Homosexual Research Articles

Not a Problem at All or Excluded by Oneself, Doctors and the Law? Healthcare Workers' Perspectives on Access to HIV-Related Healthcare among Same-Sex Attracted Men in Tanzania.

Background: An increasing body of literature focuses on access to healthcare services for men who engage in sex with other men in Africa, but how healthcare workers conceive of this topic of healthcare workers’ views on men's care has not been much studied. Drawing on qualitative research, this article explores healthcare providers’ perspectives on access to HIV-related healthcare services among gender and sexuality diverse men in Tanzania. Methods: A qualitative study was conducted among healthcare workers in Dar es Salaam and Tanga, Tanzania in 2018/2019. Data collection entailed qualitative interviewing, focus group discussions and participant observation. A purposive sampling strategy was used to select study participants who varied with respect to age, education level, work experience, and the type and location of the facilities they worked in. A total of 88 participants took part in the study. Results: This paper describes four different discourses that were identified among healthcare workers with respect to their perception of access to healthcare services for men who have sex with men. One held that access to healthcare was not a major problem, another that some same-sex attracted men did not utilize healthcare services although they were available to them, a third that some healthcare workers prevented these men from gaining access to healthcare and a fourth that healthcare for gender and sexual minority persons was made difficult by structural barriers. Conclusion: Although these are four rather different takes on the prevailing circumstances with respect to healthcare access for same-sex attracted men (SSAM), we suggest that they may all be “true” in the sense that they grasp and highlight different aspects of the same realities. More education is needed to healthcare providers to enable them accept SSAM who seek healthcare services and hence improve access to healthcare.

Abstract- Poster

BACKGROUNDGender dysphoria is characterized by persistent and intense distress about assigned sex with a desire to be of opposite sex with a prevalence of 0.005-0.014% in biological males and 0.002-0.003% in biological females. According to ICD-10, 1/3rd of gender dysphoria cases have homosexual orientation. In this poster we report a case of young boy with Gender dysphoria having Homosexual orientation.CASE REPORTA 12-year-old boy visited GSL Psychiatry OPD with C/O Intense desire to be of opposite sex and a need for sexual gratification with same gender with H/O strong preference for games engaged by opposite gender with playmates of the opposite gender, simulating female attire when he is alone, and subjective feeling of arousal with boys. Two weeks prior to the visit, patient stripped and forced himself onto his maternal uncle in absence of other family members.General physical examination and Patient’s genetalia examination were normal. Basic blood investigations were normal. Utrecht gender dysphoria scale suggested gender dysphoria.CONCLUSIONBiological and environmental factors influence particular sexual orientation and Identity. Helping patients and society in understanding this, bringing awareness and providing support can reduce interpersonal conflicts, Rejection from society, symptoms of Depression and Anxiety, Substance use disorders, Poor Self-esteem and prevent Self-harm and Suicide.

Sexual obsessions in children and adolescents: Prevalence, clinical correlates, response to cognitive-behavior therapy and long-term follow up

Sexual obsessions occur in pediatric and adult OCD including thoughts about sexual acts with family members, sexually inappropriate behavior, or homosexual orientation. They may remain undiagnosed because of embarrassment to report thoughts that are perceived as unacceptable. Prevalence studies of sexual obsessions in pediatric populations are rare. The present study investigated prevalence of sexual obsessions and treatment outcome compared to youth with OCD without sexual obsessions in a large sample. Sexual obsessions and OCD severity were assessed with the Children’s Yale-Brown Obsessive- Compulsive Scale in all 269 participants of the Nordic Longterm OCD Treatment study (mean age 12.8 years, 48.7% boys) at baseline, after treatment and three years follow-up. Treatment consisted in individual manualized CBT with exposure and response prevention. Patients with and without sexual obsessions were compared on clinical characteristics and treatment outcomes. Sexual obsessions were reported by 18%, those with sexual obsessions were slightly older (13.5 versus 12.7 years). Both groups had no difference in treatment outcome, suggesting that if addressed, the response to CBT is similar in sexual, as in other obsessions. Clinicians need to be aware that children may need help to disclose and to identify these thoughts as obsessions to address them in treatment.

Queda mucho por ver. El sexo gay en la pantalla

Gay sex has been consistently hidden, censored and manipulated throughout the history of cinema. Rarely dealt with in mainstream cinema, it has nevertheless existed on the fringes of film consumption (art films, indies), reaching only small pockets of spectators. This essay aims to synthesize the presentation of gay sex in the film screen, dwelling first on both the spaces it is associated with and the movies that have attempted to show it, and then looking at several recent films (Weekend, Stranger by the Lake) that adopt different strategies to make it finally visible.

A cross-sectional study to assess the pre-marital sexual practices among Panjab University students, Chandigarh, India.

In India, premarital partnerships whether involving sex or not are widely unacceptable. Various studies in India have reported heightened premarital sexual activities among youngsters. The objective of the study was to assess the involvement of youth in premarital sexual practices studying at Panjab University. The cross-sectional study was conducted at Panjab University situated in Chandigarh, India between February and August 2020. Purposive sampling was used to recruit students. Data was collected using a pre-tested, semi-structured, self-administered questionnaire. The nature of the data was quantitative and was analyzed through SPSS version 20. A total of 211 (female/male: 51.7%/48.3%, mean age: 22.5 years) respondents were enrolled. Prevalence of premarital sex was 68.7% with an average age of sexual debut 18.5 years. 62.1% of respondents were practicing unprotected sex. 91% of respondents were involved in vaginal sex, 61.4% in oral sex, 29% in online sex, and 19.3% in anal sex. 66.8% of respondents were involved in the habit of masturbation. In students having a positive premarital sexual background, 78.2% of respondents had sexting, 38.8% had friends with benefits, 33.9% had one-night stands, 4.8% had a threesome and 2.3% had gay sex. Out of all the respondents involved in premarital sexual practices, 86.9% were satisfied with sexual life. There is a need to empower the younger population involved in risky sexual behavior by accelerating their sexual and reproductive rights education to propagate safe sexual behavior in premarital sexual practices.

Marriage, Sexual Privacy, and Sodomy Statutes in the World: A Case Analysis

According to the traditional Judeo-Christian moral and ethical standards, which conceive of sex in purely functional terms, i.e., for the purpose of procreation only. Now days the legislation criminalizing consensual oral and anal sex is outdated and has no place in modern society. By criminalizing private, consensual same-sex conduct, some countries in the world’s penal laws serves as the weapon for police abuse; detaining and questioning, extortion, harassment, forced sex, payment of hush money; and perpetuates negative and discriminatory beliefs towards same-sex relations and sexuality minorities. This sodomy laws thus creates a class of vulnerable people that is continually victimized and directly affected by the provision as well as sexuality minorities. The inalienable component of right to life, the pursuit of happiness encompassed within the concepts of privacy, human dignity, individual autonomy and the human need for an intimate personal sphere require that privacy dignity claim concerning private, consensual, sexual relations are also afforded protection within the ambit of the said fundamental right to life and liberty. There is almost unanimous medical and psychiatric opinion that homosexuality is not a disease or a disorder and is just another expression of human sexuality.

Government communication pieces on HIV pre-exposure (PrEP) and post-exposure (PEP) prophylaxis (2016-2019): analysis of their content and circulation among gay men, trans women/travestis, and sex workers

Resumo Este artigo analisa a divulgação das profilaxias pré (PrEP) e pós-exposição (PEP) ao HIV, considerando o papel histórico das campanhas de prevenção à aids. São utilizadas 24 peças de comunicação sobre PrEP, PEP e PC (Prevenção Combinada), produzidas entre 2016 e 2019 e publicadas no site e mídias sociais do Ministério da Saúde, e o depoimento de 30 usuários(as) das profilaxias - que incluem gays, mulheres trans/travestis e profissionais do sexo - na região metropolitana do Rio de Janeiro. As peças foram classificadas quanto ao tipo, ano, público e informação de acesso, e os resultados foram interpretados a partir de três eixos: sexualidade e risco; gênero, emoções e moralidades; deslocamentos do preservativo. A análise indicou o apagamento das expressões de sexualidade e o predomínio de uma linguagem abstrata e esquemática, pressupondo um público racional e individualista, com o preservativo associado à ideia de “risco sexual”. Os relatos dos(as) usuários(as) quanto à divulgação de informações sobre essas profilaxias evidenciaram sua insuficiência. Concluímos que ocorre uma baixa exploração do potencial das campanhas de comunicação, orientadas pela realidade sociocultural dos segmentos sociais, comprometendo o acesso às profilaxias. Assim, a biomedicalização da prevenção e o avanço do conservadorismo prejudicam a resposta brasileira à aids.

Then and Now: Formative Experiences and Generational Perspectives among Flemish GBTQ Baby Boomers

Background: This paper proposes a generational approach to better understand the specific position and perspectives of older GBTQ (Gay, Bisexual, Transgender and Queer) men. Generational theory and empirical research demonstrate that experiences and social contexts in adolescence and early adulthood are formative for sexual identity formation while also informing perspectives later in life. Methods: The paper discusses the findings of a qualitative project based on in-depth interviews with sixteen Flemish men belonging to the so-called “Baby Boomer” generation, i.e., born between 1945 and 1964. They came of age before “gay liberation”, exploring and establishing their sexual identities in a period of social invisibility. Results: First, the analysis focuses on the past, in particular the period of sexual exploration and identity formation, reporting findings on formative, often difficult experiences such as the first realization of same-sex attraction, first sexual explorations, coming out, first contact with other LGBTQ (Lesbian, Gay, Bisexual, Transgender and Queer) individuals, participation in the LGBTQ scene and associations, and HIV/AIDS. Then, the focus shifts to the present, to discuss the progress the participants observe but also the problems they (still) experience, including the way they perceive intergenerational differences. Conclusions: Older GBTQ men came of age in a radically different context, struggling to embrace their sexuality, which also informs their current position in LGBTQ culture. These insights are relevant for LGBTQ associations, policy makers and (mental) health practitioners, who could do more to address the specific position and needs of this older demographic.

Acciones investigativas realizadas en universidades en relación a la comunidad homosexual y transgénero

Objective: To analyze the investigative actions carried out in universities in relation to people with homosexual sexual orientation and transgender gender identity. Methodology: Systematic review of scientific research, in which 63 were identified for analysis through the application of the PRISMA statement. In this way, a total of 56 articles were obtained that met the required inclusion criteria. Conclusions and discussions: Most of the articles found account for research carried out with the heterosexual population, inquiring about social support, attitudes and construction of meanings towards homosexual sexual orientation and transgender gender identity in the university context. On the other hand, those studies that take the homosexual and transgender population as the main actors, address the process of recognition of sexual orientation and the difficulties to which the community is exposed in the different contexts of interaction.

“Women trade sex from women in Tanzania”: findings from qualitative formative research with women who have sex with women in Dar-es- Salaam City

Recent studies indicate women are increasingly willing to pay for sex from both men and women. Most of these studies have mainly focused on the developed world and little is known about women’s willingness, reasons, and motivation to pay for sex on the African continent, the East African region and in Tanzania, in particular. We explored paid sex behaviors and practices among women who have sex with women (WSW) in Dar-es-Salaam city, Tanzania. The study was designed as a formative qualitative cross-sectional study conducted in Ilala, Kinondoni and Temeke districts in Dar-es-Salaam region. Study participants included community leaders; and WSW aged 18 years and above, who had had engaged in same-sex sex in the past year or in same-sex relationship(s), and had knowledge of WSW’s lived experiences, among other criteria. Most of the WSW participants affirmed paid sex is a common practice among them with reported reasons and motivations being more-or-less similar to those documented in other parts of the world. Findings show that commercial sex is an arena for behavioral convergences, and this calls for new pathways to comprehend (women’s) behavior, sexuality, commercial sex industry and its implications to women’s sexual and reproductive health and healthcare.

ROLE EXPECTATIONS IN ROMANTIC RELATIONSHIPS OF MEN WITH DIFFERENT SEXUAL ORIENTATION

The article considers the features of role expectations in romantic relationships of men with different sexual orientation. A comparative description of role expectations and claims of these groups is given in this article. The aim of this work is to study the features of role expectations and claims in heterosexual and homosexual couples. The study involved 80 heterosexual and 80 homosexual men Ukrainian nationality, who were interviewed about their role expectations and claims in a couple. Role expectations of men were studied by using the method of A. Volkova "Role Expectations and Claims in Marriage", which allows to determine features of role expectations and claims of partners in various spheres of family life (sexual relations, parental responsibilities, household, etc.). In addition, participants were tested by an "Incomplete sentences" method. Descriptive statistics, frequency analysis and Student's t-test were used for data processing. Obtained data indicate important similarities and differences in the perception of a partner, relationships and role expectations and claims of men of different sexual orientations. It was found that both heterosexuals and homosexuals are neutral to married life and have very positive attitude towards their partner. It was found that among both heterosexual and homosexual men dominate role expectations in the social activity and external attractiveness areas. Moreover, expectations in the external attractiveness area are significantly higher among homosexual men compared to heterosexual men. It was found that role claims of heterosexual men are identical to their role expectations. Heterosexual men do not expect more from their partners than they are willing to give in their relationship. Role claims of homosexual men demonstrate high importance of social activity, external attractiveness and emotional-psychotherapeutic role in relationships. Prospects for further research include studying of the features of role expectations and claims among men with homosexual orientation, with the further development of techniques for counseling in such couples.

Bisexual Indonesian Men’s Experiences of Islam, the Quran and Allah: A Mixed-Methods Analysis of Spiritual Resistance

Many Muslim men with same-sex sexualities experience tensions between their sexual/religious identities. However, few inquiries address how bisexual Muslim men grow and develop amidst socioreligious persecution. Therefore, the present study utilized a mixed-methods design and the Transformative Intersectional Psychology (TIP) framework to explore the spiritual resistance of 35 bisexual, Indonesian Muslim men. Participants completed online religious attitudes and experiences measures as well as open-ended questions regarding their religious/spiritual lives. Although 70% of participants reported that they felt unsupported by the Muslim community in the past year, 49% of participants described Islam in positive terms. Moreover, participants’ largely constructed their religious and spiritual experiences outside of LGBT + Muslim affirming organizations due to the pervasive LGBTQ + hostility in Indonesia. The present study helps build a stronger theoretical foundation for understanding both the positive and negative aspects of religiosity and spirituality in bisexual Muslims’ lives from a transformative and intersectional perspective.

RELIGION AND SOCIAL TOLERANCE: GENERATION Z'S VIEWS ON EXPOSURE TO HOMOSEXUALITY IN THE MASS MEDIA

The media exerts a considerable influence on individuals' views, attitudes, and behaviors, particularly on those who lack access to alternative sources of information or are still shaping and forming their identities and perspectives. Attitude towards homosexuality has been different in understanding to type of societies’ cultural and moral development or political circumstance. Arising out of this issue on homosexuality is the idea of natural law and some interpretations of that law as forbidding homosexual sex. Traditionally, homosexuals have been underrepresented and misrepresented in television series and feature films. Homosexual characters have been cast in stereotypically negative roles purely for amusing the audience. In this paper, the researchers were able to analyze how the introduction of content presenting and detailing LGBT individuals and concerns into the mainstream media affects the audiences' attitudes and acceptance of the issue, particularly the Generation Z. The findings indicated that the majority of generation Z residents in Isulan, Sultan Kudarat, aged 15-19, are not influenced by the media in their views on homosexuality, and the interpretation revealed a neutral conclusion in terms of fully tolerating homosexuality in the community.

A Critical Study of Mukhannath's Law as a Homosexual Argumentation

The term mukhannath in the study of Islamic law by Muslim feminists is considered to be the basis for the legitimacy of homosexual behavior. Muslim feminists present the meaning of mukhannath as behavior as well as sexual orientation that is permitted in Islam and in accordance with divine nature, so that homosexuality is a natural act in Islam and must be accepted as it is. On that basis, feminists distinguish homosexuality with liwath behavior that can be applied to homosexual, heterosexual and bisexual perpetrators. This is contrary to Islamic teachings/shari'a regarding the heresy of the Prophet Luth a.s who by the muslim scholars are called luthi, namely the perpetrators of liwath. Likewise, in interpreting mukhannath, the feminist framework is built from the concept of gender which is not derived from the treasures of Islamic scholarship or Islamic perspective. For this reason, the author tries to research and analyze the meaning and concept of mukhannath, and straighten it out according to the Islamic worldview. By using the descriptive-analytical method and using the literature as a database, the researchers came to the following conclusions; The meaning of mukhannath is the behavior of men who resemble women in terms of speech, gestures and clothing. This meaning does not recognize the difference between sexual orientation or behavior, but must be returned to the nature of its creation, namely its absolute gender. The muslim scholars have agreed that homosexual translation in Islam is liwath, which in the Qur'an is punished as destroying human nature (fitrah). The nature of creation (fitrah) must be in harmony with divine destiny which is eternal, as well as homosexual law in Islam is qath'i, not mutaghayyirah. For this reason, it is not appropriate if the gender analysis system is built on the basis of relatively social constructs used in the discussion of qath'i Islamic law.

Selected Doctrinal Arguments against the Admission of Persons of Homosexual Orientation to the Sacrament of Holy Orders

The problem addressed in this article is what doctrinal arguments are behind the current decision of the Holy See not to admit men with a deep-seated homosexual orientation to the sacrament of Holy Orders. The problem may be solved in three stages: by showing selected contents of the documents of the Holy See in the 20th and 21st centuries, by presenting the doctrinal themes contained therein and by attempting to evaluate their reception in the light of current challenges. The author invokes the documents of the Holy See and the statements of the popes.

Analysis on the HIV-1 molecular transmission characteristics of newly confirmed HIV/AIDS in Jiaxing city, 2017-2018

Objective: To analyze the relationship between infection and transmission of HIV/AIDS, explore the characteristics of the HIV-1 transmission network, and provide evidence for formulating targeted prevention and control measures. Methods: The newly confirmed HIV/AIDS in Jiaxing from 2017 to 2018 were selected for the study. The sociodemographic and infection transmission-related information was gathered. The blood samples were collected and RNA was extracted, RT-PCR and nested PCR amplified the pol gene of HIV-1. The phylogenetic tree was constructed by Mega 6.0 software for subtype analysis. The genetic distance between strains was calculated, and the molecular transmission network was drawn by using Cytoscape 3.6.0 software. The results of the epidemiological study based on the molecular transmission network were analyzed. Results: There were fifteen HIV-1 gene subtypes in 517 cases of HIV/AIDS. The main subtypes were CRF01_AE (37.1%)、CRF07_BC (36.2%) and CRF08_BC (11.8%). Under the 1.0% gene distance threshold, 87 molecular clusters were established, and the total clustering rate was 45.8% (237/517). The cluster risk factors were 60-81 age group (compared with 14-24 age group, OR=2.690, 95%CI:1.058-6.844), married (compared with unmarried, OR=1.698, 95%CI:1.003-2.875), CRF07_BC subtype (compared with CRF01_AE, OR=2.203, 95%CI:1.426-3.404). The largest molecular cluster, CRF07_BC-1, consisted of 50 cases (including 21 cases confirmed in 2017 cases and 29 confirmed in 2018). Multivariate analysis showed that characteristics of unmarried (compared with married, OR=2.482, 95%CI:1.140-5.402), gays (compared with heterosexual, OR=3.163, 95%CI:1.543-6.483), cases with high-risk transmission (compared with other cases, OR=7.631, 95%CI:1.783-32.654), confirmed in Nanhu and Pinghu districts of Jiaxing (compared with other districts, OR=2.225, 95%CI:1.074-4.608) were risks for entering the largest molecular cluster. There were seven suspected high-risk transmission MSM in the largest molecular cluster. The first debut of homosexual behavior was from 2010 to 2018, and the median number of gay partners was 20 (P25, P75：10, 100) within two years before being diagnosed. Six reported a recent history of looking for gay partners in an MSM dating place in Nanhu district. Conclusions: The HIV-1 subtypes of newly confirmed HIV/AIDS were diverse, mainly sporadic in Jiaxing from 2017 to 2018. There were geographical aggregation characteristics and suspected some high-risk transmission cases, suggesting that rapid transmission and targeted intensive intervention are needed.

Characteristics and influencing factors of newly HIV infection among newly confirmed HIV/AIDS cases in Ningbo city, 2017-2020

Objective: To identify the characteristics and influencing factors of local HIV infection among newly confirmed cases in Ningbo from 2017 to 2020 to provide evidence for traceability investigations on critical cases and facilitate the detection procedures and reduce new HIV infection. Methods: From January 1, 2017, to December 31, 2020, the newly confirmed HIV/AIDS in Ningbo were recruited. An epidemiological questionnaire was used to collect relevant information, including demography, sexual behaviors, results of HIV antibody tests, and the route of HIV transmission. According to the HIV testing, history of risk behaviors, and the level of CD4+ lymphocytes after confirmation, the HIV infection was acquired in the previous year, or the place was in Ningbo. The EpiData 3.1 and SPSS 23.0 software were used for input, sorting database and statistical analysis. Results: A total of 2 044 HIV/AIDS on-site investigations were completed. The average age of the subjects was (40.6±15.3) years old, including 1 684 males (82.4%), 758 unmarrieds (37.1%), 1 072 (52.5%) registered as permanent residents in Ningbo, 1 253 (61.3%) with junior high school education or below, 979 (47.9%) lived in Ningbo for more than five years. The proportion of local, new HIV infections was 34.34% (702/2 044). Multivariate logistic analysis showed that the proportion of local newly HIV infection was higher among those who were confirmed in 2020 (compared with the 2017 confirmed cases, OR=1.422, 95%CI:1.092-1.851), whose occupations were students/teachers/cadres/retirees (compared to commercial service/catering/public place service personnel, OR=1.682, 95%CI: 1.307-2.165), meeting sex partners via male social software locally in the last year (compared with without using related dating software, OR=1.353, 95%CI: 1.073-1.706). Conclusions: The proportion of local HIV infection of newly confirmed HIV/AIDS was relatively high in Ningbo city from 2017 to 2020. Meeting gay sex partners through local male social software appeared a risk factor for local newly HIV infection. Traceability investigations and internet intervention should be carried out for MSM. While male social software should be focused on identifying and controlling the risk of local newly HIV infection.

DEVIASI SOSIAL HUBUNGAN SESAMA JENIS HOMOSEKSUAL PERSPEKTIF PSIKOLOGI ISLAM

The term social deviation or more commonly referred to as deviation of behavior is a pattern of behavior that for many people this social deviation is a bad deed and exceeds the limits of the norms of propriety that can be tolerated by humans. Sexual orientation between men or gay sex is an example of behavioral deviations that clearly violate the norms of propriety in society and certainly do not conform to the teachings of any religion. exual relations between men or gay sex is an example of behavioral deviations that clearly violate the norms of propriety in society and certainly do not conform to the teachings of any religion. Studied in the view of Islam this perversion of sexual desire is clearly opposed to the creation of man by Allah SWT who must be in accordance with his codrad. The writing method used in studying maslah in the writing of this article is "library reseuarch" or literature research. The result of this study, namely deviant behavior in the form of male relationships with the same or homosexual is as a form of opposition to the human codrad that has been created by Allah SWT. Man must have high achievement in terms of the control of his passions is a way to train himself to have a high codrad that begins with the formation of noble morals. The attempt to be able to merubag akhlaq is to conquer anger, greed, and lust "shahwat". It is also an effort and a struggle of patience to build a habit. The despicable nature according to Imam Al Ghazali is a form of bathniah that if the despicable nature is erased then the praiseworthy nature will replace it.

863. Pre-Exposure Prophylaxis (PrEP) Prescriptions among Individuals at High Risk for HIV in the United States, 2012-2018

BackgroundTo describe trends in emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) PrEP uptake in 2012-2018 and characterize high risk individuals who use PrEP.MethodsThe study identified individuals aged ≥ 15 years old with claims suggesting high risk for HIV infection in the IBM MarketScan® Commercial Claims and Multi-state Medicaid Databases. High risk was defined using ICD codes indicating high risk sexual behavior or rectal/repeated bacterial sexually transmitted infection (STI). The index date was defined as the earliest of the first high risk sexual behavior diagnosis, the first rectal bacterial STI diagnosis, or the second non-rectal bacterial STI diagnosis within 12 months. Individuals were considered PrEP users if they had at least one FTC/TDF PrEP prescription within 12 months of index date. Individuals with evidence of HIV prior to or within 30 days after PrEP initiation/index date were excluded. Comorbidities were assessed using a modified Charlson Comorbidity Index that excluded HIV/AIDS.ResultsFTC/TDF PrEP uptake increased from 0.1% to 7.3% among commercially insured individuals between 2012-2018, and from 0.01% to 0.5% among Medicaid insured individuals between 2012-2017. Individuals ≥ 35 years old had the largest increase in PrEP uptake (0.1% to 13.0%), while those 16-25 years old had the smallest increase (0.03% to 2.3%). The largest proportion of PrEP users across all years were aged 25-34 while the largest proportion of non-PrEP users were aged 18-24. Compared to PrEP users, a larger proportion of PrEP non-users were female (62.9% vs. 1.4%, p < 0.05) and blacks/African American (49.1% vs. 40.3%, p < 0.05). A larger proportion of PrEP users had a risk status of homosexual (46.6% vs. 1.5%, p < 0.05) or bisexual (3.9% vs. 0.8%, p < 0.05) behavior than non-PrEP users. PrEP users also had more comorbidities than non-users among individuals with Medicaid and were less likely to have fee-for-service insurance plans overall (p < 0.05).Table 1. Characteristics of people at high-risk for HIV who do vs. do not use FTC/TDF PrEP measured during the follow-up period ConclusionDespite an increase in FTC/TDF PrEP initiations, uptake was low, especially among young adults, women, heterosexuals and blacks/African Americans. Low initiation rates in these groups may illustrate that FTC/TDF PrEP is not meeting the needs of all high-risk individuals.Disclosures Mo Zhou, PhD, Merck & Co., Inc. (Consultant) Yan Song, PhD, Merck & Co., Inc. (Consultant) Emily Gao, MS, MPH, Merck & Co., Inc. (Consultant) Yohance Whiteside, PhD, MSPH, Merck & Co., Inc. (Employee) Emma Billmyer, BA, Merck & Co., Inc. (Consultant) James Signorovitch, PhD, Merck & Co., Inc. (Consultant)

Psychiatric Disorders Mediates the Association between Sexual Orientation Discrimination and Substance Use Disorders among Sexual Minority Adults

Although sexual orientation discrimination (SO-discrimination) is associated with an increased risk of psychiatric and substance use disorders (SUD) among sexual minority (SM) adults, these relationships are not well understood, particularly in the context of SUD severity. To address this gap, we assessed the direct and indirect effect of SO-discrimination and sexual identity on psychiatric disorders and SUD severity in the context of stress and resilience among SM adults. We used data from 3,494 adults reporting nonheterosexual identity, attraction, or behavior collected as part of a nationally representative cross-sectional sample of adults in the United States. Structural equation modeling assessed potential pathways between SO-discrimination, psychiatric disorders, and SUD severity. Past-year psychiatric disorders and SUD severity were significantly correlated in the multivariate model. Concordant homosexual orientation was associated with reduced risk of psychiatric disorders, but not with past-year SUD severity. SO-discrimination was significantly associated with increased risk of psychiatric disorders, but was not a significant predictor of SUD severity. Notably, SO-discrimination was not directly associated with SUD severity, but was found to have a significant indirect effect on SUD severity through psychiatric disorders. SO-discrimination was directly associated with increased risk of psychiatric disorders, and psychiatric disorders mediated the pathway between SO-discrimination and SUD severity. Since psychiatric disorders and SUD are often cooccurring, these data indicate integrated assessment strategies and dual interventions for SM populations.