Anti-Transgender Policies and Practices in Social Work Education, Accreditation, and Licensing: A Call for Change

The social work profession is guided by the values of social justice and the dignity and worth of the person. The National Association of Social Workers (NASW) Code of Ethics requires that all social workers act in a professional manner consistent with these values. These values mandate that social workers “challenge social injustice on behalf of and in concert with vulnerable and oppressed individuals and groups.” Yet, historically, and contemporarily, the social work profession and national professional organizations (i.e., NASW, the Council on Social Work Education (CSWE), Associate of Social Work Boards (ASWB), Society for Social Work and Research (SSWR), and the American Academy of Social Work and Social Welfare (AASW) have failed to advocate for and work in solidarity with transgender and gender expansive (TGE) individuals and groups to advance social justice. This commentary will examine how the social work profession and its national professional organizations have not followed the NASW Code of Ethics as it relates to T E communities. Specifically, the article ill (1) unpack the ways in which explicit and implicit social work curriculum and standards in accredited US social work programs do little to equip students to effectively serve transgender clients and communities upon graduation, (2) discuss the lack of advocacy for and solidarity with TGE communities from professional social work organizations, and (3) review policies governing the licensure of social work practitioners related to culturally responsive social work practice with TGE clients and communities. This commentary provides a set of recommendations for countering and reducing transphobia in the social work profession in the areas education, practice, and policy. We conclude with a call for change for the social work profession that achieves the values of social justice and dignity and worth of TGE individuals, groups, and communities

Defund the Police: Moving Towards an Anti-Carceral Social Work

This paper addresses social work’s place in the movement to “defund the police.” We argue that social work’s collaboration with police and use of policing constitutes carceral social work. In defining carceral social work, we specify the ways in which coercive and punitive practices are used to manage Black, Indigenous, other people of color and poor communities across four social work arenas – gender-based violence, child welfare, schools, and health and mental health. To inform anti-carceral social work, we provide examples of interventions in these arenas that dismantle police collaborations and point to life-affirming, community-centered, and mutual aid alternatives

For Better or for Worse? A Systematic Review of the Evidence on Social Media Use and Depression Among Lesbian, Gay, and Bisexual Minorities

Background: Over 90% of adults in the United States have at least one social media account, and lesbian, gay, and bisexual (LGB) persons are more socially active on social media than heterosexuals. Rates of depression among LGB persons are between 1.5- and 2-fold higher than those among their heterosexual counterparts. Social media allows users to connect, interact, and express ideas, emotions, feelings, and thoughts. Thus, social media use might represent both a protective and a risk factor for depression among LGB persons. Studying the nature of the relationship between social media use and depression among LGB individuals is a necessary step to inform public health interventions for this population. Objective: The objective of this systematic review was to synthesize and critique the evidence on social media use and depression among LGB populations. Methods: We conducted a literature search for quantitative and qualitative studies published between January 2003 and June 2017 using 3 electronic databases. Articles were included if they were peer-reviewed, were in English, assessed social media use either quantitatively or qualitatively, measured depression, and focused on LGB populations. A minimum of two authors independently extracted data from each study using an a priori developed abstraction form. We assessed appropriate reporting of studies using the Strengthening the Reporting of Observational Studies in Epidemiology and the Consolidated Criteria for Reporting Qualitative Research for quantitative and qualitative studies, respectively. Results: We included 11 articles in the review; 9 studies were quantitative and cross-sectional and 2 were qualitative. Appropriate reporting of results varied greatly. Across quantitative studies, we found heterogeneity in how social media use was defined and measured. Cyberbullying was the most studied social media experience and was associated with depression and suicidality. Qualitative studies found that while social media provides a space to disclose minority experiences and share ways to cope and get support, constant surveillance of one’s social media profile can become a stressor, potentially leading to depression. In most studies, sexual minority participants were identified inconsistently. Conclusions: This review supports the need for research on the role of social media use on depression outcomes among LBG persons. Using social media may be both a protective and a risk factor for depression among LGB individuals. Support gained via social media may buffer the impact of geographic isolation and loneliness. Negative experiences such as cyberbullying and other patterns of use may be associated with depression. Future research would benefit from more consistent definitions of both social media use and study populations. Moreover, use of larger samples and accounting for patterns of use and individuals’ experiences on social media may help better understand the factors that impact LGB mental health disparities

Implementation of Client-Centered Care Coordination for HIV Prevention with Black Men Who Have Sex with Men: Activities, Personnel Costs, and Outcomes—HPTN 073

Background: Black men who have sex with men (MSM) experience disproportionate rates of HIV infection in the USA, despite being no more likely to engage in sexual risk behaviors than other MSM racial/ethnic groups. HIV pre-exposure prophylaxis (PrEP) has been shown to reduce risk of HIV acquisition; however, rates of PrEP use among Black MSM remain low. Clinical, psychosocial, and structural factors have been shown to impact PrEP use and adherence among Black MSM. Care coordination of HIV prevention services has the potential to improve PrEP use and adherence for Black MSM, as it has been shown to improve HIV-related care outcomes among people living with HIV. Methods: Client-centered care coordination (C4) is a multi-level intervention designed to address clinical, psychosocial, and structural barriers to HIV prevention services for Black MSM within HPTN 073, a PrEP demonstration project among Black MSM in three cities in the USA. The current study examined the implementation process of C4, specifically investigating the activities, cost, time, and outcomes associated with the C4 intervention. Results: On average, participants engaged in five care coordination encounters. The vast majority of care coordination activities were conducted by counselors, averaging 30 min per encounter. The cost of care coordination was relatively low with a mean cost of $8.70 per client encounter. Conclusion: Although client-centered care coordination was initially implemented in well-resourced communities with robust HIV research and service infrastructure, our findings suggest that C4 can be successfully implemented in resource constrained communities

The criteria used to rule out mild cognitive impairment impact dementia incidence rates in subjective cognitive decline

Acknowledgements: The authors would like to thank the patients whose data underpinned this study.Abstract Background The research criteria for subjective cognitive decline (SCD) exclude mild cognitive impairment (MCI), but do not stipulate the use of specific MCI criteria. This study compared different approaches to defining (i.e., excluding) MCI during the ascertainment of SCD, focusing on the impact on dementia incidence rates in SCD. Methods This cohort study utilized routine healthcare data collected in the Essex Memory Clinic from 1999 to 2023. Two different operationalizations of the SCD criteria were used to categorize the cohort into two SCD patient samples. One sample was based on local clinical practice – MCI was excluded according to the Winblad criteria (this sample was termed SCDWinblad). The other sample was created via the retrospective application of the Jak/Bondi criteria for the exclusion of MCI (termed SCDJak/Bondi). Only patients aged ≥ 55 years at baseline with ≥ 12 months follow-up were considered for inclusion. The initial clinical/demographic characteristics of the samples were compared. Rates of incident dementia were calculated for each sample, and unadjusted and Mantel-Haenszel-adjusted incidence rate ratios were calculated to compare dementia incidence between the SCD samples. Results The Essex Memory Clinic database included 2,233 patients in total. The SCD and study eligibility criteria were used to select SCDWinblad (n = 86) and SCDJak/Bondi (n = 185) samples from the database. Median follow-up (3 years) did not differ between the two samples. The SCDJak/Bondi sample was significantly older than the SCDWinblad at first assessment (median age: 74 versus 70 years) and had poorer scores on tests of global cognition, immediate and delayed verbal recall, and category fluency. Following adjustment for age, the dementia incidence rate ratio [95% confidence interval] was 3.7 [1.5 to 9.3], indicating a significantly greater rate of progression to dementia in SCDJak/Bondi. Conclusions This study highlights that the approach used to ascertain SCD has important implications for both SCD phenotypes and prognosis. This underscores the importance of how MCI is operationalized within SCD studies. More broadly, the findings add to a growing body of work indicating that objective cognition should not be overlooked in SCD, and offer a potential explanation for the heterogeneity across the SCD prognostic literature. </jats:sec

Effects of internalised racism and internalised homophobia on sexual behaviours among black gay and bisexual men in the USA: a systematic review protocol

Introduction Black gay and bisexual men are overburdened by HIV in the USA. While the socioecological model has been applied to understand potential mechanisms of HIV acquisition among black gay and bisexual men, there is mixed evidence on the impact of internalised stigma on HIV risk among this population. This systematic review protocol paper outlines the systematic review being conducted to determine the relationship between internalised racism, internalised homophobia and engagement in sexual behaviour, which puts individuals at risk for HIV infection.Methods and analysis For the review, we will conduct a systematic review of the literature, summarise and critique published scholarly literature on the associations between forms of internalised stigma and sexual behaviours among black gay and bisexual men. We will conduct a systematic search of published qualitative and quantitative research studies published during and after 1993. The searches will be conducted in Ovid Medline, Ovid APA PsycInfo and EBSCO SocINDEX databases. Studies will be included if they were conducted in the USA, with samples that comprised African American/black cisgender gay, bisexual, queer and other men who have sex with men, measured internalised racism and/or internalised homophobia, and assessed sexual behaviour risk for HIV acquisition.Ethics and dissemination No ethical approval will be required for this review. We will report our findings using the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Findings of this review may offer new opportunities to study internalised mechanisms impacting outcomes and to identify research gaps and spur additional queries in the group most disproportionately impacted by HIV