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Article ReferenceLGBTQ Youth-Serving Community-Based Organizations: Who Participates and What Difference Does it Make?
LGBTQ youth are at greater risk for compromised health, yet large-scale health promotion programs for LGBTQ young people have been slow to develop. LGBTQ community-based organizations—which provide LGBTQ-focused support and services—have existed for decades, but have not been a focus of the LGBTQ youth health literature. The current study used a contemporary sample of LGBTQ youth (age 15–21;  M  = 18.81;  n  = 1045) to examine who participates in LGBTQ community-based organizations, and the association between participation and self-reported mental health and substance use. Youth who participated in LGBTQ community-based organizations were more likely to be assigned male at birth, transgender, youth of color, and accessing free-or-reduced lunch. Participation was associated with concurrent and longitudinal reports of mental health and substance use. LGBTQ community-based organizations may be an underutilized resource for promoting LGBTQ youth health.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article Reference Troff document (with manpage macros)Sexual and Gender Minority Youth Alcohol Use: Within-Group Differences in Associations with Internalized Stigma and Victimization
Sexual and gender minority (SGM) youth are more likely to use alcohol than their heterosexual cisgender peers. At the same time, SGM youth experience sexuality- and gender identity-specific stressors known to exacerbate negative health outcomes. Though scholars have established a link between minority stressors (e.g., internalized stigma and victimization) and increased alcohol use for SGM youth as a whole, there is little indication of whether internalized stigma and victimization are more strongly associated with alcohol use for specific groups of SGM youth. A United States sample of 11,811 racially and geographically diverse 13–17 year old SGM youth was used to employ a series of gender-stratified multivariable regression models to examine the association among internalized stigma, victimization, and alcohol-related behaviors, and whether they differed for specific groups of sexual minority youth. Sexual orientation moderated several associations between sexual minority stressors (i.e., victimization and stigma) and youth’s alcohol use (i.e., recent use and heavy episodic drinking) across models stratified by gender (i.e., male, female, and non-binary). For example, bisexual boys had stronger associations between SGM-specific victimization and alcohol use frequency and heavy episodic drinking relative to gay boys; conversely, victimization and alcohol use frequency were more weakly associated among bisexual girls relative to lesbian/gay girls. Pansexual girls showed weaker associations between internalized stigma and alcohol use frequency compared to lesbian/gay girls. This paper demonstrates who among SGM youth are more likely to engage in alcohol-related behaviors as a function of differential forms of SGM-related victimization and stigma. These findings can inform substance use interventions that are tailored to youth of diverse sexual orientations and gender identities.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article ReferenceGenetic Clustering Analysis for HIV Infection among Men Who Have Sex with Men in Nigeria
Background:  The  HIV  epidemic continues to grow among  MSM  in countries across sub-Saharan Africa including  Nigeria . To inform prevention efforts, we used a  phylogenetic cluster  method to characterize  HIV  genetic clusters and factors associated with cluster formation among  MSM  living with  HIV  in  Nigeria . Methods:  We analyzed  HIV -1 pol sequences from 417  MSM  living with  HIV  enrolled in the TRUST/RV368 cohort between 2013 and 2017 in Abuja and Lagos,  Nigeria . A genetically linked cluster was defined among participants whose sequences had pairwise genetic distance of 1.5% or less. Binary and multinomial logistic regressions were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for factors associated with  HIV  genetic cluster membership and size. Results:  Among 417  MSM  living with  HIV , 153 (36.7%) were genetically linked. Participants with higher viral load (AOR = 1.72 95% CI: 1.04–2.86), no female partners (AOR = 3.66; 95% CI: 1.97–6.08), and self-identified as male sex (compared with self-identified as bigender) (AOR = 3.42; 95% CI: 1.08–10.78) had higher odds of being in a genetic cluster. Compared with unlinked participants,  MSM  who had high school education (AOR = 23.84; 95% CI: 2.66–213.49), were employed (AOR = 3.41; 95% CI: 1.89–10.70), had bacterial sexually transmitted infections (AOR = 3.98; 95% CI: 0.89–17.22) and were not taking antiretroviral therapy (AOR = 6.61; 95% CI: 2.25–19.37) had higher odds of being in a large cluster (size > 4). Conclusion:  Comprehensive  HIV  prevention packages should include behavioral and biological components, including early diagnosis and treatment of both  HIV  and bacterial sexually transmitted infections to optimally reduce the risk of  HIV  transmission and acquisition.
Located in MPRC People / Hongjie Liu, Ph.D. / Hongjie Liu Publications
Article ReferenceTeen Mothers’ Family Support and Adult Identity in the Emerging Adulthood: Implications for Socioeconomic Attainment Later in Life
We examined the prospective role of parental support and adult identity profiles in the transition to adulthood on teen mothers’ socioeconomic outcomes in adulthood. Analyses were based on the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of youth followed over a decade. We used data from Waves 1, 3, and 4 (mean age = 28.6, Wave 4). Analytical sample consisted of 981 females who gave birth before age 20. Analysis included design-based regression models. Findings from adjusted regression models showed no statistically significant associations between teen mothers’ parental support and socioeconomic outcomes. While teen mothers have already achieved an important marker of adulthood, variability in adult identity profiles was observed. Teen mothers with older subjective age, regardless of their levels of psychosocial maturation, had higher socioeconomic attainment on some indicators. Findings suggest that teen mothers’ adult identity profiles differentiate their socioeconomic trajectories later in life.
Located in MPRC People / Kerry Green, Ph.D. / Kerry Green Publications
Article Reference Troff document (with manpage macros)Who Experiences Leisure Deficits? Mothers' Marital Status and Leisure Time
The authors used the 2003 to 2012 American Time Use Survey to examine marital status variation in mothers' leisure time. They found that never‐married mothers have more total leisure but less high‐quality leisure when compared with married mothers. Never‐married mothers' leisure is concentrated in passive and socially isolated activities that offer fewer social and health benefits. Black single mothers have the highest amount of socially isolated leisure, particularly watching television alone. Results suggest that differences in the context and type of leisure are salient dimensions of the divergent and stratified life conditions of married, divorced, and single mothers.
Located in MPRC People / Liana C. Sayer, Ph.D. / Liana Sayer Publications
Article Reference Troff document (with manpage macros)Marital Status and Mothers’ Time Use: Childcare, Housework, Leisure, and Sleep
Assumptions that single mothers are “time poor” compared with married mothers are ubiquitous. We tested theorized associations derived from the time poverty thesis and the gender perspective using the 2003–2012 American Time Use Surveys (ATUS). We found marital status differentiated housework, leisure, and sleep time, but did not influence the amount of time that mothers provided childcare. Net of the number of employment hours, married mothers did more housework and slept less than never-married and divorced mothers, counter to expectations of the time poverty thesis. Never-married and cohabiting mothers reported more total and more sedentary leisure time than married mothers. We assessed the influence of demographic differences among mothers to account for variation in their time use by marital status. Compositional differences explained more than two-thirds of the variance in sedentary leisure time between married and never-married mothers, but only one-third of the variance between married and cohabiting mothers. The larger unexplained gap in leisure quality between cohabiting and married mothers is consistent with the gender perspective.
Located in MPRC People / Liana C. Sayer, Ph.D. / Liana Sayer Publications
Article Reference Troff document (with manpage macros)Availability of Services Related to Achieving Pregnancy in U.S. Publicly Funded Family Planning Clinics
Background Recognizing that quality family planning services should include services to help clients who want to become pregnant, the objective of our analysis was to examine the distribution of services related to achieving pregnancy at publicly funded family planning clinics in the United States. Methods A nationally representative sample of publicly funded clinics was surveyed in 2013–2014 (n = 1615). Clinic administrators were asked about several clinical services and screenings related to achieving pregnancy: basic infertility services, reproductive life plan assessment, screening for body mass index, screening for sexually transmitted diseases, provision of natural family planning services, infertility treatment, and primary care services. The percentage of clinics offering each of these services was compared by Title X funding status; prevalence ratios (PR) and 95% confidence intervals (CIs) were estimated after adjusting for clinic characteristics. Results Compared to non-Title X clinics, Title X clinics were more likely to offer reproductive life plan assessment (adjusted PR [aPR], 1.62; 95% CI, 1.42–1.84), body mass index screening for men (aPR, 1.10; 95% CI, 1.01–1.21), screening for sexually transmitted diseases (aPRs ranged from 1.21 to 1.37), and preconception health care for men (aPR, 1.10; 95% CI, 1.01–1.20). Title X clinics were less likely to offer infertility treatment (aPR, 0.55; 95% CI, 0.40–0.74) and primary care services (aPR, 0.74; 95% CI, 0.68–0.80) and were just as likely to offer basic infertility services, preconception health care services for women, natural family planning, and body mass index screening in women. Conclusions The availability of selected services related to achieving pregnancy differed by Title X status. A follow-up assessment after publication of national family planning recommendations is underway.
Located in MPRC People / Marie Thoma, Ph.D. / Marie Thoma Publications
Article Reference Troff document (with manpage macros)Diverse community contexts and community resources for sexual and gender minority youth: A mixed-methods study
Abstract Sexual and gender minority (SGM) youth face marginalization and oppression on the basis of their SGM identity, and they often lack traditional support systems to deal with these minority stressors. SGM community resources may alleviate the impact of the stressors that SGM youth face, but these have not been studied in relation to the size and climate of SGM youth's communities. This mixed-methods study examined the relationship between community size and the climate toward SGM individuals and the availability and utilization of SGM community resources. Survey findings indicate that nonmetropolitan communities were associated with less availability and utilization; hostile communities were associated with lower availability only. Interview findings reveal nuanced complexities on the relationship between community and resource provision. Implications for future research and community practice are discussed.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article Reference Troff document (with manpage macros)Sexual Minority-related Discrimination across the Life Course: Findings from a National Sample of Adults in the United States
In the United States, sexual minority (SM) status is associated with a number of health disparities. Based on mounting evidence, stigma and discrimination have been cited as key barriers to health equity for this population. We estimated the prevalence of three types of discrimination as a function of age among SM adults from the National Epidemiological Study of Alcohol Use and Related Conditions III (NESARC-III) (2012–2013). Among SM adults, reports of past-year general discrimination, victimization, and healthcare discrimination varied by age, with peaks in early adulthood and again in midlife. Age trends varied by biological sex, with males experiencing significantly more general discrimination, victimization, and healthcare discrimination at specific ages. Age trends also varied by sexual identity, as LGB-identifying SMs were significantly more likely to experience all forms of discrimination across all ages. Policies preventing homophobic discrimination and victimization are necessary given the pervasiveness of these experiences across adulthood.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article ReferenceSexual Orientation-Related Disparities in High-Intensity Binge Drinking: Findings from a Nationally Representative Sample
Abstract Purpose: The purpose of this study was to assess sexual orientation differences in high-intensity binge drinking using nationally representative data. Methods: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions III (N = 36,309), a nationally representative sample of U.S. adults collected in 2012–2013. Sex-stratified adjusted logistic regression models were used to test sexual orientation differences in the prevalence of standard (4+ for women and 5+ for men) and high-intensity binge drinking (8+ and 12+ for women; 10+ and 15+ for men) across three dimensions of sexual orientation: sexual attraction, sexual behavior, and sexual identity. Results: Sexual minority women, whether defined on the basis of sexual attraction, behavior, or identity, were more likely than sexual majority women to engage in high-intensity binge drinking at two (adjusted odds ratios [aORs] ranging from 1.52 to 2.90) and three (aORs ranging from 1.61 to 3.27) times the standard cutoff for women (4+). Sexual minority men, depending on sexual orientation dimension, were equally or less likely than sexual majority men to engage in high-intensity binge drinking. Conclusion: This study is the first to document sexual orientation-related disparities in high-intensity binge drinking among adults in the United States using nationally representative data. The results suggest that differences in alcohol-related risk among sexual minority individuals vary depending on sex and sexual orientation dimension.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications