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Objective: Transgender women encounter various barriers to healthcare access and use. Together, these contribute to under-utilisation, delay or avoidance of the healthcare system. This in-depth qualitative phenomenological study aimed to explore perceptions, interactions and experiences with medical and healthcare systems, and identify suggestions for improving healthcare access and utilisation among transgender women. Design/Setting: Fifteen (N = 15) transgender women in Los Angeles County participated in semi-structured telephone interviews. Method: Participants were recruited through emails sent to LGBTQ+ serving institutions, health centres and college campuses. The interview guide covered demographic information, experiences within medical and healthcare setting, interactions and perceptions within clinical settings, and concerns about barriers to healthcare access and utilisation. Results: Healthcare experiences were shaped by interpersonal and structural factors. Four themes were identified: (1) lack of trained and knowledgeable healthcare providers, (2) limitations in healthcare access such as cost and hormone replacement therapy access, (3) implicit bias regarding being misgendered and stereotyped, and (4) explicit bias such as denial of services, inability adding preferred personal information to medical health records, and various aspects of discrimination. Conclusion: Access to knowledgeable healthcare providers was cited as a priority area needing the most attention. Curricula and modules that address social, medical and clinical issues specific to transgender women were suggested for use in the training and continuing education of healthcare professionals. In addition to needs related to patient-provider contact, this paper highlights the broader regulatory and political changes needed to improve the health of transgender women.

In partnership with community stakeholders, the present study aimed to gather descriptive data on pandemic-related stress and its association with mental health outcomes among a community sample of self-identified sexual minority women (SMW) in Los Angeles County (N = 84; Mage = 35.61). The sample was comprised solely of women (i.e. self-identified gender identity as woman, including cisgender and transgender women). Data were collected in April 2021, the 'third wave' of the COVID-19 global pandemic. Los Angeles experienced some of the highest COVID-19 incidence rates in the United States. Yet, there was a significant lack of COVID-19 data on SMW, thus making it difficult to address the specific needs of this community. Background data were collected on pre-existing health conditions and COVID-19 infection history. Data were specific to COVID-19 stressors in the areas of mental health, financial strain, social isolation and health and discrimination concerns. Findings revealed that mental health concern was strongly associated with financial strain (r =.63, p <.01), social isolation (r =.62, p <.01) and health and discrimination concerns (r =.63, p <.01), thus demonstrating the wide-ranging negative impact of pandemic stressors on the mental health of SMW in Los Angeles during the third wave of COVID-19. Recommendations for future research, practice and policy implications are discussed. [ABSTRACT FROM AUTHOR]

Men who have sex with men (MSM) report childhood sexual abuse (CSA) at higher rates than heterosexual men. The literature has established a clear association between CSA and sexual risk taking. Biomedical HIV preventative approaches are effective tools for reducing HIV acquisition. Since many studies are conducted on MSM broadly, the objective of this review was to examine outcomes of studies on MSM with CSA histories and HIV biomedical approaches. The PRISMA checklist was used to extract data from the included studies. Of 124 studies retrieved, seven articles (n = 7) met the inclusion criteria. Studies included in the review were predominately correlational. Four themes were identified which were sexual behaviour, mental health, drug use/polydrug abuse and intimate partner violence. All identified variables impacted biomedical adherence either directly or indirectly. However, negative childhood experiences were not the dominant priority in the studies reviewed. In addition, there were confusion over how some variables were operationalized. This systematic review highlights the need for further research and intervention development based on past experiences and trauma, especially among MSM of colour. Approaches that incorporate past trauma should be the future focus of HIV prevention and management. [ABSTRACT FROM AUTHOR]

Objective: This pilot study tested the efficacy of a brief, novel, theory-driven, self-guided, home-based intervention designed to promote condom use among young men who have sex with men (YMSM). Participants: Thirty YMSM were recruited from a large public US midwestern university during spring of 2012. Methods: The intervention was tested using a repeated measures design with the primary follow-up assessment occurring 6 weeks after enrollment. Results: Forty-five percent of men reported a reduced frequency of unprotected insertive penile-anal intercourse in the past 30 days compared with baseline (p = 0.01). Consistency of condom use improved (p = 0.013), as did motivation to use condoms correctly, condom use self-efficacy, and condom attitudes. All participants indicated that they were glad they participated, would recommend the program, and that overall, they had liked the program. Conclusions: This pilot study supports an expanded trial of this intervention with MSM at high-risk of acquiring human immunodeficiency virus/sexually transmitted infections (HIV/STIs).

Sexual transmitted infections (STIs), including the human papillomavirus, are transmissible by female-to-female sexual contact, even though a common misperception is that women who have sex with women (WSW) are at lower risk for STIs. This study sought to further understand current sexual behaviors and protective mechanisms utilized by WSW. Incorporating a grounded theory approach, nineteen (N = 19) semistructured telephone interviews were conducted among WSW from four regions of the United States. Findings indicate that WSW were engaging in risky sexual behaviors due to limitations in knowledge, aversion to dental dams, gender bias, and perceived emotional connection. Implications suggest comprehensive sexuality education and community-based risk reduction education programs. [ABSTRACT FROM AUTHOR]

Sexual self-concepts are people's positive and negative perceptions as sexual beings. This study sought to further understand sexual self-concepts among young men who have sex with men with childhood sexual abuse histories. Method: Sixteen (N = 16) participants were interviewed utilizing a hermeneutical phenomenological conceptual framework and methodology. Salient themes were developed and analyzed with the assistance of NVivo. Result: Three themes were found: (1) body image concerns; (2) penile insecurities; and (3) desire for romantic attachment. Conclusion: Findings highlight several perceived factors related to sexual self-concepts that could benefit from additional exploration and consideration when providing mental health services. Nonparticipation was discussed as a limitation and a potential obstacle to service-seeking behavior among individuals that have experienced severe childhood trauma. Further awareness about the paradigm of body image and healthy relationship development could assist in improving mental health concerns among this group. [ABSTRACT FROM AUTHOR]

Sexual identity disclosure or the "coming out" process is often coupled with psychological distress and may be challenging for LGBT youth. The purpose of the present study was to investigate the disclosure process of same-sex sexual preferences among sexual minority individuals through the lenses of those who have undergone the process. Face-to-face interviews were conducted with 17 participants. Results indicate the following five main themes: (1) the importance of parental acceptance and support; (2) the need for mental health support; (3) addressing stigma; (4) the significance of comprehensive secondary school sexuality education; and (5) the use of social media for navigation and social support. We recommend the development of interventions that tackle parental support, mental health concerns, stigma, and sexuality education to reduce health disparities and assist LGBT youth through the coming out process. [ABSTRACT FROM AUTHOR]

HIV/AIDS is a global and national epidemic that affects college-aged individuals, a significant group that can be reached through prevention programs. The goal of this study was to determine whether an association between sensation seeking and sexual risk behavior exists and, if so, to assess whether HIV knowledge and sexual risk behaviors are predictors of sensation seeking among undergraduate students. Students at a Midwestern university (N = 719) were surveyed. Results indicated that sensation seeking was associated with sexual risk behaviors; however, knowledge was not a predictor of these variables. Therefore, developing university programs that not only address knowledge but also better decision making is suggested. [ABSTRACT FROM AUTHOR]