Heterosexual Orientation Research Articles

Study of Attitude Toward Homosexuality Among the Health Professionals

Background: Despite the level of awareness of homosexuality is in the increasing trend, health professionals lack a positive attitude toward homosexuality. Aim: The purpose of this study was to determine the level of attitudes toward homosexuality among health professionals. Subject and Methods: This was a cross-sectional study conducted among 600 health professionals. The attitude toward homosexuality questionnaire was used to assess the attitude of health professionals toward homosexuality. A descriptive analysis, Mann–Whitney U test, and Kruskal Wallis test were used to analyze the data. Observations: The mean score for attitude toward homosexuality questionnaire was 73.04 + 23.39 among the participants. The males had lesser degree of positive attitude compared to higher degree of positive attitude of females toward homosexuality. Participants from rural areas had neutral attitudes, and participants from the urban areas had positive attitudes toward homosexuality. Participants living in nuclear families had positive attitudes toward homosexuality, and participants living in joint families had negative attitudes toward homosexuality. Participants with heterosexual orientation had negative attitudes toward homosexuality. Conclusion: Overall, health professionals had a lesser degree of positive attitude toward homosexuality; they require sensitization to upgrade their positive attitude toward homosexuality for better doctor–patient relationship.

A-258 Hepatitis A infections among patients suspected of acute hepatitis attended in Brazilian health services

Abstract Background Millions of people worldwide are infected with Hepatitis A Virus (HAV) annually - the leading widely spread causes of acute viral hepatitis in developing countries across all continents. Objective To evaluate the prevalence of anti-HAV antibodies; to determine HAV genotypes by nucleotide sequencing in patients suspected of acute hepatitis at public healthcare institutions; and to assess the association between this infection with age, gender, region, and other risk factors Methods Between October 2019 and May 2023, we analyzed 1,562 patients with more than 18 years old with clinical suspected acute hepatitis. Results Out of the 1,562 individuals, 1,244 were seropositive for Anti-HAV IgG, a median age of 45 years (IQR: 35 to 56) vs. 31 years (IQR: 25 to 39) in non-reactive individuals (p<0.001). A higher seropositivity was found in men compared to women (p=0.002). North region showed the highest seropositivity (p<0.001). There was also an association between poor sanitation conditions and seropositivity, such as lack of sewage collection and consumption of untreated water (p<0.001), as well as an association between heterosexual orientation and higher likelihood of seropositivity (p=0.015). In the logistic regression analysis for anti-HAV IgG seropositivity, age and male sex were significantly associated with seropositivity (OR = 1.09, 95% CI: 1.08 to 1.11, p<0.001; OR = 1.56, 95% CI: 1.16 to 2.11, p=0.004). North region showed a significant increase in the odds for seropositivity compared to all other regions. For anti-HAV IgM, out of the 1,562 individuals, 97 were seropositive, significantly higher in younger individuals [median age of 34 years (IQR: 28 to 40) vs. 42 years (IQR: 32 to 54) in non-reactive individuals (p<0.001)] and in males (p<0.001). South and Southeast regions had higher seropositivity (p<0.001). Non-heterosexual orientation and more than 2 sexual partners significantly correlated with seropositivity (p<0.001). In the logistic regression analysis for anti-HAV IgM, age showed an inverse association with seropositivity (OR = 0.96, 95% CI: 0.94 to 0.98, p<0.001), being more frequent in men (OR = 1.86, 95% CI: 1.11 to 3.21, p=0.021). Consumption of seafood was significantly associated with increased odds of seropositivity for anti-HAV IgM (OR = 2.26, 95% CI: 1.43 to 3.56, p<0.001). South and Southeast regions showed more IgM positive cases than North, Northeast and Midwest regions. Among the 1,562 cases, 35 complete (or almost complete) HAV genomes were successfully recovered from metagenomics sequencing data. These genomes range from 6,625 to 7,462 bp in length (89-100% completeness), sequences were fairly similar in pairwise nucleotide alignment, classified as genotype I.A, and displaying identities ranging from 94.7 to 99.7%. Conclusions Hepatitis A infection was found among 6.2% acute hepatitis cases attended in public services in Brazil while previous infections or vaccinated patients were found in 78.9% patients. While anti-HAV IgG positive patients where most frequent in the North region of Brazil, acute hepatitis A (IgM-positive) were more frequent in South and Southeast regions. Our results reinforce the need to implement vaccination against hepatitis A among individuals with more than 18 years in our country.

Global prevalence and determinants associated with the acceptance of monkeypox vaccination.

Assessing the acceptance of the monkeypox vaccine is crucial for the success of vaccination programs, yet the prevalence reports remain inconclusive. The aim of this study was to determine the global prevalence of monkeypox vaccine acceptance and identify its associated factors. A meta-analysis was conducted with a comprehensive search strategy on the following databases, including Scopus, Embase, and PubMed, for articles published up to April 5, 2024. This study utilizes a single-arm meta-analysis to calculate the pooled prevalence of monkeypox vaccine acceptance. A Z-test was employed to identify factors associated with the vaccine acceptance. Our study analyzed 51 articles encompassing 98,746 participants, revealing an overall monkeypox vaccine acceptance rate of 65%. Notably, the highest acceptance rates were observed among men who have sex with men (MSMs), while healthcare workers (HCWs) showed the lowest acceptance rates. Additionally, our findings indicated an increased acceptance in individuals with educational attainment beyond a bachelor's degree, a history of COVID-19 and influenza vaccination, homosexual orientation, and HIV-positive status. Conversely, lower acceptance risk was associated with those with educational attainment below a bachelor's degree, heterosexual orientation, and bisexual orientation. In conclusion, our current study has determined the rate of monkeypox vaccine acceptance and identified its associated factors. These findings offer valuable insights as the foundation for targeted policies to manage and increase acceptance rates.

Heterosexual, Lesbian, and Gay Adults’ Reactions to Same-Gender versus Other-Gender Flirtation: Findings from a German Study

Using a vignette methodology, this study examined reactions to same-gender versus other-gender flirtation in a sample of 445 German young adults: 320 participants with a heterosexual orientation and 125 participants with a lesbian or gay (LG) orientation. Even in LG-friendly societies as Germany, receiving advances from someone of the same gender might still evoke heterosexuals’ homonegativity. Another factor that might influence heterosexuals’ reactions to same-gender flirtation is the fear of being misidentified as LG (social contagion concerns). Contrary to hypothesis, results provided little evidence to classify heterosexual participants’ reactions to same-gender flirters as homonegative. Firstly, heterosexual participants showed the same degree of negative affect and avoidance behavior in the same-gender flirtation condition as LG participants did in the other-gender flirtation condition. Only positive affect scores were somewhat lower for heterosexual participants in the same-gender flirtation condition compared to LG participants in the other-gender flirtation condition. Secondly, when anti-LG attitudes and social contagion concerns were considered together, only social contagion concerns contributed to explaining variance in heterosexual participants’ response to same-gender flirters. Specifically, the impact of social contagion concerns on heterosexual participants’ avoidance of same-gender flirters was mediated by (lacking) positive affect, but not negative affect.

Sociopolitical Trends and Attitudes Towards Transgender People: A Validation Study of the Transgender Knowledge, Attitudes, and Beliefs (T-KAB) Scale in a Portuguese Sample

Abstract Introduction Attitudes towards transgender and gender diverse (TGD) individuals are associated with discrimination against TGD people and underly TGD minority stress. Despite Portugal’s progressive legal framework, anti-trans interactions and discourse are reported. Nonetheless, studies on trans attitudes are still incipient in Portugal. The Transgender Knowledge, Attitudes, and Beliefs (T-KAB) scale is a psychometrically sound measure of transgender attitudes. However, its convergent validity with transphobia is yet to be tested, and its ability to study sociopolitical factors driving pro-trans attitudes is unexplored. Methods We explored the psychometric properties of the European Portuguese version of T-KAB in an online collected (February 2022 to May 2022) sample of Portuguese adults (N = 447), and tested differences (ANOVA; t-test) in T-KAB according to sociopolitical factors. Results Results from the Principal Axis Factoring and Parallel Analysis showed a two-factor measure of acceptance, comfort, and social tolerance towards trans people. Both factors presented an excellent internal consistency (α = .94 and α = .95) and were significantly associated with the Genderism and Transphobia Scale. Conclusions Results found that participants with a heterosexual orientation, less contact with TGD people, less educated, religious, and who endorsed a right-wing or conservative political ideology showed lower T-KAB scores. These results corroborate the psychometric validity of the T-KAB, as well as its ability to identify sociopolitical segments of the population according to their attitudes towards TGD people. Policy Implications This study informs future research on tailored interventions to increase transgender acceptance, comfort, and social tolerance in the general population.

Analysis of Patient Examination Results with Clinical Symptoms of Gonorrhea Using Microscopic Examination at Puskesmas Dasan Agung

Tropical clinical symptoms of gonorrhea occur in men, to confirm a clinical diagnosis then use microscopic examination with gram coloring. The Puskesmas of Dasan Agung became a reference to the inspection of the STI in the city of Mataram. The purpose of this study is to identify clinical symptoms and results of microscopic examination using gram coloring. This type of research is descriptive observational which aims to know or describe the picture of a disease based on direct observation objectively. The population in this study were all patients who came with symptoms that lead to sexually transmitted diseases in January - March, totaling 13 respondents. Sampling was done by non-random purposive sampling method. This research was conducted at the Dasan Agung Health Center laboratory. The results of a study of 13 patients with clinical symptoms of STI obtained 13 positive respondents (100%) identified Neisseria gonorrhoeae. 10 male patients (67.9%) and 3 female patients (23.1%) were identified with heterosexual sexual orientation in 10 cases and 3 were homosexual.

Does the Paraphilia Scale Work for Everyone? Confirmatory Factor Analysis and Measurement Invariance Across Gender and Sexual Orientation Groups

ABSTRACT We conducted three studies to examine the factor structure and measurement invariance of the Paraphilia Scale, a measure of paraphilic interests used in multiple studies. In the first study, we conducted a confirmatory factor analysis (CFA) testing different a priori models with a community sample of 1,040 adults previously reported by Seto et al. (2021), and found support for a hierarchical four-factor model: An agonistic continuum involving coercion or physical pain (biastophilia, sexual sadism, masochism), chronophilias (pedophilia, hebephilia), courtship disorders (voyeurism, exhibitionism, and frotteurism), and fetishism (object fetishism, transvestic fetishism, urophilia-coprophilia). This factor structure was replicated in a second study comprising a combined sample of 400 mTurk participants and 870 university students. The third study analyzed the community sample and found evidence of configural invariance but not scalar or metric invariance across gender (man or woman) and sexual orientation for gender (heterosexual or other sexual orientation). This indicates that the factor structure of the Paraphilia Scale is robust for gender and sexual orientation for gender, but factor loadings differ across these groups, as do the loadings of individual items on the four factors. Implications for research on gender and sexual orientation differences in paraphilic interests are discussed.

Understanding the influence of Social Determinants of Health (SDH) on suicidal behaviors among HIV-positive men who have sex with men (MSM) in China: A population-based study

BackgroundHIV-positive men who have sex with men (MSM) are at high risk of suicide and experience intersectional inequalities. The Social Determinants of Health (SDH) framework provides valuable insights into how inequalities can lead to adverse outcomes. This study aimed to employ the SDH framework to identify factors that contribute to suicidal behaviors among this population. Methods1410 HIV-positive MSM were recruited using a web-based questionnaire, whose mean age was 30.77 ± 6.92 years old. Participants completed questionnaires including baseline information and psychological measurements, such as Suicidal Behaviors Questionnaire-Revised (SBQ-R). Logistic regression analysis was conducted to screen for risk factors associated with suicidal behaviors. ResultsMore than half of the participants (53.3 %, 752/1410) had an SBQ score of 7 or higher. Binary logistic regression analysis of structural and intermediary determinants (Model 3) revealed that sexual orientation, stigma (ORs: 1.018, 95 % CI: 1.005–1.032), interpersonal needs (ORs: 1.021, 95 % CI: 1.010–1.031), depression (ORs: 1.037, 95 % CI: 1.001–1.074) and entrapment (ORs: 1.018, 95 % CI: 1.004–1.032) were positively correlated with suicidal behaviors. Individuals with other or unknown sexual orientation had significantly higher rates of suicidal behaviors compared to those with a heterosexual sexual orientation (ORs: 5.021, 95 % CI: 1.529–17.640). LimitationsSampling of HIV-positive MSM posed challenges in data collection. It may introduce selection bias and affect generalizability. ConclusionThis study identified that sexual orientation, stigma, interpersonal needs, depression, and entrapment were significantly associated with suicidal behaviors among HIV-positive MSM. Additionally, these factors can be social determinants of health that contribute to suicidal behaviors.

Correlation of CD4+ levels and caspase-3 in condyloma acuminata with HIV reactive patients

Background: Human papillomavirus is an infection that causes malignancy because of persistency and modulation of apoptotic pathways, especially caspase-3. Factors that can increase persistency, recurrency, and malignancy of HPV infection include HIV infection with low CD4 levels. There is disagreement or deep molecular understanding of the induction and modulation of apoptosis in HIV-mediated CD4+ T cell depletion, especially in CA. However, it is necessary to see how CD4+ levels can influence caspase-3, so it may open up new avenues for supporting investigation to consider the presence of malignancy or therapeutic strategies regarding CD4+ can induce apoptosis.Purpose: This study aimed to determine whether there is a correlation between CD4+ levels and caspase-3 expression in condyloma acuminata with HIV reactive patients.Methods: This is an analytic observational study with a cross-sectional design. The research was conducted at Dr. Moewardi General Hospital from August to December 2023. Nineteen patients with condyloma acuminata and HIV reactive were included in this study with a consecutive sampling technique. The expression of caspase-3 was assessed using immunohistochemical staining, looking at the percentage of stained cell nuclei and cytoplasm and CD4+ levels with flow cytometry examination—data analysis using Pearson correlation.Results: Respondents in this study were primarily men, self-employed with heterosexual orientation and genito-genital-oral sexual intercourse. The statistical analysis showed no significant relationship (p: 0.300, r: -0.251) between CD4+ levels and caspase-3 expression.Conclusions: While not statistically significant, CD4+ level is reduced in correlation with increased caspase-3 expressions.

Prevalence of anal cytology screening among persons with HIV and lack of access to high-resolution anoscopy at HIV care facilities.

People with HIV at highest risk of anal cancer include gay, bisexual, and other men who have sex with men and transgender women aged 35 years or older as well as other people with HIV aged 45 years or older. Identifying and treating precancerous lesions can reduce anal cancer incidence in these groups. We assessed the prevalence of anal cytology and access to high-resolution anoscopy among people with HIV overall and in those individuals at highest risk. Data were obtained from the Centers for Disease Control and Prevention's Medical Monitoring Project, a population-based survey of people with HIV aged 18 years and older, and a supplemental Medical Monitoring Project facility survey. We report weighted percentages of people with HIV receiving anal cytology during the past 12 months, access to high-resolution anoscopy, and characteristics of HIV care facilities by availability of high-resolution anoscopy. Overall, 4.8% (95% confidence interval [CI] = 3.4% to 6.1%) of people with HIV had undergone anal cytology in the prior 12 months. Only 7.7% (95% CI = 5.1% to 10.6%) of gay, bisexual, and other men who have sex with men as well as transgender women 35 years of age or older and 1.9% (95% CI = 0.9% to 2.9%) of all other people with HIV aged 45 years and older had anal cytology. Prevalence was statistically significantly low among people with HIV with the following characteristics: non-Hispanic or Latino, Black or African American, high school education or less, heterosexual orientation, and living in southern Medical Monitoring Project states. Among people with HIV, 32.8% (95% CI = 28.0% to 37.7%) had no access to high-resolution anoscopy on-site or through referral at their care facility; 22.2% (95% CI = 19.5% to 24.9%) had on-site access; 45.0% (95% CI = 41.5% to 48.5%) had high-resolution anoscopy available through referral. Most facilities that received Ryan White HIV/AIDS Program funding, cared for more than 1000 people with HIV, or provided on-site colposcopy also provided high-resolution anoscopy on-site or through referral. Rates of anal cytology and access to high-resolution anoscopy were low among people with HIV, including those individuals at highest risk of anal cancer. Our data may inform large-scale implementation of anal cancer prevention efforts.

Partnership Dynamics of LGB People and Heterosexuals: Patterns of First Partnership Formation and First Cohabitation

In this study we examine partnership dynamics among people with different sexual orientations in Germany. More specifically, we explore the process of first partnership formation and first cohabitation among men and women who self-identify as heterosexual, homosexual or bisexual. Given the various discriminations against same-sex lifestyles, and the limited opportunities to meet potential partners, we assume that lesbian, gay and bisexual (LGB) people form partnerships later in life and less frequently than heterosexuals. We further expect that the constantly improving social and legal climate for sexual minorities will lead to a reduction in differences in partnership behaviour by sexual orientation. We use retrospectively reported partnership biographies from the German Socio-Economic Panel, which was supplemented in 2019 with a boost sample of sexual and gender minority households. Using discrete-time event history models, we analyse nearly 15,000 episodes of being single and nearly 20,000 episodes of living without a partner in the household. Around 4.5% of these episodes are from people who self-identify as LGB. The results clearly show that patterns of partnership and coresidential union formation differ by sexual orientation. People with a homosexual orientation—and to a lesser extent people with a bisexual orientation—are less likely to enter into a first partnership and a first cohabitation than people with a heterosexual orientation. Significant changes occur across cohorts: LGB people from younger birth cohorts enter (cohabiting) partnerships much earlier and more frequently than those from older cohorts. Thus, the union formation patterns of LGB and straight people have converged slightly.

Variables with a negative impact on the quality of life of gays and lesbians in Spain: evaluation of homophobic and lesbophobic indicators to guide youth education.

Despite the evidence about the negative impact of homophobic and lesbophobic attitudes on the quality of life of these individuals, the World Health Organisation (WHO) continues to report a lack of research and understanding regarding the health of gays and lesbians and LGTB people in general. There is a growing commitment in public health to understand and improve the health and well-being of LGTB people, and it is very important that professionals in social, educational and health care settings are adequately trained and informed to solve the problems that persist in this population. The aim of this study was to identify homophobic and lesbophobic attitudes in a Spanish youth population, analyzing the relationship of these attitudes with sociodemographic, cultural, political and personal variables. A descriptive, cross-sectional study was carried out with 325 young people aged 18-30 years. The information was collected through the Modern Homophobia Scale of Raja & Stokes, in which sociodemographic and sociocultural variables were also gathered. The data were analyzed and correlations were estimated. The males showed a more negative attitude toward homosexual people compared to the females. The participants with a higher education level presented more positive attitudes toward homosexual people. Younger people with a heterosexual orientation had more negative attitudes toward homosexual people compared to those with a homosexual orientation. The participants with a stronger right-wing political tendency presented a greater percentage of negative attitudes toward LGTB people. Variables such as education level, sexual orientation and political ideology may have a significant influence on the attitudes toward homosexual men and/or lesbian women. Different results were obtained as a function of sex, thus it is important to consider the gender perspective in future studies that tackle this topic.

(038) Health-Related Quality of Life after Gender-Affirming Pelvic Surgery: A Systematic Review and Meta-Analysis

Abstract Introduction Various validated questionnaires have been designed to evaluate sexual dysfunction as it relates to specific phases of the sexual response cycle, which include desire, arousal, orgasm, and resolution. Although there is a breadth of data on the surgical and aesthetic outcomes of patients who have undergone gender-affirming pelvic surgery (GAPS), there are limited data on sexual outcomes as they relate to the sexual response cycle after GAPS. Questionnaires are a crucial tool for research and clinical assessment of sexual dysfunction. However, many of the validated questionnaires for sexual dysfunction were not created for use in transgender patients after GAPS. To date, there is not a validated questionnaire specifically for patients who have undergone GAPS. Objective We sought to review the most commonly used sexual function questionnaires and assess their inclusivity as it relates to transgender patients who have undergone GAPS. Methods A PubMed and PsycINFO search was carried out using the keywords: “Validated questionnaires” AND “sexual dysfunction” OR “arousal” OR “desire” OR “libido” OR “satisfaction” OR “quality of life”. We then reviewed the most commonly used validated sexual dysfunction questionnaires and graded them on the metrics of medical applicability of patients who had undergone vaginoplasty, metoidioplasty, or phalloplasty, affirming language, and inclusion of identities beyond fully binary transgender people. The validated questionaries were reviewed by a comprehensive sexual health expert and a gender-affirming surgeon. Results Of the 13 questionnaires reviewed, only 5 met all metrics for inclusiveness. 4/13 of the validated questionnaires used exclusionary gendered language (female vs male), 6/13 were not physiologically applicable to patients who had undergone GAS (vaginal lubrication, ejaculation etc) and 2/13 assumed heterosexual orientation. Conclusions The current clinical and research tools used to define sexual dysfunction are not inclusive of people who have undergone gender-affirming surgery. Validated questionnaires are needed to optimally assess the sexual outcomes of patients who have undergone GAS. Disclosure No.

America's perceptions of opioid related impairment: A national randomized study examining how different individuals may stigmatize addiction in response to different terminology

IntroductionPrior research has found that different ways of describing opioid-related impairment influences the types and degrees of stigmatizing beliefs held by the American public. In this study we examined the extent to which different characteristics of the American public (i.e., age, gender, race/ethnicity, religiosity, sexual orientation, political affiliation, personal history of addiction/mental health problem) are associated with holding different types and degrees of stigmatizing beliefs when asked to consider someone treated for opioid-related impairment. We also assessed whether any observed differences in stigmatizing beliefs related to participant characteristics are dependent on how an opioid-impaired patient is described in terms of both the nature of the impairment (e.g., as a “chronically relapsing brain disease”, “brain disease”, “disease”, “illness”, “disorder”, or “problem”) as well as the gender of the depicted opioid-impaired person. MethodsA nationally representative sample of the U.S. population (N = 3643) was randomized to one of six vignettes describing a patient being treated for opioid-related impairment that differed only in the way the impairment was described (as a “chronically relapsing brain disease”, “brain disease”, “disease”, “illness”, “disorder”, or “problem”). Participants subsequently were asked to rate statements assessing five stigma dimensions (blame, prognostic pessimism, continuing care, dangerousness, and social distance). ResultsSeveral characteristics were associated with different types and higher levels of stigmatizing beliefs: older age, male gender, White race, heterosexual orientation, being religious, Republican political affiliation, and having no prior alcohol/drug or mental health problem history (ps < 0.001). With very few exceptions, the way the opioid-impairment was described or whether the depicted patient was a man or a woman did not influence the strength of these associations. ConclusionsCertain characteristics of members of the US population were associated with holding different types and degrees of stigmatizing attitudes when asked to consider someone receiving treatment for opioid-related impairment and these were largely unaffected by how the impairment was labeled or the opioid-impaired person's gender. Depending on the specific target of clinical and public health anti-stigma campaigns, both addiction terminology and the beliefs held by certain population sub-groups will need to be considered when creating opioid use disorder related anti-stigma campaigns.

Social epidemiology of the Mediterranean-dietary approaches to stop hypertension intervention for neurodegenerative delay (MIND) diet among early adolescents: the Adolescent Brain Cognitive Development Study

BackgroundThe purpose of our study was to understand the relationship between sociodemographic factors and adherence to the MIND (Mediterranean-DASH [Dietary Approaches to Stop Hypertension] Intervention for Neurodegenerative Delay) diet in a demographically diverse national population-based sample of 9–12-year-olds in the US.MethodsWe analyzed data from the Adolescent Brain and Cognitive Development (ABCD) Study (Year 1, N = 8333). Multivariable linear regression analysis was used to identify associations between MIND diet score and sociodemographic factors, including race/ethnicity, household income, parent education level, age, sex, and sexual minority status.ResultsCompared to White adolescents, Latino adolescents showed the greatest adherence to the MIND diet. Boys had lower adherence to the MIND diet than girls. Lower household income was associated with lower adherence to the MIND diet. Older age was associated with lower adherence to the MIND diet. Sexual minorities had a lower adherence to the MIND diet when compared to their heterosexual counterparts.DiscussionFemale sex, Latino ethnicity, Asian and Black race, high household income, heterosexual sexual orientation, and younger age were associated with higher adherence to the MIND diet. These sociodemographic differences can inform targeted screening and counseling for clinicians and public health organizations among diverse adolescent populations.Impact StatementSociodemographic disparities in diet quality have been documented, but none have explored adherence to the MIND (Mediterranean-DASH [Dietary Approaches to Stop Hypertension] Intervention for Neurodegenerative Delay) diet in early adolescence.In this demographically diverse sample of 9–12-year-old early adolescents in the U.S., we found notable and nuanced sociodemographic disparities in adherence to the MIND diet.Sociodemographic factors associated with higher adherence to the MIND diet included female sex, Latino ethnicity, high household income, heterosexual sexual orientation, and younger age.

Cluster-Based Multinomial Logistic Regression Model for Health-Related Quality of Life Among People Living with HIV in Brazil.

Improvement in treatment options has increased the survival of people living with HIV (PLHIV). Thus, we evaluated the factors associated with better health-related quality of life (HRQoL) among PLHIV in Brazil. This was a cross-sectional study carried out among 349 PLHIV. Data were collected using an interview-based questionnaire, and HRQoL was assessed by the Brazilian version of the WHOQOL HIV BREF instrument. We used non-hierarchical cluster analysis (K-means) to compile the WHOQOL HIV BREF's overall and domain scores into a unique more multidimensional measure for HRQoL consisting of three clusters: poor, fair and good; associations with clusters of better HRQoL were assessed using multinomial logistic regression models. The mean and median overall HRQoL scores were 15.13 (SD = 3.39) and 16, respectively. The reliability and validity of the Brazilian version of the WHOQOL HIV BREF instrument was confirmed among PLHIV in a non-metropolitan, medium-sized municipality of Brazil, which reaffirmed the cross-cultural validity of this instrument. The factors male sex; heterosexual and asexual orientations; higher individual income; undetectable viral load; absence of any comorbidity and presence of an infectious or a chronic comorbidity, with mental illness as the reference; and never having consumed illegal substances were independently associated with good HRQoL. Thus, the compilation of the WHOQOL HIV BREF's overall and domain scores into a unique multidimensional measure for HRQoL, which this study proposed for the first time, may facilitate more robust interpretations and models of predictors. These differentials could simplify HRQoL as an indicator of health and wellbeing to be routinely used as a key outcome in the clinical management of patients and in the global monitoring of health system responses to HIV.

Dimensi Kepribadian Big Five Berdasarkan Orientasi Seksual yang Terjadi di Kota X

Nowadays, there are many cases of sexual orientation deviations such as homosexuality circulating among society. Homosexuals are a minority whose existence, both from a religious and social perspective, is undesirable, so they often receive various forms of rejection in the social, educational or work environment. , the ban on the existence of homosexuals gave rise to a community called homophobia. The emergence of homophobia as a form of society's rejection of the existence of homosexuals is increasingly common in society. People who have sexual deviance problems are very vulnerable to mental health problems such as anxiety, low self-esteem, unhappiness, problems with sexual satisfaction, use of illegal drugs, depression, and even suicide attempts, in contrast to people who have heterosexual orientation who do not have mental problems related to their sexual orientation. Sexual orientation problems experienced by a person are related to personality. This research aims to determine the differences in the big five personality dimensions based on sexual orientation. The subjects of this research are people who have heterosexual and homosexual sexual orientations, where homosexuals are divided into two groups, namely gays and waria. The number of subjects in this study was 30 heterosexual people, 30 gay people and 30 transgender people. The instrument used for data collection is the big five scale. Data were analyzed using the ANOVA analysis technique. The results of this study show that there are no differences in the big five personality dimensions (neuroticism, extraversion, agreeableness, open to experience and conscientiousness) based on sexual orientation (gay, transgender and heterosexual).

The attitude of medical undergraduate students from North India toward transgender and change thereafter by educational intervention.

There is a widespread gap among medical professionals about transgender, and it needs to be addressed through proper educational intervention to inculcate positive attitudes toward transgender people. This study aimed to assess the attitude of medical undergraduate students toward transgender and change thereafter by educational intervention. A total of 169 final-year undergraduate students (aged 22-25 years; 50.3% males; all having heterosexual orientation) were assessed for their attitudes toward transgender people using the Genderism and Transphobia Scale (GTS) and Attitude toward Transgender Individuals Scale (ATTIS). Subsequently, an educational intervention was conducted. The attitude scores were again evaluated immediately and after one month of post-intervention. A paired t-test, independent-samples t-test, and analysis of variance (ANOVA) were used to compare the data. Mean ATTIS and GTS scores before intervention were 67.02 ± 9.20 and 80.84 ± 26.07, respectively. After the educational intervention, these scores were 79.27 ± 7.18 and 63.20 ± 12.11, respectively, thus showing a significant change in both scores. The change in GTS score was significantly higher in males than in females (P < 0.001) and in urban than in rural residents (P = 0.017). No significant association of demographic factors was observed concerning the change in ATTIS scores. On evaluating the recall value, no significant decline in GTS or ATTIS scores was observed following a one month of interval. There is a need to positively reinforce these changes brought about by educational intervention in the attitude of undergraduate medical students toward transgender people. Such cognitive gains are achievable in developing a humanistic society.

“We must help them despite who they are…”: healthcare providers’ attitudes and perspectives on care for young gay, bisexual and other men who have sex with men in Nairobi, Kenya

BackgroundCompared to young heterosexual men, young gay, bisexual and other men who have sex with men (YMSM) face a disproportionate burden of sexual health conditions. This disparity is occasioned by factors such as criminalization and stigmatization of same-sex practices, YMSM’s limited access to non-judgmental and non-discriminatory health services, and challenges associated with healthcare delivery. We explored the attitudes and perspectives of tertiary academic institution-based healthcare providers (HCPs) toward provision of services to YMSM in Nairobi, Kenya.MethodsIn September 2021, six in-person focus group discussions (FGDs) were held with 36 HCPs drawn from six public tertiary academic institutions within the Nairobi metropolis. HCPs were drawn from six cadres: front office staff, nurses, clinicians, counsellors, laboratory technologists, and pharmaceutical technologists. Discussions were conducted in English, transcribed verbatim and analyzed thematically using NVivo version 12.ResultsAnalysis showed that despite expressing disapproval of same-sex practices, HCPs recognized their professional duty to provide care to YMSM, voiced challenges they experienced when providing care to YMSM, and suggested possible strategies for improving care for YMSM. Disapproval of same-sex practices mainly stemmed from HCPs’ personal values, societal norms and religious beliefs, though some HCPs identified religious principles such as the golden rule of “treating others as one would want to be treated” as motivation to providing care to YMSM. HCPs did not perceive criminalization of same-sex practices as a barrier to providing care to YMSM. Healthcare delivery challenges included inadequate knowledge and skills, a desire to “convert” YMSM’s perceived deviant homosexual to the normative heterosexual orientation, secondary stigma from other HCPs, and healthcare settings that did not support YMSM to disclose same-sex practices. Suggestions for improving care comprised sensitization and training of HCPs, encouraging more HCP-YMSM interaction, providing YMSM-friendly and inclusive services, and advocacy for YMSM services.ConclusionThere is need for interventions to improve HCPs’ knowledge of YMSM’s health needs, build skills to respond to these needs, and foster affirming attitudes toward same-sex practices. By so doing, YMSM can hopefully be able to access services that meet their needs, and are non-discriminatory, non-stigmatizing and non-judgmental.

Variations in gender identity and sexual orientation of university students

Abstract Background Previous studies have shown that a small percentage of people in the general population have atypical gender identity and/or sexual orientation. Aim This study aimed to explore variations in gender identity and sexual orientation in university students and determine genetic factors associated with these variations. Methods Deviations from complete gender congruence and exclusive heterosexual orientation in 736 Japanese university students were quantitatively assessed with self-assessment questionnaires. Next, we conducted genetic tests for 80 participants who showed relatively low gender identity scores and/or atypical sexual orientation. These genetic tests consisted of repeat number analysis of the androgen receptor gene (AR) and a SKAT-O: an optimal unified sequence kernel association test, which is an exome-based rare variant association study. The results of the genetic tests were compared with the Japanese reference data and the results of our 637 control samples. Outcomes We calculated the gender identity and sexual orientation scores of all participants and analyzed the molecular data of 80 selected participants. Results The gender identity scores of 736 participants were broadly distributed: only ~15% of natal males and ~5% of natal females had the maximum score that corresponds to complete gender congruence. The sexual orientation scores also varied: ~80% of natal males and ~60% of natal females showed exclusive heterosexual orientation. We found no association between gender characteristics and AR repeat numbers. The SKAT-O showed that rare damaging variants of TDRP and 3 other genes were more common in the 80 participants than in the control group. Clinical Implications Our data support the view that gender is a phenotypic continuum rather than a binary trait. Strength and Limitations This study quantitatively assessed the gender characteristics of a large cohort of university students. Moreover, we conducted systematic screening for genetic factors associated with gender variations. The weaknesses of the study were the limited analytic power of the questionnaires, the relatively small sample for molecular analyses, and incomplete clinical information and relatively advanced ages of the control group. Conclusion This study revealed significant variations in gender identity and sexual orientation in university students, which may be partly associated with variants in TDRP or other genes.