings of a national workforce survey of demographics and working patterns within T&O in Scotland. A questionnaire devised by a working group was delivered by the Client Analyst and Relationship Development (CARD) group. Utilizing a secure third party ensured anonymity for all respondents. Data were recorded and analyzed by the CARD group. A total of 353 responses were recorded, representing 71% of the known workforce. Overall, 261 respondents (74%) identified as male, 85 (24%) female, and seven (2%) preferred not to say. For specialist trainee (ST)3 to ST6, 148 (42%) were female, and for ST7 to ST8, 131 (37%) were female. In total, 226 of all respondents (64%) were white-British, 35 (10%) were white-European, and 92 (26%) were of an ethnic minority background. A total of 321 of respondents (91%) identified as heterosexual, 14 (4%) preferred not to say, and 18 (5%) identified as LGBTQ+ or preferred to self-describe. This is the largest national workforce survey in contemporary surgical literature. The findings demonstrate a greater proportion of female surgeons overall compared to other studies in T&O. This proportion of females was highest among more junior trainees. The Scottish T&O workforce is more ethnically diverse than the demographics of the population it serves. This study suggests that T&O in Scotland is an evolving speciality in terms of equality and diversity, and is making positive progress.

Examining eating pathology and psychosocial functioning across subjective eating disorder recovery stages in sexual and gender minority individuals

ABSTRACT Subjective eating disorder (ED) recovery has important clinical relevance. However, studies have focused on the perspectives of cisgender heterosexual individuals, which is notable given that sexual and gender minority (SGM) people often describe feelings misrepresented by prevailing ED conceptualizations. We examined eating pathology and psychosocial functioning across subjective recovery stages in SGM individuals (N = 196). Analyses of variance tested differences between active ED (n = 106, 54.1%), partial recovery (n = 82, 41.8%), and full recovery (n = 8, 4.1%) groups. Groups differed in body dissatisfaction, binge eating, restricting, clinical impairment, autonomy, environmental mastery, and self-acceptance. Most differences were observed between the full recovery and active ED groups and the full recovery and partial recovery groups, such that subjectively higher levels of ED recovery were generally associated with lower transdiagnostic ED symptoms and better psychosocial functioning. Clinical profiles appear similar between SGM and cisgender heterosexual individuals across subjective ED recovery stages.

Health Care Stereotype Threat During the COVID-19 Pandemic Among Sexual and Gender Minority Individuals.

Objectives. To determine the levels and differentials in health care stereotype threat experienced during the COVID-19 pandemic by individuals with sexual or gender minority identities. Methods. The National Couples' Health and Time Use Study is a national cross-sectional US population‒ based sample of partnered individuals interviewed during the pandemic between September 2020 and April 2021 with oversamples of sexual and gender minority individuals. The analytic sample consisted of 3614 individuals (n = 2043 heterosexual and n = 1571 sexual minority individuals along with 3489 cisgender and 125 noncisgender people). Results. Individuals with sexual minority identities experienced significantly more health care stereotype threat than heterosexual people. Cisgender women and those with another gender identity experienced significantly more health care stereotype threat than cisgender men. These results persisted after the inclusion of indicators of health conditions, insurance, COVID-19 experience, and sociodemographic factors. Conclusions. Gender and sexual minority‒identifying people reported high levels of worries about health discrimination. Our work suggests that providing positive health care experiences may reduce these worries and offer a potential antidote to sexual and gender minority health disparities that are driven by structural and interpersonal discrimination. These findings support calls for the further education and transformation of health care provision and systems. (Am J Public Health. Published online ahead of print January 16, 2025:e1-e9. https://doi.org/10.2105/AJPH.2024.307926).

Federal Priorities to Address Homelessness as a Community Health Problem

Homelessness is a major public health problem across communities in the United States. This commentary reviews required Learning Agendas of all 24 US federal agencies for items related to homelessness and housing instability covering the years 2022-2026. Across 7 federal agencies (Departments of Agriculture; Homeland Security; Labor; Health and Human Services; Housing and Urban Development; Treasury; Veterans Affairs) and 2 cross-government plans (American Rescue Plan Equity; Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Equity), there is a stated focus on homelessness and housing instability. These federal priorities seek to address homelessness and housing instability in families, Native American communities, unsheltered individuals, veterans, and sexual and gender minority individuals. Several agencies also have a stated focus on evaluating the impact of housing assistance and other supports provided during the COVID-19 pandemic. These findings reflect a national recognition and reframe of homelessness as an interdisciplinary, community health problem with opportunities for inter-agency collaboration and government support for primary and secondary prevention that have not been fully realized.

Social Determinants of Health and Healthcare Access among Latina/x/o Sexual and Gender Minority Adults.

This study aims to identify current social determinants of health (SDOH) and healthcare access barriers impacting health outcomes among Latina, Latinx, and Latino (Latina/x/o) sexual and gender minority (SGM) individuals. We conducted cross-sectional surveys of 521 Latina/x/o adults with a focus on SGM individuals from November 2022 to June 2023 in Cook County, IL. We recruited using social media groups and in person community venues geared towards Latina/x/o and/or Lesbian/Gay/Bisexual/Transgender/Questioning (LGBTQ+) individuals. We examined associations between demographic predictors and SDOH (housing, food, and job insecurity) or healthcare access outcomes (insurance status, access to primary care, and time since last provider visit) using multivariable logistic regression. Respondents included 68.8% (n=329) SGM individuals, of whom 48.6% (n=157) identified as gay or lesbian, 42.7% (n=138) identified as bisexual, pansexual, or queer, and 15.8% (n=48) identified as transgender. Across sexual and gender identities, our study population had a high burden of housing insecurity (n=286, 56.9%), food insecurity (n=177, 35.3%), and job insecurity (n=90, 27.8%). There were also a high proportion of uninsured individuals (n=120, 25.2%) and people who had not seen a provider in the last year (n=188, 36.2%). Public health interventions and policy reform are urgently needed to address the SDOH and healthcare barriers that drive health disparities for the diverse groups within Latina/x/o SGM populations.

Associations between gender and solicited adverse events after passive infusion of VRC01 or placebo in HVTN 704/HPTN 085

Background: Realizing the potential of HIV prevention options requires understanding product tolerability across diverse groups vulnerable to HIV acquisition. Gender minority (GM) individuals are understudied in clinical trials. Setting: HVTN 704/HPTN 085, a phase 2b randomized HIV prevention trial, enrolled MSM and transgender participants from Brazil, Peru, Switzerland, and the US to receive an infusion every 8 weeks (10 total) of VRC01 30mg/kg, VRC01 10mg/kg, or placebo. Solicited adverse events (AEs) were recorded for 3 days after each infusion. Methods: Gender was defined by self-report and sex assigned-at-birth. Multivariate mixed logistic models were employed to estimate the association between gender (cisgender men [CM] vs. GM participants [transgender women, transgender men, or another gender]) and solicited AE frequency and severity. Results: GM participants reported more solicited AEs than CM among all participants (adjusted OR 1.59, 95%CI 1.20-2.10, p=0.001) and among placebo recipients (1.72, 1.05-2.81, p=0.031). The severity of solicited AEs (occurrence of ≥Grade 2 event) did not significantly differ overall (1.83, 0.79-4.20, p=0.174) or among placebo recipients (3.05, 0.76-12.32, p=0.112). Grade 2 events were reported after 1% and 2% of total infusions among CM and GM participants, respectively. Grade 3-4 events were rare overall (&lt;0.1%). Completion of 10 infusions was high (78.6%) and slightly higher in CM (79.2%) than GM participants (73%). Conclusion: This is the first report of associations between gender and solicited AEs following monoclonal antibody infusion. GM participants reported more events; severity was low. HIV prevention trials must engage and support GM individuals to best evaluate tolerability of novel agents.

Voices from the margins: A qualitative study exploring components influencing psychosocial health and wellbeing among gender minority forced migrants.

To explore the components that influence health and wellbeing of gender minority forced migrants residing in Sweden. Qualitative exploratory study based on semi-structured interviews with gender minority forced migrants recruited through a combination of convenience, purposeful and snowball sampling. Guided by the levels in the social ecological model, transcripts were analysed with systematic text condensation in a collaborative process between experts by lived experience, researchers and clinical psychologist. Participants expressed resilience and hope about their future. Loneliness was a major issue contributing to health burdens and peer support was highly appreciated. Barriers hindering access to health services and judgemental behaviours among health professionals were described. Affirming support through empathy, trust, safety, confidentiality, continuity and respect was highlighted as essential in health services. While societal openness and safety for gender minority individuals was appreciated, participants faced an uncertain asylum process and unmet basic needs. Gender minority forced migrants show resilience and appreciate the newfound societal safety. However, they find themselves in the margins of society and encounter various multi-layered challenges. Loneliness is a public health concern that could be addressed through peer support, which is highly desired and valued. Ensuring access to affirming health services should be a prioritized area for researchers, professionals, stakeholders and policy-makers.

Navigating LGBTQ+ visibility in Poland: evidence from a community experiencing minority stress

The aim of this study was to analyse the visibility management strategies used by individuals within the LGBTQ+ community in Poland. Narrative interviews were conducted with ten adults who had experienced minority stress, affecting their family, school, professional and social lives. In the process of coming out, all the interviewees had adopted at least two visibility management strategies. These strategies included avoidance, pretence/fitting in, escape, aggression/defence, and openness. Findings contribute to understanding of the visibility management strategies used by individuals who experience minority stress and illustrate the individual aspects of the visibility management process as influenced by the family and social context. The conclusions reached should be treated as the starting point for further research on visibility management among gender and sexuality minority individuals in Poland.

Potential Harm in the Psychological Treatment of Sexual and Gender Minority Youth.

Sexual and gender minority (SGM) individuals show disproportionately high rates of mental distress relative to their cisgender, heterosexual peers resulting from minority stress, or unique identity-related stressors. The majority of research on minority stress and mental health in SGM individuals has focused on adults, a notable gap given that SGM youth face unique developmental factors that intersect with identity development and availability of support resources. SGM youth therefore represent a critical population for the mental health workforce to serve competently. Mental health providers risk significant harm to their SGM youth clients if they do not understand the mechanisms underlying mental health disparities in this population. This article will review treatment practices that carry the potential for harm with SGM youth, including harms that are more overt and attempt to change SGM identities (i.e., so-called "conversion therapies"), and others that are more covert, such as neglecting to consider SGM identity in conceptualization and treatment (e.g., eating disorders), pathologizing SGM identity and behaviors (e.g., personality disorders, social anxiety), and reinforcing stigma related to SGM identities (e.g., obsessive-compulsive disorder). Accordingly, this article reviews each of these potential harms in detail and provides alternative recommendations for affirming and justice-based treatment for SGM youth.

Trying to Comprehend Physicians’ Feelings and Behaviors toward Sex and Gender Minorities in Terms of Improving Minorities’ Access to Healthcare Services

The fundamental basis of human existence is the enjoyment of rights and freedoms. The capacity of sexual and gender minority (SGM) individuals to enjoy equal access to their right to health is inextricably linked to the manner in which physicians interact with and treat SGM individuals. It is therefore evident that the perception of SGM individuals by physicians is a matter that requires further examination. The objective of this study was to gain insight into the attitudes of physicians toward SGM individuals by examining their feelings and behaviors. In this cross-sectional study of 193 physicians, a series of t-tests and chi-square tests were conducted to determine whether there were significant differences between the various sociodemographic categories of the participants. The findings indicate that physicians’ approach to SGM individuals is largely aligned with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of the American Psychiatric Association (APA). A comparison of the attitudes of male and female participants reveals a greater proclivity toward egalitarianism among the latter with regard to SGMs. Additionally, it was determined that medical professionals engaged in the field of internal medicine exhibited a comparatively less traditionalist perspective on gender roles and a more egalitarian stance toward individuals who identified as sexual and gender minorities. The stress, fear, and anxiety experienced by SGM individuals impose a responsibility on physicians to demonstrate greater awareness and consideration of their behavior while providing health services. In order for physicians to become more aware and responsible, it is necessary to provide them with a higher level of education in medical content based on an egalitarian legal framework for sexual orientation and gender identity. Furthermore, the study recommends the implementation of more inclusive social practices.

Perceptions of the Harm of Cigarettes, Mental Health, and Quality of Life Among Transgender Adults Who Smoke Menthol Cigarettes: Results from Wave 5 of the Population Assessment for Tobacco and Health (PATH) Study.

Sexual and gender minority (SGM) individuals in the United States are at greater risk for combustible tobacco use and mental health problems compared to heterosexual and cisgender individuals. National data comparing associations of menthol cigarette use and mental health among transgender and cisgender individuals in the United States are lacking. The goals of the current study were to (1) characterize transgender and cisgender individuals who smoke menthol cigarettes, and (2) investigate cross-sectional associations between gender identity, harm perceptions of cigarettes, mental health experiences, and quality of life. Data were drawn from Wave 5 of the Population Assessment of Tobacco and Health (PATH) Study (2018-2019). A total of 3989 cisgender (mean [SD] age, 40.47 [0.32] years) and transgender (mean [SD] age, 38.36 [0.09] years) participants who reported current (past 30-day) menthol cigarette use were included in the analysis. Comparing transgender to cisgender groups, significant differences were found in associations between harm perceptions of cigarettes (adjusted odds ratio [AOR] 0.07; 95% CI: 0.02-0.28) and reported depression (AOR 4.57; 95% CI: 1.36-15.33). Collectively, these findings provide evidence that transgender adults who smoke menthol cigarettes are less likely than cisgender adults who smoke menthol cigarettes to perceive smoking as harmful to health and more likely to report recent experiences of depression.

Coping styles moderate the relationships between general and minority stress and depression among sexual and gender minority populations in Thailand: a cross-sectional study.

Sexual and gender minority (SGM) individuals experience elevated rates of depression due to exposure to unique social stressors associated with membership in a stigmatised minority group. Coping style has been shown to buffer or exacerbate responses to stress. To date, little is known about the risk or protective influence of coping styles on the relationships between stressors and depression in SGM populations. To examine the moderating effects of coping styles on the relationships between stressors and depression in Thai SGMs. This cross-sectional descriptive survey was conducted between March and August 2018 using in-person and online surveys. Convenience and snowball recruitment strategies were used. Standardised measures were selected according to the Minority Stress Model. Bivariate and multivariate analyses were conducted. Hayes's PROCESS macro was used to test for significant interactions. Of the 411 participants, 40% of the participants reported symptoms of depression that were associated with multiple stressors. Problem-focused coping was reported by most participants (95.8%), followed by social support (83.1%) and avoidance (49.1%) coping. Problem-focused coping weakened the relationships between stressors and depression, whereas avoidance coping strengthened the relationships between depression and stress, loneliness and discrimination. Social support coping was negatively related to depression, with no statistically significant moderating effects. Problem-focused coping served to mitigate the influence of stressors on depression, whereas avoidance coping strategies exacerbated the impact. Nursing interventions aimed at improving problem-focused coping may reduce the negative consequences of stressors on the mental health of SGMs.

Providing Palliative Care for Sexual and Gender Minority Individuals: A Qualitative Interview Study of Physicians' Attitudes and Experiences.

Introduction: Sexual and gender minority (SGM) individuals face increased risk of receiving suboptimal care, including palliative care. Despite research demonstrating strategies to improve care, little is known about the experiences of palliative care clinicians providing care to these communities. Objectives: The primary aim of this study is to characterize attitudes and practices of palliative care physicians around providing care to SGM individuals. Design: This exploratory, qualitative study used semi-structured interviewing. Interviews were transcribed and coded using reflexive thematic analysis. Setting and Participants: Twenty-four palliative care physicians practicing in the homecare, hospice, and hospital settings from geographically diverse sites across Canada were recruited from palliative care organizations using convenience and snowball sampling. Results: Four main themes represent perspectives on improving palliative care for SGM individuals: (1) increasing experience with and knowledge about SGM communities increases clinicians' confidence and competency; (2) standardizing inclusive sexual orientation and gender identity (SOGI) data collection and documentation can improve patient care; (3) addressing individual, systemic, and societal biases may improve palliative care provided to SGM individuals; and (4) knowing SOGI improves care quality. Conclusions: Clinicians must familiarize themselves with the importance of SOGI to the care provided as well as the palliative care needs of SGM communities. Institutions should provide tailored training around the unique needs of SGM patients and implement policies and tools that standardize sexual and gender orientation data collection and documentation.

Association Between Exposure to LGBTQ-Targeted Tobacco Marketing and Tobacco Use Behaviors Among US Young Adults

Background A risk factor for tobacco use among sexual and gender minority people is exposure to tobacco marketing. This study aimed to assess exposure to tobacco marketing by sexual and gender identity via general venues (e.g., bars/clubs, newspapers/magazines), determine the frequency of targeted marketing via LGBTQ venues, and examine how exposure to tobacco marketing in LGBTQ venues relates to tobacco use among sexual and gender minority young adults. Methods We conducted an online survey of US young adults (ages 18–30 years) between July and August 2023. We estimated exposure to tobacco marketing in general and LGBTQ venues. We conducted adjusted logistic regression analyses to examine the association between frequency (“0 times [never],” “1 time,” “2 times,” “3 times,” “4 times,” “5 times or more”) of tobacco marketing exposure in general and LGBTQ venues and current (past-30-day) tobacco use among sexual and gender minority young adults. The models were adjusted for age, sex, race, alcohol and cannabis use. Results Among respondents (N = 1378), n = 682 (49.5%) identified as sexual and gender minority individuals. The top 3 LGBTQ venues for tobacco marketing were websites (15%), shows on streaming services (14%), and social media/apps (13%). More frequent exposure to LGBTQ marketing in LGBTQ stores (aOR = 1.58, 95% CI = 1.18, 2.11, p = 0.002), newspapers/magazines (aOR = 2.07, 95% CI = 1.30, 3.30, p = 0.002), and at events like Pride Festivals (aOR = 1.38, 95% CI = 1.11, 1.71, p = 0.003), were associated with current tobacco use among LGBTQ young adults. Conclusions This study highlights implications for tobacco marketing regulation such as regulation of tobacco marketing presence in LGBTQ venues.

Characterizing Event-Driven PrEP Use and Investigating its Association with Experiences of PrEP-Related Barriers Among a US National Sample of PrEP Users.

After a decade of implementation in the US, PrEP uptake remains underutilized by communities that would greatly benefit from it. Event-Driven (ED) PrEP is a potential avenue to increase uptake, however very little is known about its use in the US. We analyzed data derived from Together 5000, an internet-based U.S. national cohort of Sexual and Gender Minority (SGM) individuals aged 16-49years and at risk for HIV. First, we looked at predictors of ED PrEP use using a framework based on current US-based PrEP implementation-related variables. Then, we explored whether experiencing certain types of barriers were associated with choice of ED PrEP over daily PrEP using logistic regression analysis. Our findings showed that variables related to education and sexual behaviors were associated with ED PrEP choice, while experiencing barriers to daily PrEP had no effect. We found a gradient effect with education, where individuals who reported having some college had 3 times the odds of taking ED PrEP, those reporting a bachelor's degree had 3.25 times the odds, and those with graduate school education had 7.56 times the odds of choosing ED PrEP compared to those with a high school diploma or less. Individuals who reported having 2 or more hours of lead time for sex had 3.35 times the odds of using ED PrEP (aOR = 3.35, 95% CI 2.23-5.47). Participants who reported having an STI within the last 6months had 60% lower odds of using ED PrEP (aOR = 0.4, 95% CI 0.2-0.72). The use of ED PrEP is a promising pathway for expanding PrEP due to its success and protection levels. Our studies indicated that educational background and behavior influence PrEP choice. Ensuring PrEP candidates and users have access to information about new PrEP types may increase uptake and support implementation efforts.