Video intervention to increase perceived self-efficacy for condom use in a randomized controlled trial of female adolescents

Study Objective: To assess the effects of the Seventeen Days interactive video on young women’s perceived self-efficacy for using condoms six months after being offered the intervention, relative to a control. Design: Multisite randomized controlled trial. Setting: Twenty participating health clinics and county health departments in Ohio, Pennsylvania, and West Virginia. Participants: Sexually active females ages 14 to 19: Interventions: Seventeen Days (treatment intervention; sex education) versus Driving Skills for Life (control intervention; driving education). Main Outcome Measures: Perceived self-efficacy for condom use. Results and Conclusions: Participants in the Seventeen Days group reported higher perceived condom acquisition self-efficacy after six months than those in the driving group. This finding held after controlling for baseline self-efficacy scores and other covariates. The Seventeen Days program shows promise to improve perceived self-efficacy to acquire condoms among sexually active female adolescents—an important precursor to behavior change

Disparities in Adverse Childhood Experiences among Sexual Minority and Heterosexual Adults: Results from a Multi-State Probability-Based Sample

BACKGROUND: Adverse childhood experiences (e.g., physical, sexual and emotional abuse, neglect, exposure to domestic violence, parental discord, familial mental illness, incarceration and substance abuse) constitute a major public health problem in the United States. The Adverse Childhood Experiences (ACE) scale is a standardized measure that captures multiple developmental risk factors beyond sexual, physical and emotional abuse. Lesbian, gay, and bisexual (i.e., sexual minority) individuals may experience disproportionately higher prevalence of adverse childhood experiences. PURPOSE: To examine, using the ACE scale, prevalence of childhood physical, emotional, and sexual abuse and childhood household dysfunction among sexual minority and heterosexual adults. METHODS: Analyses were conducted using a probability-based sample of data pooled from three U.S. states’ Behavioral Risk Factor Surveillance System (BRFSS) surveys (Maine, Washington, Wisconsin) that administered the ACE scale and collected information on sexual identity (n = 22,071). RESULTS: Compared with heterosexual respondents, gay/lesbian and bisexual individuals experienced increased odds of six of eight and seven of eight adverse childhood experiences, respectively. Sexual minority persons had higher rates of adverse childhood experiences (IRR = 1.66 gay/lesbian; 1.58 bisexual) compared to their heterosexual peers. CONCLUSIONS: Sexual minority individuals have increased exposure to multiple developmental risk factors beyond physical, sexual and emotional abuse. We recommend the use of the Adverse Childhood Experiences scale in future research examining health disparities among this minority population

Garnering an In-depth Understanding of Men Who Have Sex with Men in Chennai, India: A Qualitative Analysis of Sexual Minority Status and Psychological Distress

Men who have sex with men (MSM) in India are a hidden and largely understudied population, and havean HIV prevalence 17 times higher than that of the general Indian population. Experiences of social marginalization and negative psychosocial conditions occur concurrent to HIV risk among Indian MSM. To better understand the contextual variables driving HIV risk and inform intervention development, five focus groups (n = 46) and nine key informant interviews were conducted with 55 MSM in Chennai in 2010. NVivo software was used to code the transcripts, and data were analyzed using qualitative descriptive analysis methodology. Participants described sources of psychological distress and low self-worth related to gender non-conformity and sexual minority status. These included stigma from society, pressure to marry, lack of familial acceptance, childhood sexual abuse, and the imperative to keep sexual minority status a secret. Participants' personal evaluations revealed that self-acceptance may be an important resilience factor that can shield these psychosocial and HIV risk factors. In promoting health-seeking behavioral changes for Indian MSM at an individual level, our findings point to the potential strength of strategies that focus on self-acceptance of one's sexual minority identity to foster better psychosocial and overall health

Comparing the Rates of Early Childhood Victimization across Sexual Orientations: Heterosexual, Lesbian, Gay, Bisexual, and Mostly Heterosexual

Few studies have examined the rates of childhood victimization among individuals who identify as "mostly heterosexual" (MH) in comparison to other sexual orientation groups. For the present study, we utilized a more comprehensive assessment of adverse childhood experiences to extend prior literature by examining if MH individuals' experience of victimization more closely mirrors that of sexual minority individuals or heterosexuals. Heterosexual (n = 422) and LGB (n = 561) and MH (n = 120) participants were recruited online. Respondents completed surveys about their adverse childhood experiences, both maltreatment by adults (e.g., childhood physical, emotional, and sexual abuse and childhood household dysfunction) and peer victimization (i.e., verbal and physical bullying). Specifically, MH individuals were 1.47 times more likely than heterosexuals to report childhood victimization experiences perpetrated by adults. These elevated rates were similar to LGB individuals. Results suggest that rates of victimization of MH groups are more similar to the rates found among LGBs, and are significantly higher than heterosexual groups. Our results support prior research that indicates that an MH identity falls within the umbrella of a sexual minority, yet little is known about unique challenges that this group may face in comparison to other sexual minority groups

Diversity Issues in Pediatric Behavioral Health Care

Youth from racial/ethnic, sexual, and gender minority groups have significant disparities in health and mental health outcomes. While the literature suggests that evidence-based cognitive behavioral therapies benefit youth and families with minority or marginalized status, less research has focused specifically on these populations in pediatric behavioral health care. Existing evidence pointing to the potential positive impact of pediatric psychologists working with marginalized communities including racial/ethnic minority and LGBTQ youth will be reviewed, along with a brief discussion of the relevance of culturally adapted or tailored interventions in pediatric behavioral health care. Important considerations for practitioners working with minority or marginalized youth and families will be discussed, including issues of mistrust, stigma, and accessibility of services.https://nsuworks.nova.edu/cps_facbooks/1668/thumbnail.jp