Religious Climate and Health Risk Behaviors in Sexual Minority Youths: A Population-Based Study

Hatzenbuehler, Mark L.; Pachankis, John E.; Wolff, Joshua R.

doi:10.2105/ajph.2011.300517

Cited by 126 publications

(89 citation statements)

References 26 publications

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“…36,37 Among LGBT individuals, poor mental health, specifically anxiety and depression, is associated with health risks. [22][23][24][25][38][39][40][41] Furthermore, individuals in same-sex relationships report significantly more barriers to healthcare access than individuals in opposite-sex relationships. 42 Based on data from other countries, these disparities might be attributable to minority stress, healthcare discrimination, and lack of LGBT-specific medical expertise.…”

Section: Introductionmentioning

confidence: 99%

“…42 Based on data from other countries, these disparities might be attributable to minority stress, healthcare discrimination, and lack of LGBT-specific medical expertise. 22,25,40,[43][44][45][46][47][48][49][50] By targeting mental health concerns through psychosocial interventions, physical health risk behaviors are concomitantly addressed. 51,52 LGBT-competent mental healthcare, which is urgently needed given LGBT individuals' elevated prevalence of psychiatric disorders, 22,[25][26][27][28]30,53 is lacking in Romania (LelutiuWeinberger C, Manu M, Lȃscut F, et al: Preliminary efficacy of the first mobile health intervention to reduce HIV risk among MSM in Romania.…”

Section: Introductionmentioning

confidence: 99%

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Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Leluţiu-Weinberger

Pachankis

2017

LGBT Health

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Purpose: Lesbian, gay, bisexual, and transgender (LGBT) individuals in Romania encounter pervasive stigma and discrimination and there is a high need for LGBT-competent mental health professionals (MHPs). We tested the impact of a pilot LGBT-affirmative training for MHPs in Romania on these professionals' LGBT-relevant attitudes, knowledge, and perception of clinical skills. Methods: We conducted a 2-day training for MHPs in Bucharest. Fifty-four attended and 33 provided training evaluation data at baseline and follow-up. Results: The majority of trainees were female (90%) and heterosexual (73%) with a mean age of 36.4 (SD = 7.7). From baseline to follow-up, trainees demonstrated a significant increase in perceived LGBT-relevant clinical skills (P < 0.001) and perceived knowledge (P < 0.05).LGBT-affirmative practice attitudes (P < 0.05) and comfort in addressing the mental health of LGBT individuals (P < 0.01) increased significantly, and homonegative and transnegative attitudes decreased significantly (P < 0.01). Negative attitudes toward LGBT individuals were low at both baseline and follow-up. The majority of trainees reported being highly interested in the training (84%), which they reported had prepared them to interact with and care for LGBT individuals (74%). Conclusion: This pilot training appeared to be effective in increasing perceived LGBT competence among participating MHPs. This type of training model needs to be tested further in a randomized controlled trial with longer follow-up periods to assess intervention durability and implementation of clinical skills. Future trainings can be incorporated into existing curricula. National accreditation bodies might consider encouraging such training as part of standard educational requirements.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Leluţiu-Weinberger

Pachankis

2017

LGBT Health

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“…'' 6,50 Structural factors, such as institutional climate, have been shown to influence important decisions among SGM, including those regarding health behaviors and expenditures. [51][52][53][54][55][56] Given the demonstrated influence of structural factors, our findings merit further study. In addition, the items used to evaluate climate were adapted for use with medical students from a scale originally designed and validated for use with undergraduate populations.…”

Section: Discussionmentioning

confidence: 82%

Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate

Sitkin

Pachankis

2016

LGBT Health

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Purpose: Sexual and gender minorities (SGMs) in medicine experience unique stressors in training. However, little is known about SGM specialty choice. This study examined predictors of SGM specialty choice, associations between specialty prestige and perceived SGM inclusion, and self-reported influences on specialty choice. Methods: Medical trainees and practitioners (358 SGM, 1528 non-SGM) were surveyed online. We operationalized specialty choice at the individual level as respondents' specialty of practice; at the specialty level, as a percentage of SGM respondents in each specialty. We examined specialty prestige, perceived SGM inclusivity, and medical school climate as predictors of SGM specialty choice, and we compared additional influences on specialty choice between SGM and non-SGM. Results: The percentage of SGM in each specialty was inversely related to specialty prestige (P = 0.001) and positively related to perceived SGM inclusivity (P = 0.01). Prestigious specialties were perceived as less SGM inclusive (P < 0.001). Medical school climate did not predict specialty prestige (P = 0.82). SGM were more likely than non-SGM to indicate that sexual and gender identity strongly influenced specialty choice (P < 0.01). SGM most frequently rated personality fit, specialty content, role models, and work-life balance as strong influences on specialty choice. Exposure as a medical student to SGM faculty did not predict specialty prestige among SGM. Conclusion: Specialty prestige and perceived inclusivity predict SGM specialty choice. SGM diversity initiatives in prestigious specialties may be particularly effective by addressing SGM inclusion directly. Further research is needed to inform effective mentorship for SGM medical students. Exposure to SGM in medical training reduces anti-SGM bias among medical professionals, and SGM in medicine often assume leadership roles in clinical care, education, and research regarding SGM health. Supporting and promoting SGM diversity across the spectrum of medical specialties, therefore, represents a critical avenue to improve the care delivered to SGM populations and addresses the role of providers in the health disparities experienced by SGM.

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“…Consequently, it is not known how belonging to religions that discourage homosexuality as measured at the national level was borne out in the interactions between the individual MSM and their local religious environments, or whether the men necessarily perceived any interaction or exposure to such environments as negative. Therefore, the possibility of spurious associations due to misclassification bias cannot be ruled out (Hatzenbuehler, Pachankis, & Wolff, 2012). There is little research that investigates the perceptions of childhood religious affiliations and its effect on Black MSM.…”

Section: Limitationsmentioning

confidence: 99%

Childhood Exposure to Religions With High Prevalence of Members Who Discourage Homosexuality Is Associated With Adult HIV Risk Behaviors and HIV Infection in Black Men Who Have Sex With Men

et al. 2016

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Exposure to childhood religious affiliations where the majority of members discourage homosexuality may have negative psychological impacts for Black men who have sex with men. This study tested the hypothesis that exposures to these environments during childhood were associated with adulthood human immunodeficiency virus (HIV)/sexually transmitted infection (STI) behavioral risk and HIV infection, because these exposures influenced HIV/STI risk by undermining race/sexual identity congruence and increasing internalized homophobia and interpersonal anxiety. Structural equation modeling as well as logistic and Poisson regressions were performed using baseline data from HIV Prevention Trials Network 061 ( N = 1,553). Childhood religion affiliations that were more discouraging of homosexuality were associated with increased likelihood of HIV infection; however, the association was no longer significant after adjusting for age, income, and education. Having a childhood religion affiliation with high prevalence of beliefs discouraging homosexuality was associated with increased numbers of sexual partners (adjusted odds ratio = 4.31; 95% confidence interval [3.76, 4.94], p < .01). The hypothesized path model was largely supported and accounted for 37% of the variance in HIV infection; however, interpersonal anxiety was not associated with HIV/STI risk behaviors. Structural interventions are needed that focus on developing affirming theologies in religious institutions with Black men who have sex with men congregants.

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Religious Climate and Health Risk Behaviors in Sexual Minority Youths: A Population-Based Study

Abstract: The religious climate surrounding LGB youths may serve as a determinant of their health risk behaviors.

Cited by 126 publications

References 26 publications

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate

Childhood Exposure to Religions With High Prevalence of Members Who Discourage Homosexuality Is Associated With Adult HIV Risk Behaviors and HIV Infection in Black Men Who Have Sex With Men

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