Objectives We examined the relationships among sexual minority status, sex, and mental health and suicidality, in a racially/ethnically diverse sample of adolescents. Methods Using pooled data from 2005 and 2007 Youth Risk Behavior Surveys, hierarchical linear modeling was used to examine 6 mental health outcomes across 6 racial/ethnic groups, intersecting with sexual minority status and sex. Based on an omnibus measure of sexual minority status, there were 6,245 sexual minority adolescents in the current study. The total sample was N = 72,691 Results Compared to heterosexual peers, sexual minorities reported higher odds of feeling sad; suicidal ideation, planning and attempts; suicide attempt treated by a doctor or nurse, and self-harm. Among sexual minorities, compared with White youth, Asian and Black youth had lower odds of many outcomes, whereas American Native/Pacific Islander, Latino and Multi-racial youth had higher odds. Conclusions Although in general, sexual minority youth were at heightened risk of suicidal outcomes, risk varied based on sex and on race/ethnicity. More research is needed to better understand the manner in which sex and race/ethnicity intersect among sexual minorities to influence risk and protective factors, and ultimately, mental health outcomes.
Kidney failure is common in patients with Coronavirus Disease-19 (COVID-19) resulting in increased morbidity and mortality. In an international collaboration, 284 kidney biopsies were evaluated to improve understanding of kidney disease in COVID-19. Diagnoses were compared to five years of 63,575 native biopsies prior to the pandemic and 13,955 allograft biopsies to identify diseases increased in patients with COVID-19. Genotyping for APOL1 G1 and G2 alleles was performed in 107 African American and Hispanic patients. Immunohistochemistry for SARS-CoV-2 was utilized to assess direct viral infection in 273 cases along with clinical information at the time of biopsy. The leading indication for native biopsy was acute kidney injury (45.4%), followed by proteinuria with or without concurrent acute kidney injury (42.6%). There were more African American patients (44.6%) than patients of other ethnicities. The most common diagnosis in native biopsies was collapsing glomerulopathy (25.8%) which associated with high-risk APOL1 genotypes in 91.7% of cases. Compared to the five-year biopsy database, the frequency of myoglobin cast nephropathy and proliferative glomerulonephritis with monoclonal IgG deposits was also increased in patients with COVID-19 (3.3% and 1.7%, respectively), while there was a reduced frequency of chronic conditions (including diabetes mellitus, IgA nephropathy, and arterionephrosclerosis) as the primary diagnosis. In transplants, the leading indication was acute kidney injury (86.4%), for which rejection was the predominant diagnosis (61.4%). Direct SARS-CoV-2 viral infection was not identified. Thus, our multi-center large case series identified kidney diseases that disproportionately affect patients with COVID-19, demonstrated a high frequency of APOL1 high-risk genotypes within this group, with no evidence of direct viral infection within the kidney.
be strengthened by informed and uniform integration of STI testing within HIV programs, uptake of knowledge, awareness and health services much rely on engagement and involvement of vulnerable communities. Thus, enabling and building community response is critical in addressing issues pertaining to STI management. Community involvement can guide implementation and design for STI-focused interventions; strengthen on-ground outreach; identify barriers; and promote awareness of testing and treatment. As quality evidence is vital for informing strategies, it is critical to strengthen capacities and have communities' involvement in STI research. While community engagement and -stake may not address all challenges, it will be a solid step toward mitigating critical issues of low risk-perception and low uptake of STI testing and treatment among vulnerable communities.
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