Mountain Laurel Room Oral Abstracts
June 01, 2019 09:00 AM - 10:15 AM(America/Los_Angeles)
20190601T0900 20190601T1015 America/Los_Angeles Concurrent Session 4 - Substance Use

Session Chair

Gregory Lee Phillips II, PhD, Assistant Professor of Medical Social Sciences and Preventive Medicine, Northwestern University

Highlighted Posters:

Saturday, Poster #27 - Unpacking the Effects of Stress and Discrimination on Substance Use: Similarities and Differences Among Latino, Black, and Multi-Racial/Ethnic Young Men Who Have Sex with Men - Eric LaylandSaturday, Poster #34 - The potential role of early alcohol initiation in lesbian, gay and bisexual disparities in adult alcohol outcomes: Results from a national sample - Megan Schuler Saturday, Poster 35 - Hidden in plain sight: America's epidemic of drug and alcohol misuse among men, transmen, and transwomen who have sex with men - Drew Westmoreland
Mountain Laurel Room 2019 National LGBTQ Health Conference nationalLGBTQHealthConference@gmail.com
31 attendees saved this session

Session Chair

Gregory Lee Phillips II, PhD, Assistant Professor of Medical Social Sciences and Preventive Medicine, Northwestern University


Highlighted Posters:

  • Saturday, Poster #27 - Unpacking the Effects of Stress and Discrimination on Substance Use: Similarities and Differences Among Latino, Black, and Multi-Racial/Ethnic Young Men Who Have Sex with Men - Eric Layland
  • Saturday, Poster #34 - The potential role of early alcohol initiation in lesbian, gay and bisexual disparities in adult alcohol outcomes: Results from a national sample - Megan Schuler 
  • Saturday, Poster 35 - Hidden in plain sight: America's epidemic of drug and alcohol misuse among men, transmen, and transwomen who have sex with men - Drew Westmoreland
"Do e-cigarettes represent a harm reduction approach for the LGBT community? How do we reduce disparities in use?"
OralSubstance Use 09:00 AM - 10:15 AM (America/Los_Angeles) 2019/06/01 16:00:00 UTC - 2019/06/01 17:15:00 UTC
Issue: LGBT people are 1.5 to 2.5 times as likely to smoke regular cigarettes, a major driver of cancer and cardiovascular health disparities. Data indicate that LGBT people vape at a higher rate as well: the 2016 Mass. Behavioral Risk Factor Surveillance System survey found three times the rate of e-cigarette use among 18- to 24-year-old LGBT respondents. National Population Assessment of Tobacco and Health data (2013-2014) found higher rates of experimental tobacco use, including e-cigarettes, among lesbian and bisexual women under age 25 compared to heterosexual women. Do e-cigarettes represent a harm reduction approach to tobacco addiction, or are they increasing nicotine addiction by introducing a purportedly lower risk method of smoking, like “light” cigarettes did decades ago? What does the research say about the risk of e-cigarettes? What should provider and public health messaging be? What messages are LGBT community institutions sending about the social acceptability of e-cigarette use? Setting: Presenters will describe the latest research, guidance, and best practices on how to address e-cigarette use among LGBT individuals. Intended audiences include health care providers, case managers, public health professionals, policy makers, and researchers. Project: Presenters will address recent trends in e-cigarette use among LGBT people based on national and state-level population-based data sets, effects of e-cigarette use on LGBT people’s health, and describe structural policies of LGBT community institutions, such as LGBT Pride Celebrations and LGBT bars and clubs, that promote e-cigarette use among LGBT people. They will also describe best practices for providers to discuss the relative risk of e-cigarettes with patients. Results: E-cigarettes are a recent innovation, and research on the long-term effects of vaping on cardiovascular health, lung health, cancer risk, and other health conditions is limited. E-cigarettes contain nicotine and other chemicals, which increase the risk for a wide range of diseases and comorbidities. Providers should screen patients for vaping or e-cigarette use as well as smoking traditional cigarettes. E-cigarettes may represent a harm reduction approach for current smokers, but they are far from risk free. Many young people are becoming addicted to nicotine from vaping, without ever smoking regular cigarettes. Recently the Food and Drug Administration has taken important steps to regulate and limit youths’ ability to access e-cigarettes. While traditional tobacco use is less acceptable today, LGBT Pride celebrations accept sponsorship from e-cigarettes and vape shops, and some LGBT clubs allow vaping even as cigarette smoking is prohibited. Lessons Learned: Health care providers, public health professionals, policy makers, and LGBT institutions can take a number of steps to reduce smoking and vaping. LGBT community organizations should eschew policies that send a message that vaping is acceptable, and that actually promote the use of e-cigarettes.
Presenters
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Regina Washington
P.O. Box 24490, CenterLink, Inc.
SC
Sean Cahill
Director, Health Policy Research, The Fenway Institute
Latent profile analysis of a syndemic of victimization, depression, and substance use affecting sexual risk behavior in adolescent males who have sex with males
OralAdolescent Health 09:00 AM - 10:15 AM (America/Los_Angeles) 2019/06/01 16:00:00 UTC - 2019/06/01 17:15:00 UTC
Background: HIV and sexually transmitted infections (STIs) disproportionately affect men who have sex with men in the United States. Adolescent males who have sex with males (MSM) are an especially high risk group within this population, with HIV/STI incidence partially driven by sexual risk behaviors. Per syndemic theory, mutually reinforcing risk factors may converge to have a cumulative effect on a health outcome. Victimization, depression, and substance use may form a syndemic among adolescent MSM, impacting sexual risk behaviors. Thus, our study purpose is to test for a syndemic of these factors affecting sexual risk behaviors among adolescent MSM.
Methods: We conducted a cross-sectional study using the 2015 and 2017 Youth Risk Behavior Survey (YRBS), a nationally representative dataset. We restricted our sample to males who reported at least one lifetime same-sex sexual partner (n=448). Exposures included 6 non- sexual victimization measures (bullying, electronic bullying, fights, fights at school, threatened with a weapon, absent due to fear), 3 sexual victimization measures (sexual violence, sexual assault, forced intercourse), 1 depression measure, and 10 substance use measures (heavy drinking, binge drinking, marijuana, cocaine, heroin, methamphetamines, ecstasy, synthetic marijuana, prescription drug abuse, injecting drugs). Sexual risk behavior outcomes were substance use at last intercourse, condomless sex at last intercourse, and number of sexual partners in the past 3 months. In addition to bivariate analyses, we conducted an inclusive latent profile analysis (LPA) using each of the exposures and our outcomes. The LPA model was selected by comparing adjusted likelihood ratio tests (aLRT), entropy, and Bayesian Information Criterions (BIC) across models. Log-binomial and cumulative complementary log-log models were used to generate prevalence ratios (PR) for each outcome across profiles, both unadjusted and adjusted (aPR) for age, race, and survey year. All analyses accounted for the survey design effects. Analyses were conducted in R 3.4.0 and SAS 9.4.
Results: All victimization, depression, and substance use measures were associated with more substance use at last intercourse. Every exposure other than bullying was associated with more recent sex partners. Only forced intercourse was associated with condomless sex. Our LPA identified a 3 profile model as an ideal fit (Entropy=0.995, BIC=41030.82, aLRT p
Presenters
RT
Rodman Turpin
Lecturer, University Of Maryland
Co-Authors
JS
John Salerno
PhD Student, University Of Maryland
AR
Andre Rosario
INOVA Healthcare
BB
Bradley Boekeloo
1234 BCH Dept, University Of Maryland
Racial/ethnic differences in mental health, substance use, and bullying victimization among self-identified bisexual youth
OralIntersections of Race/Ethnicity and LGBTQ Health 09:00 AM - 10:15 AM (America/Los_Angeles) 2019/06/01 16:00:00 UTC - 2019/06/01 17:15:00 UTC
Background: Sexual minority youth are at increased risk for mental health problems and substance use, and accumulating evidence indicates that bisexual youth are at greatest risk. However, bisexual youth are not a homogenous group and scholars have called for greater attention to the intersections of multiple marginalized identities. As such, we examined racial/ethnic differences in mental health, substance use, and bullying victimization among self-identified bisexual youth in grades 9-12 in the United States. Methods: Data from the local versions of the Youth Risk Behavior Survey (YRBS) were pooled across jurisdictions and years (2005-2015), resulting in an analytic sample of 27,967 self-identified bisexual youth (40.9% White, 18.3% Black, 30.5% Hispanic, 10.3% other races). Sex-stratified, multivariable logistic regression models were used to estimate the odds of each outcome associated with race/ethnicity, first controlling for age and survey year and then controlling for bullying victimization. Results: Compared to White bisexual female youth, Black bisexual female youth were less likely to report sadness/hopelessness (OR = 0.39), suicidal ideation (OR = 0.42), cigarette use (OR = 0.33), binge drinking (OR = 0.43), and illicit drug use (OR = 0.56); Hispanic bisexual female youth were less likely to report sadness/hopelessness (OR = 0.72), suicidal ideation (OR = 0.72), and cigarette use (OR = 0.69); and bisexual female youth of other races were less likely to report binge drinking (OR = 0.57) and marijuana use (OR = 0.55). In an exception, Black bisexual female youth were more likely to report marijuana use, but only after controlling for bullying victimization (OR = 1.42). Black bisexual male youth were also more likely to report marijuana use than White bisexual male youth (OR = 2.72), but there were no other racial/ethnic differences in the health of bisexual male youth. Finally, bisexual youth of color (female and male) were less likely to report bullying victimization than White bisexual youth (OR range from 0.29-0.70), and most of the racial/ethnic differences in mental health and substance use remained significant after controlling for bullying victimization (except the reduced odds among Hispanic bisexual female youth). Discussion: We found substantial evidence of racial/ethnic differences in mental health problems and substance use among bisexual female youth, but limited evidence among bisexual male youth. Most of the racial/ethnic differences remained significant after controlling for bullying (except the reduced odds among Hispanic bisexual female youth). Bisexual female youth of color may be less likely to report mental health problems and substance use because of unique strengths that provide resilience in the face of stigma. However, they may also be less likely to disclose their sexual orientation resulting in less exposure to stigma. Our data cannot explain why Black bisexual youth were more likely to report marijuana use. It will be important to continue to examine the mechanisms underlying racial/ethnic differences in the health of bisexual youth. In sum, our findings highlight the heterogeneity of bisexual youth and the need to consider multiple marginalized identities to understand the health disparities affecting this diverse population.
Presenters Brian Feinstein
Research Assistant Professor, Northwestern University Institute For Sexual And Gender Minority Health And Wellbeing
Co-Authors
BT
Blair Turner
Northwestern University
Lauren Beach
Postdoctoral Research Fellow, Northwestern University Institute For Sexual And Gender Minority Health And Wellbeing
AK
Aaron Korpak
Northwestern University
Gregory Phillips II
Assistant Professor, Northwestern University
Tobacco: A Tool for Gender Minority Young Adult Identity Management
No preferenceAdolescent Health 09:00 AM - 10:15 AM (America/Los_Angeles) 2019/06/01 16:00:00 UTC - 2019/06/01 17:15:00 UTC
Background: Tobacco use can be conceptualized as a social behavior used by individuals to express themselves, and to signal their membership in certain groups. Among men, adoption of traditional masculine gender norms is associated with health risk behaviors that include cigarette smoking. Research also points to cigarette use as an expression of rebellion or non-conformity to a society that attaches stigma to groups, such as the larger lesbian, gay, bisexual, and transgender (LGBT) community. Little research has examined how transgender and other gender diverse individuals (those whose biological sex and gender identity do not match) use tobacco to express their identities. This study investigated the ways gender minority (GM) young adult smokers use tobacco to express and uphold their gender identity. Methods: Twenty-five current or former tobacco-using GM young adults (mean age=23.2 years, 64.0% non-Hispanic White) participated in 1-hour, one-on-one, semi-structured interviews that focused on their tobacco use patterns, reasons for use, and contexts of use. Interviews were audio recorded, transcribed, and thematically coded by independent raters. Results: Smoking behaviors were frequently used to establish and maintain close social circles, as well as to bridge potentially awkward interactions with non-transgender individuals in public settings. Some participants highlighted smoking as a way to signal the rebellious and close-knit nature of their queer community. One participant described smoking as a tool for exhibiting masculine behavior that validated an otherwise externally invisible masculine identity. Discussion: GM young adults describe unique ways tobacco use is tied to their gender identity and expression. Tobacco use, especially cigarettes, provide a means of expressing and validating gender identity that is often stigmatized or hidden. Smoking is also seen as a way to signal group membership in a larger society where smoking behaviors are decreasingly accepted. Health professionals should consider the unique ways GM young adults use tobacco when tailoring prevention and cessation messages.
Presenters Josephine Hinds
Doctoral Candidate, The University Of Texas At Austin
Co-Authors
AL
Alexandra Loukas
The University Of Texas At Austin
CP
Cheryl Perry
UT Health Science Center At Houston
Doctoral Candidate
,
The University of Texas at Austin
Research Assistant Professor
,
Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing
Lecturer
,
University of Maryland
P.O. Box 24490
,
CenterLink, Inc.
Director, Health Policy Research
,
The Fenway Institute
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