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Summary: Sleep quality is essential to biopsychosocial functioning, yet there remains limited longitudinal research on sleep and mental or social well‐being within low‐ or middle‐income countries. This study utilised longitudinal cohort data from a community‐based empowerment programme in Meru County, Kenya to assess cross‐lagged correlations between sleep disturbance, social support, symptoms of depression, anxiety, and posttraumatic stress. Participants (n = 373; 92% women; age range 18–86 years) who reported more sleep disturbance at T1 reported significantly more symptoms of depression, anxiety, and PTSD, and significantly less social support at T2 (average 11 weeks later), controlling for all within‐time correlations across measures, within‐measure correlations across time, and sociodemographic background characteristics. The findings are consistent with research across high‐income countries, underscoring the need for more contextualised research into sleep behaviours across low‐ and middle‐income countries. The findings may inform interventions to increase mental and social well‐being within Kenya. [ABSTRACT FROM AUTHOR]

Background: Anal cancer disproportionately affects sexual and gender minority individuals living with HIV. High-resolution anoscopy (HRA) is an in-clinic procedure to detect precancerous anal lesions and cancer, yet prospective data on factors associated with HRA attendance are lacking. We examined whether anal HPV sampling at home versus in a clinic impacts HRA uptake and assessed HRA acceptability. Methods: Sexual and gender minority individuals were randomised to home-based self-sampling or clinical sampling. All were asked to attend in-clinic HRA 1 year later. We regressed HRA attendance on study arm using multivariable Poisson regression and assessed HRA acceptability using χ 2 tests. Results: A total of 62.8% of 196 participants who engaged in screening attended HRA. Although not significant (P = 0.13), a higher proportion of participants who engaged in clinic-based screening attended HRA (68.5%) compared to home-based participants (57.9%). Overall, HRA uptake was higher among participants with anal cytology history (aRR 1.40, 95% CI 1.07–1.82), and lower among participants preferring a versatile anal sex position versus insertive (aRR 0.70, 95% CI 0.53–0.91), but did not differ by race or HIV serostatus. In the clinic arm, persons living with HIV had lower HRA attendance (42.9%) versus HIV-negative participants (73.3%) (P = 0.02) and Black non-Hispanic participants had lower HRA attendance (41.7%) than White non-Hispanic participants (73.1%), (P = 0.04). No differences in attendance by race or HIV status were observed in the home arm. Conclusions: HRA uptake differed significantly by race and HIV status in the clinic arm but not the home arm. Anal cancer disproportionately affects men who have sex with men living with HIV. We examined whether anal HPV sampling at home versus in a clinic impacts uptake of high-resolution anoscopy (HRA), an in-clinic procedure. Anal cytology history and insertive anal sex position were associated with higher HRA uptake, and attendance differed by race and HIV status in the clinic arm. Given that people living with HIV and Black men who have sex with men are disproportionately affected by anal cancer, interventions are needed to support their clinic attendance. [ABSTRACT FROM AUTHOR]

Because housing is central to the recovery of individuals with experiences of homelessness and incarceration, it is important to consider how U.S. policies denying housing to residents with criminal histories can adversely affect racial and ethnic minorities and individuals with a history of homelessness. The state of Texas passed a rule specifying certain criteria that Low-Income Housing Tax Credit (LIHTC) supportive housing providers must use to screen tenants using criminal history. A retrospective cohort of 600 LIHTC supportive housing residents was used to estimate the potential impact of the rule. Based on this sample, the rule would have resulted in significantly higher proportions of Black and chronically homeless individuals being denied housing compared to the proportions of White and low-income individuals, respectively, who would have been denied housing. With the exception of drug convictions, there was no significant difference in recidivism between residents who would have been affected by the rule and unaffected residents who also had criminal justice involvement within a comparable time frame before move-in. [ABSTRACT FROM AUTHOR]

This study examined spending behaviors of U.S. tenants who reported delaying rent payments during federal eviction moratoria in 2020-2021, enacted in response to the Coronavirus Disease-2019 (COVID-19) pandemic. A national sample of 772 middle and low-income tenants who reported delaying rent payments because of the eviction moratoria were assessed from May 2020 to October 2020. Among tenants who delayed paying rent, most rent money was spent on groceries (11-19%), utilities (9-14%), substance use (8-10%), and debt (7%) across two time periods; the remaining rent money was spent on other expenses including recreation and medical care. Sociodemographic and psychiatric characteristics together only explained 2-3% of the variance in spending in major expense categories suggesting the broad impact of the COVID-19 pandemic. Together, these findings provide insight into spending behaviors of tenants during a time of great financial and psychological distress. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study evaluated a collaborative service model between the largest Medicaid managed care organization (MCO) in Texas, Superior HealthPlan, and the affordable housing provider Prospera Housing CommunityServices. STUDY DESIGN: Using a quasi-experimental 2-groups research design, we compared health care outcomes and costs between a sample of 104 participants served by the Prospera+Superior collaborative model and a group of 104 participants who had health care coverage through the Superior HealthPlan Medicaid MCO but did not live atProspera properties (ie, Superior-only group). METHODS: Data from medical claims were analyzed to examine change in outcomes 12 months before and after implementation of the Prospera+Superior collaborative model in 2019. RESULTS: The Prospera+Superior group had a 56% lower rate of emergency department/urgent care visits and spent $2061 less in prescription costs than the Superior-only group after implementation. CONCLUSIONS: These findings provide needed evidence of the clinical and economic value of forming multisector collaborative models between MCOs and other communityproviders. [ABSTRACT FROM AUTHOR]

Background: While self-sampling could help address anal cancer screening barriers, no studies have investigated annual engagement with this method or compared it to annual screening with a provider. Building on our baseline paper,(7) we compared annual anal screening engagement between home-based self-sampling and clinic-based clinician sampling., Methods: The Prevent Anal Cancer Self-Swab Study recruited and randomized sexual and gender minority individuals 25 years and over who have sex with men to a home or clinic arm. Home-based participants were mailed an anal human papillomavirus self-sampling kit at baseline and 12 months, while clinic-based participants were asked to schedule and attend one of five participating clinics at baseline and 12 months. Using Poisson regression, we conducted an intention-to-treat analysis of 240 randomized participants who were invited to screen at both timepoints., Results: 58.8% of participants completed annual (median = 370 days) anal screening. In the home arm, 65.0% of participants engaged in annual screening compared to 52.5% of clinic-based participants (p = 0.049). When stratified by HIV status, persons living with HIV had a higher proportion of home (71.1%) versus clinic (22.2%) annual screening (p < 0.001). Non-Hispanic Black participants participated more in home-based annual anal screening(73.1%) than annual clinic screening(31.6%) (p = 0.01). Overall, annual screening engagement was significantly higher among participants who had heard of anal cancer from an LGBTQ organization, reported "some" prior anal cancer knowledge, preferred an insertive anal sex position, and reported any prior cancer diagnosis., Conclusions: Annual screening engagement among those at disproportionate anal cancer risk was higher in the home arm., Competing Interests: Conflicts of Interest: The authors declare no conflicts of interest., (Copyright © 2024 American Sexually Transmitted Diseases Association. All rights reserved.)

Marginalized communities have been disproportionately affected by COVID-19, including both racial/ethnic minority and sexual minority populations. To date, there has been little research examining the impact of the COVID-19 pandemic at the intersections of marginalized identities. Furthermore, available national data on COVID-19 outcomes may obscure our understanding of region-specific outcomes, particularly in the U.S. South. Using an intersectional approach, we explore differences in worries over COVID-19, preventative behaviors, and COVID-19 outcomes in the early months of the pandemic in a diverse sample of LGBTQ people ( N  = 1076) living in Texas. Our findings indicated that LGBTQ Latinx people in Texas reported more COVID-19 related worries and adverse outcomes than non-Latinx LGBTQ people. These findings are in line with previous research that found that the increased risk to Latinx and LGBTQ populations in public health crises is often overlooked and can be attributed to many factors such as socioeconomic status, occupational propensity, disparities in physical health, and barriers to healthcare access. Furthermore, our findings suggest the necessity of utilizing an intersectional approach when examining the disproportionate burden marginalized communities face in public health crises.