Stigma and Health最新文献

Introduction: The mental health of gay and bisexual men (GBM) who use pre-exposure prophylaxis (PrEP) may be negatively impacted by experiences of stigma.

Methods: To assess the relationship between stigma and mental health among GBM who use PrEP in Guatemala, we conducted a survey with 162 PrEP users recruited in a community-based PrEP clinic.

Results: In multiple linear regression analyses, greater internalized (ß=1.94, SE=0.85, p=0.023) and enacted sexual orientation stigma (ß=0.50, SE=0.12, p<0.001) were associated with greater depressive symptoms. Greater internalized (ß=1.82, SE=0.80, p=0.023) and enacted sexual orientation stigma (ß=1.33, SE=0.11, p=0.003) were also associated with greater anxiety symptoms. Additionally, individuals with high social support and high anticipated PrEP stigma had fewer depressive symptoms than individuals with low social support and high anticipated PrEP stigma (ß=-3.25, SE=1.40, p=0.022). This relationship was marginally significant for anxiety (ß=-2.54, SE=1.31, p=0.055).

Conclusion: Sexual orientation and PrEP stigma may affect PrEP users' mental health. Interventions addressing stigma are needed to support uptake and sustained PrEP use in this population.

The purpose of this study was to examine the experiences of discrimination during prostate cancer treatment and assess the association with health-related quality of life (HRQOL) in a cohort of gay and bisexual men (GBM) prostate cancer survivors. This is a cross-sectional analysis of the 24-month follow-up survey from the Restore-2 clinical trial that tested the effectiveness of an online rehabilitation program tailored for GBM prostate cancer survivors in the U.S. This analysis uses data from the 347 participants who completed all items of the Everyday Discrimination Scale (EDS) at the 24-month follow-up. A log-binomial regression model estimated the risk of experiencing discrimination across treatment received and demographic characteristics. Multivariable linear regression models estimated mean differences in HRQOL measures with discrimination as a binary variable after adjustment for relevant covariates. Nearly half (49.3%) of participants endorsed at least one experience of discrimination during prostate cancer treatment. About half (52%) of these rated the discrimination as "rare" (total EDS = 1-3), while 48% reported it as more common (total EDS ≥ 4). Most attributed the discrimination to their sexual orientation (35.5%) or to their provider's attributes (29.6%). Those who underwent systemic/combined treatment (vs. either surgery or radiation only) and those with less than a bachelor's or graduate-level degree (vs. bachelor's degree) were more likely to report discrimination. Experiencing any discrimination was associated with significantly worse HRQOL outcomes. Discrimination during prostate cancer treatment appears to be a common experience for GBM patients and may result in poorer treatment outcomes.

"Religious conscience" or "healthcare denial" policies allow healthcare providers and institutions to refuse to provide services in the name of religious freedom. Denial policies are a form of structural stigma that could impede access to healthcare for sexual and gender minority (SGM) populations, particularly SGM young adults. This study describes SGM university students' response to policies permitting healthcare providers to deny care based on their religious beliefs. Data were obtained from 8,322 SGM students at 38 colleges and universities who participated in the spring 2020 Healthy Minds Study. Descriptive statistics are reported for the level of distress due to the denial policies and likelihood to avoid identity disclosure. Over 90% of SGM students report distress knowing about denial policies (sexual minority: 6.95/10; gender minority: 8.05/10). Students also reported similarly high distress imagining that they had been denied care (sexual minority: 8.05/10; gender minority: 8.57/10). The majority of sexual (69.2%) and gender minority (82.2%) students agreed the policy would make them less likely to disclose their identity to a new provider. Experiencing, or even anticipating, discrimination in healthcare settings through denial policies has negative impacts on the health of SGM populations and has the potential to exacerbate existing mental health disparities for SGM young adults.