Journal of LGBT health research最新文献

This study systematically reviews the existing literature on sexually transmitted infections (STIs) including human immunodeficiency virus (HIV) infection in the men who have sex with men (MSM) in India. After a comprehensive literature search of Medline (1950-June 2008), Embase (1980-June 2008), and the Cochrane Library (1950-June 2008), 12 published studies met the inclusion criteria. The link between sexual identity and sexual behavior is a complex phenomenon strongly embedded in a very specific context in India. MSM in India are an important risk group for acquiring STIs/HIV and effective culturally sensitive prevention programs should be designed for them. The combined estimate of HIV prevalence in the MSM population in India calculated from 5 included studies was 16.5% (95% confidence intervals: 11% to 22%). The review also identifies the lacunae in existing literature and provides future directions for research in the MSM community in India.

There is a lack of community-based studies that have examined level and context of homosexual activity in India among male youth. As part of a larger study on sexual behavior and gender attitudes of rural youth in Northern India, this study identified a subgroup of young men who reported homosexual experiences, even though they did not identify themselves as homosexual. This article attempts to examine the levels and range of sexual practices and attitudes of the homosexually active male youth by comparing them with their peers who reported heterosexual experiences. Study findings indicate that about one-fifth of sexually active male youth reported homosexual experiences. These young men begin their sexual careers early; engage with a higher number of sexual partners, both male and female; and are more likely to report inconsistent condom use, as compared to their heterosexually active peers. With high levels of partner mixing and inconsistent condom, use it appears that, for this subgroup of young men with high risk behaviors, homosexual experiences are only one part of their sexual lives and not the main factor that would contribute to their HIV vulnerability. Interventions need to be mindful of these issues, rather than rushing into labelling youth as homosexual or heterosexual for programmatic purposes. At the same time, as high-risk behaviors are largely unexplored among a general population of rural male youth, there is need for more in-depth ethnographic and culturally specific sexuality research to explore if there is a subculture that may promote sexual practices including same-sex activities that influences HIV vulnerability.

Despite condom interventions since year 2000 with the transgender (hijra) population, condom use remains low. Consequently, hijra suffer from higher rates of active syphilis, putting them under threat of HIV transmission. In an ethnographic study, 50 in-depth interviews with diverse groups of hijra along with 20 key-informants interviews with various stakeholders, and 13 focus group discussions (FGDs) were conducted with comprehensive field observations. Findings indicate that most hijra understand the importance of condoms, but none use condoms consistently. Complex underlying reasons positioned beyond the individual's cognitive domain include: low self-confidence; economic hardships for mere survival; multiple transient partners; sexual desire, preferences, and eroticisms concerning anal sex; stigma associated with purchasing condoms; poor quality and interrupted supply of condoms and lubricants; limitation of fear-producing messages in favor of condoms; inadequate professional skills and motivational impetus of the outreach staff for condom promotion, and incompetent management with inadequate understanding about the dynamics of condom use. Imposing condoms by disregarding socio-cultural and socio-economic scripts of sexual relationships and eroticism of hijra-sexuality have challenged the effectiveness of current condom interventions. Interventions should not mechanize the process, rather they may humanize and eroticize sexual lives of the hijra. A paradigm shift is required where condoms enhance the dignity and quality of sexual lives of the hijra beyond the framework of disgrace, disease, and death.

The purpose of this research was to compare differences in the experiences of gay men and lesbian women who describe experiences of depression or depressed mood. The 2 main research questions were how do descriptions of depression and daily life differ between gay males and lesbian females. To this end, Weblogs containing narratives of 19 gay men and 19 lesbian women were coded, analyzed, and compared using qualitative content analysis methods. Differences in described sources of depression and responses to depression, but not features of depression were found. Women and men also differed with respect to their main priorities; their descriptions of social interactions, social issues, reflections, and emotions; and a number of other daily life experiences. Findings were discussed with respect to implications for treatment and prevention of depression among sexual minorities.

Few population-based surveys in the United States include sexual orientation as a demographic variable. As a result, estimating the proportion of the U.S. population that is gay, lesbian, or bisexual (GLB) is a substantial challenge. Prior estimates vary widely, from 1-21%. In 2001, questions on sexual orientation and sexual behavior were added to the Massachusetts Behavioral Risk Factor Surveillance System (MA BRFSS) and have been asked continually since that time. The purpose of this study was to determine the prevalence of adults in Massachusetts identifying as GLB and providing a demographic description of this group. The study also examined the correlation of reported sexual behavior and sexual identity within this group. Overall, 1.9% of Massachusetts adults identified as gay or lesbian and 1.0% of Massachusetts adults identified as bisexual. Of those identifying as gay or lesbian, 95.4% reported sexual behavior concordant with this identification, and 99.4% of respondents identifying as heterosexual reported behavior concordant with heterosexual sexual orientation. Among those reporting a GLB sexual orientation, men were more likely than women to identify as gay, and women were more likely than men to identify as bisexual. Younger adults (18-25 years old) were more likely than people in other age groups to identify as bisexual. Respondents with 4 or more years of education were more likely to identify as gay or lesbian than those in all other education categories. The addition of sexual orientation to population-based surveys will allow for research on the health of GLB adults and provide critical information for those charged with the creation of public policy regarding sexual orientation.

Sexually transmitted infections (STIs) are a significant health issue for lesbian and bisexual women. Older age and having a history of sexual intercourse with males are primary risk factors for STIs among this population. However, little research has been conducted to assess sexual risk among lesbian and bisexual college women exclusively. A cross-sectional Internet survey was conducted with 230 self-identified lesbian and bisexual female college students to examine their sexual risk and to determine with which, if any, STIs they had ever been diagnosed. Eight percent of lesbian and bisexual college women reported ever being diagnosed with an STI; the human papillomavirus, bacterial vaginosis, and genital herpes accounted for 84% of STI cases. Number of lifetime sex partners was significantly associated with an STI diagnosis among this population. Older age, engaging in penile-vaginal intercourse with a male (lifetime), and younger age at first same-sex experience were significantly associated with a greater number of lifetime sex partners. Results may be useful to sexual health programs targeting lesbian and bisexual college women and/or their providers.

Objective: To carry out a study using cognitive processing interview methods to explore ways in which adolescents understand sexual orientation questions currently used on epidemiologic surveys.

Methods: In-depth, individual interviews were conducted to probe cognitive processes involved in answering four self-report survey questions assessing sexual identity, sexual attraction, and sex of sexual partners.A semi-structured interview guide was used to explore variation in question interpretation, information retrieval patterns and problems, item clarity, valence of reactions to items (positive, negative, neutral), respondent burden, and perceived threat associated with the measures. Thirty adolescents aged 15 to 21 of diverse sexual orientations and race/ethnicities participated in the study, including female, male, and transgender youth.

Results: A question on sexual attraction was the most consistently understood and thus was easy for nearly all youth to answer. In contrast, a measure of sexual identity with options heterosexual, bisexual, gay/lesbian, and unsure was the most difficult to answer. Most preferred a sexual identity item that also provided the intermediate options mostly heterosexual and mostly homosexual, which many said reflected their experience of feeling between categories. Participants had varying and inconsistent interpretations of sexual behavior terms, such as sex and sexual intercourse, used in assessing the sex of sexual partners.

Conclusion: Differences in understanding could affect interpretation of survey data in important ways. Development of valid measures of sexual orientation will be essential to better monitor health disparities.

Research into antigay violence has been limited by a lack of attention to issues of gender presentation. Understanding gender nonconformity is important for addressing antigay prejudice and hate crimes. We assessed experiences of gender-nonconformity-related prejudice among 396 Black, Latino, and White lesbian, gay, and bisexual individuals recruited from diverse community venues in New York City. We assessed the prevalence and contexts of prejudice-related life events and everyday discrimination using both quantitative and qualitative approaches. Gender nonconformity had precipitated major prejudice events for 9% of the respondents and discrimination instances for 19%. Women were more likely than men to report gender-nonconformity-related discrimination but there were no differences by other demographic characteristics. In analysis of events narratives, we show that gender nonconformity prejudice is often intertwined with antigay prejudice. Our results demonstrate that both constructs should be included when addressing prejudice and hate crimes targeting lesbian, gay, bisexual, and transgender individuals and communities.

This study explored the prevalence, disparity, and cohort trends in suicidality among bisexual teens vs. heterosexual and gay/lesbian peers in 9 population-based high school surveys in Canada and the U.S. Multivariate logistic regressions were used to calculate age-adjusted odds ratios separately by gender; 95% confidence intervals tested cohort trends where surveys were repeated over multiple years. Results showed remarkable consistency: bisexual youth reported higher odds of recent suicidal ideation and attempts vs. heterosexual peers, with increasing odds in most surveys over the past decade. Results compared to gay and lesbian peers were mixed, with varying gender differences in prevalence and disparity trends in the different regions.

These analyses are part of a larger study designed to investigate the developmental, behavioral, and sociocultural lives of gay and bisexual men who identify as barebackers. We examined the sexual behaviors of these men, as well as the relation of these behaviors to matters of identity and perceived benefits of barebacking. Of the 102 men who completed the study, about half reported barebacking with main partners and 92% reported barebacking behaviors with casual partners whom they met in a variety of social venues. The frequency of these behaviors with casual partners (but not main partners) varied across serostatus of participant and the serostatus of his partners. Identification as a barebacker was unrelated to the frequency of these sexual acts. This sample of self-identified barebackers perceived greater benefits to barebacking than a more general community- based sample. Although previous research has contended that intention is central to the construct of barebacking, only half of our sample indicated that they understood the construct in these terms. It appears that gay and bisexual men, despite their identification as barebackers, incorporate harm reduction strategies with regard to this behavior which is guided by their perception of risk related to specific sexual acts, as well as the seroconcordance of their casual sexual partners. Our findings suggest that barebacking is a construct that is only beginning to be understood, and that more detailed understandings of this construct are needed to disentangle the meanings that gay and bisexual men ascribe to this behavior, including the relationship between both individual and partner serostatus.