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Purpose: Substance use, that is of cigarettes, alcohol and chemical inhalants, is a major contributor to health‐compromising behaviors and the related consequences among adolescents around the world. The purpose of this paper is to examine trends in this phenomenon in South Korea among sexually active adolescents who reported sexual minority behaviors as compared to their heterosexual (HS) peers. Design and Methods: This study used data from the annual web‐based survey called Korea Youth Risk Behavior Survey in 5‐year intervals: 2006, 2011, and 2016. From 2017, the questions regarding the gender of sex partners were excluded from the survey, thus no data is available for sexual minorities after 2016. Selected data (Unweighted n = 10,029) was used to assess whether substance use increased, decreased, or remained unchanged among adolescents who reported same‐sex (SS) behaviors and bisexual (BS) behaviors compared to their peers reporting HS behaviors. Demographic variables included age and assigned gender. Substances referred to are cigarettes, alcohol, and chemical inhalants. Logistic regression models were sex‐stratified according to assigned gender. Trend analyses were carried out to examine disparities in substance use among sexually active adolescents across the three survey years. Results: Across the three survey years, cigarette use, alcohol use, and problematic drinking declined among all sexually active youths, but there were some differences among the subgroups. In 2016, SS girls were more likely to use cigarettes than HS girls. The prevalence of alcohol use and problematic drinking among BS girls was relatively higher than among girls who exhibited either HS or SS behaviors. Inhalant use was very high among both boys and girls with SS and BS behaviors. Practice Implications: The findings of the study reveal disparities in substance use between sexual minority and heterosexual adolescents in South Korea. This creates an alarm for collecting data separately for sexually diverse youth in future Korean national surveys with a goal of reducing substance use among all adolescents. [ABSTRACT FROM AUTHOR]

This conceptual paper identifies future directions for information practices theoretical discourses addressing marginality, community, and embodiment. We extend arguments from critical research identifying how existing discourses fail to capture the nuanced, lived experiences of people and communities confronting marginalization, predominantly via their reinforcement of deficit narratives. We then connect a series of qualitative projects examining the information practices of lesbian, gay, bisexual, transgender, queer, intersex, and asexual communities in the American South with relevant Library and Information Science (LIS) research to examine how marginality, community, and embodiment shape these practices. Specifically, we introduce a conceptual model that describes marginality by framing information practices as tactical and agentic responses to and refutations of social and structural barriers and risks. While some of the information practices of participants and communities appear to be uninformed or unsafe, they represent the products of community sharing and vetting. Embodied navigations further inform participant practices as they navigate information worlds produced and informed by their intersectional identities. These arguments coincide with key categories established within our model that describe information practices: defensive and protective, and community and self. Based on these insights, we offer directions for future research and theory to reorient existing discourses in ways that inspire middle‐range theory building that fully captures people's lived experiences. [ABSTRACT FROM AUTHOR]

This paper examines two significant moments in sexual minority citizenship in England and Wales in relation to one of the Marshallian sets of rights, namely, civil or legal rights, focusing specifically on the Sex Offences legislation and policing practices. The first moment that will be examined here is the process whereby homosexual acts were decriminalized in the 1950s and 1960s: here special attention will be paid to the recommendations made by the Wolfenden Committee. The second moment is one we are currently experiencing, which is associated with the inclusive policing of sexual minority communities (especially lesbian, gay, bisexual and transgender communities) under the provisions of the Crime and Disorder Act 1998 and in the review of Sex Offences, especially in the consultation paper (Home Office 2000) and White Paper (Home Office 2002) associated with this review. Privacy and toleration dominate the first moment, at the same time it shall be demonstrated that privacy is also central to the British Sexual Citizenship literatures that have emerged in sociology in the post Wolfenden context. However, as the title suggests, the second moment under examination points to the emergence of a rather more extensive sexual minority citizenship beyond the boundaries of ‘homosexual privacy’ (which British Sexual Citizenship Studies is not currently engaging with) and perhaps even beyond the boundaries of toleration through ever more ‘inclusive’ policing strategies and through the review of sex offences in which many discriminatory laws are being ‘de-homosexualized’. [ABSTRACT FROM AUTHOR]

Motives are situated vocabularies providing insight into the social context and identities of activists and volunteers. In this paper, we examine motives for participation in the AIDS movement. We focus on an understudied group of volunteers and activists ( N = 75) in the USA, Latino gay and bisexual men. Participants elaborated on 11 motives: values, helping others, reciprocity, understanding, personal development, career enhancement, community concern, social change, esteem enhancement, personal experience, and social networking. Across almost all categories of motives, activists spoke of working for, and meeting, other Latinos and other Latino gay and bisexual males, and about fighting what they consider oppressing forces. Motives were articulated within the context of a collective identity. Participants' descriptions highlight the process by which they create and reproduce identity and community through their involvement and as they articulate their motives. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper focuses on the questions which heterosexual trainees ask about lesbian, gay and bisexual (LGB) experience within diversity training about LGB issues. Drawing on a data corpus of 162 questions asked by trainees in 13 tape-recorded training sessions, questions were coded into six categories: (1) general ‘understanding’ questions; (2) questions about the trainer's life, experience and practices; (3) professional practice questions; (4) questions about lesbian and gay related legislation, policies and procedures; (5) questions about specific people and projects and (6) questions about the meanings, derivations and correct use of terms and symbols. ‘Real’ questions are compared with the decontexualized questions (and answers to them) that are provided in training manuals and it is demonstrated that these questions differ markedly from how questions actually get asked and how they actually get answered. Recommendations are provided for improving training and the argument made for turning towards analyses of the real world in action, especially when considering intergroup relations. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper reviews evidence for a link between suicide or suicidal behavior and sexual orientation by (1) reviewing studies of the rates of completed and attempted suicides for gay, lesbian, and bisexual (GLB) people compared to the general population; (2) examining risk factors that might explain any differences; (3) outlining opportunities for prevention; and (4) providing directions for future research. Studies suggest an elevated risk of suicide attempts among some cohorts of GLB people, particularly GLB youth. Evidence is also strong that GLB youth are at high risk for associated maladaptive risk behaviors. Mental health problems and substance abuse disorders are critical predisposing factors for GLB suicide, as for the general populations. Future prevention research should he guided by a model that incorporates both risk and resilience factors among GLB persons. [ABSTRACT FROM AUTHOR]

Although considerable research has examined how members of advantaged groups think and feel about disadvantaged groups, fewer studies have examined responses to "intermediate" social groups—groups that are perceived to fall between more commonly acknowledged groups on the same dimension of social identity. We measured judgments of intermediate groups, including novel groups designed to manipulate social group intermediacy (Studies 1–5), Black/White biracial people (Study 6), and bisexual people (Study 7). In each study, participants provided separate evaluations of an intermediate group and two comparison groups (e.g., Black/White biracial people, Black people, White people). Intermediate groups were consistently rated as less conceptually legitimate (e.g., less distinctive, not a "real" group) than other groups. The view that intermediate groups are not "real" groups helped explain negative evaluations of them, and participants who strongly identified with an advantaged ingroup were especially prone to this pattern of judgments. These results are consistent with the idea that an intermediate group can threaten the distinctiveness of a valued ingroup, leading people to dismiss and denigrate the intermediate group. Studying perceptions of intermediate groups facilitates a nuanced account of an increasingly heterogeneous social world. [ABSTRACT FROM AUTHOR]

The article presents the author's views on the recurring dominance of heterosexual perspectives in the society. It is rather difficult to define heterosexuality. According to the author there is a pressure which arises out of a wish to "get it right" regarding these issues, or rather, a fear of "getting it wrong." This pressure tends to discourage openness about homophobia and clumsiness in this area. If this is widespread then it may partly explain why so little is done positively by way of providing services or in dealing with issues (such as anticipated homophobia) which are a major obstacle to accessing a service for those who may identify as lesbian, gay or bisexual. Talking about "the gay community" is problematic, as the phrase seems to be associated more with men, so people use "gay men and lesbian," but this is also inadequate as one need to add "bisexual." All these phrases seem inadequate, defining people entirely in terms of sexual identity as if it is always the most salient feature of their lives. The author says that his heterosexuality, like his whiteness and maleness, has been relatively invisible to him for most of the time, as are the oppressive aspects of such dominant perspectives which make counteracting its effects that much harder. There can be little doubt about the nationalization of lesbian, gay male and bisexual communities. They share some of the struggles faced by other communities.

Subjectivities such as (what would be termed in English) lesbians, bisexual, and queer (LBQ) women and transgender people are contested topics in Ukraine. Linking Laclau and Mouffe's discourse analysis with Loseke's narrative approach, we reviewed eight national, text‐based, journalistic media sources to read equivalence chains within the data as publicly available formula stories about LGBTQ+ people. Formula stories are not about actual people or typically told by LBQ women and transgender people themselves, but rather exist as publicly circulating stories for consumption by non‐LGBTQ+ people. Our findings shore up previous evidence that homophobia and transphobia (including criminalization and pathologization) are commonly articulated in media outlets in Ukraine. Importantly, media outlets owned by Russia and the United States and stories about events outside of Ukraine contribute most to the formula stories circulating in Ukraine, demonstrating the continuing position of Ukraine as a fulcrum of geopolitical contestations in the post‐socialist "cold war." Analyzing sexual politics through formula stories illuminates ongoing transnational connections of imperialism and Europeanization to racialization, colonialism, and contestations of power. A video abstract is available at https://youtu.be/v3dCj0yYm_g. [ABSTRACT FROM AUTHOR]

Introduction: Sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) disproportionately affect young gay, bisexual and other men who have sex with men (GBMSM) and transgender women of colour. We explored the experiences of community‐based peer navigators ('Community Navigators') who participated in Impact Triad, a bilingual multilevel intervention developed by our community‐based participatory research partnership to reduce STIs and HIV and address social determinants of health (e.g., employment, education, social support and discrimination) among young GBMSM and transgender women of colour. Methods: Individual in‐depth interviews were conducted with 15 Community Navigators who participated in Impact Triad. Themes were identified through constant comparison. Results: Community Navigators' mean age was 31.4 years. Seven were self‐identified as African American/Black, 5 as Latine, 2 as multiracial/multiethnic, 1 as Asian American, 10 as cisgender men, 4 as transgender women and 1 as gender nonbinary. Thirteen themes emerged in three domains: (1) key aspects of the Community Navigator role (e.g., desire to serve as a community resource, the importance of being part of the communities in which one was working, the value of having an official role, being connected to other Community Navigators to problem‐solving and sustaining intervention aspects long‐term); (2) experiences implementing Impact Triad (e.g., engaging community members, meeting prioritized needs, building trust, using social media, increasing awareness and knowledge and challenges related to COVID‐19) and (3) lessons learned for future interventions (e.g., facilitating access to broader resources, building additional skills and increasing interactions among Community Navigators). Conclusion: Interviews identified important learnings about serving as Community Navigators and implementing Impact Triad that can guide future efforts to address STI/HIV disparities and social determinants of health through community‐based peer navigation. Patient or Public Contribution: Throughout this intervention trial, our partnership worked collaboratively with a study‐specific community advisory board (CAB) comprised primarily of young GBMSM and transgender women of colour. Members of this CAB participated in all aspects of the trial including trial design, intervention development, recruitment and retention strategies, data collection and analysis, interpretation of findings and dissemination. [ABSTRACT FROM AUTHOR]

Background: Blood operators screen donors to reduce the risk of transfusion‐transmitted infections (TTIs). Many are evolving screening procedures from those that defer all who have had a sexual interaction with gay, bisexual, or other men who have sex with men (gbMSM) to an approach that assesses individual donors' recent sexual risk behavior with any partner. Study Design and Methods: A representative sample of current blood donors (N = 1194) was recruited online and randomized to complete either the existing (at the time of the study) Canadian Blood Services' donor questionnaire (DQ) that screens out those with recent gbMSM sexual experience, a modified donor questionnaire (MDQ) that assesses individuals' recent sexual behavior with any partner, or an MDQ that assesses individual sexual behavior with any partner and explains why these questions are asked. Respondents were asked for their perceptions concerning difficulty, comfort, and acceptability of these screening questionnaires. Results: Across experimental conditions, current donors regarded screening questionnaire difficulty to be low; discomfort in responding was minimal; screening questionnaires were perceived to be relatively inoffensive and justified, and very few donors would cease donating if the screening questionnaire they responded to became the one in general use. Some minor sex differences were observed, and in some cases, perceptions of the MDQ with explanation were somewhat more positive than those of the DQ and MDQ without explanation. Discussion: An individual risk behavior screening approach appears to be acceptable to current blood donors as an alternative to screening out all who have recently engaged in gbMSM sexual interactions. [ABSTRACT FROM AUTHOR]

We study basic information treatments regarding sexual orientation using randomized experiments in three countries with strong and widespread anti‐gay attitudes: Serbia, Turkey, and Ukraine. Participants who received information about the economic costs to society of sexual orientation discrimination were significantly more likely than those in a control group to support equal employment opportunities based on sexual orientation. Information that the World Health Organization (WHO) does not regard homosexuality as a mental illness increased social acceptance of sexual minorities, but only for those who reported trust in the WHO. Our results have important implications for policymakers aiming to expand the rights of lesbian, gay, and bisexual people worldwide. [ABSTRACT FROM AUTHOR]

This chapter reports on the evaluation of state and local level National Standards for Culturally and Linguistically Appropriate Services in Health Care (aka CLAS Standards), specifically those standards addressing the health needs of sexual minority individuals, with an emphasis on the inclusion of bisexual+ communities and the implications of bisexual+ (non)inclusion in CLAS standards. At the state and local levels, bisexual identity is rarely recognized as distinct from other sexual identities. This lack of representation raises an essential issue of how local communities, states, and the federal government struggle with sexual minority data classification and prioritizing health benchmarks for sexual minority populations and subpopulations. We also found that the CLAS cultural competency policy definition at the federal level lacks an appropriate degree of bi‐inclusivity. The findings from this study reveal that the five states in our sample implemented CLAS Standards in ways that demonstrated bi‐erasure. Specifically, states defined gender and sexual minorities through exclusionary categories that place emphasis on the "Other". LGBTQ+ evaluators can rely on the Principles of LGBTQ+ Evaluation to create strategies that demonstrate how to effectively address the intersecting ramifications of bi‐erasure at the policy level. [ABSTRACT FROM AUTHOR]

In the United States, Black gay and bisexual men account for a quarter of HIV infections and face intersecting social and structural stigmas along the axes of race, sexuality and class. For those diagnosed with HIV, these inequities shape their lived experiences which include HIV disclosure. Public health has privileged HIV status disclosure as the appropriate moral and responsible choice to protect sex partners, reduce stigma and obtain social support. Though little is known about the emotional aspects of HIV disclosure for Black gay and bisexual men, or how they are shaped by social and structural contexts. Using the frameworks of healthism and emotion work, I explore HIV disclosure among a sample of 30 Black gay and bisexual men living with HIV in the Deep South. Drawing on in‐depth, qualitative interviews, I identify the emotion work that men engaged in to manage their own emotions and protect the emotions of others before, during and after disclosure or nondisclosure. These findings challenge public health research that has explored disclosure as discrete measurable events by illustrating how HIV disclosure is embedded in ongoing social and structural relations and provide insights that can guide new approaches focused on structural inequities that constitute HIV disclosure. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association between chemsex drug use and HIV clinic attendance among gay and bisexual men in London. Methods: A cross‐sectional survey of adults (> 18 years) diagnosed with HIV for > 4 months, attending seven London HIV clinics (May 2014 to August 2015). Participants self‐completed an anonymous questionnaire linked to clinical data. Sub‐optimal clinic attenders had missed one or more HIV clinic appointments in the past year, or had a history of non‐attendance for > 1 year. Results: Over half (56%) of the 570 men who identified as gay or bisexual reported taking recreational drugs in the past 5 years and 71.5% of these men had used chemsex drugs in the past year. Among men reporting chemsex drug use (past year), 32.1% had injected any drugs in the past year. Sub‐optimal clinic attenders were more likely than regular attenders to report chemsex drug use (past year; 46.9% vs. 33.2%, P = 0.001), injecting any drugs (past year; 17.1% vs. 8.9%, P = 0.011) and recreational drug use (past 5 years; 65.5% vs. 48.8%, P < 0.001). One in five sub‐optimal attenders had missed an HIV clinic appointment because of taking recreational drugs (17.4% vs. 1.8%, P < 0.001). In multivariable logistic regression, chemsex drug use was significantly associated with sub‐optimal clinic attendance (adjusted odds ratio = 1.71, 95% confidence interval: 1.10–2.65, P = 0.02). Conclusions: Our findings highlight the importance of systematic assessment of drug use and development of tools to aid routine assessment. We suggest that chemsex drug use should be addressed when developing interventions to improve engagement in HIV care among gay and bisexual men. [ABSTRACT FROM AUTHOR]

Cultural heterosexist ideologies assume heterosexuality to be the default norm. Four studies investigated when concepts of romantic love are heterosexual‐by‐default (N = 685). In Studies 1–2, participants generated features of romantic love, in general (i.e., the default prototype) or among one of three sexual orientation‐specific couples (lesbian, gay, or heterosexual). Heterosexual‐identified participants' default prototypes were more similar to heterosexual than same‐gender prototypes (Study 1). Lesbian‐ and gay‐identified participants' default prototypes were more similar to both heterosexual and gay male than lesbian prototypes, whereas bisexual‐identified participants' sexual orientation‐specific prototypes were equivalently similar to the default (Study 2). However, heterosexual‐identified participants rated presented features of love similarly across sexual orientation‐specific conditions (Study 3). In a timed feature‐verification task (Study 4), participants categorized fewer peripheral features of romantic love as relevant to same‐gender than mixed‐gender couples. Activating sexual orientation‐specific representations affected subsequent default concepts of romantic love. We discuss implications for heterosexism theories and intervention. [ABSTRACT FROM AUTHOR]

Since the 2012 FDA approval of HIV Pre‐exposure Prophylaxis (PrEP) as a method to prevent HIV, its uptake among gay and bisexual men has been met with conflict. Drawing on discussions of PrEP from focus groups with gay and bisexual men in New York City (N = 5 groups, n = 32 participants), we sought to make meaning of the moral debate surrounding the implementation of biomedical HIV prevention medications. Grounded in the constructionist perspective on social problems, this case study focuses on the competing claims making activities gay and bisexual men engage in when framing PrEP and PrEP users. As HIV prevention is a communicative endeavour, analysing the micro level social problems work on PrEP provides key insight into the subcultural norms and values that shape sexual health practices and beliefs within gay and bisexual communities. [ABSTRACT FROM AUTHOR]

Abstract: Aims: We estimated sexual‐orientation differences in alcohol use trajectories during emerging adulthood, and tested whether alcohol use trajectories mediated sexual‐orientation differences in alcohol use disorders (AUDs). Design: Longitudinal self‐reported survey data from the Growing Up Today Study. Setting: United States. Participants: A total of 12 493 participants aged 18–25 during the 2003, 2005, 2007 or 2010 surveys. Measurements: Stratified by gender, longitudinal latent class analyses estimated alcohol use trajectories (using past‐year frequency, quantity and binge drinking from 2003 to 2010). Multinomial logistic regression tested differences in trajectory class memberships by sexual orientation [comparing completely heterosexual (CH) participants with sexual‐minority subgroups: mainly heterosexual (MH), bisexual (BI) and gay/lesbian (GL) participants]. Modified Poisson regression and mediation analyses tested whether trajectories explained sexual‐orientation differences in AUDs (past‐year DSM‐IV abuse/dependence in 2010). Findings: Six alcohol use trajectory classes emerged for women and five for men: these included heavy (23.5/36.9% of women/men), moderate (31.8/26.4% of women/men), escalation to moderately heavy (9.7/12.0% of women/men), light (17.0% for women only), legal (drinking onset at age 21; 11.1/15.7% of women/men) and non‐drinkers (7.0/9.1% of women/men). Compared with CH women, MH and BI women had higher odds of being heavy, moderate, escalation to moderately heavy and light drinkers versus non‐drinkers (odds ratios = 2.02–3.42; P‐values < 0.01–0.04). Compared with CH men, MH men had higher odds of being heavy, moderate and legal drinkers versus non‐drinkers (odds ratios = 2.24–3.34; P‐values < 0.01–0.01). MH men and women, BI women and GLs had higher risk of AUDs in 2010 than their same‐gender CH counterparts (risk ratios = 1.34–2.17; P‐values < 0.01). Alcohol use trajectories mediated sexual‐orientation differences in AUDs for MH and GL women (proportion of effect mediated = 30.8–31.1%; P‐values < 0.01–0.02), but not for men. Conclusions: In the United States, throughout emerging adulthood, several sexual‐minority subgroups appear to have higher odds of belonging to heavier alcohol use trajectories than completely heterosexuals. These differences partially explained the higher risk of alcohol use disorders among mainly heterosexual and gay/lesbian women but not among sexual‐minority men. [ABSTRACT FROM AUTHOR]

Background: Like a number of other countries, Australia mandates that a man who has had sex with men is deferred from donation until 12 months has elapsed since the sexual activity. This review examined whether this deferral period is justified by current evidence.Study Design and Methods: Databases (Medline, EMBASE, Scopus) were searched using terms "blood donation" and "gay" or "MSM" and "HIV risk" from the mid-1980s to the present to investigate the history of donor deferral policy and its rationale in Australia.Results: Gay and bisexual men in Australia face a higher risk of human immunodeficiency virus and other blood-borne viruses (BBVs) than other populations. All blood donations, however, are tested for BBVs, and with current testing technologies the window period during which infection may be present but not detected is now less than 1 week. While there is a moral imperative to maintain blood safety, there is also a moral imperative to ensure that differential treatment of population groups with regard to donation eligibility is scientifically justified. Potential social harms that may flow from a dissonance between deferral policy and its evidence base include loss of trust and increased nonadherence to policy.Conclusions: A 12-month deferral for gay and bisexual men exceeds what is required to maintain blood safety. This disparity potentially causes social harm without any additional benefit to public health. Reducing the deferral period to 3 months will not increase health risk to recipients and may have the social benefit of increasing inclusiveness. [ABSTRACT FROM AUTHOR]

Although binegativity, the stigmatization of bisexuality, is prevalent among heterosexual and lesbian and gay communities, little research has addressed how the quantity and quality of intergroup contact affect binegativity. Drawing on intergroup contact theory, this study examined contact with and attitudes toward bisexuals among heterosexual undergraduates, heterosexual adults, and lesbians and gay men. Knowing more bisexuals (quantity) predicted more positive attitudes toward and decreased intergroup anxiety with male and female bisexuals. A multilevel structural equation model indicated that contact quality simultaneously predicted higher perceived stability of female bisexuality (but not male bisexuality) and tolerance of and less intergroup anxiety with male and female bisexuals when contact quantity was controlled for. This research suggests that both quantity and quality of contact with bisexuals predicts improved intergroup attitudes. Implications for future research on reducing binegativity are discussed. [ABSTRACT FROM AUTHOR]

Objectives The aim of the study was to explore HIV testing frequency among UK men who have sex with men ( MSM) in order to direct intervention development. Methods Cross-sectional surveys were completed by 2409 MSM in Edinburgh, Glasgow and London in 2011 and a Scotland-wide online survey was carried out in 2012/13. The frequency of HIV testing in the last 2 years was measured. Results Overall, 21.2% of respondents reported at least four HIV tests and 33.7% reported two or three tests in the last 2 years, so we estimate that 54.9% test annually. Men reporting at least four HIV tests were younger and less likely to be surveyed in London. They were more likely to report higher numbers of sexual and anal intercourse partners, but not 'higher risk' unprotected anal intercourse ( UAI) with at least two partners, casual partners and/or unknown/discordant status partners in the previous 12 months. Only 26.7% (238 of 893) of men reporting higher risk UAI reported at least four tests. Among all testers ( n = 2009), 56.7% tested as part of a regular sexual health check and 35.5% tested following a risk event. Differences were observed between surveys, and those testing in response to a risk event were more likely to report higher risk UAI. Conclusions Guidelines recommend that all MSM test annually and those at 'higher risk' test more frequently, but our findings suggest neither recommendation is being met. Additional efforts are required to increase testing frequency and harness the opportunities provided by biomedical HIV prevention. Regional, demographic and behavioural differences and variations in the risk profiles of testers suggest that it is unlikely that a 'one size fits all' approach to increasing the frequency of testing will be successful. [ABSTRACT FROM AUTHOR]

HIV prevalence among Chinese men who have sex with men has rapidly increased in recent years. In this randomized, controlled study, we tested the feasibility and efficacy of motivational interviewing to reduce high-risk sexual behaviors among this population in Changsha, China. Eighty men who have sex with men were randomly assigned to either the intervention group, in which participants received a three-session motivational interviewing intervention over 4 weeks, or the control group, in which participants received usual counseling from peer educators. High-risk behavior indicators and HIV knowledge level were evaluated at baseline and 3 months after the intervention. Motivational interviewing significantly improved consistent anal condom use. However, there was no significant change in consistent condom use for oral sex or in the number of sexual partners over time. HIV knowledge scores improved equally in both groups. This study demonstrated that an intervention using motivational interviewing is feasible and results in increased condom use during anal sex for Chinese men who have sex with men. However, further work must be done to increase the use of condoms during oral sexual encounters. [ABSTRACT FROM AUTHOR]

Aims and objectives The aim of this study was to report on an analysis of the concept of successful ageing in lesbian, gay and bisexual older people. Background Research indicates that lesbian, gay and bisexual older people experience significant health disparities. Yet there is a lack of understanding on what factors contribute to successful ageing in this population. Nursing has lagged behind other disciplines in investigating the health of lesbian, gay and bisexual older people. Design A concept analysis using Rodgers' evolutionary method. Data sources Twenty studies were retrieved by searching PubMed, CINAHL, PsycInfo, EMBASE, Cochrane Library and Scopus for English-language peer-reviewed studies published from January 2004 to March 2014. Methods The antecedents, attributes and consequences of the concept were identified through the Rodgers' method of concept analysis. Results Attributes included support from families of origin and/or families of choice, access to lesbian, gay, and bisexual-friendly services and crisis competence. Self-realisation of lesbian, gay and bisexual identity (coming out to oneself) and age >50 were identified as antecedents. Three consequences of successful ageing in lesbian, gay and bisexual older people were social engagement, optimism and resilience. Conclusion Successful ageing in lesbian, gay and bisexual older people is defined as a subjective and multifactorial concept that is characterised by support from families of origin/families of choice, access to lesbian, gay, and bisexual-friendly services and the development of crisis competence skills which impact the ageing experience of LGB individuals. Implications for practice Successful ageing models can provide a roadmap for developing culturally competent interventions to address key healthcare issues present in this population. The nursing profession's multidisciplinary knowledge and competence in providing health promotion makes nurses well positioned to take a leading role in reducing disparities of lesbian, gay and bisexual older people. [ABSTRACT FROM AUTHOR]

Objectives There is evidence that HIV-positive patients are suffering from a greater burden of morbidity as they age due to non AIDS-related complications. To date it has been difficult to determine what part of this excess risk is due to the health effects of HIV, its treatment or to lifestyle factors common to gay and bisexual men ( GBM). We calculated overall and cause-specific hospitalisation rates and risk factors for hospitalisations in HIV-negative and HIV-positive cohorts of GBM and compare these with rates in the general male population. Methods We conducted a record linkage study, linking two cohorts of HIV-negative ( n = 1325) and HIV-positive ( n = 557) GBM recruited in Sydney, New South Wales ( NSW), Australia with the NSW hospital discharge data register. We compared rates of hospitalisation in the two cohorts and risk factors for hospitalisation using random-effects Poisson regression methods. Hospitalisation rates for each cohort were further compared with those in the general male population using indirect standardisation. Results We observed 2032 hospitalisations in the HIV-negative cohort during 13 016 person-years ( PYs) [crude rate: 15.6/100 PYs (95% CI: 14.9-16.3)] and 2130 hospitalisations in the HIV-positive cohort during 5571 PYs [crude rate: 38.2/100 PYs (95% CI: 36.6-39.9)]. HIV-positive individuals had an increased risk of hospitalisation compared with the HIV-negative individuals [adjusted- IRR: 2.34 (95% CI: 1.91-2.86)] and the general population [ SHR: 1.45 (95% CI: 1.33-1.59)]. Hospitalisation rates were lower in the HIV-negative cohort compared with the general population [ SHR: 0.72 (95% CI: 0.67-0.78)]. The primary causes of hospitalisation differed between groups. Conclusions HIV-positive GBM continue to experience excess morbidity compared with HIV-negative GBM men and the general population. HIV-negative GBM had lower morbidity compared with the general male population suggesting that GBM identity does not confer excess risk. [ABSTRACT FROM AUTHOR]

Research suggests that the experience of being a lesbian or bisexual woman influences women's interactions with health care providers, and their perception of the quality of care. Limited research to date, however, has examined how ageing and sexuality mediates women's experiences of quality, when accessing health care in the community. To fill a gap in the literature, this study investigated older lesbian and bisexual women's perspectives on the meaning of quality of care in the context of receiving home care services. This was a qualitative single case study. Sixteen participants, aged 55-72 from Ontario, Canada, participated in semi-structured interviews between 2011 and 2012. The interviews were recorded and transcribed. The interview data were analysed using iterative thematic analysis and guided by a feminist ethic of care perspective. Participants described quality of care in ways that were in line with a feminist ethic of care; that is, they wanted care providers to be responsive and attentive to their needs, to involve them in the caring process and to demonstrate respect and caring. Participants also indicated that providers' comfort with, and knowledge of, sexual diversity was important for enabling quality of care. These findings deepen our understanding of how to support quality of care for this population through changes to provider education and training, and health policy. [ABSTRACT FROM AUTHOR]

In recent years there has been a growth in organizational discourse concerning the lives of older lesbian, gay and/or bisexual ( LGB) adults, which has started to address the serious omission and invisibility of this group of people in research, policy making and service provision. Whilst this development is welcomed, it inevitably draws attention to the identification 'older LGB adults' on which it is based. Using insights from queer theory, in addition to the sociological perspectives of ethnomethodology and conversation analysis, this article troubles or 'queers' such identifications. It does this, not only theoretically, but empirically, by conducting a membership categorization analysis ( MCA) of some data emanating from a small organizational scoping study of older LGB adults. The ramifications of this for organizational research, policy making and practice are considered in the conclusion. [ABSTRACT FROM AUTHOR]

As English social care services reconstruct themselves in response to the personalization agenda, there is increased interest in the contribution of micro-providers - very small community-based organizations, which can work directly with individuals. These micro-providers are assumed to be able to cater for the 'seldom heard' groups which have been marginalized within mainstream social care services. This article reviews recent literature from the UK published in peer-reviewed journals from 2000 to 2013 on support provision for people with protected characteristics under the Equality Act 2010. It considers the marginalising dynamics in mainstream, statutory social care support provision, and how far local community, specialist or small-scale services are responding to unmet need for support and advice among marginalized groups. The review found that there is a tradition of compensatory self-organization, use of informal networks and a mobilization of social capital for all these groups in response to marginalization from mainstream, statutory services. This requires recognition and nurturing in ways that do not stifle its unique nature. Specialist and community-based micro-providers can contribute to a wider range of choices for people who feel larger, mainstream services are not suitable or accessible. However, the types of compensatory activity identified in the research need recognition and investment, and its existence does not imply that the mainstream should not address marginalization. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Cross-sectional studies support that bisexual and gay (BG) men are at increased risk for eating pathology, and romantic relationships may buffer against risk; however, no studies have examined this association longitudinally. The current study examined how romantic relationships impact the trajectory of eating pathology in BG versus heterosexual men. Method BG ( n = 51) and heterosexual ( n = 522) men completed surveys of health and eating behaviors at baseline and 10-year follow-up. Results For BG men, being single at baseline prospectively predicted an increase in Drive for Thinness scores over 10-year follow-up. Additionally, for BG men in relationships at baseline, lower relationship satisfaction predicted an increase in Drive for Thinness scores over time. Conversely, these relationship variables did not predict trajectory of eating pathology for heterosexual men. Discussion Implications for theoretical models of risk, including objectification theory and sexual minority stress theory, and prevention, including peer-led cognitive dissonance based interventions, are discussed. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:700-707) [ABSTRACT FROM AUTHOR]

Increasing numbers of lesbian, gay and bisexual ( LGB) adults are entering into parenthood. Previous studies indicate many of these parents receive little or no support from their families of origin due to family members' negative attitudes toward homosexuality. This study looks at the extent to which LGB parents report a lower sense of connectedness to family of origin and friendship networks than heterosexual parents and whether this has an impact on psychological wellbeing in either of these groups. Data were derived from two studies of parents: Work, Love, Play, a study of Australian and New Zealand LGB parents (n=324); and the Longitudinal Study of Australian Children, a population-based study of young children and parents (n=6460). Structural equation modelling was used to explore the relationships between: parent sexuality and family/friendship connectedness, family/friendship connectedness and psychological wellbeing, parent sexuality and psychological wellbeing. LGB parents reported feeling less connected to their families of origin but more connected to their friendship groups than heterosexual parents. Counter to previous studies, we found no difference in the psychological wellbeing of LGB parents compared to heterosexual parents when examining the direct effect of sexuality on psychological wellbeing. Clinical implications for counsellors and family therapists are discussed. [ABSTRACT FROM AUTHOR]

Using data drawn from the National Longitudinal Study of Adolescent Health, this study (1) examines the sensitivity of the estimated earnings penalty of sexual minority status to family-level unobserved heterogeneity, and (2) explores whether the earnings effects of sexual orientation differ by the degree of fluidity in individuals' self-reported sexual identity over time. Evidence from sibling pairs suggests that unobserved family heterogeneity is not an important source of bias in the estimated relationship between sexual orientation and young adult earnings. I find that gay males and bisexuals earn lower wages than their heterosexual counterparts, while lesbians earn wages that are not significantly different from heterosexual females. Finally, I examine the role of fluidity in sexual orientation over time and find that males who are longer-term gay identifiers earn wages that are 26.4 percent lower than their consistently heterosexual-identifying counterparts. [ABSTRACT FROM AUTHOR]

Individuals with lesbian, gay, and bisexual ( LGB) identities have higher prevalence of self-directed violence, but very little is known about racial/ethnic differences between LGB populations. This study aimed to examine racial/ethnic differences in self-harm, suicidal ideation, suicide attempt, and depression among LGB and heterosexual emerging adults. Data are compiled from the Fall 2008 and Spring 2009 National College Health Assessment and limited to respondents within emerging adulthood (ages 18-24) who indicated their sexual orientation and racial/ethnic identities ( n = 89,199). Within each racial/ethnic group, LGB individuals were significantly more likely to report self-harm, suicidal ideation, suicide attempt, and depression than non- LGB individuals. [ABSTRACT FROM AUTHOR]

ABSTRACT Appearance is one way in which lesbian and bisexual identities and affiliation to lesbian, gay, bisexual (LGB) subculture can be demonstrated. 'Butch' and 'androgynous' styles have been used by lesbian women to communicate a non-heterosexual identity. However, some LGB appearance researchers have argued that there has been a mainstreaming and diversification of lesbian style in the last couple of decades, which has resulted in less distinction between lesbian and straight looks. This research draws on the Social Identity approach to explore contemporary style in lesbian and bisexual communities. Fifteen lesbian and bisexual women took part in semi-structured interviews which were analysed using thematic analysis. Although some participants reported a diversification of lesbian style, most used the term 'butch' to describe lesbian style, and a 'boyish' look was viewed as the most common contemporary lesbian style. By contrast, most participants could not identify distinct bisexual appearance norms. The data provide evidence of conflicting desires (and expectations) to visibly project social identity by conforming to specific lesbian styles, and to be an authentic, unique individual by resisting these subcultural styles. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Medical Education 2012: 46: 903-913 Objectives There are significant health disparities according to sexual orientation and gender identity, particularly in mental health; however, very few mental health professionals specialise in caring for lesbian, gay, bisexual and transgender (LGBT) communities. The purpose of this study was to explore how providers with LGBT-focused practices have developed their capacity for working with these populations. Methods Eight semi-structured interviews were conducted with practising mental health service providers with extensive experience serving LGBT individuals. Participants represented four professional disciplines: psychiatry ( n = 2); social work ( n = 3); psychotherapy ( n = 2), and psychology ( n = 1). The data were analysed for themes that were identified using a descriptive phenomenological approach. Results All providers self-identified as members of LGBT communities; however, most agreed that this membership was not necessary to provide supportive, appropriate care for LGBT individuals. Providers described their self-identity as members of LGBT communities, associated lived experiences and recognition of the need for mental health services that are sensitive to the unique needs of LGBT individuals as influential factors in their career decisions. The lack of training opportunities and resources specific to the provision of LGBT-sensitive mental health services was highlighted. Provider recommendations included the introduction of mandatory LGBT health content in education curricula that addresses basic LGBT-related terminology, appropriate interview questions to facilitate the disclosure of sexual orientation and gender identity, information regarding the health impact of heterosexism and homophobia, and specific health care needs of sexual and gender identity minority people. Conclusions Data from this study suggest there are few opportunities for medical providers to access training and gain expertise in the provision of care to LGBT people. Additional research is needed to consider whether the lack of LGBT health content in medical and psychiatric training programme curricula indirectly contributes to the health disparities experienced by these populations. [ABSTRACT FROM AUTHOR]

Despite the judicial and cultural progress that has been made in Flanders (i.e., Dutch-speaking part of Belgium), lesbians, gay men, and bisexuals (LGBs) are still a stigmatized sexual minority. They are assumed to rely extensively on the support of friends to compensate for lack of familial support (i.e., family-of-choice hypothesis). In this article, we compare the support networks of 2,754 Flemish LGBs and 1,199 Flemish citizens and find convincing support for the family-of-choice hypothesis. LGBs seem to rely primarily on friends, while the average Fleming primarily relies on family for confidant support. We discuss the supportive potential captured in these friendship networks and raise the question 'Are friends all a person needs?' [ABSTRACT FROM AUTHOR]

Concerns have been raised that individuals who are having difficulty coming out as gay or bisexual may be misdiagnosed with borderline personality disorder. In this analogue study, 141 psychologists evaluated a hypothetical client with problems that resembled borderline symptoms but were also consistent with a sexual identity crisis. Client descriptions varied by sexual orientation and gender. Results revealed an effect of sexual orientation for male clients, but not female clients. Male clients whom therapists perceived likely to be gay or bisexual, and male clients with partners of unspecified gender, were more likely to be diagnosed with borderline personality disorder. Therapists were more confident and willing to work with female clients and gave them a better prognosis. Therapists' responses are discussed in light of gender role bias and social desirability. © 2006 Wiley Periodicals, Inc. J Clin Psychol 62: 751–770, 2006. [ABSTRACT FROM AUTHOR]

We describe the dilemmas we encountered in the informed consent process for an HIV prevention project targeting Black gay, bisexual, and non-gay identified young men. We highlight the complexities of applying informed parental consent procedures to sexual minority youth and identify some of the challenges that researchers who work with sexual minority youth face when they must balance the needs and rights of this population against the needs and rights accorded to parents by federal guidelines for protecting minor participants in research. [ABSTRACT FROM AUTHOR]

Male sailfin mollies ( Poecilia latipinna) can be sexually parasitized by closely related, unisexual, gynogenetic Amazon mollies ( Poecilia formosa). This study examined possible cues used by male P. latipinna to distinguish between conspecific females and sympatric, heterospecific P. formosa. Digital photos were used to create models to test male P. latipinna preference for model female P. latipinna and P. formosa with a full suite of traits and altered models of P. latipinna and P. formosa. Male P. latipinna significantly preferred models of either species over no stimulus, demonstrating that models elicit a male response. Males also significantly preferred female P. latipinna models over P. formosa models. We also examined species recognition by female sailfin mollies using the same models, and found that female sailfin mollies significantly preferred to associate with female P. latipinna over P. formosa. These results taken together suggest that the use of fish models yield results similar to those studies using live stimuli. Male preference was then tested for unaltered vs. altered models in the following combinations: (i) P. formosa vs. P. formosa with a female P. latipinna fin; (ii) P. formosa vs. P. formosa with a female P. latipinna lateral spot pattern; (iii) P. formosa vs. P. latipinna with a P. formosa fin and their spotless lateral pattern. Males did not significantly prefer models with any isolated traits over the unaltered P. formosa models. Thus, males may be using traits other than the ones isolated for species recognition or males may be using a suite of multiple traits to recognize conspecific females. [ABSTRACT FROM AUTHOR]

This article offers suggestions and resources for infusing information about working with gay, lesbian, and bisexual clients into a counselor education curriculum or for use in one's professional development as a counselor. Information is provided for core counseling areas and clinical instruction. [ABSTRACT FROM AUTHOR]

I explore a bisexual male patient's need to differentiate highly problematic 'feminine' identifications - originating in childhood sexual abuse and impingement by men as well as women - from identifications with more admired aspects of his mother. My main focus is on the patient's sexual identity - the personal meaning he gave to being male - rather than on his bisexuality - his desire for both sexes. In psychoanalytic literature powerful opposite-sex identifications are usually associated either with psychotic confusion or celebrated as a source of psychic strength. The co-existence of problematic and highly valued cross-sex identifications is rarely discussed. I also look at how this patient re-negotiated his identity through the transference relationship with a female psychotherapist, given that his 'masculinity' derived mainly from childhood experiences of 'stealing' his mother's phallic power. Through a wide-ranging theoretical review I conclude that we need to draw together opposing psychoanalytic perspectives about maternal and paternal power, opening up new ways of thinking about triangular relationships in the transference. [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of the Sexual Orientation Counselor Competency Scale (SOCCS), an instrument that measures the attitudes, skills, and knowledge of counselors who work with lesbian, gay, and bisexual individuals. Internal consistency of the SOCCS was .90, and 1-week test-retest reliability was .84. Criterion, concurrent, and divergent validity tests established the SOCCS as a psychometrically sound instrument. [ABSTRACT FROM AUTHOR]

When lesbian, gay, and bisexual (LGB) people encounter antigay campaigns and elections, they face explicit and implicit homophobic attacks. In order to understand the points of stress and the bases for resilience in the face of these attacks, we developed a 130-item quantitative survey on the basis of results of an earlier qualitative study. Three hundred, sixteen Colorado LGB people endorsed items representing sources of stress and sources of resilience associated with the campaign for and passage of an antigay referendum. Factor analyses of the results suggested 5 sources of stressors and 5 sources of resilience for LGB persons and their communities. [ABSTRACT FROM AUTHOR]

This article outlines the contributions of multicultural counseling to 3 areas of counselor competence with lesbian, gay male, and bisexual male and female (LGB) clients: conceptualization of competence, counselor education, and assessment of counselor competence. The authors describe the foundations of multicultural counseling and extend the concepts to counselor competence with LGB clients. [ABSTRACT FROM AUTHOR]

The present investigation surveyed 162 self-identified lesbian, gay, and bisexual individuals recruited from LGB-related social organizations or contacted through networking procedures with regard to suicidal behaviors, suicide risk factors, and reasons for living. Approximately 41% of the respondents indicated a serious consideration of suicide including the identification of a specific suicide plan (23%) or a past suicide attempt (36%) with significant intent to die (13%). Forty-six percent of the sample indicated at least some degree of chance of attempting suicide in the future. Grounded in the existential-constructivist theory of suicide (Rogers, 2001), empirically and theoretically identified suicide risk factors were found as a group to predict suicidal ideation (R2 = .16) and attempts (R2 = .17), with abuse-related items independently predicting both suicidal ideation (R2 = .03) and attempts (R2 = .08). Items related to self-identity issues and social acceptance were predictive of suicidal ideation (R2 = .04), while substance abuse was predictive of suicidal ideation (R2 = .05) and attempts (R2 = .13) for males only. The established factor structure of the Reasons for Living Inventory (Linehan et al., 1983) was not supported in the current data, suggesting that it may not be an appropriate measure of reasons for living with LGB individuals. [ABSTRACT FROM AUTHOR]

I provide an empirical assessment of the religious commitments of gays, lesbians, and bisexuals in the United States. I compare the religiosity of gay men and lesbians and bisexuals to each other and to male and female heterosexuals, while controlling for a host of sociodemographic factors that may contribute to differences across the gender/sexuality groups. To accomplish this, I examine data from the 1991-2000 General Social Surveys (GSS). During this period, the GSS asked respondents for the sex of their sex partners over the last five years. The GSS finds that 4.3 percent of men and 3.1 percent of women report same-sex sexual partners in the five years preceding the interview--this is a larger proportion than members of "other" races, Episcopalians, or Jews. I find that gay men have high rates of religious participation, while lesbians and bisexuals have significantly lower rates of participation. Nonheterosexuals are more likely to become apostates when compared to female heterosexuals, but no more so than are heterosexual men. My findings are at odds with religious pundits who suggest that alternative sexuality mixes with religion more often for females than for males. The results are in concert with contemporary theories regarding the formation of religious preferences, and risk preferences and religiosity. [ABSTRACT FROM AUTHOR]

Explores sexual identity and its biological versus social origins, internalized biphobia, coming out, relationship patterns, and therapist issues. Factors to consider when helping people come to terms with their sexual identity; Debate over whether people are born with their sexual identity or whether sexual identity is created; Issues that need to be explored by the therapist treating the bisexual client.

Evaluates a number of conceptual and ethical issues surrounding the study and psychological treatment of gay men, lesbians and bisexuals (GLB). Relevance and irrelevance of sexual orientation; Role of therapist biases in assessment and treatment planning; Issue of trust in protected sex; Social support issues for GLB youth; Social invisibility of lesbians.

Analyzes the use of cognitive-behavioral therapy in the treatment of gay, lesbian and bisexual (GLB) clients. Clinical guidelines for psychotherapy with GLB clients; Case illustrations; Need for the therapist to provide care in a nonjudgmental, culturally sensitive manner.

Ten human immunodeficiency virus-1 (HIV-1) infected homosexual or bisexual individuals (ages 24-45) with no history of opportunistic infection were examined, by culture, for the presence of yeasts in whole saliva and on oral mucosa. All were HIV-1 antibody-positive men, non-smokers, non-denture wearers, and taking no medication. The mean salivary level of yeast was four logs higher in the HIV-1 infected group compared to a control group of normal, unmedicated, non-smoking men (ages 20-41) who denied any risk behavior for HIV-1 infection. Identification of the yeast in these HIV-1 positive individuals established that Candida albicans was the predominant species found in whole saliva and on buccal mucosa and tongue. Distinct hyphae were observed with only one mucosal sample. No significant correlation was found between whole saliva yeast concentration and the T4/T8 lymphocyte ratios or absolute number of T4 cells. No correlation was observed between oral yeast concentration and anti-C. albicans IgA titers. The high level of oral yeast in these individuals prior to the development of opportunistic infections is consistent with the suggestion that oral defense mechanisms are compromised in individuals following HIV-1 infection. [ABSTRACT FROM AUTHOR]