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Brian Mustanski - One of the best experts on this subject based on the ideXlab platform.

  • reduction and cessation of alcohol cannabis and stimulant use prospective associations with changes in depressive symptoms across two cohort studies of sexual and Gender Minorities
    Journal of Studies on Alcohol and Drugs, 2020
    Co-Authors: Christina Dyar, Ethan Morgan, Heather M Bradley, Patrick S Sullivan, Brian Mustanski
    Abstract:

    Objective Sexual and Gender Minorities (SGM) are at increased risk for substance use and depression. However, little research has examined the directionality of associations between substance use and depression in this high-risk population, and we are not aware of any to parse associations between depression and changes in the frequency of substance use versus substance use cessation. Such research can help to inform the development of future interventions to address health disparities affecting SGM. Method We used data from two longitudinal cohorts of SGM assigned male at birth (SGM-AMAB; N = 1,418) to examine associations between changes in frequency of alcohol, cannabis, and stimulant use and depressive symptoms. Multilevel models tested whether changes in substance use predicted changes in depressive symptoms and vice versa. Results Results indicate that when SGM-AMAB decreased their alcohol use or ceased alcohol, cannabis, or stimulant use, they experienced concurrent decreases in depressive symptoms. Only reducing stimulant use (not alcohol or cannabis use) was associated with decreases in depressive symptoms over the subsequent 6 months. Depressive symptoms did not prospectively predict cessation or reduction in the use of any substance. Conclusions These findings suggest that clinical interventions targeting substance use may simultaneously reduce depressive symptoms and that reductions in alcohol use (even in the absence of cessation) may simultaneously benefit mental health among SGM-AMAB. The limited evidence of prospective effects over 6 months suggests that studies with shorter lags may be better equipped to examine the directionality of the association between depressive symptoms and substance use/reduction.

  • Sexual Agreements Among Young Sexual and Gender Minorities Assigned Male at Birth: Associations with Relationship Quality and Break-Up
    Archives of Sexual Behavior, 2020
    Co-Authors: Lisa M. Godfrey, Christina Dyar, Sarah W Whitton, Michael E Newcomb, Brian Mustanski
    Abstract:

    Previous studies have shown that sexual non-monogamy is not associated with lower relationship satisfaction among adult male same-sex couples and may therefore be a viable alternative to monogamy. However, sexual minority men with non-monogamous agreements have reported lower commitment and trust in their relationships than those with monogamous agreements—potentially raising their risk of break-up. In this study, we investigated whether sexual agreements (monogamous, non-monogamous, or no sexual agreement) were associated with relationship quality and rates of break-up over 1 year in a sample of 338 young sexual and Gender Minorities assigned male at birth (SGM-AMAB). Participants reported their sexual agreement and indices of relationship quality (satisfaction, trust, and commitment) at baseline, as well as their relationship status (intact or broken up) at 6- and 12-month follow-up. Results showed no significant differences by sexual agreement in concurrent trust, but participants with monogamous agreements reported higher satisfaction and commitment than those with non-monogamous agreements or no sexual agreement. Despite these significant differences in relationship quality, there were no significant differences in rates of break-up at 6- or 12-month follow-up across the sexual agreement types. However, having a monogamous agreement was indirectly associated with lower rates of break-up through relationship commitment. Although results were mixed, findings provide some preliminary support that young SGM-AMAB in relationships with monogamous agreements may have higher satisfaction and commitment at early relationship stages, and that monogamous agreements may be a protective factor against break-up over 1 year through the mechanism of relationship commitment.

  • perceptions of marijuana decriminalization among young sexual and Gender Minorities in chicago an initial measure validation and test of longitudinal associations with use
    Cannabis and Cannabinoid Research, 2020
    Co-Authors: Ethan Morgan, Christina Dyar, Christina Hayford, Sarah W Whitton, Michael E Newcomb, Brian Mustanski
    Abstract:

    Background: There is a high rate of marijuana use among young sexual and Gender Minorities (SGM) and, as a result of recent state-level, fragmented marijuana laws, there is also likely high variabi...

  • cardiovascular disease risk factors are elevated among a cohort of young sexual and Gender Minorities in chicago
    Journal of Behavioral Medicine, 2019
    Co-Authors: Ethan Morgan, Richard T Daquila, Mercedes R Carnethon, Brian Mustanski
    Abstract:

    To date, little research has examined cardiovascular (CVD) risk among young sexual and Gender Minorities, a population which behavioral research has suggested may be at unique risk of poor CVD outcomes. We assessed behavioral risk factors and biomarkers of CVD risk among young sexual and Gender Minorities (YSGM) aged 16-29 in Chicago who are participants in the RADAR cohort (analytic N = 936). Multiplex cytokine and inflammatory biomarker assays were run on plasma from all HIV+ participants and demographically-matched HIV- participants (n = 237). Geographic data were used to assess mean C-reactive protein (CRP) level per community area of residence in Chicago. YSGM in this cohort exhibited lower rates of obesity (19.2% in RADAR vs. 35.7% in earlier studies of heterosexual youth) and comparable rates of past 30-day tobacco use (37.9 vs. 38.1%). Conversely, higher rates were observed among several other risk factors including C-reactive protein (mean = 6.9 mg/L vs. 2.1 mg/L), marijuana use (72.5 vs. 45.3%), perceived stress (mean = 15.5 vs. 14.2), and HIV (20.0 vs. < 1% nationally). Finally, we observed geographic heterogeneity in mean CRP values by community area across the Chicago region with the highest and lowest values both found in neighborhoods on the North side of the city. In sum, these analyses demonstrate that YSGM may be at increased risk of CVD beginning from an early age. Future research should assess whether sexual minority-related stressors increase long-term CVD risk and should also longitudinally study the role of multiple risk factors on CVD morbidity and mortality among YSGM.

Matthew Mansh - One of the best experts on this subject based on the ideXlab platform.

  • Skin Cancer and Skin Cancer Risk Factors in Sexual and Gender Minorities.
    Dermatologic clinics, 2019
    Co-Authors: Dustin H. Marks, Sarah T. Arron, Matthew Mansh
    Abstract:

    Sexual and Gender Minorities have unique risk factors that may increase their risk of developing skin cancer. In particular, sexual minority men report a higher prevalence of skin cancer (including both keratinocytes carcinomas and melanoma), higher rates of indoor tanning, and overall poorer sun protection behaviors. Sexual and Gender Minorities also have high rates of alcohol and tobacco use, and infection with human immunodeficiency virus and human papillomavirus, which may increase overall risk of developing skin cancer in these populations. In this review, we discuss the evidence surrounding skin cancer and associated risk factors among sexual and Gender Minorities.

  • from patients to providers changing the culture in medicine toward sexual and Gender Minorities
    Academic Medicine, 2015
    Co-Authors: Matthew Mansh, Gabriel Garcia, Mitchell R Lunn
    Abstract:

    Equality for sexual and Gender Minorities (SGMs)-including members of the lesbian, gay, bisexual, and transGender communities-has become an integral part of the national conversation in the United States. Although SGM civil rights have expanded in recent years, these populations continue to experience unique health and health care disparities, including poor access to health care, stigmatization, and discrimination. SGM trainees and physicians also face challenges, including derogatory comments, humiliation, harassment, fear of being ostracized, and residency/job placement discrimination. These inequities are not mutually exclusive to either patients or providers; instead, they are intertwined parts of a persistent, negative culture in medicine toward SGM individuals.In this Perspective, the authors argue that SGM physicians must lead this charge for equality by fostering diversity and inclusion in medicine. They posit that academic medicine can accomplish this goal by (1) modernizing research on the physician workforce, (2) implementing new policies and programs to promote safe and supportive training and practice environments, and (3) developing recruitment practices to ensure a diverse, competent physician workforce that includes SGM individuals.These efforts will have an immediate impact by identifying and empowering new leaders to address SGM health care reform, creating diverse training environments that promote cultural competency, and aligning medicine with other professional fields (e.g., business, law) that already are working toward these goals. By tackling the inequities that SGM providers face, academic medicine can normalize sexual and Gender identity disclosure and promote a welcoming, supportive environment for everyone in medicine, including patients.

Marshall H Chin - One of the best experts on this subject based on the ideXlab platform.

Anthony J Silvestre - One of the best experts on this subject based on the ideXlab platform.

  • mental health drug and violence interventions for sexual Gender Minorities a systematic review
    Pediatrics, 2019
    Co-Authors: Robert W S Coulter, James E Egan, Suzanne Kinsky, Reuel M Friedman, Kristen L Eckstrand, Jessica Frankeberger, Barbara L Folb, Christina Mair, Nina Markovic, Anthony J Silvestre
    Abstract:

    CONTEXT: Compared with cisGender (nontransGender), heterosexual youth, sexual and Gender minority youth (SGMY) experience great inequities in substance use, mental health problems, and violence victimization, thereby making them a priority population for interventions. OBJECTIVE: To systematically review interventions and their effectiveness in preventing or reducing substance use, mental health problems, and violence victimization among SGMY. DATA SOURCES: PubMed, PsycINFO, and Education Resources Information Center. STUDY SELECTION: Selected studies were published from January 2000 to 2019, included randomized and nonrandomized designs with pretest and posttest data, and assessed substance use, mental health problems, or violence victimization outcomes among SGMY. DATA EXTRACTION: Data extracted were intervention descriptions, sample details, measurements, results, and methodologic rigor. RESULTS: With this review, we identified 9 interventions for mental health, 2 for substance use, and 1 for violence victimization. One SGMY-inclusive intervention examined coordinated mental health services. Five sexual minority–specific interventions included multiple state-level policy interventions, a therapist-administered family-based intervention, a computer-based intervention, and an online intervention. Three Gender minority–specific interventions included transition-related Gender-affirming care interventions. All interventions improved mental health outcomes, 2 reduced substance use, and 1 reduced bullying victimization. One study had strong methodologic quality, but the remaining studies’ results must be interpreted cautiously because of suboptimal methodologic quality. LIMITATIONS: There exists a small collection of diverse interventions for reducing substance use, mental health problems, and violence victimization among SGMY. CONCLUSIONS: The dearth of interventions identified in this review is likely insufficient to mitigate the substantial inequities in substance use, mental health problems, and violence among SGMY.

Igor Toskin - One of the best experts on this subject based on the ideXlab platform.

  • violence motivated by perception of sexual orientation and Gender identity a systematic review
    Bulletin of The World Health Organization, 2018
    Co-Authors: Karel Blondeel, Marleen Temmerman, Sofia De Vasconcelos, Claudia Garciamoreno, Rob Stephenson, Igor Toskin
    Abstract:

    Objective: To assess the prevalence of physical and sexual violence motivated by perception of sexual orientation and Gender identity in sexual and Gender Minorities. Methods: We searched nine databases without language restrictions for peer-reviewed and grey literature published from 2000 to April 2016. We included studies with more than 50 participants that measured the prevalence of physical and sexual violence perceived as being motivated by sexual orientation and Gender identity or Gender expression. We excluded intimate partner violence and self-harm. Due to heterogeneity and the absence of confidence intervals in most studies, we made no meta-analysis. Findings: We included 76 articles from 50 countries. These covered 74 studies conducted between 1995 and 2014, including a total of 202 607 sexual and Gender minority participants. The quality of data was relatively poor due to a lack of standardized measures and sometimes small and non-randomized samples. In studies where all sexual and Gender Minorities were analysed as one population, the prevalence of physical and sexual violence ranged from 6% (in a study including 240 people) to 25% (49/196 people) and 5.6% (28/504) to 11.4% (55/484), respectively. For transGender people the prevalence ranged from 11.8% (of a subsample of 34 people) to 68.2% (75/110) and 7.0% (in a study including 255 people) to 49.1% (54/110). Conclusion: More data are needed on the prevalence, risk factors and consequences of physical and sexual violence motivated by sexual orientation and Gender identity in different geographical and cultural settings. National violence prevention policies and interventions should include sexual and Gender Minorities.

  • evidence and knowledge gaps on the disease burden in sexual and Gender Minorities a review of systematic reviews
    International Journal for Equity in Health, 2016
    Co-Authors: Karel Blondeel, Lale Say, Doris Chou, Igor Toskin, Rajat Khosla, Elisa Scolaro, Marleen Temmerman
    Abstract:

    Sexual and Gender Minorities (SGM) include individuals with a wide range of sexual orientations, physical characteristics, and Gender identities and expressions. Data suggest that people in this group face a significant and poorly understood set of additional health risks and bear a higher burden of some diseases compared to the general population. A large amount of data is available on HIV/AIDS, but far less on other health problems. In this review we aimed to synthesize the knowledge on the burden of communicable and non-communicable diseases, mental health conditions and violence experienced by SGM, based on available systematic reviews. We conducted a global review of systematic reviews, including searching the Cochrane and the Campbell Collaboration libraries, as well as PubMed, using a range of search terms describing the populations of interest, without time or language restrictions. Google Scholar was also scanned for unpublished literature, and references of all selected reviews were checked to identify further relevant articles. We found 30 systematic reviews, all originally written in English. Nine reviews provided data on HIV, 12 on other sexually transmitted infections (STIs), 4 on cancer, 4 on violence and 3 on mental health and substance use. A quantitative meta-analysis was not possible. The findings are presented in a narrative format. Our review primarily showed that there is a high burden of disease for certain subpopulations of SGM in HIV, STIs, STI-related cancers and mental health conditions, and that they also face high rates of violence. Secondly, our review revealed many knowledge gaps. Those gaps partly stem from a lack of original research, but there is an equally urgent need to conduct systematic and literature reviews to assess what we already know on the disease burden in SGM. Additional reviews are needed on the non-biological factors that could contribute to the higher disease burden. In addition, to provide universal access to health-care for all, more information is needed on the barriers that SGM face in accessing health services, including the attitudes of health-care providers. Understanding these barriers and the additional health risks they impose is crucial to improving the health status of SGM.