Minority People Research Articles

Abstract P458: An Examination of the Influence of Daily Intersectional Minority Stressors on Sleep Health in Sexual and Gender Minority People of Color

Background: Sexual and gender minority (SGM; e.g., gay, lesbian, bisexual, transgender) people of color are at higher risk for poor sleep health outcomes than both White SGM adults and non-SGM people of color. Growing evidence suggests that chronic minority stressors (i.e., unique stressors attributed to one or more of an individual’s minoritized identities) are associated with short sleep duration and worse sleep quality in SGM adults. However, no study has examined the associations of daily intersectional minority stressors (i.e., attributed to any reason, such as race, sexual identity, gender) with sleep health outcomes in SGM people of color. Objective: To determine the associations of intersectional minority stressors (i.e., anticipated and experienced discrimination) with subsequent sleep health outcomes (i.e., sleep duration, sleep disturbances, and sleep-related impairment) at the day level among SGM people of color. Methods: An online sample of SGM people of color living in the United States participated in a 30-day daily diary study. Daily anticipated discrimination (i.e., expectation of encountering discrimination) and personally experienced discrimination as well as daily subjective sleep health outcomes were assessed using morning and evening electronic diaries. Daily anticipated and experienced discrimination were assessed using validated measures. Patient-Reported Outcomes Measurement Information System (PROMIS) 4-item measures were used to assess daily subjective sleep disturbances and sleep-related impairment. Continuous wrist-worn actigraphy was used to objectively assess sleep duration. Multilevel linear models (MLMs) were used to estimate the independent associations of daily intersectional minority stressors with subsequent sleep health outcomes, adjusted for demographic factors and chronic minority stressors. Results: The sample included 43 SGM people of color with a mean age of 27.0 years (+/- 7.7) of which 84% were Latinx, 47% were multi-racial, and 37% were bisexual. Results of MLMs indicated that greater report of daily experienced discrimination was positively associated with same-night sleep disturbances ( B[SE] = 0.33[0.12], p = 0.01). Further, daily anticipated discrimination was positively associated with sleep-related impairment on the following day ( B[SE] = 0.39[0.17], p = 0.02). However, daily anticipated and experienced discrimination were not associated with same-night sleep duration. Conclusions: This is the first study to simultaneously examine the influence of daily anticipated and experienced discrimination on sleep health in any population. Further research is needed to identify factors driving the link between daily intersectional minority stressors and subjective sleep health outcomes in SGM people of color. This work is crucial to inform precision sleep health interventions tailored for this population.

Abstract P355: Examining Sexual Identity Differences in Self-Measured Blood Pressure Monitoring Among Adults in the Behavioral Risk Factor Surveillance System

Background: Hypertension is a leading risk factor for cardiovascular disease. Self-measured blood pressure (SMBP) monitoring has been identified as an effective strategy to achieve BP control among adults with hypertension. Although there is growing evidence that sexual minority (e.g., gay/lesbian, bisexual) adults are at higher risk of hypertension than heterosexual adults, there is no data on hypertension self-management among sexual minority people with hypertension. Methods: We used data from the 2019 Behavioral Risk Factor Surveillance System to examine differences in SMBP monitoring between sexual minority and heterosexual participants with hypertension. Participants were asked questions regarding SMBP monitoring at home, including whether they were advised by a healthcare professional to check their BP at home, regularly checked their BP at home, and if they shared their home BP readings with a healthcare professional. We ran sex-stratified logistic regression models, adjusted for demographic factors and healthcare utilization, to estimate differences in SMBP monitoring between sexual minority and heterosexual participants. Results: The sample included 25,461 participants with a mean age of 54.1 ( ± 16.8) of which 95.1% were heterosexual, 1.7% were gay/lesbian, and 2.2% were bisexual. Although there were no differences in the odds of being advised by a healthcare professional to check their BP at home, lesbian women were more likely than heterosexual women to report taking their BP at home (AOR 1.23, 95% CI = 1.03-4.85) and sharing their home BP readings with a healthcare professional (AOR 2.31, 95% CI = 1.04-5.17). In contrast, bisexual women were less likely than heterosexual women to report taking their BP at home (AOR 0.59, 95% CI = 0.43-0.81) and sharing their home BP readings with a healthcare professional (AOR 0.56, 95% CI = 0.40-0.78). No differences in SMBP monitoring were found between sexual minority and heterosexual men. Conclusions: As the first examination of sexual identity differences in SMBP monitoring among adults with hypertension, this study addresses important knowledge gaps within cardiovascular and sexual minority health research. Lesbian women with hypertension exhibited more favorable self-management behaviors compared to heterosexual women. However, bisexual women with hypertension were less likely than heterosexual women to engage in SMBP monitoring. Findings suggest there is a need for clinical interventions to improve hypertension self-management among bisexual women.

The permanently minority people: Palestinian refugees in Jordan and Lebanon , (Attempted) social death and desire to return

Seventy-three years, seven million people in exile; it has been this long since the Palestinian diaspora set foot. By expanding the Social Death theory to include “territory bounded culture,” this paper argues that Israeli regime is inflicting an (attempted) social death upon Palestinian refugees by dispossessing them of their lands and denying their existence. This article attempts to unlatch another portal by exhibiting the possibility of creating an anti-thesis to the Social Death theory by the Palestinian resistance. Thus, showing the very act of Israel’s attempted social death becomes the very fuel for the Palestinian resistance to social death. We also illustrate the interconnection between social death and hope to return, allowing another room for analysis of refugee’s desirability to return and the problems of universalisation of solutions to the refugee crisis, in particular the cases of Palestinian refugees in Lebanese and Jordanian refugee camps.

Sex and gender in neurodevelopmental conditions.

Health-related conditions often differ qualitatively or quantitatively between individuals of different birth-assigned sexes and gender identities, and/or with different gendered experiences, requiring tailored care. Studying the moderating and mediating effects of sex-related and gender-related factors on impairment, disability, wellbeing and health is of paramount importance especially for neurodivergent individuals, who are diagnosed with neurodevelopmental conditions with uneven sex/gender distributions. Researchers have become aware of the myriad influences that sex-related and gender-related variables have on the manifestations of neurodevelopmental conditions, and contemporary work has begun to investigate the mechanisms through which these effects are mediated. Here we describe topical concepts of sex and gender science, summarize current knowledge, and discuss research and clinical challenges related to autism, attention-deficit/hyperactivity disorder and other neurodevelopmental conditions. We consider sex and gender in the context of epidemiology, behavioural phenotypes, neurobiology, genetics, endocrinology and neighbouring disciplines. The available evidence supports the view that sex and gender are important contributors to the biological and behavioural variability in neurodevelopmental conditions. Methodological caveats such as frequent conflation of sex and gender constructs, inappropriate measurement of these constructs and under-representation of specific demographic groups (for example, female and gender minority individuals and people with intellectual disabilities) limit the translational potential of research so far. Future research and clinical implementation should integrate sex and gender into next-generation diagnostics, mechanistic investigations and support practices.

An Exploratory Study of the Mpox Media Consumption, Attitudes, and Preferences of Sexual and Gender Minority People Assigned Male at Birth in the United States.

Purpose: This study examined the consumption of, attitudes toward, and preferences for mpox media among U.S. sexual and gender minority (SGM) people assigned male at birth (AMAB). Methods: A total of 496 SGM people AMAB completed an online cross-sectional survey between August 6 and 15, 2022. Data were analyzed with descriptive statistics and logistic regressions. Results: Approximately two-thirds of participants overall agreed that media-related content about mpox targeted (66.3%) and stigmatized gay, bisexual, and other men who have sex with men (69.2%). The three most preferred mpox content were the destigmatization of SGM people (44.2%), mpox vaccine accessibility (25.2%), and mpox transmission and prevention (19.2%). Rural participants had a lower likelihood of consuming mpox-related media than urban participants. Conclusion: SGM people AMAB prefer mpox messaging campaigns to be grounded in stigma-reduction to ensure that messages do not perpetrate stigma against them. Stigmatizing content might foster SGM people AMAB to distrust mpox interventions.

Stigma, mental illness & ethnicity: Time to centre racism and structural stigma.

This article critically reviews previous research in the field of stigma, mental illness and 'race' and ethnicity, and argues for a shift of focus from individual and community blame, as inferred by mental illness stigma, to a more comprehensive view of how stigma operates against a backdrop of structural and institutional racism. Ethnic minority people have poorer mental health outcomes compared with White majority populations. Dominant narratives of greater mental illness stigma in ethnic minority populations, due to religious, spiritual or traditional beliefs and leading to a lower use of services, have taken centre stage in the explanations for these consequent poorer outcomes. This article argues that this 'fact' has become taken for granted as knowledge without corresponding comparative research evidence. Research in the field has also failed to robustly consider how racism might operate in conjunction with different forms of mental illness stigma (particularly structural stigma) to exacerbate mental illness and influence pathways to mental health treatment. Future research should centre the role of racism and structural stigma in explaining the poorer mental health outcomes for ethnic minority people.

Участие домохозяйств этнических меньшинств в развитии фермерского хозяйства: свидетельство Центрального нагорья Вьетнама

Abstract. Previous studies have highlighted relationships between socioeconomic factors and farmers’ participation in agricultural development program but have not found it under minority people contexts. The aim of the study is to quantify the participation levels of minority households and identify the determinants of their participation in farm development policies and programs (FDPAP). Methods. To achieve this, both primary and secondary sources of data are used. The data are gathered through survey 438 farmers from the 5 most populous ethnic groups (namely Jarai, Bahnar, E De, Tay, and Nung) in 10 communes and towns in 8 districts of study area by a questionnaire that was designed on a five-point Likert scale. Content analysis is used to determine the participation extent to which the research model includes five groups of factors (Perception of the householder about the farm economy; Mechanisms and policies of the government/state agency on agriculture; Household characteristics; Economic benefits; Production capacity) corresponded to the identified 24 criteria. Results. The findings indicate that their participation is only at a manipulative or passive level. The main factors tending to deter their participation are households’ characteristics and production capacity. In contrast, specific policies and tangible economic benefits are the factors that motivate them to participate more deeply. Scientific novelty lies in reliable information on the livelihoods and culture of minority farmers based on these results, plays an extremely important role in the success of agricultural policies as public officials push to integrate them into the national agenda.

Tobacco Cessation and Prevention Interventions for Sexual and/or Gender Minority-Identified People and the Theories That Underpin Them: A Scoping Review.

This scoping review takes stock of the social and behavior change theories that have underpinned tobacco interventions tailored to sexual and/or gender minority (SGM) people and reflects on the need to target contextually based drivers of SGM tobacco use inequities. Data sources were Medline (Ovid), Scopus, PubMed, and Google Scholar (January 01, 1946 to October 27, 2022). Peer-reviewed publications in English from anywhere in the world describing SGM-tailored tobacco cessation and/or prevention interventions were independently identified by a librarian and screened by the first and third authors. Three hundred and sixty-seven articles were extracted; an additional two were found by hand searching. A total of 369 articles were assessed for eligibility. Exclusion criteria were: Not an intervention, review article, not SGM-tailored, or tobacco-focused. We documented the intervention name, intervention components, theoretical frameworks cited in reference to intervention design and/or implementation, and evaluation outcomes. All authors provided input on theoretical framework categorization. We identified 22 publications corresponding to 15 unique interventions. Individual-level behavior change theories (ie, those focusing on within-person behavior change processes) were the most prominent. Among these, the Transtheoretical Model was the most frequently utilized, while Social Inoculation Theory, Theory of Reasoned Action, and Theory of Psychological Reactance were also employed. A minority of interventions referenced frameworks that more explicitly engaged with SGM people's social contexts, namely, Theory of Diffusion of Innovations and Minority Stress Model. Future SGM-tailored tobacco interventions should leverage both the strengths of individual-level behavior change theories and those of frameworks that understand tobacco use inequities as indivisible from place, context, and policy. This scoping review describes the theoretical underpinnings of sexual and/or gender minority (SGM)-tailored tobacco interventions published in the peer-review literature in English. It reflects on the need for greater utilization of social and behavior change theoretical frameworks that can engage with unique drivers of SGM tobacco use and barriers to cessation.

COVID-19 Vaccine Hesitancy in an Underrepresented Minority Community.

To assess factors influencing acceptability of COVID-19 vaccine in a population of predominantly indigent, minority, pregnant and non-pregnant people of reproductive age. Cross-sectional survey using a modified Health Belief model administered between January 2021 and January 2022 at four hospitals in Brooklyn. Participants included English-speaking reproductive aged persons attending clinics at the participating sites. Descriptive and univariate data analyses were used for analysis. 283 eligible reproductive persons were approached of whom 272 completed the survey (96%). Three quarters said they would take the vaccine under certain circumstances ("as soon as it is ready" [28.6%], "when my doctor recommends it" [21.3%] or "when enough people have received it to know if it works" [25%]), while 25% said they would never take the vaccine. When comparing persons that would take it under certain circumstances to those that never would, the "never" group was significantly more likely to note that, "they would not trust any COVID vaccine" (71.4% vs. 28.5%; p ≤ 0.0001). This greater level of distrust extended to greater distrust of doctors, government, family, newspapers, and media. However, 36% said they would be influenced by their doctor's recommendation. Pregnant participants were significantly more likely to wait until their doctor recommended it (17.6% of pregnant persons compared to 3.7% of non-pregnant p < 0.0001). Despite mistrust and other discouraging factors, many persons, under appropriate circumstances (e.g., reassurance about vaccine safety) may be motivated to take the vaccine. Even those who claimed that they wouldn't take the vaccine under any circumstance may be influenced by their health care providers.

Enhancing an online cognitive behavioural therapy intervention for depression: Harnessing the feedback of sexual and gender minority youth to help improve SPARX.

SPARX is an online cognitive behavioural therapy self-help intervention for adolescent depression provided in serious game format. Since 2014, it has been freely available in Aotearoa New Zealand (NZ) due to funding from the NZ government. In 2020/21, feedback from sexual and gender minority youth (SGMY) was used to refine and update SPARX. Three online focus groups and follow-up email consultations involved 12 SGMY (16 to 25 years old) in NZ. A general inductive approach was used to analyse data. SGMY had specific needs as well as preferences and four themes were identified: attend to our contextual realities; portrayals of sexual and gender minority people in games; envisaged ideals for serious gaming and appraisals of SPARX. SGMY feedback was used to improve SPARX for this unique population, with the updates launched in October 2021. SGMY are underserved in terms of their mental health needs. Refining or tailoring existing interventions proffers a potential way forward in terms of addressing these needs.

Identity affirmation is associated with adaptive cardiovascular flexibility in response to stress among sexual and gender minority people of color

BackgroundResearch with sexual and gender minority (e.g., lesbian, gay, bisexual, queer, asexual, trans, non-binary) people of Color (SGM-PoC) has largely focused on risk and negative health outcomes. The existing strengths-based mental health research suggests that identity affirmation may be associated with psychological resilience and good mental health among SGM-PoC, but little is known about predictors of physiological resilience and biomarkers of physical health in this population. Adaptive cardiovascular flexibility is an indicator of physiological resilience and physical health in that it enables the body to mobilize resources to adapt to challenges. This study explored the association between identity affirmation and physiological resilience, observed through cardiovascular flexibility in response to stress among SGM-PoC. MethodsParticipants were 95 SGM-PoC of varying ethnoracial backgrounds, sexual orientations, and gender identities, residing in Canada. Participants completed questionnaires on sociodemographic and psychosocial variables, including a measure of identity affirmation, the Queer People of Color Identity Affirmation Scale (QPIAS). In a laboratory setting, we induced stress using the Trier Social Stress Test and measured heart rate variability (HRV) over time using wearable electrocardiogram devices. ResultsResults from multilevel modeling analyses revealed that high QPIAS scores were associated with adaptive cardiovascular flexibility, as evidenced by reduced HRV during stress exposure, followed by HRV increase during recovery. As QPIAS scores increased, the shape of HRV trajectory increasingly reflected our predicted pattern of adaptive cardiovascular flexibility. Meanwhile, low QPIAS scores were not associated with this pattern and appeared to predict a more flatlined HRV activity during the experiment. ConclusionsFindings indicate that Queer People of Color identity affirmation may be related to physiological resilience, observed through a more adaptive cardiovascular profile when responding to stress. Identity affirmation may thus be a protective factor for SGM-PoC, pointing to the critical importance of affirming resources and strengths-based health research.

Exploring Stroke Risk Factors and Outcomes in Sexual and Gender Minority People.

Cerebrovascular disease in sexual and gender minority (SGM) people remains poorly understood. Our primary objective was to describe the epidemiology and outcomes in a sample of SGM people with stroke. As a secondary objective, we compared this group with non-SGM people with stroke to assess for significant differences in risk factors or outcomes. This was a retrospective chart review study of SGM people admitted to an urban stroke center with primary diagnosis of stroke (ischemic or hemorrhagic). We evaluated stroke epidemiology and outcomes, summarizing with descriptive statistics. We then matched 1 SGM person to 3 non-SGM people by year of birth and year of diagnosis to compare demographics, risk factors, inpatient stroke metrics, and outcomes. A total of 26 SGM people were included in the analysis: 20 (77%) had ischemic strokes, 5 (19%) intracerebral hemorrhages, and 1 (4%) subarachnoid hemorrhage. Compared with non-SGM people (n = 78), stroke subtypes showed a similar distribution (64 (82%) ischemic strokes, 12 (15%) intracerebral hemorrhages, 1 (1%) subarachnoid hemorrhage, and 1 nontraumatic subdural hematoma, p > 0.05) but suspected ischemic stroke mechanisms had a different distribution (χ2 = 17.56, p = 0.01). Traditional stroke risk factors were similar between the 2 groups. The SGM group seemed to have higher rates of nontraditional stroke factors, including HIV (31% vs 0%, p < 0.01), syphilis (19% vs 0%, p < 0.01), and hepatitis C (15% vs 5%, p < 0.01) but were more likely to be tested for these risk factors (χ2 = 15.80, p < 0.01; χ2 = 11.65, p < 0.01; χ2 = 7.83, p < 0.01, respectively). SGM people were more likely to have recurrent strokes (χ2 = 4.39, p < 0.04) despite similar follow-up rates. SGM people may have different risk factors, different mechanisms of stroke, and higher risk of recurrent stroke compared with non-SGM people. Standardized collection of sexual orientation and gender identity would enable larger studies to further understand disparities, leading to secondary prevention strategies.

Factors contributing to delay in family building among sexual/gender minority people in the COVID-19 pandemic

Factors contributing to delay in family building among sexual/gender minority people in the COVID-19 pandemic

Queering Filipino American History: Exploring LGBTQ+ Filipina/x/o American THEIR/OURstories

Abstract: The histories of lesbian, gay, bisexual, transgender, queer, and other sexual minority (LGBTQ+) people in the United States are often minimal, nonexistent, or erased—mainly due to the systemic transphobia and heterosexism that have prevented LGBTQ+ of the past from living authentically in their gender identities and sexualities. For queer and trans people of color, including LGBTQ+ Filipina/x/o Americans, histories are even more susceptible to invisibility or erasure, due to the added stigmas within and toward communities of color, religious groups, and immigrants. This paper draws on limited existing resources and speculative analysis to highlight the histories of LGBTQ+ Filipina/x/o Americans from early to contemporary migration waves—utilizing primary sources, as well as queer theories and methods. Personal reflections and future directions for Filipina/x/o American history are discussed.

Homestead Farming Systems and Their Impact on Livelihood of the Ethnic Minority People of Northwestern Hilly Area of Bangladesh

Homestead farming has been playing an important role in the livelihood of the ethnic minority groups, including Garo and Koch in Bangladesh. It secures the integrated production of crops, trees and livestock in the premises of household and its surrounding areas. The northwestern hill forest is decreasing day by day at an alarming rate. In the context of the prevailing shortage of fuel wood and excessive deforestation, the existing homestead farming system of the ethnic people needs to be strengthened for their better livelihood. From this point of view, the study was conducted in two villages of Jhenaigati Upazila (the smallest administrative unit of Bangladesh) of Sherpur District of Bangladesh to find out changes of the homestead farming systems and their impact on people’s livelihood. Fourteen different homestead farming systems were categorized by the presence of different livestock populations. A total of 109 plant species from 60 families were recorded in the study area. Among them 28 percent were identified as fruit species, 20 percent medicinal, 13 percent vegetable, 10 percent timber, 10 percent ornamental, 5 percent spices and 5 percent fuel wood. Fruit tree species like mango and jackfruit showed dominance. This dominance may be associated with the multipurpose usage of fruit trees as food, fuel wood, fodder and timber. About 20% households replaced their cassava plantation area with a mixed garden of fruits and timber yielding species. Exotic timber yielding species and medicinal plants were grown for commercial purposes as well as daily consumption. About fifty percent households had mixed garden of fruit and timber yielding species. Almost all households planted exotic timber yielding species in their mixed gardens. Medicinal plants were grown commercially, which was not practiced ten years back in the study area. The livestock species found in the homestead were cattle, chicken, duck, pig, goat, sheep and rabbit. Households having large homestead area had a tendency to raise more diversified livestock species. Pig rearing has shown a declining trend due to high price of piglets.

Psychiatric morbidities among sexual minorities in India: A cross-sectional study from a north-east state of Manipur

Background: Sexual minorities refer to individuals whose sexual identity, gender orientation, and sexual practices differ from that of surrounding society. In general, they are called lesbian, gay, bisexual, transgender, and queer individuals. Because of the stigma and discrimination, they are prone to many psychological issues. Aims and Objectives: The aim of the study was to study the psychiatric morbidities among sexual minority people of Manipur. Materials and Methods: A cross-sectional study conducted with the help of a non-governmental organization in a northeast state of Manipur after getting ethical committee approval. A total of 70 sexual minority individuals were selected using non-probability sampling. After taking the consent, a semi-structured pro forma was used to collect sociodemographic details. Mini‑international neuropsychiatry interview‑plus was administered to assess psychiatric morbidities. Results: Lesser family support and a higher history of sexual abuse were present in our study group. Depression was found in 25% of lesbians and transgender each and in 20% of gay people in our group whereas current suicidal risk was seen among 31.2% of transgender and 15% among lesbians and gays in our study sample. Anxiety spectrum of disorders was present in 41.6% of lesbians, 35% of gays, 33.3% of bisexuals, and in 53.1% of transgender. Substance dependence was present among 41.6% lesbians, 66.6% of gays, 66.6% of bisexuals, and 43.7% of transgender. Conclusion: Higher prevalence of psychiatric morbidities was found among these sexual minority individuals and hence prompting for a necessary intervention at the earliest.

An immersive field trip focused on beef production increases the sense of belonging in ethnoracial minority college students.

Sense of belonging is a student's sense of feeling accepted, valued, and included by others in their discipline. Imposter syndrome is self-perceived intellectual fraud in areas of success. Sense of belonging and imposter syndrome can influence behavior and well-being and are linked to academic and career outcomes. Our objective was to evaluate if a 5-d tour of the beef cattle industry changed college students' sense of belonging and imposter tendencies with a focus on ethnicity/race. Procedures involving human subjects were approved by the Texas State University (TXST) IRB (#8309). Students from TXST and Texas A&M University (TAMU) attended a beef cattle industry tour in the Texas Panhandle in May 2022. Identical pre- and post-tests were administered immediately before and after the tour. Statistical analyses were conducted with SPSS v.26. Independent sample t-tests were used to evaluate the change from pre- to post-survey and one-way ANOVA was used to evaluate the effect of ethnicity/race. Students (n = 21) were mostly female (81%); attended TAMU (67%) or TXST (33%); and were White (52%), Hispanic (33%), or Black (14%). "Hispanic" and "Black" were combined as a single variable to analyze differences between White and ethnoracial minority students. Before the tour, there was a difference (P = 0.05) in sense of belonging in agriculture between White (4.33 ± 0.16) and ethnoracial minority (3.73 ± 0.23) students such that White students had stronger belonging. There was no change (P = 0.55) in White students' sense of belonging as a result of the tour, from 4.33 ± 0.16 to 4.39 ± 0.44. However, there was a change (P ≤ 0.01) in ethnoracial minority students' sense of belonging, from 3.73 ± 0.23 to 4.37 ± 0.27. There was no change (P = 0.36) in imposter tendencies from the pre-test (58.76 ± 2.46) to the post-test (60.52 ± 2.79). Ultimately, participating in the tour increased ethnoracial minority, but not White, students' sense of belonging and did not impact imposter syndrome tendencies across or within ethnicity/race. One benefit of implementing experiential learning opportunities in dynamic social environments is the potential to improve students' sense of belonging, especially in disciplines and careers where ethnoracial minority people are underrepresented.

Coronavirus (COVID-19) and sexualised drug use among men who have sex with men: a systematic review.

Drug-related harms, including harms from sexualised drug use (SDU), are disproportionately experienced by sexual and gender minority people, relative to their majority counterparts. Chemsex, a type of SDU practiced mainly by MSM, is associated with methamphetamine use and increased HIV seropositivity or risk of acquisition. Therefore, participants are at increased risk of immunocompromise. Existing evidence suggests that drug use increases following natural disasters. The impact of coronavirus disease 2019 (COVID-19) on chemsex is unknown. A PRISMA-adherent systematic review was conducted to synthesise reports of changes in the prevalence, frequency, or characteristics of drug use (and factors associated with these changes) following the onset of the COVID-19 pandemic. This report presents findings related to SDU/chemsex among MSM. A comprehensive search across nine databases, supplemented with backward-forward citation searching and contact with key opinion leaders, was conducted. Two reviewers carried out title-abstract screening, full-text screening, and data extraction. Following a final, single database search, nine studies were included in the narrative synthesis. More than half the sample were studies investigating HIV pre-exposure prophylaxis use. Twenty percent of participants in most studies reported chemsex participation. In four, participants reported a net increase or maintenance of chemsex participation during the pandemic and five reported a net decrease. Increased chemsex participation was associated with loneliness, cravings, and working during the pandemic. Decreased chemsex practice was associated with COVID-19-related fear. This synthesis suggests that chemsex practice continued, and for some MSM increased, throughout COVID-19 pandemic 'lockdowns'. This may have increased COVID-19 transmission and severity among potentially vulnerable MSM.

Experiences of key populations in getting and sharing HIV and AIDS-related information: A descriptive phenomenological study

Despite the long-running targeted communication programs, the concentrated HIV epidemic in key populations has not declined as expectedin Nepal.In this context, the present descriptive phenomenological study was carried out in Nepalgunj Submetropolitan City to explore the experiences of key populations in getting and sharing HIV and AIDS-related information. In-depth interviews were carried out with nine participants selected through snowball sampling from sexual minority people, and female sex workers. Colaizzi’s descriptive phenomenological analysis method was adopted in data analysis. Participants were increasingly using digital means of communication. Peer approach was experienced as more confidential and training in drop-in-center a friendly mode of communication. Experiences of embarrassment, stigma, and discrimination were also prevalent. The findings of this study indicate HIV communication needs to be easily accessible, confidential, and friendly.

Outness, Discrimination, and Psychological Distress Among LGBTQ+ People Living in the Southern United States.

Purpose: Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) people face mental health disparities. These disparities are amplified in the Southern regions of the United States. This study assessed the role of outness, discrimination, and other demographic variables on possible serious mental illness (SMI) among LGBTQ+ Southerners. Methods: This study used data from the 2017 LGBT Institute Southern Survey, a cross-sectional convenience sample of 6502 LGBTQ+ adults living in 14 Southern states. Multivariable logistic regression was performed to examine differences between those with and without possible SMI. Results: Outness was associated with a lower likelihood of possible SMI (odds ratio [OR]: 0.696, 95% confidence interval [CI]: 0.574-0.844, p = 0.001), especially when controlling for discrimination in the past 12 months (OR: 0.693, 95% CI: 0.576-0.834, p ≤ 0.001) and lifetime discrimination (OR: 0.678, 95% CI: 0.554-0.829, p = 0.001). Lifetime discrimination was associated with a higher likelihood of possible SMI (OR: 1.413, 95% CI: 1.034-1.932, p = 0.033), as was discrimination experienced in the past 12 months (OR: 1.626, 95% CI: 1.408-1.877, p ≤ 0.001). Black/African American respondents had the lowest percentage of possible SMI (21.0%) compared with other races, despite having lower or comparable rates of outness. Conclusion: These results indicate a possible promotive effect of outness against possible SMI among LGBTQ+ Southerners, as well as possible promotive group-level factors among Black/African American LGBTQ+ Southerners. Policies and interventions that address discrimination against LGBTQ+ Southerners should be expanded, and future research should address how the relationships between outness, discrimination, and mental health outcomes may vary by subgroup.