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This study, using scenarios, examined the impact of two kinds of cause-related marketing (CRM) efforts (a traditional donation of a portion of sales to a related cause and a more strategic one-for-...

The purpose of this study was to compare psychological well-being among transgender women, transgender men, genderqueer/nonbinary individuals, and their cisgender sexual minority counterparts. A total of 2,932 gender and sexual minority individuals participated in the online study. While controlling for age, race/ethnicity, employment status, education, and relationship status, there was significant variation between gender minority subgroups in depression (p < 0.001); anxiety (p = 0.003); stress (p = 0.004); perceived social support (p < 0.001); self-esteem (p = 0.031); self-perceived need for mental health care (p < 0.001); family history of mental illness (p = 0.003); personal history of mental health concerns (p = 0.003); and being in recovery (p = 0.004). Overall, transgender women had the poorest psychological well-being across the majority of variables. In contrast to their transgender peers, genderqueer/nonbinary–identified individuals did not significantly differ from their cisgender sexu...

The use of addictive substances by adolescents is a major public health concern; however, rural vs. urban variations are poorly understood. The purpose of the current study was to examine rural-urban differences in the prevalence of recent use of 11 substances in grades 6–12 in a statewide sample of students from the Georgia Student Health Survey II (n = 513,909). We found that rural-urban differences in substance use depend largely upon grade level, with rural middle school students demonstrating higher rates of alcohol, smoking tobacco, and chewing tobacco use, and urban high school students demonstrating higher rates of illicit drugs.

The purpose of this study was to compare rates of elevated levels of depression, anxiety, and stress among six different lesbian, gay, bisexual, and transgender (LGBT) subgroups (cisgender lesbians, cisgender gay males, cisgender bisexual females, cisgender bisexual males, transgender females, and transgender males). A total of 2,702 LGBT-identified individuals participated in the online study. While controlling for other demographic factors, rates of elevated levels of depression (p < 0.001), anxiety (p = 0.015), and stress (p < 0.001) all varied significantly between LGBT subgroups. Post-hoc examinations of pairwise differences revealed substantial and unexpected variations, highlighting the importance of separately examining LGBT subgroups when considering mental health outcomes.

The purpose of the current study was to examine rural lesbians’ experiences of psychological distress and barriers to mental healthcare compared with their nonrural counterparts. A geographically diverse sample of 716 lesbians from across the United States participated in an online study. Results revealed that compared with their nonrural counterparts, rural lesbians experience higher levels of psychological distress. In addition, after controlling for age, race, and education level, rural lesbians were also more likely to report the following barriers to needed mental healthcare: (1) a lack of coverage/financial limitations, (2) a limited availability of providers in their area, and (3) avoidance of care due to fears of discrimination/unfair treatment by a provider. Rural lesbians appear to face greater mental health related vulnerabilities. Implications for research and clinical practice are discussed.

Current recruitment strategies to reach lesbian, gay, bisexual, and transgender (LGBT) groups typically yield highly localized, mostly urban samples. Online recruitment strategies hold much promise for engaging rural and other underrepresented LGBT individuals in health research, but little research has been conducted examining the relative strengths of differing online recruitment methods. The purpose of the current study was to explore the effectiveness of both email and Craigslist recruitment to access rural sexual and gender minorities, and to examine if individuals across modalities differ significantly from each other with regards to demographic and psychosocial characteristics. Participants for the study were recruited through two sequentially implemented online convenience sampling recruitment methods: listserv based and Craigslist based. Participants completed an online battery assessing demographic characteristics, disclosure of sexual orientation/gender identity, health behaviors, and various psychosocial characteristics. A total of 3279 LGBT-identified individuals were recruited, 980 through Listservs and 2299 through Craigslist. Participants came from all 50 US states and nearly 30 % reported living in a rural area. When comparing the Listserv and Craigslist recruits, the groups differed on nearly every demographic and psychosocial characteristic assessed, ranging from racial/ethnic diversity to levels of psychological distress. Online recruitment strategies are feasible for accessing both rural and urban LGBT populations, and are highly effective at doing so. These strategies yield samples with remarkable diversity geographically, demographically, and psychosocially. In addition, similar to comparisons between in-person and online recruitment, samples recruited through different online methods significantly differ from each other in demographic and psychosocial characteristics.

The bisexual community may face unique barriers to health care that affect mental health outcomes; however, previous research has not specifically compared bisexual and gay men and women on these factors. This study explored differences between bisexual and gay men and women in barriers to care and psychological distress among a sample of 2,500 bisexual and gay men and women recruited online. Bisexual men and women were more likely to report barriers to care ranging from limited availability of providers to less comfort discussing their sexual orientation with their provider. Differences in specific mental health outcomes centered on sexual orientation, but not gender. Bisexual women reported the highest levels of depression, stress, and anxiety, and bisexual men reported higher levels of anxiety than gay men and gay women. Findings suggest that the sociocultural pressures affecting barriers to care and psychological distress may be disproportionately affecting bisexual individuals, even more so than prev...

Optimal management of HIV disease requires high levels of lifelong adherence once a patient initiates highly active antiretroviral therapy (HAART). Because suboptimal adherence to HAART is associated with adverse consequences, many providers are hesitant to prescribe HAART for patients whom they perceive as not being ready to initiate treatment. Accurately predicting HIV treatment readiness is challenging. Despite the importance of this construct, few reliable and valid instruments to assess HIV treatment readiness have been developed; none of these have been validated with adolescents and young adults, who comprise an increasing proportion of new HIV cases diagnosed. As a first step to achieve this goal, we developed the HIV Treatment-Readiness Measure (HTRM) for administration by way of audio computer-assisted self-interview (ACASI) and conducted a study to examine its internal consistency, test-retest reliability, acceptability, and preliminary factor structure. We recruited 201 adolescents and young adults living with HIV from 15 adolescent medicine clinics that were part of the Adolescent Trials Network for HIV Interventions. Youth completed the initial assessment and two weeks later the retest assessment. The refined HTRM had high internal consistency (α = 0.84). Test-retest reliability using both sum scores and mean scores were high. The HTRM was also highly acceptable and feasible to use in routine clinical practice. In exploratory factor analysis we found that a five-factor solution was the best fit; each of the subscales (Disclosure, Psychosocial Issues, Connection with Care, HIV Medication Beliefs, and Alcohol and Drugs) had good to acceptable alphas and eigenvalues greater than 2.0. Our findings support conducting a future study to examine the tool's predictive validity.

Despite continued high HIV risk among Hispanic men who have sex with men (HMSM), culturally tailored, theoretically based interventions have yet to be developed and tested. As a first step toward intervention development, we collected quantitative and qualitative data on sociocultural and psychological factors associated with drug use and risky sex among 566 HMSM recruited from community and Internet venues. Participants reported high rates of drug use (43%), unprotected anal sex (45%), and multiple sex partners (median 4) in the past 6 months. In multivariate analyses, use of drugs was associated with HIV seropositivity, less orientation to the Hispanic community, stronger attachment to the gay community, lower levels of homophobia, higher numbers of sex partners and more unprotected anal sex. The need for acceptance and desire to please partners emerged as core drivers of HIV risk in the qualitative data. Findings were used to guide development of Proyecto SOL, a theoretically grounded intervention that targets core determinants of HIV risk, builds on protective cultural influences, and strengthens positive social connections.

OBJECTIVE: The goal of this study is to describe the sexual practices, drug use behaviors, psychosocial factors, and predictors of unprotected anal intercourse (UAI) in a sample of Hispanic men who have sex with men (MSM) born in Latin American and Caribbean (LAC) countries who currently reside in Miami-Dade County, Florida. METHODS: Hispanic MSM (N = 566) recruited from community and Internet venues completed a computer-assisted self-interview assessing sociodemographic factors, drug use, sexual behaviors, and psychosocial factors. We focused on the 470 men who were born in LAC countries, including Puerto Rico. We first examined separately, by country of origin, the sexual practices, drug use behaviors, and psychosocial factors of the sample. We then collapsed the groups and examined the factors associated with UAI in the previous 6 months for the entire sample of Hispanic MSM from LAC countries. RESULTS: In the previous 6 months, 44% of the sample engaged in UAI, and 41% used club drugs. At the multivariate level, psychological distress, higher number of sexual partners, club drug use, HIV-positive status at the time of immigration, and greater orientation to American culture were significantly associated with UAI in the previous 6 months. CONCLUSIONS: Many MSM born in LAC countries engage in HIV-related risk behaviors in the AIDS epicenter of Miami-Dade County, Florida. Culturally appropriate interventions should address these risk behaviors in this underserved population.

OBJECTIVE: The goal of this study is to describe the sexual practices, drug use behaviors, psychosocial factors, and predictors of unprotected anal intercourse (UAI) in a sample of Hispanic men who have sex with men (MSM) born in Latin American and Caribbean (LAC) countries who currently reside in Miami-Dade County, Florida. METHODS: Hispanic MSM (N = 566) recruited from community and Internet venues completed a computer-assisted self-interview assessing sociodemographic factors, drug use, sexual behaviors, and psychosocial factors. We focused on the 470 men who were born in LAC countries, including Puerto Rico. We first examined separately, by country of origin, the sexual practices, drug use behaviors, and psychosocial factors of the sample. We then collapsed the groups and examined the factors associated with UAI in the previous 6 months for the entire sample of Hispanic MSM from LAC countries. RESULTS: In the previous 6 months, 44% of the sample engaged in UAI, and 41% used club drugs. At the multivariate level, psychological distress, higher number of sexual partners, club drug use, HIV-positive status at the time of immigration, and greater orientation to American culture were significantly associated with UAI in the previous 6 months. CONCLUSIONS: Many MSM born in LAC countries engage in HIV-related risk behaviors in the AIDS epicenter of Miami-Dade County, Florida. Culturally appropriate interventions should address these risk behaviors in this underserved population.OBJETIVO: Describir las prácticas sexuales, el consumo de drogas y los factores psicosociales y de predicción del coito anal sin protección (CASP), en una muestra de hombres nacidos en América Latina y el Caribe (ALC) residentes actualmente en el Condado de Miami-Dade, Florida, que tienen sexo con hombres. MÉTODOS: En total, 566 hispanos que tienen sexo con hombres (HSH), captados en la comunidad y sitios de Internet, completaron una encuesta autoaplicada por computadora que abordaba los factores socioeconómicos, el consumo de drogas, el comportamiento sexual y los factores psicológicos. El estudio se centró en 470 hombres nacidos en ALC, incluido Puerto Rico. La muestra se analizó por país de origen, prácticas sexuales, consumo de drogas y factores psicológicos. Luego se unieron los grupos y se analizaron los factores asociados con el CASP en los 6 meses previos en toda la muestra. RESULTADOS: En los 6 meses previos, 44% de la muestra tuvo CASP y 41% consumió drogas de las llamadas recreativas. Según el análisis multifactorial, los factores asociados significativamente con el CASP en los 6 meses previos fueron: los problemas psicológicos, el mayor número de parejas sexuales, el consumo de drogas recreacionales, la positividad al VIH en el momento en que inmigró y el mayor grado de orientación hacia la cultura estadounidense. CONCLUSIONES: Muchos HSH nacidos en ALC incurren en comportamientos de riesgo de infección por el VIH en el epicentro de sida del Condado de Miami-Dade, Florida. Se deben aplicar intervenciones culturalmente apropiadas para combatir estos comportamientos de riesgo en la población marginada estudiada.

Objectives To determine whether use of crystal methamphetamine increases HIV risk behaviors beyond the risk associated with use of other recreational drugs among Hispanic men who have sex with men (HMSM). Design We compared the sexual behaviors and psychosocial characteristics of non-recreational drug users (non-users), recreational drug users who did not use crystal (non-crystal drug users), and recreational drug users who used crystal (crystal users). Methods We recruited 294 HMSM from Internet and 272 from community venues. Eligible men completed an ACASI to assess socio-demographic factors, drug use, sexual behaviors and psychosocial factors and received $50. Results In the multivariate model, crystal users were more likely than non-crystal drug users to have lower Hispanicism, higher attachment to the gay community, and history of suicide attempts. Crystal users were not significantly different from non-crystal drug users in number of sex partners; however, differences in unprotected receptive anal sex approached significance. Conclusions The additional risk of crystal above that of other recreational drugs needs to be disentangled from those associated with poly-drug use. Our data suggest that it may depend on how one defines risky sexual behavior and is influenced by psychological, physiologic and social factors.