Experiences of Stigma by Gay and Bisexual Men in Rural Oklahoma

Hubach, Randolph D.; Currin, Joseph M.; Giano, Zachary; Meyers, Hunter J.; DeBoy, Kyle R.; Wheeler, Denna L.; Croff, Julie M.

doi:10.1089/heq.2018.0095

Cited by 34 publications

(29 citation statements)

References 47 publications

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“…10,14,15 These concerns are amplified within rural communities where social norms related to sex and sexuality are increasingly restrictive and access to sexual health care is largely lacking. 7,9,10,15,21 Most participants perceived themselves to be at low risk for HIV/STI acquisition, as found in other research. [22][23][24] Specifically, previous work demonstrates discordance between college students' perceived risk and their reported sexual behavior, wherein students are less likely to use condoms for oral, anal, and vaginal sex within primary and nonprimary partners.…”

Section: Discussionsupporting

confidence: 75%

Rural College Students’ Amenability Toward Using At-Home Human Immunodeficiency Virus and Sexually Transmitted Infection Testing Kits

et al. 2021

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Background: College students residing in rural areas of the United States have limited access to human immunodeficiency virus (HIV) and sexually transmitted infection (STI) screening programs; yet, have increased rates of infection.Methods: Students (N = 326), attending a state university located within a rural community, completed an online survey containing open-ended questions that gauged their perceptions and experiences with HIV/STI testing, amenability to at-home testing technology, and preferences for obtaining at-home testing kits. Inductive coding was used to create themes for each open-ended question.Results: Students encounter a number of perceived barriers to accessing clinical HIV/STI testing venues including cost, utilization of parents' medical insurance, and stigma. Students desired screening paradigms that allow for a greater sense of privacy and the ability to be empowered through self-sampling methods. This includes the use of at-home testing kits, which could be accessed via mail, campus, or the local community. Although students were overwhelmingly amenable to using at-home testing, students discussed concerns with potential user error that could impact testing accuracy.Conclusions: Study findings suggest the importance of developing less clinically oriented systems of HIV/STI screening, which allow students to choose from an array of screening options. Removing perceived barriers, notably access and privacy concerns, to HIV/STI testing by leveraging at-home testing is one potential method to increase screening uptake among this at-risk population.

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Section: Discussionsupporting

confidence: 75%

Rural College Students’ Amenability Toward Using At-Home Human Immunodeficiency Virus and Sexually Transmitted Infection Testing Kits

et al. 2021

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“…Rural men who have sex with men experience substantial stigma and lack robust access to HIV preventative care [31][32][33][34]. Our results corroborate this experience in a real-world setting of users on GSN app specific to men who have sex with men, and demonstrate the need to expand preventive health services to these populations-in fact, the digital fluency of these users in leveraging a GSN-based app for sexual partnership suggests that such platforms may be ideal for deployment of interventions to support preventive care among rural populations of men who have sex with men.…”

Section: Principal Findingsmentioning

confidence: 99%

Engagement With HIV and COVID-19 Prevention: Nationwide Cross-sectional Analysis of Users on a Geosocial Networking App

Gaither¹,

Sigalos²,

Landovitz³

et al. 2022

J Med Internet Res

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Background Geosocial networking (GSN) apps play a pivotal role in catalyzing sexual partnering, especially among men who have sex with men. Objective To quantify the prevalence and disparities in disclosure of pre-exposure prophylaxis (PrEP) use and COVID-19 vaccination among GSN app users, mostly men who have sex with men, in the United States. Methods Web-based Grindr profiles from the top 50 metropolitan areas as well as the 50 most rural counties in the United States by population were randomly sampled. Grindr provides an option to disclose current PrEP use (HIV positive, HIV negative, or HIV negative with PrEP use). The free text in all profiles was analyzed, and any mention of COVID-19 vaccination was recorded. Multivariable logistic regression to assess independent associations with PrEP disclosure and COVID-19 vaccination was performed. Imputation analyses were used to test the robustness of the results. Results We evaluated 1889 urban and 384 rural profiles. Mean age among urban profiles was 32.9 (SD 9.6) years; mean age among rural profiles was 33.5 (SD 12.1) years (P=.41). Among the urban profiles, 16% reported being vaccinated against COVID-19 and 23% reported PrEP use compared to 10% and 8% in rural profiles, respectively (P=.002 and P<.001, respectively). Reporting COVID-19 vaccination (adjusted odds ratio [aOR] 1.7, 95% CI 1.2-2.4), living in an urban center (aOR 3.2, 95% CI 1.8-5.7), and showing a face picture as part of the Grindr profile (aOR 4.0, 95% CI 2.3-7.0) were positively associated with PrEP disclosure. Self-identified Black and Latino users were less likely to report PrEP use (aOR 0.6, 95% CI 0.4-0.9 and aOR 0.5, 95% CI 0.4-0.9, respectively). Reporting PrEP use (aOR 1.7, 95% CI 1.2-2.4), living in an urban center (aOR 2.5, 95% CI 1.4-4.5), having a “discreet” status (aOR 1.6, 95% CI 1.0-2.5), and showing a face picture (aOR 2.7, 95% CI 1.5-4.8) were positively associated with reporting COVID-19 vaccination on their profile. Users in the southern United States were less likely to report COVID-19 vaccination status than those in the northeast United States (aOR 0.6, 95% CI 0.3-0.9). Conclusions Variations in PrEP disclosure are associated with race, whereas COVID-19 vaccination disclosure is associated with geographic area. However, rural GSN users were less likely to report both PrEP use and COVID-19 vaccination. The data demonstrate a need to expand health preventative services in the rural United States for sexual minorities. GSN platforms may be ideal for deployment of preventative interventions to improve access for this difficult-to-reach population.

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“…LGBTQ+ individuals in rural locations face specific obstacles and distressing challenges as a result of their geographic location (Lee & Quam, 2013; Movement Advancement Project, 2019; Willging et al, 2006). In the rural State of Oklahoma specifically, researchers have identified a lack of affirming policies, hostile cultural norms, earnings gaps, and exclusionary institutional practices that negatively impact LGBTQ+ people (Hubach et al, 2019; Mallory et al, 2011). However, not all research findings support the idea that rural and urban areas are associated with different distress levels.…”

Section: Oklahoma As a Rural Statementioning

confidence: 99%

Profiles of distress and self-harm among LGBTQ+ transitional youth in a rural state.

Knutson¹,

Jacobs²,

Hakman³

et al. 2021

Journal of Rural Mental Health

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In the rural state of Oklahoma, suicide rates are nearly double the U.S. national average. Self-harm behaviors are among the risk factors for suicide and are believed to regulate negative emotions such as depression and anxiety. LGBTQ+ transitional youth in rural areas are likely to experience elevated rates of depression, anxiety, and stress, relative to heterosexual, cisgender populations. In an effort to identify emotional and behavioral dynamics that may underlie self-harm in a rural state, 316 LGBTQ+ transitional youth in Oklahoma were recruited. Participants completed measures of negative affect, emotion regulation, outness, and self-harm. A cluster analysis was conducted to identify distressrelated trends in the data and identified clusters of high, moderate, and low distress groups. Chi-square analyses identified associations among groups based on gender expression, gender identity, sexual orientation, education, and homelessness. A regression equation identified predictors of self-harm. Cluster analysis results informed hierarchical organization of a linear regression equation in which the study team controlled for between-group differences and outness. In the final regression model [F (10, 305) = 14.20, p < .001], distress, emotion dysregulation, education variables, homelessness, and outness predicted self-harm behaviors. Implications of study findings for the distribution of resources and guidance for healthcare professionals and community advocates are discussed. Public Health Significance StatementThis study presents profiles of self-harm and distress among transitional youth in the state of Oklahoma. Results indicate that a variety of emotional and demographic factors predict self-harm behaviors in the survey participants.

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Experiences of Stigma by Gay and Bisexual Men in Rural Oklahoma

Cited by 34 publications

References 47 publications

Rural College Students’ Amenability Toward Using At-Home Human Immunodeficiency Virus and Sexually Transmitted Infection Testing Kits

Rural College Students’ Amenability Toward Using At-Home Human Immunodeficiency Virus and Sexually Transmitted Infection Testing Kits

Engagement With HIV and COVID-19 Prevention: Nationwide Cross-sectional Analysis of Users on a Geosocial Networking App

Profiles of distress and self-harm among LGBTQ+ transitional youth in a rural state.

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