245 research outputs found
Supplemental Material, Selfridge_RDS_2019_SUPPLEMENTAL_TABLES_Oct_7th_2019 - Respondent-Driven Sampling With Youth Who Use Drugs: A Mixed Methods Assessment
No full textSupplemental Material, Selfridge_RDS_2019_SUPPLEMENTAL_TABLES_Oct_7th_2019 for Respondent-Driven Sampling With Youth Who Use Drugs: A Mixed Methods Assessment by Marion Selfridge, Kiffer G. Card, Alissa Greer, Sarah Ferencz, Nathan Lachowsky and Scott Macdonald in Contemporary Drug Problems</p
sj-docx-1-jmh-10.1177_15579883231206618 – Supplemental material for Conformity to Masculinity Norms and Mental Health Outcomes Among Gay, Bisexual, Trans, Two-Spirit, and Queer Men and Non-Binary Individuals
No full textSupplemental material, sj-docx-1-jmh-10.1177_15579883231206618 for Conformity to Masculinity Norms and Mental Health Outcomes Among Gay, Bisexual, Trans, Two-Spirit, and Queer Men and Non-Binary Individuals by Sarah Cooper, Tristan Péloquin, Nathan J. Lachowsky, Travis Salway, John L. Oliffe, Benjamin Klassen, David J. Brennan, Janie Houle and Olivier Ferlatte in American Journal of Men's Health</p
Escape expectancies and sexualized substance use among gay, bisexual, and other men who have sex with men
No full textMcKirnan’s Cognitive Escape Theory (1996) is often characterized by the hypothesis that drugs are used during sex by gay, bisexual, and other men who have sex with men (gbMSM) to relieve internal cognitive conflict over safe-sex norms and sexual desire. We examined how McKirnan’s Cognitive Escape Scale (CES) is related to other widely used constructs relevant to sexualized substance use with hopes of better situating the theory within the evolving landscape of HIV-prevention. Associations between CES and trait anxiety, depression, treatment optimism, sexual altruism, sexual sensation seeking, and self-perceived risk for HIV transmission/acquisition were tested. Mediation analyses tested whether associated psychological measures mediated the effect of CES on the proportion of events in which participants reported co-occurrent substance use and condomless anal sex. Results indicated that CES is associated with higher sexual sensation seeking, treatment optimism, trait anxiety, and perceived likelihood of HIV transmission/ acquisition. Mediation analyses suggest that CES is related to but operates independently of treatment optimism, sensation seeking, and trait anxiety. Nevertheless, the intersection of HIV- related worries and substance use expectancies are clearly more nuanced than is widely reported is discussions on cognitive escap
sj-docx-1-dhj-10.1177_20552076231173557 - Supplemental material for Acceptability of an existing online sexually transmitted and blood-borne infection testing model among gay, bisexual and other men who have sex with men in Ontario, Canada
No full textSupplemental material, sj-docx-1-dhj-10.1177_20552076231173557 for Acceptability of an existing online sexually transmitted and blood-borne infection testing model among gay, bisexual and other men who have sex with men in Ontario, Canada by Joshun JS Dulai, Mark Gilbert, Nathan J Lachowsky, Kiffer G Card, Ben Klassen, Jessy Dame, Ann N Burchell, Catherine Worthington, Aidan Ablona, Praney Anand, Ezra Blaque, Heeho Ryu, MacKenzie Stewart, David J Brennan and Daniel Grace in DIGITAL HEALTH</p
Patterns of online and offline connectedness among gay, bisexual, and other men who have sex with men
No full textThis study examined patterns of connectedness among 774 sexually-active gay, bisexual, and other men who have sex with men (GBM), aged ≥ 16 years, recruited using respondent-driven sampling in Metro Vancouver. Latent class analysis examined patterns of connectedness including: attendance at gay venues/events (i.e., bars/clubs, community groups, pride parades), social time spent with GBM, use of online social and sex seeking apps/websites, and consumption of gay media. Multinomial regression identified correlates of class membership. A three-class LCA solution was specified: Class 1 “Socialites” (38.8%) were highly connected across all indicators. Class 2 “Traditionalists” (25.7%) were moderately connected, with little app/website-use. Class 3 “Techies” (35.4%) had high online connectedness and relatively lower in-person connectedness. In multivariable modelling, Socialites had higher collectivism than Traditionalists, who had higher collectivism than Techies. Socialites also had higher annual incomes than other classes. Techies were more likely than Traditionalists to report recent serodiscordant or unknown condomless anal sex and HIV risk management practices (e.g., ask their partner’s HIV status, get tested for HIV). Traditionalists on the other hand were less likely to practice HIV risk management and had lower HIV/AIDS stigma scores than Socialites. Further, Traditionalists were older, more likely to be partnered, and reported fewer male sex partners than men in other groups. These findings highlight how patterns of connectedness relate to GBM’s risk management
A syndemic in nonurban gay and bisexual men in British Columbia and within Island Health
No full textInequitable HIV acquisition persists among gay and bisexual men (GBM). In 2017, GBM represented 69.8% of new HIV diagnoses in British Columbia (BC) and 80.5% of new HIV diagnoses within Island Health (BCCDC, 2019). I used syndemic theory to examine the relationship between nonurban living environment, syndemic factors, and health outcomes among GBM within Island Health and in BC. I conducted a secondary analysis of the Community Based Research Centre’s Sex Now 2015, a national cross-sectional survey of approximately 8000 Canadian GBM. I conducted chi-square tests to compare levels of stigma stratified by urban or nonurban, Cramer’s V to examine the association between syndemic factors, and Poisson regression to determine which demographics and health outcomes were associated with more syndemic outcomes. I found prevalent stigma that negatively impacts urban and nonurban GBM. Urban GBM experience more stigma (e.g., called names or slurs) and worse outcomes (e.g., considered suicide) than nonurban GBM in Island Health and BC. Among nonurban GBM within Island Health, Cramer’s V may demonstrate a syndemic (e.g., strong associations between several measures of stigma such as verbal violence and discrimination at work and health outcomes such as depression, suicide, partner violence, and alcohol use). Among nonurban GBM within Island Health, Poisson regression revealed that more syndemic factors were associated with negative health outcomes and risk factors, such as attempting suicide, condomless sex, having sexual partners of unknown HIV status, and living with HIV. These findings suggest that a syndemic can occur among nonurban GBM without migration to a large urban centre. Key implications include a need for structural change to destigmatize sexual diversity. Results illustrate a need to normalize conversations about mental health among GBM who would benefit from co-located services that address stigma, mental health, substance use, and sexual health.Graduat
BLOOD DONATION IN THE ERA OF BIOMEDICAL HIV PREVENTION AND GENDER-NEUTRAL DONOR SCREENING
No full textObjective.
Canada’s implementation of gender-neutral sexual behaviour screening allows sexually active men who have sex with men to donate blood for the first time. Public health campaigns promoting effectiveness of pre-exposure prophylaxis (PrEP) and undetectable = untransmittable (U=U) for HIV prevention heavily target sexual and gender minorities. Donor deferral policies remain in place for both methods. This thesis explores the tension between the effectiveness of these HIV prevention methods and donor policies considering them indicators of HIV risk.
Methods.
I wrote an algorithm approximating donor eligibility producing two analytic samples; one including PrEP use, one including HIV-negative men using U=U. I then estimate the proportion of donors who would be deferred for each prevention method. Chapter Two uses logistic regression to investigate PrEP use as a motivator for blood donation. Chapter Three describes HIV risk and protective factors for HIV and compares these observations to population health estimates of HIV incidence risk.
Results.
The algorithm identified n = 2,301 potential donors when PrEP users were included. Of these n = 85 (3.7%) would have been deferred for PrEP use. When repeated with HIV-negative donors using U=U, n= 2,354 donors were identified and n = 53 (2.3%) would have been deferred. PrEP use was not associated with willingness to donate. Estimates of HIV acquisition risk observed in the U=U analytic sample showed high risk of HIV acquisition. Contradictorily, a high number of combination HIV prevention strategies were also observed in the sample.
Conclusion.
It is likely donors are deferred solely for their choice of HIV prevention method. Having made a past donation was the best predictor of willingness to donate blood. Observed combination HIV prevention strategies employed by the U=U analytic sample did not support high public health estimates of HIV acquisition risk. Future research should explore PrEP adherence in samples of donors deferred for PrEP use and adjusting estimates of HIV acquisition risk to consider PrEP and U=U in risk estimates.Graduat
The Medicine Bundle Pilot: An Indigenous Two-Spirit Approach to HIV and STBBI Health in British Columbia
No full textThe social determinants of health and the determinants of Indigenous health, including the historical and ongoing effects of settler-colonialism across Turtle Island, contribute to increased rates of HIV and sexually transmitted and blood-borne infections (STBBI) facing Indigenous people in Canada. Two-Spirit and queer Indigenous folks face further systemic barriers to accessing sexual health resources. The Medicine Bundle Pilot project takes a strengths-based approach to addressing health inequities in HIV and STBBI awareness and prevention. The Medicine Bundle Pilot was developed by the Community-Based Research Centre’s Two-Spirit Program to address barriers and increase culturally safe access to sexual health resources for Indigenous people in British Columbia. The Medicine Bundle is an Indigenous-developed approach to the HIV self-test kit and dried-blood spot test, combining traditional Indigenous medicines with Western sexual health resources. Medicine Bundles were distributed to Indigenous communities and community members across British Columbia, fostering safer pathways to care. My thesis aimed to (1) understand participants’ experience with the Medicine Bundle Pilot, and (2) determine barriers and access limitations to sexual health resources for Indigenous people in British Columbia. Existing barriers include limited access to sexual health resources within communities and being wrongfully denied access to services. Results demonstrate that the Medicine Bundle is a very effective sexual health resource for Indigenous people, and participants reported improved experiences with testing through the Medicine Bundle.Graduate2025-01-1
Medical assistance in dying and mental illness: Perspectives from 2S/LGBTQ+ individuals in Atlantic Canada
No full textIn March 2027, medical assistance in dying (MAID, also referred to as physician-assisted suicide) in Canada will be available to those with mental illness (MI) as the sole underlying condition (MAID-MI). The literature surrounding MAID-MI rarely consults individuals with MI; consequently, there is urgent need to understand this population’s perspectives. A key intersecting/sub-population is 2S/LGBTQ+ (Two-Spirit, lesbian, gay, bisexual, transgender, queer) Atlantic Canadians with MI, who will be disproportionately affected by the change in MAID eligibility for several reasons. These include: 1) intersections of sexual/gender minority status with homelessness and poverty, and the impact of rising costs of living in Atlantic Canada; 2) associations between sexual/gender minority status and MI/suicidality, and the impact of barriers to accessing timely and competent healthcare in Atlantic Canada, specifically gender-affirming and mental health care; and 3) associations between homelessness, suicidality, and likelihood of seeking MAID. This study used an interpretive description methodology, informed by a feminist-of-colour disability framework, and community collaboration, and engaged 2S/LGBTQ+ Atlantic Canadians with mood disorders through qualitative one-on-one interviews to understand their perspectives on MAID-MI and how their experiences and identities impacted these perspectives. Of the 38 participants, 63% were white and the remaining 37% represented diverse races/ethnicities: Indigenous, First Nations, Métis, or Inuit; Black, East or Southeast Asian; Latino/Latina/Latine/Latinx; and South Asian. A minority (21%) identified as cisgender. A reflexive thematic analysis of the verbatim interview transcripts focused on the topic of autonomy in the context of MAID-MI within the Atlantic Canadian healthcare system. These results identify possible complications for MAID-MI implementation and highlight areas where additional safeguards could be enacted to ensure equity for and prevent abuse of power against 2S/LGBTQ+ or other marginalized communities.Graduat
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