Predictors of Readiness to Quit Among a Diverse Sample of Sexual Minority Male Smokers

ABSTRACT Introduction: Readiness to quit smoking - a pattern of attitudes, intentions, and behaviors that reflect a likelihood of engaging in cessation activities—is a useful heuristic for understanding smoking disparities based on sexual orientation. This study examined demographic, tobacco-use patterns, psychosocial and cognitive factors associated with readiness to quit among gay and bisexual male smokers. Methods: A cross-sectional survey was conducted as part of a larger Tobacco Elimination and Control Collaboration (Q-TECC) initiative in the lesbian, gay, bisexual, and transgender (LGBT) community. Readiness to quit was measured by a composite score created from four variables (motivation to quit, importance of quitting, plan to quit, and confidence in quitting) (alpha=.87, M=3.42, SD=.96, range 1-5). Results: The sexual minority smokers in the sample (N=208; M=33 years) were racially/ethnically diverse. Latino men had significantly lower levels of readiness to quit compared to African American and White men. Hierarchical linear regression analyses were performed to explore the relative contributions of sociodemographic, tobacco-use patterns, psychosocial and cognitive factors on Readiness to Quit. In the final model, the following variables were associated with readiness to quit scores: Latino ethnicity, fewer quit attempts, positive expectancies for the beneficial effects of smoking, and lower perceived importance of smoking as an important LGBT health issue. None of the psychosocial factors were associated with readiness to quit. Discussion: Readiness to quit scores were largely predicted by modifiable attitudes, behaviors, and expectancies. Study findings have implications for improving outreach and awareness and for the development of effective treatment approaches

HIV Prevention and Care Among Black Cisgender Sexual Minority Men and Transgender Women: Protocol for an HIV Status–Neutral Cohort Study Using an Observational-Implementation Hybrid Approach

Background: Black cisgender gay, bisexual, and other sexual minority men (SMM) and transgender women (TW) continue to be heavily affected by HIV. Further research is needed to better understand HIV prevention and care outcomes in this population. In particular, there is a need for research examining the impact of substance use and sleep health on HIV prevention and treatment outcomes among Black SMM and TW. Objective: This paper outlines the study methods being used in the recently launched follow-up study to the Neighborhoods and Networks (N2) study, which we refer to as N2 Part 2 (N2P2). N2P2 aims to address this gap in the literature, build off the findings of the original N2 study, and identify socioenvironmental determinants of health, including whether neighborhood and network factors mediate and moderate these relationships. Methods: Building on the N2 cohort study in Chicago from 2018 to 2022, N2P2 used a prospective longitudinal cohort design and an observational-implementation hybrid approach. With sustained high levels of community engagement, we aim to recruit a new sample of 600 Black SMM and TW participants residing in the Chicago metropolitan statistical area. Participants are asked to participate in 3 study visits across an 18-month study period (1 visit every 9 months). Four different forms of data are collected per wave: (1) an in-person survey, (2) biological specimen collection, (3) a daily remote ecological momentary assessment for 14 days after each study visit, and (4) data from electronic health records. These forms of data collection continue to assess neighborhood and network factors and specifically explore substance use, sleep, immune function, obesity, and the implementation of potential interventions that address relevant constructs (eg, alcohol use and pre-exposure prophylaxis adherence). Results: The N2P2 study was funded in August 2021 by the National Institute of Drug Abuse (R01DA054553 and R21DA053156) and National Heart, Lung, and Blood Institute (R01HL160325). This study was launched in November 2022. Recruitment and enrollment for the first wave of data collection are currently ongoing. Conclusions: The N2P2 study is applying innovative methods to comprehensively explore the impacts of substance use and sleep health on HIV-related outcomes among an HIV status-neutral cohort of Black SMM and TW in Chicago. This study is applying an observational-implementation hybrid design to help us achieve findings that support rapid translation, a critical priority among populations such as Black SMM and TW that experience long-standing inequities with regard to HIV and other health-related outcomes. N2P2 will directly build off the findings that have resulted from the original N2 study among Black SMM and TW in Chicago. These findings provide a better understanding of multilevel (eg, individual, network, and neighborhood) factors that contribute to HIV-related outcomes and viral suppression among Black SMM and TW. International registered report identifier (irrid): DERR1-10.2196/48548.</p

Behavioral Risks and STI Outcomes in Men who have Sex with Men: Chicago, 2002-2010.

Behavioral Risks and STI Outcomes in Men who have Sex with Men: Chicago, 2002-2010

Understanding the Barriers and Enablers for Seeking Psychological Support following a Burn Injury

Burn injuries can be traumatic and distressing for patients, with a prolonged period of recovery. This qualitative study aimed to explore adult burn patients’ perceptions of the barriers and facilitators to accessing psychological support in a Regional Burns Service in Southeast England. Participants (five females and six males) were under the care of the burns unit and were not currently accessing psychological support. Eleven semi-structured interviews were conducted. Responses were analysed using thematic analysis. Four main themes highlighted how access to psychology was influenced by communication between the patient and service, beliefs about mental health, environmental challenges, and patient hope. Recommendations for improving access to burn psychological care included (1) the provision of patient resources to increase awareness and reduce stigma; (2) psychological skills training to encourage staff to recognise distress and respond appropriately; (3) staff training in the practice of cultural humility; (4) increasing psychological presence in outpatient appointments and via routine follow-ups

Another published paper

Trends in homelessness and injection practice

Trends in homelessness and injection practices among young urban and suburban people who inject drugs: 1997-2017

BACKGROUND: Among young people who inject drugs (PWID) homelessness is associated with numerous adverse psychosocial and health consequences, including risk of relapse and overdose, psychological distress and suicidality, limited treatment access, and injection practices that increase the risk of HIV and hepatitis C (HCV) transmission. Homeless PWID may also be less likely to access sterile syringes through pharmacies or syringe service programs. METHODS: This study applied random-effects meta-regression to examine trends over time in injection risk behaviors and homelessness among young PWID in Chicago and surrounding suburban and rural areas using data from 11 studies collected between 1997 and 2017. In addition, subject-level data were pooled to evaluate the effect of homelessness on risk behaviors across all studies using mixed effects logistic and negative binomial regression with random study effects. RESULTS: There was a significant increase in homelessness among young PWID over time, consistent with the general population trend of increasing youth homelessness. In mixed-effects regression, homelessness was associated with injection risk behaviors (receptive syringe sharing, syringe mediated sharing, equipment sharing) and exchange sex, though we detected no overall changes in risk behavior over time. CONCLUSIONS: Increases over time in homelessness among young PWID highlight a need for research to understand factors contributing to youth homelessness to inform HIV/STI, HCV, and overdose prevention and intervention services for this population