Age Cohort Differences in the Effects of Gay-Related Stigma, Anxiety and Identification with the Gay Community on Sexual Risk and Substance Use

Leluţiu-Weinberger, Corina; Pachankis, John E.; Golub, Sarit A.; Walker, Ja’Nina J.; Bamonte, Anthony; Parsons, Jeffrey T.

doi:10.1007/s10461-011-0070-4

Cited by 117 publications

(118 citation statements)

References 58 publications

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“…It is essential that mental health providers (in any context or country) integrate mental and physical health (including sexual health) in their approach to treatment for both sexual and gender minorities, given their increased risk for STI and HIV 25,[66][67][68] and the previously documented link between poor mental health and sexual risk. 29,39,69 The module focused on the role of MHPs in counseling LGBT individuals to seek preventive healthcare (e.g., annual exams and HIV/STI testing [70][71][72][73] ) and treatment (e.g., follow-up on test results and medication adherence). The module trained MHPs to teach clients about the biology of HIV transmission and the role of stigma in increasing risk, 12 and oriented MHPs to the scarcity of LGBT-competent medical services in Romania.…”

Section: 64mentioning

confidence: 99%

“…36,37 Among LGBT individuals, poor mental health, specifically anxiety and depression, is associated with health risks. [22][23][24][25][38][39][40][41] Furthermore, individuals in same-sex relationships report significantly more barriers to healthcare access than individuals in opposite-sex relationships. 42 Based on data from other countries, these disparities might be attributable to minority stress, healthcare discrimination, and lack of LGBT-specific medical expertise.…”

Section: Introductionmentioning

confidence: 99%

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Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Leluţiu-Weinberger

Pachankis

2017

LGBT Health

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Purpose: Lesbian, gay, bisexual, and transgender (LGBT) individuals in Romania encounter pervasive stigma and discrimination and there is a high need for LGBT-competent mental health professionals (MHPs). We tested the impact of a pilot LGBT-affirmative training for MHPs in Romania on these professionals' LGBT-relevant attitudes, knowledge, and perception of clinical skills. Methods: We conducted a 2-day training for MHPs in Bucharest. Fifty-four attended and 33 provided training evaluation data at baseline and follow-up. Results: The majority of trainees were female (90%) and heterosexual (73%) with a mean age of 36.4 (SD = 7.7). From baseline to follow-up, trainees demonstrated a significant increase in perceived LGBT-relevant clinical skills (P < 0.001) and perceived knowledge (P < 0.05).LGBT-affirmative practice attitudes (P < 0.05) and comfort in addressing the mental health of LGBT individuals (P < 0.01) increased significantly, and homonegative and transnegative attitudes decreased significantly (P < 0.01). Negative attitudes toward LGBT individuals were low at both baseline and follow-up. The majority of trainees reported being highly interested in the training (84%), which they reported had prepared them to interact with and care for LGBT individuals (74%). Conclusion: This pilot training appeared to be effective in increasing perceived LGBT competence among participating MHPs. This type of training model needs to be tested further in a randomized controlled trial with longer follow-up periods to assess intervention durability and implementation of clinical skills. Future trainings can be incorporated into existing curricula. National accreditation bodies might consider encouraging such training as part of standard educational requirements.

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Section: 64mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Leluţiu-Weinberger

Pachankis

2017

LGBT Health

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“…Although some studies have included older MSM in their samples, only a few studies have investigated sexual risk and HIV issues specifically in midlife and older MSM (Dolcini, Catania, Stall, & Pollack, 2003;Jacobs et al, 2010;Lelutiu-Weinberger et al, 2011;Lim et al, 2011;Murray & Adam, 2001;Ober, Shoptaw, Wang, Gorbach, & Weiss, 2009;Pope, Wierzalis, Barret, & Rankins, 2007). Rates of HIV infection among older urban MSM in the United States are very high, particularly among those in their 50s.…”

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confidence: 99%

Condom Use, Disclosure, and Risk for Unprotected Sex in HIV-Negative Midlife and Older Men Who Have Sex With Men

2012

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Sexual risk behaviors account for most HIV infections in men who have sex with men (MSM), and the risk of exposure from each sexual encounter increases with age. The focus of this study was to investigate which behaviors in midlife and older MSM influence their sexual risk/protection. Cross-sectional data were collected from a community-based sample of 802 MSM aged 40 years and older from community venues (e.g., bars) who completed an anonymous questionnaire. Data from a subset of 420 MSM who were HIV-negative (aged 40-81 years) were used to investigate which behaviors were associated with greater risk for unprotected anal sex. Regression analyses indicated that erection difficulties (odds ratio [OR] = 4.7; 95% confidence interval [CI] = 1.8-12.2), practicing safe sex with outside partners but not with one’s primary partner (OR = 0.54; 95% CI = 0.3-0.94), and recreational drug use (OR = 2.6; 95% CI = 1.3-5.1) were associated with higher risk for unprotected receptive anal intercourse. Younger age (OR = 0.96; 95% CI = 0.9- 0.9), not telling partners about HIV status (OR = 3.2; 95% CI = 1.5-6.5), finding partners in backrooms/sex clubs (OR = 2.8; 95% CI = 1.1- 6.8), and erection difficulties (OR = 10.3; 95% CI = 2.8-37.8) were associated with higher risk for unprotected insertive anal intercourse. These data indicate there may be certain factors specific to older MSM that influence their sexual risk taking behaviors. Programs may be more effective if they are tailored for older cohorts of MSM and address interpersonal communication, erection problems, and substance use to reduce health risks and promote healthier lifestyles.

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“…Specific cohorts may experience distinct factors due to different socio-historical contexts. 51 Different life periods such as young adulthood, middle-age, and older adulthood present developmental characteristics specific to each life period 51 especially in the context of living with HIV. Cahill and Valadéz stated that there are significant differences between a 50-year-old person living with HIV/AIDS and a 75-year-old person living with HIV/AIDS.…”

Section: Discussionmentioning

confidence: 99%

Disclosure and Self-Efficacy Among HIV-Positive Men Who Have Sex with Men: A Comparison Between Older and Younger Adults

Brown

Serovich

Kimberly

et al. 2015

AIDS Patient Care and STDs

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Men who have sex with men (MSM) continue to be disproportionately affected by HIV in the US. HIV among older adults also continues to be an important public health problem. Age is associated with disclosure of HIV serostatus and self-efficacy for condom use. However, studies examining self-efficacy and disclosure among older MSM (age 50 and older) living with HIV are lacking. The aim of this study was to assess the associations between being 50 and older, and disclosure behaviors, intentions and attitudes, and self-efficacy for condom use, disclosure, and negotiation for safer sex practices among HIV-positive MSM. Data were gathered from 340 participants at the baseline assessment of a longitudinal disclosure intervention study. Linear regression was used to determine the association between being older (age 50 and older) and disclosure behaviors, intentions and attitudes, and selfefficacy for condom use, disclosure, and negotiation for safer sex practices. After adjusting for time since diagnosis and number of sexual partners, MSM aged 50 and older scored lower in disclosure behavior (b = -7.49; 95% CI: -14.8, -0.18) and in self-efficacy for negotiation of safer sex practices (b = -0.80; 95% CI: -1.57, -0.04) compared to MSM 18-34 years. Intervention and prevention programs should endeavor to improve disclosure and self-efficacy for negotiating safer sex practices among older HIV-positive MSM. More health care providers should initiate sexual health discussions, especially among older HIV-positive MSM populations, which may help to improve their disclosure behavior and self-efficacy for negotiating safer sex practices.

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Age Cohort Differences in the Effects of Gay-Related Stigma, Anxiety and Identification with the Gay Community on Sexual Risk and Substance Use

Cited by 117 publications

References 58 publications

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Condom Use, Disclosure, and Risk for Unprotected Sex in HIV-Negative Midlife and Older Men Who Have Sex With Men

Disclosure and Self-Efficacy Among HIV-Positive Men Who Have Sex with Men: A Comparison Between Older and Younger Adults

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