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Introduction: Sexual minorities may experience sexual orientation-based discrimination in healthcare settings, and recent literature has aimed to explore this phenomenon. However, the findings of related literature and their implications have never been reviewed. Methods: A scoping review was conducted to identify the breadth of this literature, summarize findings, and appraise the tools being used to study perceived discrimination in healthcare. PubMed and Web of Science databases were searched for relevant literature published between 1992 and 2022. After duplicates were removed, the search yielded 3,467 results. After removing articles that did not meet inclusion criteria, fifty-eight papers remained and were assessed via full-text review for eligibility. Ultimately, twenty studies were determined to meet study criteria and were included in the present review. Results: Articles published on sexual orientation-based perceived discrimination in US healthcare settings are fairly limited and vary in approach. Measures being used vary widely across studies and generally lack psychometric grounding; common issues include using single-item measures, adapting existing measures without validating them for use in sexual minority samples, and using measures that are not based in underlying theory or informed by existing research. Perceived discrimination in healthcare was inversely associated with some healthcare utilization behaviors. Conclusions: Future research should use psychometrically evaluated instruments for studying perceived discrimination in healthcare due to sexual orientation. Policy Implications: Culturally competent policies that promote equitable care for sexual minorities are crucial for reducing discrimination in healthcare. [ABSTRACT FROM AUTHOR]

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Expanding PrEP access necessitates training that supports healthcare providers' progression along the PrEP implementation cascade, moving from PrEP awareness to prescription. We surveyed 359 USA providers about PrEP training content and format recommendations. We examined the association between cascade location and training recommendations. Most providers were aware of PrEP (100%), willing to prescribe PrEP (97.2%), had discussed PrEP with patients (92.2%), and had prescribed PrEP (79.9%). Latent class regression analysis revealed that cascade location was associated with training recommendations. Although all providers recommended PrEP-specific content (e.g., patient eligibility), providers who were located further along the cascade also recommended more comprehensive content, including sexual history-taking and sexual and gender minority competence training. Providers further along the cascade were also more likely to recommend interactive training formats (e.g., role-playing). These insights from providers furthest along the cascade indicate the importance of including comprehensive content and interactive formats in future PrEP training initiatives. [ABSTRACT FROM AUTHOR]

Despite being grouped together in epidemiological risk categories, gay, bisexual, and other men who have sex with men (GBM) are not a homogenous group. In addition to traditional segmentation along race, ethnicity, and socioeconomic status, many GBM also identify with sexual subcultural communities. Previous research has shown differences across a variety of health outcomes between these sexual subcultural communities. The purpose of this study was to determine whether HIV prevention practices among GBM differed according to sexual subcultural community. The study was conducted in collaboration with a popular social and sexual networking smartphone application company. A total of 23,577 GBM responded to the survey. A latent class analysis identified 6 distinct classes related to sexual subcultural community identification. We found significant differences across sociodemographic characteristics, HIV prevention practices, and condomless anal sex in the past 6 months related to sexual subculture identification. Findings suggest that sexual subcultural identity is related to decision-making around HIV prevention among GBM. Differences in HIV prevention strategies are likely a function of group norms, unique shared experiences among GBM identifying with a particular sexual subculture community, and sociodemographic characteristics associated with these groups. As such, sexual subculture identity should be considered in developing interventions and social marketing campaigns to increase uptake of biomedical HIV prevention tools among GBM. Identifying group norms and shared experiences related to HIV prevention practices among sexual subcultures is necessary to understand the role these identities play in lives of GBM, especially as it relates to their sexual health and well-being. [ABSTRACT FROM AUTHOR]

Research has focused on adolescents' feelings about their first sexual experiences, but little research has examined this topic in sexual minority adolescents. In this study, we examined how experiencing emotional and physical satisfaction at first same-sex anal sex differed by age of first sex for young gay and bisexual men. We applied the time-varying effect model to data from an Internet survey of men who initiated first sex between ages 14–26 (n = 6401) to examine emotional and physical satisfaction at first same-sex anal sex across continuous age of onset and by partner factors. The majority of men reported satisfaction across all ages; however, satisfaction was generally less likely for men who had first anal sex with a non-relationship partner, an older partner, or a partner they had sex with only once and this was particularly true at earlier ages. Findings suggest that many young gay and bisexual men report satisfaction with their first anal sex and that relationship context can be important in predicting satisfaction, particularly at younger ages. [ABSTRACT FROM AUTHOR]

This research investigates the sexuality of trans women (individuals who were assigned male status at birth who currently identify as women), by focusing on the "bodily techniques" (Crossley, 2006) they use in "doing" sexuality. The "doing sexuality" framework not only is modeled after the "doing gender" approach of West and Zimmerman (1987), but also utilizes the idea of "sexual embodiment" to emphasize the agency of trans women as they conceptualize and organize their sexuality in a socially recognized way. This is often difficult as they confront discrimination from medical and legal professionals as well as intimate partners who may find it difficult to adapt to the trans woman's atypical body and conception of gender. However, with a study group of 25 trans women from San Francisco, we found the study participants to be adept at overcoming such hurdles and developing techniques to "do" their sexuality. At the same time, we found trans women's agency constrained by the erotic habitus (Green, 2008) of the wider society. The interplay between innovation and cultural tradition provides an opportunity to fashion a more general model of "doing" sexuality. [ABSTRACT FROM AUTHOR]

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Men who have sex with men (MSM) are disproportionally affected by HIV. Although some theoretical models created to explain why individuals engage in risky sexual behavior contain an affective component, there has been relatively little focus on the influence of affect on sexual risk-taking. The goal of this study is to investigate the association between affect and condom use among MSM using an archival dataset from a survey of users of a popular sex-oriented website. Multilevel modeling was used to analyze daily diary data from 2871 MSM. At the within-person level, positive affect was positively related to condomless anal sex (CAS), whereas negative affect was negatively related to CAS. However, these results were qualified by interactions of trait affect and relationship to sex partner. These findings suggest that interventions focused on emotional regulation may have the potential to reduce CAS among MSM. [ABSTRACT FROM AUTHOR]

Black men have historically been stereotyped as hedonistic, aggressive, and animalistic in their sexual interactions. This study sought to describe pleasure, affection, and love experienced by Black men who have sex with men (MSM) during their last male-partnered sexual event and to examine differences relative to White, Latino, and Asian MSM. A total of 21,696 (793 Black, 18,905 White, 1,451 Latino, and 547 Asian) U.S. men ages 18-87 ( M = 39) were recruited from social/sexual networking sites targeting MSM in 2010-2011. Participants reported multiple dimensions of sexual experience (pleasure, affection, and love) occurring at their last male-partnered sexual event, partner relationship, and sociodemographic characteristics. Across relationship categories, a sizeable percentage of Black MSM reported pleasure (72-87 % orgasmed, 57-82 % experienced high subjective pleasure) and affection (70-91 % kissed, 47-90 % cuddled). Love was primarily reported for events involving main partners (felt love for partner: 96 %; felt loved by partner: 97 %; verbalized love to partner: 89 %). Latent class analysis with MSM of all races, adjusting for partner relationship and sociodemographic characteristics, revealed three distinct profiles of sexual experience: affection and love (Class 1); affection in the absence of love (Class 2); and neither affection nor love (Class 3). Pleasure was probable across profiles. Some racial differences in profile probability were present, but no overall pattern emerged. Contrary to Black male stereotypes, Black MSM commonly reported pleasure, affection, and love at their last male-partnered sexual event and did not show a meaningful pattern of difference from other-race MSM in their likelihood of experiencing all three. [ABSTRACT FROM AUTHOR]

The HIV epidemic in Latin America is highly concentrated in men who have sex with men (MSM). In the United States, multiple co-occurring psychosocial conditions have been shown to act as intertwined epidemics to potentiate HIV transmission among MSM. To date, no study has examined the role of syndemics and condomless sex among MSM in Latin America. In 2012, an online survey was conducted among members of the largest social/sexual networking website for MSM in Latin America. Participants were asked about demographics, sexual behaviors, HIV/STI diagnoses, and psychosocial well-being, including depression, suicidal ideation, hazardous alcohol use, hard drug use during sex, history of childhood/adolescent sexual abuse, intimate partner violence, and sexual compulsivity. Multivariable logistic generalized estimation equations were used to assess the relationship of syndemic factors and (1) engagement in higher risk condomless anal sex and (2) self-report of prior HIV diagnosis. Among 24,274 survey respondents, 74.6 % of the sample had at least one syndemic factor. In an additive model, syndemics were associated with increased odds of higher risk condomless anal sex, ranging from adjusted odds ratio of 1.31 (95 % CI 1.20, 1.43) for one syndemic factor to 4.06 (95 % CI 3.25, 5.09) for 6/7 syndemic factors. Similarly, syndemics were associated with increased odds of HIV infection ( p < .0001). This study provides initial evidence that intertwined syndemics increase HIV risk behavior and HIV infection among MSM in Latin America. In the Latin American context, comprehensive HIV prevention interventions for MSM should be developed and tested that simultaneously address co-occurring psychosocial conditions and HIV risk. [ABSTRACT FROM AUTHOR]

Few comparative data are available internationally to examine health differences by transgender identity. A barrier to monitoring the health and well-being of transgender people is the lack of inclusion of measures to assess natal sex/gender identity status in surveys. Data were from a cross-sectional anonymous online survey of members (n > 36,000) of a sexual networking website targeting men who have sex with men in Spanish- and Portuguese-speaking countries/territories in Latin America/the Caribbean, Portugal, and Spain. Natal sex/gender identity status was assessed using a two-step method (Step 1: assigned birth sex, Step 2: current gender identity). Male-to-female (MTF) and female-to-male (FTM) participants were compared to non-transgender males in age-adjusted regression models on socioeconomic status (SES) (education, income, sex work), masculine gender conformity, psychological health and well-being (lifetime suicidality, past-week depressive distress, positive self-worth, general self-rated health, gender related stressors), and sexual health (HIV-infection, past-year STIs, past-3 month unprotected anal or vaginal sex). The two-step method identified 190 transgender participants (0.54 %; 158 MTF, 32 FTM). Of the 12 health-related variables, six showed significant differences between the three groups: SES, masculine gender conformity, lifetime suicidality, depressive distress, positive self-worth, and past-year genital herpes. A two-step approach is recommended for health surveillance efforts to assess natal sex/gender identity status. Cognitive testing to formally validate assigned birth sex and current gender identity survey items in Spanish and Portuguese is encouraged. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Men who have sex with men (MSM) continue to be disproportionately impacted by STIs and HIV. In addition to traditional risk factors, increasing attention has been given to the potential role of affective components of a sexual encounter, including mood state. To date, no study has described sexual behaviors engaged in by those who report being in love (or not) during a given sexual event. Internet-based survey data were collected from 24,787 gay and bisexual men who were members of online websites facilitating social or sexual interactions with other men. Measures included sociodemographics, recent sexual behavior history, sexual event characteristics, and perceptions of 'love' with men's most recent male sexual partner. Participants' mean age was 39.2 years; ethnicities included white (84.6 %), Latino (6.4 %), and African American (3.6 %). Nearly all men (91 %) were matched by presence (I love him/he loves me), absence (I don't love him/he doesn't love me), or uncertainty (I don't know if I do/I don't know if he does) of love with their most recent sexual partner. Men who reported love for their partner and believed their partner loved them were significantly more likely to have engaged in behaviors, such as cuddling and kissing on the mouth. Differences were also seen in regard to love and men's reports of anal intercourse and oral sex. Findings highlight differences in sexual behaviors based on perceptions of love and suggest the need to further explore how these differences influence sexual health. [ABSTRACT FROM AUTHOR]

Recent studies have documented that vibrators are an important part of the sexual repertoires of both men and women and have demonstrated positive sexual health outcomes among individuals who use such products. However, little is known about the use of other sexual enhancement products, particularly among gay and bisexually identified men. This study sought to document the extent to which gay and bisexually identified men report using sex toys and the sexual and relational situations within which they used them. Data were collected via an internet-based survey from 25,294 gay and bisexually identified men throughout the U.S. recruited from an Internet site popular among men seeking social or sexual interactions with other men. A majority (78.5%) of gay and bisexually identified men reported having used at least one type of sex toy, including dildos (62.1%), non-vibrating cock rings (51.9%), vibrators (49.6%), butt plugs (34.0%), masturbation sleeves (27.9%), and anal beads or balls (19.3%). Among users, toys such as dildos or butt plugs were commonly inserted into one's own anus during masturbation (95.7%, n = 11,781) and insertion into their partners anus (72.0% n = 4,197) during partnered sexual activities. These data suggest that sex toy use is common among gay and bisexual men during both solo and partnered sexual activities and considered by these men as enhancing the quality of their sexual experiences. [ABSTRACT FROM AUTHOR]

Little is known about men's potential motivations and barriers associated with specific sexually transmitted infections (STI) testing methods. In this study, we examined experiences of self-sampling for ano-rectal STI among men who have sex with men (MSM) in a midwestern community in the U.S. A total of 75 MSM were recruited from community venues throughout Indianapolis, Indiana. Participants completed semi-structured interviews, were asked to obtain ano-rectal self-sample in a private restroom, and were asked open-ended questions about their experiences with ano-rectal self-sampling for STI. Participants included 35 White, 27 Black, and 13 Latino MSM who ranged in age from 18 to 57 years. Regardless of sexual practices, most participants who obtained an ano-rectal self-sample (68/75) reported that the sampling procedure was relatively painless and physically easy. However, regardless of previous receptive anal sex, participants also expressed concerns about the nature of the test (i.e., inserting something into their rectum), which required increased levels of privacy and cleanliness compared to collection of urine samples. Self-sampling proved to be a feasible and acceptable method of collecting ano-rectal STI specimens among MSM. Increased testing for ano-rectal STI among MSM may require addressing the location of sampling and testing sites, existing negative perceptions of ano-rectal self-sampling, and the measures in place to promote privacy and cleanliness. [ABSTRACT FROM AUTHOR]

The article discusses the Internet as a valuable tool for promoting a new framework for sexual health among gay men and other men who have sex with men (MSM). The fundamental elements involved in a sexual health framework that promotes the overall well-being of MSM while reducing human immunodeficiency virus (HIV) incidence are described, including an assets-based approach to research and programs that focus on resilience in the individual and the community. The need for collaborative partnerships to reach MSM who frequent the Internet is discussed.

A correction to the article "Trans Women Doing Sex in San Francisco" which was published online on June 17, 2016 is presented.

Despite health inequities, many Black sexual minority men are resilient and often utilize spirituality as a culturally distinct self-protective and self-enhancing resource to maintain their health. However, little is known about how spirituality impacts health within a cultural framework that is specific to Black sexual minority men. We conducted 10 individual in-depth interviews, reaching code saturation, with Black sexual minority men across the USA. Our study was guided by grounded theory and a Black psychology theoretical framework. Seven themes were discovered and revealed that participants' level of spiritual consciousness influenced their engagement in psychological and behavioral processes that were related to mental and physical health. These themes were: (a) suboptimal worldview, (b) emotional revelation, (c) emotional emancipation, (d) emotional regulation, (e) health motivations, (f) health behaviors, and (g) links between spiritual consciousness, mental health, and physical health. Implications of these findings for clinicians and researchers are discussed. [ABSTRACT FROM AUTHOR]

Purpose of Review: The purpose of this review is to update what is known about sexual orientation and gender identity development, including factors that facilitate positive development, and healthcare experiences of sexual and gender minority youth (SGMY) in relation to their identity. Recent Findings: Models of identity development have been proposed that draw on the experiences of young people and their families rather than adult models of identity development. Family support can both help and hinder identity development, and healthcare providers are in a unique position to intervene. However, SGMY and their families experience significant barriers to accessing appropriate and affirming healthcare. Summary: Key improvements in provider knowledge, healthcare systems, quality of care, and support for SGMY and their families are needed. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the hypothesis that non-steroidal anti-inflammatory drugs (NSAIDs) lower lung cancer risk.Methods: We analysed pooled individual-level data from seven case-control and one cohort study in the International Lung Cancer Consortium (ILCCO). Relative risks for lung cancer associated with self-reported history of aspirin and other NSAID use were estimated within individual studies using logistic regression or proportional hazards models, adjusted for packyears of smoking, age, calendar period, ethnicity and education and were combined using random effects meta-analysis.Results: A total of 4,309 lung cancer cases (mean age at diagnosis 65 years, 45% adenocarcinoma and 22% squamous-cell carcinoma) and 58,301 non-cases/controls were included. Amongst controls, 34% had used NSAIDs in the past (81% of them used aspirin). After adjustment for negative confounding by smoking, ever-NSAID use (affirmative answer to the study-specific question on NSAID use) was associated with a 26% reduction (95% confidence interval 8 to 41%) in lung cancer risk in men, but not in women (3% increase (-11% to 30%)). In men, the association was stronger in current and former smokers, and for squamous-cell carcinoma than for adenocarcinomas, but there was no trend with duration of use. No differences were found in the effects on lung cancer risk of aspirin and non-aspirin NSAIDs.Conclusions: Evidence from ILCCO suggests that NSAID use in men confers a modest protection for lung cancer, especially amongst ever-smokers. Additional investigation is needed regarding the possible effects of age, duration, dose and type of NSAID and whether effect modification by smoking status or sex exists. [ABSTRACT FROM AUTHOR]