Search

LGBTQI+ (lesbian, gay, bisexual, transgender, queer, intersex and additional gender, sexual and romantic minority identities) individuals often experience stress due to their minority identity. This stress is caused by experiences of discrimination, harassment, and ostracisation and has been noted as a driving force behind the commonly reported mental health problems within this community. Acceptance and Commitment Therapy (ACT) has potential utility as an evidence-based therapeutic framework to combat this problem as it cultivates psychological flexibility (PF), which evidence shows may help buffer minority stress. This systematic review aimed to describe how ACT has been used to help LGBTQI+ individuals improve wellbeing and PF, and how it was tailored to suit LGBTQI+ individuals' needs. Five of the initial 1430 papers identified were included in this review. Results suggested that ACT can promote PF for LGBTQI+ individuals, consequentially leading to symptom reduction for a variety of mental health problems. ACT has also been tailored to LGBTQI+ individuals unique challenges, and participants appeared to find it a tolerable therapeutic approach. While results are promising, the small number of studies and overall methodological weaknesses limit interpretation. This paper serves as a call for action for researchers to overcome methodological challenges to expand our knowledge of ACT with this community who have been historically underserved and systematically impacted by heterosexism and cissexism. It also emphasises the importance of delivering LGBTQI+ tailored care. • There is a dearth of literature evaluating ACT for LGBTQI + individuals. • ACT can promote psychological flexibility and wellbeing in this community. • ACT is easily tailored for the unique needs of LGBTQI + individuals. • Emerging evidence shows participants found ACT interventions engaging and useful. • More research with greater methodological rigor is necessary. [ABSTRACT FROM AUTHOR]

Abstract Background Ethiopia has adopted the global plan to end the epidemic of HIV/AIDS. The aim of this study was to assess the progress made towards achieving this plan. Methods A review and analysis of national population-based surveys, surveillance, and routine programme data was executed. The data analysis was conducted using Excel 2016 and Stata 14 (StataCorp LP, College Station, TX, USA). Results Between 2011 and 2016, the number of HIV-related deaths dropped by 58%, while that of new HIV infections dropped by only 6%. Discriminatory attitudes declined significantly from 77.9% (95% confidence interval (CI) 77.3–78.4%) in 2011 to 41.5% (95% CI 40.6–42.4%) in 2016. Around 79% of adult people living with HIV (PLHIV) were aware of their HIV status; 90% of PLHIV who were aware of their HIV status were taking antiretroviral treatment (ART) and 88% of adult PLHIV on ART had viral suppression in 2016. The proportion of people aged 15–49 years who had ever been tested for HIV and had received results increased from 39.8% (95% CI 39.2–40.4%) in 2011 to 44.8% (95% CI 44.2–45.4%) in 2016. This proportion was very low among children below age 15 years at only 6.2% (95% CI 5.9–6.5%). Among regions, HIV testing coverage varied from 13% to 72%. Female sex workers had lower coverage for HIV testing (31%) and ART (70%) than the national average in the adult population. International funding for HIV dropped from more than US$ 1.3 billion in 2010–2012 to less than US$ 800 million in 2016–2018. Conclusions Ethiopia is on track to achieve the targets for HIV testing, ART, viral suppression, and AIDS-related deaths, but not for reductions in new HIV infections, discriminatory attitudes, and equity. Ending the epidemic of HIV/AIDS requires a combined response, including prevention and treatment, tailored to key populations and locations, as well as increased funding. [ABSTRACT FROM AUTHOR]