ObjectiveTo understand rates of human papillomavirus (HPV) vaccine acceptability and factors correlated with HPV vaccine acceptability.DesignMeta-analyses of cross-sectional studies.Data sourcesWe used a comprehensive search strategy across multiple electronic databases with no date or language restrictions to locate studies that examined rates and/or correlates of HPV vaccine acceptability. Search keywords included vaccine, acceptability and all terms for HPV.Review methodsWe calculated mean HPV vaccine acceptability across studies. We conducted meta-analysis using a random effects model on studies reporting correlates of HPV vaccine acceptability. All studies were assessed for risk of bias.ResultsOf 301 identified studies, 29 were included. Across 22 studies (n=8360), weighted mean HPV vaccine acceptability=50.4 (SD 21.5) (100-point scale). Among 16 studies (n=5048) included in meta-analyses, perceived HPV vaccine benefits, anticipatory regret, partner thinks one should get vaccine and healthcare provider recommendation had medium effect sizes, and the following factors had small effect sizes on HPV vaccine acceptability: perceived HPV vaccine effectiveness, need for multiple shots, fear of needles, fear of side effects, supportive/accepting social environment, perceived risk/susceptibility to HPV, perceived HPV severity, number of lifetime sexual partners, having a current sex partner, non-receipt of hepatitis B vaccine, smoking cigarettes, history of sexually transmitted infection, HPV awareness, HPV knowledge, cost, logistical barriers, being employed and non-white ethnicity.ConclusionsPublic health campaigns that promote positive HPV vaccine attitudes and awareness about HPV risk in men, and interventions to promote healthcare provider recommendation of HPV vaccination for boys and mitigate obstacles due to cost and logistical barriers may support HPV vaccine acceptability for men. Future investigations employing rigorous designs, including intervention studies, are needed to support effective HPV vaccine promotion among men.

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This grounded theory study utilized interviews with 16 service providers and 19 lesbian, gay, bisexual, trans, and queer (LGBTQ) youth to develop a substantive theory of resilience processes among LGBTQ youth. The core category, paving pathways through the pain, suggests that LGBTQ youth build on emotional pain inflicted by external adversities to carve out pathways to resilience. Youth employed the following resilience processes: (1) navigating safety across contexts, (2) asserting personal agency, (3) seeking and cultivating meaningful relationships, (4) un-silencing marginalized identities, and (5) engaging in collective healing and action. Youth focused on particularly painful adversities and engaged intentionally in one or more of the resilience processes related to the origins of their pain.

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Hostile social environments can have detrimental impacts on lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth. Considering the profession's commitment to social justice and person-in-environment perspectives, social workers are well positioned to promote not only the internal capacity of LGBTQ youth but also the capacity of their social ecologies to better support them. This article suggests the relevance of a social ecological framework of resilience to social work practice with LGBTQ youth. Findings of the author's grounded theory study, along with other relevant literature, are used to specify elements in applying this framework to working with LGBTQ youth. A youth case will be discussed to inform interventions that can be employed across the micro, mezzo, and macro levels of practice.

Sexual and gender diversity is an overlooked subject in resilience research. This study seeks to advance the conceptualization of resilience among lesbian, gay, bisexual, trans, and queer (LGBTQ) youth. Informed by social ecological theory of resilience, grounded theory analysis of interviews with service providers (n = 16) and LGBTQ youth (n = 19) yielded the following categories: (a) facing adversities across contexts, and (b) “doing well” while still in pain. LGBTQ youth face both general and LGBTQ-specific adversities. LGBTQ youth, even in a so-called “post-gay” era, remain challenged to navigate marginalization to maintain their well-being. Participants endorsed a context-dependent understanding of “doing well,” rather than using normative criteria of health (e.g., absence of psychopathologies). Although resilience is known as “ordinary magic,” this article alternatively proposes that resilience is LGBTQ youths’ extraordinary acts to “show up” every day to battle through adversities.

Previous research has highlighted the association between HIV sexual risk behaviors, muscularity concerns, and masculinity among gay and bisexual men (GBM). A few studies that explored these issues, however, have used relatively small sample sizes and predominantly White GBM samples. In addition, little is known about whether a drive for muscularity and perceptions of masculinity are associated with HIV sexual risk behaviors among GBM of color. This community-based study examined the association between drive for muscularity, masculinity, and HIV sexual risk among a sample of 389 GBM of color in Toronto. In multivariable analyses, drive for muscularity and masculinity were significantly associated with HIV sexual risk, after controlling for sociodemographic variables and internalized homophobia. Findings suggest that a desire to be more muscular or a disappointment with one’s musculature, as well as an endorsement of body image and penis size as indicators of masculinity may play a role in HIV sexual risk behaviors. This study is among the first to examine the role of drive for muscularity and notions of masculinity in relation to HIV sexual risk exclusively among an ethnoracially diverse sample of GBM. Further research is needed to better understand the link between body image and masculinity to reduce HIV risk among GBM of color.

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