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Health Care Experiences of Black Transgender Women and Men Who Have Sex With Men
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Black sexual and gender minorities (SGM) are at greater risk for HIV compared to their White, cisgender, heterosexual counterparts. Linkage to culturally sensitive health care is, therefore, pivotal for HIV prevention and treatment of Black SGM. Unfortunately, social and structural challenges undermine Black SGM individuals' abilities to obtain adequate health care services, indicating a need to understand Black SGM perceptions of health care. To address this gap, we interviewed Black men who have sex with men and transwomen about their experiences with health care providers. Participants discussed needs and concerns, including provider SGM identity diversity and education; assumptions, judgment, stigma, and discrimination; and ability to establish a personal bond, trust, and familiarity. Black SGM indicated that providers often did not meet their needs in different ways regarding their SGM identities. Findings suggest a need for provider cultural sensitivity education programs that address the needs of Black SGM in health care.
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MPRC People
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Donna E. Howard, Dr.PH.
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Donna E. Howard Publications
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Health Care Experiences of Black Transgender Women and Men Who Have Sex With Men
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Black sexual and gender minorities (SGM) are at greater risk for HIV compared to their White, cisgender, heterosexual counterparts. Linkage to culturally sensitive health care is, therefore, pivotal for HIV prevention and treatment of Black SGM. Unfortunately, social and structural challenges undermine Black SGM individuals' abilities to obtain adequate health care services, indicating a need to understand Black SGM perceptions of health care. To address this gap, we interviewed Black men who have sex with men and transwomen about their experiences with health care providers. Participants discussed needs and concerns, including provider SGM identity diversity and education; assumptions, judgment, stigma, and discrimination; and ability to establish a personal bond, trust, and familiarity. Black SGM indicated that providers often did not meet their needs in different ways regarding their SGM identities. Findings suggest a need for provider cultural sensitivity education programs that address the needs of Black SGM in health care.
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MPRC People
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Bradley Boekeloo, Ph.D., Sc.M.
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Bradley Boekeloo Publications
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The association between interpregnancy interval and severe maternal morbidities using revised national birth certificate data: A probabilistic bias analysis
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Severe maternal morbidity continues to be on the rise in the US. Short birth spacing is a modifiable risk factor associated with maternal morbidity, yet few studies have examined this association, possibly due to few available data sources to examine these rare events. To examine the association between interpregnancy interval (IPI) and severe maternal morbidity using near‐national birth certificate data and account for known under‐reporting using probabilistic bias analysis. We used revised 2014‐2017 birth certificate data, restricting to resident women with a non–first‐born singleton birth. We examined the following: (a) maternal blood transfusion, (b) admission to intensive care unit (ICU), (c) uterine rupture (among women with a prior caesarean delivery) and (d) third‐ or fourth‐degree perineal laceration (among vaginal deliveries) by IPI categories (<6, 6‐11, 12‐17, 18‐23, 24‐59 and 60+ months). Risk ratios and 95% confidence intervals were estimated using log‐binomial regression, adjusting for select maternal characteristics. Probabilistic bias analyses were performed. Compared with IPI 18 to 23 months, adjusted models revealed that the risk of maternal transfusion followed a U‐shaped curve with IPI, while risk of ICU admission and perineal laceration increased with longer IPI. Risk of uterine rupture was highest among IPI <6 months. With the exception of maternal transfusion, these findings persisted regardless of the extent or type of misclassification examined in bias analyses. Associations between IPI and maternal morbidity varied by outcome, even after adjusting for misclassification of SMM. Differences across maternal health outcomes should be considered when counselling and making recommendations regarding optimal birth spacing.
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MPRC People
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Marie Thoma, Ph.D.
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Marie Thoma Publications
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Spousal migration and married adults’ psychological distress in rural China: The roles of intimacy, autonomy and responsibility
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Spousal separation due to migration is a prevalent phenomenon in the developing world, but its psychological consequences for left-behind partners are largely understudied. Using data from 2010, 2012 and 2014 China Family Panel Studies (CFPS), this paper first examined whether spousal migration causes rural married adults any psychological distress; this finding was then advanced by testing the mechanisms that could potentially explain the linkage between these two variables. Inverse Probability Weighting (IPW) for multivalued treatment effect models and paired Propensity Score Matching (PSM) have been used to correct the potential selection bias of spousal migration. The results show that prolonged spousal separation through migration increases the depressive symptoms of married adults in rural China, and the detrimental effects on left-behind spouses' psychological well-being can be explained by the reduced level of emotional intimacy between husband and wife, and partially by women becoming the master of the household. Considering that being the master of the household is accompanied by elevated stress levels associated with increasing family responsibilities, further examination showed that economic resources can buffer the negative effect associated with being the master of the household when the spouse migrates. However, we did not find that time use is an effective mechanism to link spousal migration and left-behind spouses’ well-being.
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Retired Persons
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Feinian Chen, Ph.D.
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Feinian Chen Publications
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The Impact of Community Size, Community Climate, and Victimization on the Physical and Mental Health of SGM Youth
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Sexual and gender minority (SGM) youth experience high rates of victimization leading to health disparities. Community size and community climate are associated with health outcomes among SGM youth; however, we lack studies that include them as covariates alongside victimization to understand their collective impact on health. This study utilized minority stress theory to understand how community context shapes experiences of victimization and health among SGM youth. SGM youth in one Midwestern U.S. state completed an online survey ( n = 201) with measures of physical health, mental health, community context, and victimization. Data were analyzed via multiple regression using a path analysis framework. Results indicate that perceived climate was associated with mental, but not physical, health; Community size was unrelated to health outcomes. Victimization mediated the association between community climate and mental health. Findings are discussed in light of current literature and implications for research and practice are shared.
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MPRC People
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Jessica N Fish, Ph.D.
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Jessica N Fish Publications
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Desai editorial details decline in Indian women's employment
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Flags a squandered 'gender dividend'
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News
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Family Structure Change Among Latinos: Variation by Ecologic Risk
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We examined differences in family structure change in an urban sample of mothers (N = 1,314) from their child’s birth to age 5 and whether ecological risk moderated this association. We found that compared with U.S.-born Latino mothers, foreign-born Latino mothers were 62% less likely to break up and 75% less likely to repartner than remain stably resident. Across nativity status, Latina mothers with fewer children, more economic stress, less income, and less frequently reported father involvement were more likely to break up and repartner than remain stably resident. We found no moderation effects of ecological risk.
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MPRC People
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Natasha Cabrera, Ph.D.
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Natasha Cabrera Publications
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Sayer’s findings important element of new report
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Moms with husbands, live-in male partners are sleeping less and doing more housework than single mothers.
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News
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Population Health Trends among Hetrosexual and Sexual Minority Adults
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Jessica N. Fish, Family Science, investigates sexual-orientation-related disparities in mental, behavioral, and physical health
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Resources
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Seed Grant Program
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Seed Grants Awarded
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Cohen research aids examination of infidelity and marriage
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What if infidelity is a hidden factor helping to stabilize marriages which would otherwise end in divorce?
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News