Search

Unlike native gay and bisexual male (GBM), immigrant/refugee GBM in Lebanon have an added vulnerability to poor sexual health. The objective was to compare sexual health variables between these two communities. GBM who are immigrants/refugees were more likely to report non-university level of education, heterosexual marriage, engagement in sex work, past diagnosis of syphilis, healthcare and employment stigma, lower STI knowledge, and a higher number of male sex partners. Being foreign and feeling sufficiently informed about STIs were indicators of STI knowledge. This study highlights the roles of education and immigrant/refugee status in STI knowledge in migrant GBM in Lebanon.

OBJECTIVE The present study focuses on factors that predict sexual risk behaviors and sexual health screening behaviors in a sample of university students in Lebanon. PARTICIPANTS A convenience sample of 250 undergraduate students was recruited at a private university in Beirut, Lebanon. METHODS Students completed measures of religiosity, psychological distress, contraceptives usage, human immunodeficiency virus (HIV)/sexually transmitted infections (STI) screening, and sexual risk behaviors. RESULTS Religiosity was negatively associated with a range of risky sexual behaviors whereas psychological distress was positively associated with these behaviors. Sex under the influence of alcohol/drugs, discussing methods of contraception, and engaging in sexual activities later regretted had significant effects on having had condomless vaginal sex. Gender (being female) and sex under the influence of alcohol had significant effects on STIs screening. CONCLUSION Interventions that focus on managing drug and alcohol use in students, unwanted pregnancy, religion, stigma related to screening, and sexual health education are recommended.

Background In Lebanon, HIV is concentrated in both native and refugee communities of men who have sex with men (MSM). For over 10 years, the National AIDS Program (NAP) has offered HIV voluntary counselling and testing through a partnership with nongovernmental organizations (NGOs). In 2018, implementation of HIV self-tests (HIVST) was introduced, and this self-care intervention has been further scaled up during the coronavirus disease 2019 (COVID-19) pandemic. This paper (1) describes the effectiveness of implementing HIVST in Lebanon, and (2) discusses how the success of HIVST implementation has been reflected during the COVID-19 pandemic. Methods The NAP conducted a series of workshops (July–November 2018) to introduce HIVST services for healthcare workers working at different NGOs. The workshops highlighted that HIVST would be distributed for free, that it would be confidential and voluntary, and that participants were encouraged to notify the NGOs of their results, which would be kept strictly confidential. NGOs collected data anonymously and confidentially from beneficiaries (age, consistency of condom use and HIV testing history), who were asked to call back with the results of their HIVST. At the NAP, data were combined, aggregated and analysed. Results In 2019, the NGOs distributed 1103/1380 (79.9%) HIVST kits to their beneficiaries. The NGOs collected feedback on 111 kit results, of which two were HIV-positive. Feedback about HIVST results from beneficiaries was low (111/1103) due to noncompliance of beneficiaries and the lack of human and financial resources in the NGOs. From January through May 2020, a total of 625/780 HIVST kits (80.1%) were distributed. This period was divided into pre-COVID-19 and during COVID-19. The follow-up with the beneficiaries during COVID-19 was much improved because of the absence of on-site activities, shifting more efforts towards HIVST (449/625). There have been no reports of social harm related to HIVST. Conclusion HIVST implementation in Lebanon serves as an example of introducing a self-care intervention as part of a community-led effort. In order to maintain HIVST services at the same improved level, reorganization of care is needed within each NGO following the adaptation process due to COVID-19, along with continuous monitoring and evaluation of HIVST reported data.

Drawing on identity process theory from social psychology, this study explores the protective and risk factors of psychological distress and self-harm in a religiously diverse sample of heterosexual and non-heterosexual students at an English-speaking university in Lebanon. A convenience sample of 209 undergraduate students participated in a cross-sectional survey and completed measures of religiosity, identity threat, psychological distress and self-harm. Results indicated that non-heterosexual participants exhibited higher levels of psychological distress, were more likely to report self-harm, and reported lower levels of religiosity than their heterosexual counterparts. The multiple regression analyses showed that religiosity is protective against psychological distress, and that sexual orientation distress predicts self-harm. In order to reduce the risk of psychological distress and self-harm, it will be necessary to challenge stigma towards sexual minorities, to promote engagement with a broader range of social identity categories (other than just religion), and to ensure that individuals of all faiths and sexualities in Lebanon are able to access counselling support if they require it.

Background There are very few studies from the Middle East on HIV knowledge, attitudes, and other sexual health issues among university students. This is particularly true for Lebanon. The present study focuses on factors that predict sexual risk behaviors and sexual health screening behaviors in a sample of university students in Lebanon. Methods A diverse sample of 250 undergraduate students at a university in Beirut, Lebanon participated in a survey study. They completed measures of religiosity, ethnic identification, identity threat, psychological distress, self-harm, contraceptives usage, HIV/STI screening, and sexual risk behaviors. Results Religion is negatively associated with a range of risky sexual behaviors. Psychological distress is associated with having sex under the influence of alcohol and drugs, engaging in a sexual activity later regretted, and feeling forced to engage in a sexual activity that they did not want to engage in. Sex under the influence of alcohol and drugs/substances, discussing methods of contraception, and willingly engaging in sexual activities later regretted had significant effects on the variance of having had condomless vaginal sex in the past month. Gender and sex under the influence of alcohol had significant effects on screening for STIs. Conclusion Religiosity appears to be protective against identity threat and psychological distress and negatively associated with a variety of sexual risk behaviors. Perceived stigma associated with female sexuality can limit STIs screening. Interventions that focus on managing different variables (drug and alcohol use in students, unwanted pregnancy, religion, stigma related to screening, and sexual health education) are recommended.

Background Unlike native gay and bisexual male (GBM), immigrants/refugees GBM have an added vulnerability to poor sexual health due to their stigmatized sexual minority status. The objective of this cross-sectional study was to compare sexual health variables in a sample of native-born and immigrants/refugees GBM in Lebanon. This study also aimed to identify the correlates of sexually transmitted infections (STIs) knowledge. Methods This study was conducted in November 2019 following modified time-location sampling. Instruments included rapid tests for HIV and Hepatitis B and C and a behavioral questionnaire. Results Our results can be grouped into three main levels: education, stigma and risky behavior. Compared with native-born GBM, immigrants/refugees GBM were more likely to report non-university level of education, and lower STIs knowledge. Moreover, they showed more healthcare and employment respective stigma. Hence, more heterosexual marriage, more commercial sex work, more history of syphilis in the last 12 months and a higher mean number of male sex partners in the last 6 months were noted among these communities. Positive correlations were found between STIs knowledge and socioeconomic status; feeling sufficiently informed about STIs. Being immigrants/refugees and feeling sufficiently informed about STIs were strong indicators of STIs knowledge. Conclusion This study highlights the respective roles of education and immigrant/refugee status in STIs knowledge in Lebanon. Efforts to increase general educational opportunities for immigrants/refugees and specifically sexual education would be helpful inherently, and might also support higher STIs knowledge. Moreover, our participants most probably had to conform to cultural and religious norms and get married. This entails a degree of hiding their true identity and causing distress. Both hiding identity and experiencing stigma may push people of sexual minorities to cope in a wide range of ways and one possible strategy might be sexual risk-taking.

Purpose Coronavirus disease 2019 (COVID-19) is an infectious disease that has rapidly spread to most cities in the world since December 2019 causing a rise in global mortality and adverse effects on mental health. This paper aims to examine the potential implications of the pandemic for mental health in societies with economic and political instability, focusing on Lebanon. Design/methodology/approach Previous empirical research into mental health and COVID-19 was examined in relation to the Lebanese context. Findings There is a risk of poor mental health in Lebanon owing to the deleterious effects of military conflict and political instability over several decades. More recently, the country is also experiencing the worst economic crisis in its history with unprecedented rates of unemployment, inflation, poverty, and devaluation of the national currency. It is suggested that the lockdown measures may be depriving the Lebanese people of effective coping strategies, such as group memberships (e.g., religion), social support and community involvement, during the COVID-19 outbreak. This in turn may lead to the deployment of maladaptive coping strategies in the population. Practical implications Mental health services are still in their formative phases in Lebanon and mostly run by civil society organizations. There is an urgent need for a national action plan to respond to the potential mental health burden and use of maladaptive coping strategies which may arise in the aftermath of COVID-19. Originality/value This paper provides a novel analysis of mental health in Lebanese society through the lens of social, political, economic and psychological factors.

Background The coronavirus-2019 (COVID-19) has had compounding effects on the political and economic crisis with severe economic and health consequences. Throughout the lockdown, one of the largest sexually transmitted infections (STIs) and HIV clinics in Beirut with linkages to major civil organizations in direct contact with sexual health beneficiaries has remained open for emergencies. The main objective of this study was to measure COVID19 impact on sexual health services in this clinic in Beirut. Methods A review of electronically based STIs screenings and diagnoses for the period February-December 2020 was conducted. Results The clinic has noted a major reduction in STI testing rates. Only 116 screenings were recorded in the mentioned period which contrasts with the 334 screenings conducted during the same period of 2019 (65% drop in 2020). All the screenings were among men who have sex with men (MSM). On the other hand, PEP was prescribed 86 times in the period February-December 2020 compared to 67 times during the same period of time in 2019 (28% increase). All cases of PEP prescriptions were for MSM. A range of risky behaviors and a 12% prevalence of HIV have been documented in MSM in Lebanon. Conclusion The increase in PEP prescription for MSM indicates that sexual risk-taking has persisted despite potential fear of contracting COVID-19. Two factors could explain our Results (1) social psychological stressors (political and economic instability, huge explosion, COVID19) may threaten identity and wellbeing, leading MSM to resort to sexual risk behaviours;(2) data on epidemiology of STIs in COVID19 time are inconsistent due to the lack of stratification by incubation period, acute versus chronic type, duration of symptoms and sexual orientation. Future studies should ascertain the impact of COVID19 on both mental and sexual health especially in stigmatized communities such as MSM.

Although the prevalence of obesity has rapidly increased in the low‐ and middle‐income countries of the Middle East and North Africa (MENA) and Latin America and the Caribbean (LAC) regions, child undernutrition remains a public‐health challenge. We examined region‐specific sociodemographic determinants of this double burden of malnutrition, specifically, the co‐occurrence of child stunting and overweight, using Demographic and Health Survey and Multiple Indicator Cluster Survey data (2003–2016) from 11 countries in the MENA (n = 118,585) and 13 countries in the LAC (n = 77,824) regions. We used multiple logistic regressions to model region‐specific associations of maternal education and household wealth with child nutritional outcomes (6–59 months). The prevalence of stunting, overweight, and their co‐occurrence was 24%, 10%, and 4.3% in children in the MENA region, respectively, and 19%, 5%, and 0.5% in children in the LAC region, respectively. In both regions, higher maternal education and household wealth were significantly associated with lower odds of stunting and higher odds of overweight. As compared with the poorest wealth quintiles, decreased odds of co‐occurring stunting and overweight were observed among children from the second, third, and fourth wealth quintiles in the LAC region. In the MENA region, this association was only statistically significant for the second wealth quintile. In both regions, double burden was not statistically significantly associated with maternal education. The social patterning of co‐occurring stunting and overweight in children varied across the two regions, indicating potential differences in the underlying aetiology of the double burden across regions and stages of the nutrition transition.

In Lebanese men who have sex with men (MSM), the prevalence of HIV is 12% and the prevalence of having at least one symptom of a sexually transmitted infection (STI) is 34.9%.1 Low HIV testing rates, unprotected unprotected sexual intercourse, alcohol and substance use contribute to this epidemic.2 Here we present data on the prevalence of STIs in a sample of MSM attending a sexual health clinic in order to identify the correlates of risk-taking behaviour, and of testing behaviour in this population. Addressing these questions is crucial for reducing the incidence of HIV/STIs and, thus, for enhancing sexual health outcomes in this high-risk population in Lebanon.

Alcohol, tobacco and other drug use continue to pose serious public health concerns among youth. Bullying victimization has been identified as a risk factor and religiosity a protective factor for adolescent substance use. No previous research has examined the potential moderating role of religiosity. We explore the association between bullying victimization and substance use in adolescents with low and high levels of religiosity. A cross-sectional survey was conducted with a representative sample of high school students in greater Beirut. Binary and multinomial logistic models were used, adjusting for demographics, and stratified by level of religiosity. Of the 986 students responding to the survey, 65% were females; 48% had experienced some form of bullying; and 52% self-rated as low in religiosity. Between 10 and 30% were current users of alcohol or tobacco. Students of lower religiosity levels who had been bullied were more likely to use substances than those who self-rated as high religiosity. Religiosity may be a potential moderator of the association between being bullied and substance use, but the exact mechanisms and underlying reasons need further investigation.

Background In the context of the global nutrition transition, large inequalities in the burden of child undernutrition persist across populations and are often concomitantly reported with increases in rates of overweight in these same communities. We aimed to compare the prevalence of stunting and overweight in Palestinian children younger than 5 years living in Lebanon and the occupied Palestinian territories and to investigate the predictors of undernutrition and overnutrition in these populations. Methods We used maternal and child health data, sociodemographic variables, and anthropometric measurements from the 2010 Multiple Indicator Cluster Surveys (MICS) undertaken among Palestinian refugees living in Lebanon (1922 children) and the occupied Palestinian territories (11 273 children). Z-scores for height-for-age and body-mass index-for-age for children younger than 5 years were based on WHO's child growth standards. Prevalence of stunting, overweight, and double burden (ie, children with stunted growth and overweight) was estimated. Logistic regression adjusted for survey design was used to model predictors of stunting, overweight, and double burden (STATA version 13). Findings Prevalence of stunting, overweight, and double burden were all higher in Lebanon than in the occupied Palestinian territories (for stunting, 10·9% vs 10·1%, p Interpretation Stunting of growth was a predictor for being overweight in Palestinian children younger than 5 years, with boys at a higher risk than girls. Susceptibility to child malnutrition varied most by region of residence, highlighting the role of structural factors. Nutritional interventions aimed at addressing the common structural determinants of stunting and overweight should be targeted to these subpopulations. Funding Faculty of Health Sciences, American University of Beirut.