The Mental Health of Male Sexual Minority Asylum Seekers and Refugees in Nairobi, Kenya: A Qualitative Assessment

Very little information exists about the experiences of asylum seekers and refugees who are men who have sex with men (MSM). Therefore, this study explores the psychological distress of MSM asylum seekers and refugees in the Nairobi metropolitan area. We collected data using in-depth interviews transcribed verbatim, coded using NVivo 12 Plus, and analyzed using the six-step thematic analysis framework. Four major themes emerged from the study: psychological distress, traumatic stress symptoms, mental health care access, and coping strategies. Although we did not use any diagnoses, the results indicate that MSM asylum seekers and refugees share mental health problems with other refugees. However, MSM have specific needs that derive from their persecution based on their sexual minority status. The results confirm extant findings, as seen in the discussion, and encourage more research. Further research will inform collaborative, culturally sensitive, and targeted interventions that decrease adverse mental health outcomes for MSM asylum seekers and refugees in the Nairobi metropolitan area.Peu d'informations existent sur le vécu des demandeurs d’asile et réfugiés qui sont des hommes ayant des relations sexuelles avec des hommes (). Par conséquent, cette étude explore la détresse psychologique des demandeurs d’asile et réfugiés dans la région métropolitaine de Nairobi. Nous avons procédé à la collecte de données en effectuant des entretiens approfondis dont les verbatims retranscrits ont été codés à l’aide de Plus 12, puis analysés suivant une analyse thématique en six étapes. Quatre thèmes principaux émergent de cette la détresse psychologique, les symptômes de stress post-traumatique, l’accès aux services de santé mentale et les stratégies d’adaptation. Bien que nous n’ayons utilisé aucun diagnostic, les résultats indiquent que les demandeurs d’asile et réfugiés partagent des problèmes de santé mentale avec d’autres réfugiés. Les ont cependant des besoins spécifiques qui découlent de leur persécution sur la base de leur appartenance à une minorité sexuelle. Ces résultats confirment ceux des travaux existants, comme le démontre la discussion, et appellent à davantage de recherches. Des recherches plus approfondies contribueront à l’élaboration d’interventions collaboratives, culturellement adaptées et ciblées afin de réduire les effets néfastes sur la santé mentale des demandeurs d’asile et réfugiés dans la région métropolitaine de Nairobi

Taking a stance: A qualitative analysis on how major German corporations developed their position regarding the Russia-Ukraine war

In light of organizational advocacy and issue management, this study examines on which decision-making basis large German companies have developed their positioning in relation to the Russia-Ukraine war and sheds light on the resulting insights for future communicative measures. The process of positioning is considered from the meso-level of the organizations. Eleven qualitative guided interviews with communicators show that while in many cases the positioning of a company is based on catalogues of decisions and criteria, it is usually carried out in an ad hoc manner. Above all, external factors, such as time or active demands from stakeholders, as well as internal factors, such as perceived positioning pressure, have an impact on a company’s public statement. Regarding potential future crisis cases, each communicative challenge is seen as an opportunity for learning and further development. In summary, the article shows that dealing with an issue or crisis - depending on the perspective - such as the Russia-Ukraine war, cannot be carried out according to generally valid criteria, but must always be configured individually to the respective case and the affectedness of the company. The study expands the current state of research by taking a deeper look at the underlying processes of companies' positioning in crisis situations. At the same time, it opens possibilities for further research

A mixed methods approach to assess the likelihood of testing for STI using self-collected samples among behaviourally bisexual women

Objectives Behaviourally bisexual women (women who have sex with women and men (WSWM)) are more likely to report a history of sexually transmitted infections (STI) than women who have sex exclusively with men or exclusively with women. Barriers to care may prohibit WSWM from seeking STI testing. The present study investigated participant willingness to self-collect oral, vaginal and anal samples for STI testing. Methods Eighty WSWM were recruited from two midwestern locations. After completing an online questionnaire, a subset of the participants were interviewed (n=54) and provided the option to self-collect oral, vaginal and/or anal samples to screen for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. Results Over two-thirds (67.5%, n=54) of the participants completed the baseline scheduled and attended the interview. The majority of these participants provided vaginal (87.0%, n=47), oral (85.2%, n=46) and/or anal (61.1%, n=33) samples. Participants with a history of anal play were significantly more likely to provide an anal sample. C. trachomatis infection was identified in the samples of 6.8% (n=3) of the participants including 4.5% (n=2) of the vaginal samples and 3.3% (n=1) of the anal samples. None of the samples were positive for N. gonorrhoeae or T. vaginalis. Participants who reported a recent history of anal sexual behaviour with a male partner were significantly more likely to self-collect an anal sample. Conclusions Given the comparatively high STI rates among WSWM, self-sampling in non-traditional settings may present a unique opportunity to provide needed care to this underserved population of women

Addressing Training Gaps: A Competency-Based, Telehealth Training Initiative for Community Health Workers

BACKGROUND: To overcome vast variations in Community Health Worker (CHW) training, investigators for the CHW Core Consensus Project (CCCP) derived three types of CHW (Category 1, 2, 3) and established competencies for each category. However, studies are needed that implement these competencies in real-world settings. OBJECTIVE: Using the six competency domains of the CCCP as a theoretical backbone, we developed and evaluated a training for METHODS: We developed five telehealth-based, bilingual (Spanish/English) training sessions and implemented them among RESULTS: All (18/18) CHWs achieved at least 70% on the posttest (mean: 93.7%; range 73.3-100%). Training attendance was 98.9%. Using a six-point scale, CHWs reported high levels of satisfaction overall (5.72 ± 0.57/6.0), with telehealth (5.72 ± 0.58/6.0), effectiveness of teaching strategies/methods (5.89 ± 0.32/6.0), achieving training objectives (5.96 ± 0.15/6.0), knowledge improvement (5.72 ± 0.57/6.0), and interest (5.78 ± 0.43/6.0). CONCLUSION: We successfully developed and evaluated a bilingual training program for Category 1 CHWs to address core competency gaps. High CHW attendance reinforces the value of telehealth modalities and their potential to increase the reach for CHW training. To overcome gaps in chronic disease training, investigations are needed to address additional CHW trainings

Lifetime Lubricant Use among a Nationally Representative Sample of Lesbian- and Bisexual-Identified Women in the United States

Introduction The diversity in self-identified lesbian and bisexual women's sexual interactions necessitates better understanding of how and when they integrate personal lubricant into different experiences. However, little is known about lesbian and bisexual women's lifetime lubricant use, particularly at the population level. Aims The aim of this study was to examine the prevalence and characteristics of lubricant use among adult lesbian and bisexual women in the United States. Methods Data were drawn from a subset of lesbian and bisexual participants who participated in the 2012 National Survey of Sexual Health and Behavior, an online questionnaire administered to a nationally representative probability sample of U.S. adults ages 18 and older. Main Outcome Measures We examined socio-demographic characteristics, recent and lifetime lubricant use, lubricant use in associated with specific sexual behaviors and condom use, frequency of use, motivations for use, as well as perception of lubricant when used. Results A majority of lesbian- (60.1%) and bisexual-identified (77.1%) women reported ever using lubricant; 25.7% of lesbian women and 32.7% of bisexual women used it in the last 30 days. Across most age groups, lubricant was commonly used during partnered sexual play, partnered sexual intercourse, or when a vibrator/dildo was used. Lesbian and bisexual women reported using lubricants to increase arousal/sexual pleasure/desire, to make sex more fun, or to increase physical comfort during sex. Conclusions Lubricant use is identified as a part of lesbian and bisexual women's sexual experience across the life span, as a part of both solo and partnered experiences. As part of evolving sexual health assessments, clinicians and health educators may find value in integrating lubricant-focused conversation with their lesbian and bisexual patients and clients, particularly

Health-Related Quality of Life and Recovery Capital Among Recovery Residents Taking Medication for Opioid Use Disorder in Texas

BACKGROUND: Recovery from opioid use disorder (OUD) includes improvements in health-related quality of life (HRQOL) and is supported by recovery capital (RC). Little is known about RC and HRQOL among recovery residents taking medication for OUD. We described HRQOL and RC and identified predictors of HRQOL. METHODS: Project HOMES is an ongoing longitudinal study implemented in 14 recovery homes in Texas. This is a cross-sectional analysis of data from 358 participants\u27 on HRQOL (five EQ-5D-5L dimensions-mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and RC (Assessment of Recovery Capital scores) collected from April 2021 to June 2023. Statistical analyses were conducted using T-, Chi-squared, and Fisher\u27s exact tests. RESULTS: Most participants were 35 years/older (50.7%), male (58.9%), non-Hispanic White (68.4%), heterosexual (82.8%), and reported HRQOL problems, mainly anxiety/depression (78.4%) and pain/discomfort (55.7%). Participants who were 35 years/older [mean (SD) = 42.6 (7.3)] were more likely to report mobility and pain/discomfort problems than younger participants. Female participants were more likely to report pain/discomfort problems than male participants. Sexual minorities were more likely to report anxiety/depression problems than heterosexual participants. Married participants and those in committed relationships were more likely to report problems conducting self-care than single/never-married participants. Comorbid conditions were associated with mobility, pain/discomfort, and usual activities problems. Most participants reported high social (65.4%), personal (69.0%), and total (65.6%) RC. Low personal RC was associated with mobility (aOR = 0.43, CI = 0.24-0.76), self-care (aOR = 0.13, CI = 0.04-0.41), usual activities (aOR = 0.25, CI = 0.11-0.57), pain/discomfort (aOR = 0.37, CI = 0.20-0.68), and anxiety/depression (aOR = 0.33, CI = 0.15-0.73) problems. Low total RC was associated with problems conducting self-care (aOR = 0.20, CI = 0.07-0.60), usual activities (aOR = 0.43, CI = 0.22-0.83), pain/discomfort problems (aOR = 0.55, CI = 0.34-0.90), and anxiety/depression (aOR = 0.20, CI = 0.10-0.41) problems. Social RC was not associated with HRQOL. CONCLUSION: Personal and total RC and comorbid conditions predict HRQOL. Although the opioid crisis and the increasing prevalence of comorbidities have been described as epidemics, they are currently being addressed as separate public health issues. Our findings underscore the importance of ensuring residents are provided with interprofessional care to reduce the burden of comorbidities, which can negatively impact their OUD recovery. Their RC should be routinely assessed and enhanced to support their recovery and improve HRQOL

Assessing the Need and Receptivity for an Integrated Healthy Sexual and Dating Relationships Intervention for Community College Students

Background: In emerging adulthood, youth often become involved in more serious romantic relationships. However, many lack the skills to avoid an unplanned pregnancy or sexually transmitted infection (STI), and to ensure a healthy dating relationship. Community college students serve nearly half of all undergraduate students in the United States; yet, community colleges typically lack resources for sexual health promotion. Purpose: To assess the need and receptivity for a web-based integrated healthy sexual and dating relationships intervention among community college students. Methods: In summer 2016, we partnered with three community colleges in South Central Texas to conduct an online survey of students’ sexual behaviors and dating relationships, and usability testing of activities from an integrated, web-based healthy sexual and dating relationship intervention. Results: Online survey participants (n=271) were 70% female, 38% Hispanic, 24% White, 17% Black, and 16% Asian; 20% self-identified as sexual minority; mean age was 20.8 years (SD = 2.05). Participants reported high rates of sexual risk behavior including sex without a condom or an effective birth control method, low use of long-acting reversible contraception, frequent use of emergency contraception, and low use of dual protection to prevent pregnancy and sexually transmitted infections. Two-thirds reported experiencing any type of dating violence perpetration or victimization in the past year. Usability testing participants (n=14) were 86% female, 42% Hispanic, 50% Asian/Pacific Islander, 14% Black, and 7% White; 71% were sexually experienced; mean age was 20.7 years (SD = 1.64). The web-based activities were highly rated in terms of usability parameters, and positively impacted short-term psychosocial outcomes related to condom use, accessing contraceptive health services, and constructive interpersonal conflict resolution. Conclusion: Findings underscore the high need and receptivity for an integrated healthy sexual and dating relationship web-based intervention among community college students, an understudied subgroup of youth in emerging adulthood

Determining Call-To-Entry Rate and Recruitment Barriers in Clinical Studies For Community Clinics Serving Low-income Populations: a Cohort Study

BACKGROUND: Recruitment for clinical studies is challenging. to overcome barriers, investigators have previously established call-to-entry rates to assist in planning. However, rates specific to low-income minority populations are needed to account for additional barriers to enrolment these individuals face. OBJECTIVE: to obtain a call-to-entry rate in a low-income uninsured Hispanic population with chronic disease. METHODS: We used data from four of our randomised clinical studies to determine the call-to-entry rate for individuals (n=1075) with or at risk for type 2 diabetes: participants needed/potential participants contacted=recruitment rate (yield). Research staff contacted potential participants to enrol in a study that evaluated 6 month diabetes programmes at community clinics from 2015 to 2020. We recorded call-to-entry rates, reasons for declining the study, show rates, and attrition. RESULTS: The call-to-entry rate was 14.5%. Forty per cent of potential participants could not be contacted, and 30.6%, 19.1%, and 5.4% responded CONCLUSIONS: We described a call-to-entry rate and detailed recruitment data, including reasons to decline the study. This valuable information can assist investigators in study planning and overcoming enrolment barriers in low-income populations. Telehealth-based or strategies that limit transportation needs may increase participant involvement. TRIAL REGISTRATION NUMBER: NCT03394456

Examining the vulva: The relationship between female genital aesthetic perceptions and gynecological care

Despite the known benefits of gynecological exams, women's concerns about displaying their genitalia may function as a deterrent to care. While little is known about women's genital perceptions, the current rise of female genital cosmetic surgeries suggests that women may be dissatisfied with the deviation of their vulva from a uniform appearance ideal. Thus, the current study investigated the construction of this ideal and the relationship to gynecological care. Specifically, the current study tested a path through which exposure to either a constrained or varied vulva picture set would differentially activate a concatenation of cognitions and emotions that would, in turn, predict gynecological care perceptions and intentions. Young, undergraduate women (N=485) completed the on-line survey at a computer of their choosing. Contrary to the hypothesis, picture set exposure was unrelated to vulva perceptions. However, as predicted, young women's genital perceptions were significantly related to their gynecological care perceptions and intentions