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Please read and accept the terms and conditions and check the box to generate a sharing link. Black young gay, bisexual, and other men who have sex with men YGBMSM are at high risk for negative health outcomes, though this population is underrepresented in the health literature.
An extensive literature review and content analysis of health-related peer-reviewed articles was conducted that targeted Black YGBMSM, examining five content areas: sexual health, health care, substance use, psychosocial functioning, and sociostructural factors. A coding sheet was created to collect information on all content areas and related subtopics and computed descriptive statistics. Important sociostructural factors, including sexual networks and race-based discrimination, were poorly represented. Last, there was a noteworthy deficit of qualitative studies and research exploring intersectional identity and health.
More research is needed on the diverse health issues of a vulnerable and underexamined population. The health and well-being of adolescents and young adults has been an area of prominent focus in public health. These factors serve to contextualize behavioral health risk and health outcomes for adolescents and young adults.
While these health concerns are applicable to youth as a whole, lesbian, gay, bisexual, transgender LGBTand other nonheterosexually identified youth may face additional challenges related to health. Researchers have reported that LGBT adolescents have considerably higher rates of substance use when compared with heterosexual adolescents, and that substance use is also associated with sexual risk taking and suicide attempts among gay and bisexual youth Jordan, ; Marshal et al.
Furthermore, LGBT adolescents have much higher rates of depression, suicidal ideation, and suicide completion when compared with heterosexual youth Haas et al. Taken together, these concerns highlight a need for continued research that addresses psychosocial functioning, but also speaks to a need to examine the social determinants that give rise to adverse health outcomes. Sexual health is another important health domain for LGBT adolescents. Young gay, Large ebony dating sexual encounters, and other men who have sex with men YGBMSM in particular are at elevated risk for adverse sexual health outcomes.
YGBMSM also have nuanced experiences across a of general sexual health that may have important implications for sexual health outcomes, including age of partners, race of partners, sexual positioning e. Many of these factors remain hypothetical as few empirical studies have explored the relationship between HIV infection and macro-level variables that may influence health outcomes Maulsby et al.
In an effort to develop prevention and intervention initiatives tailored to the specific needs of Black YGBMSM, it will be important for HIV researchers to examine community, cultural, and sociostructural correlates of HIV risk within this population. In addition to sexual health risk, many important nonsexual health domains for Black YGBMSM—such as mental health and intersectional identity development across marginalized groups e.
It is essential, however, to consider the needs and experiences of Black YGBMSM holistically, especially when this population continues to suffer disproportionate rates of negative health outcomes. The investigators examined a broad scope of health domains for this population, covering five substantive content areas: a sexual health, b health care, c substance use, d psychosocial functioning, and e sociostructural factors. The first from each search term combination on Google Scholar were checked for a total of search. Across all search engines, duplicate citations were quickly identified and avoided due to browser settings that highlight ly clicked links in a different color.
A content analysis coding and data sheet was created to gather information on demographics, recruitment strategies, research methods used in each article, the five core content areas related to health, and related subtopics within each content area. For sexual orientation, the investigators recorded every sexual identity label used by the authors and identified 26 identity labels in total.
Many of these labels included combined identity terms e. Through a thematic analysis process, the comprehensive set of identity labels were collapsed into a smaller set of similar. The investigators coded for recruitment strategies and research methodologies employed in each article; a list of these are noted on Table 1.
The investigators coded for five substantive areas of health with each content area including a set of specific topics and subtopics. All topics for sexual health, health care, and substance use are listed on Table 2and all topics for psychosocial functioning and sociostructural factors are listed on Table 3. Table 1. Article Characteristics, Demographics, Recruitment, and Methodology. The analytic strategy was informed using ly established guidelines around quantitative content analysis Krippendorf, For these cases, the N was calculated by multiplying the percentage by the total sample size and rounded to the nearest whole.
Frequencies and percentages were calculated for all content areas, all topic and subtopic content codes and all demographic. Last, the of articles published per year in the target date range were collected as well as overall percentages for each year. In total, 54 articles were identified that met the inclusion criteria, which is an approximate average of two articles per year all articles included in the review are denoted with an asterisk in the references section. A total of 22 articles Only 38 articles Of these, the mean age of participants was Of the articles with a mixed gender sample, one included seven transidentified participants male to female.
Approximately two fifths A sizable portion MSM that were strictly nongay identified composed 0. In contrast, Considerably fewer participants were categorized as straight 0. No article included a school-based venue for recruitment. Last, there was a pronounced skew in the distribution of publication dates over time.
A total of 49 articles Only three articles 5. Overall, 10 of the articles Eight articles No article included data on tobacco use, and only two articles 3. Six articles Of the subtopics for homophobia, six articles Only four articles 7. Of the subtopics for racism, one article 1. This study aimed to provide an integrative review and content analysis of health literature targeting Black YGBMSM between and As the issue of identity would feature prominently in this review, the investigators saw fit to begin the discussion on the basic classification strategies that researchers used to describe the study sample.
Specifically, the matter of sexual identity was of particular interest and proved to be somewhat complex. Across articles, researchers used a wide range of different sexual identity labels, many of which were conflated into one e. The confluence of multiple identity terms may be problematic, as the meaning and ificance of one term may not be interchangeable with another, and may thus be an inaccurate representation of the participants involved in the study. Identity labels that have emerged as popular alternatives to traditional LGBT identity terms, such as pansexual and same gender loving, were not reported in any article in this review.
Other identity labels, such as two-spirited and questioning, were used sparingly and in combination with other terms as noted above. Nearly half of the participants were classified as MSM with no other identity term, reflecting a common trend in the academic literature of reducing gay and bisexual men to a set of behaviors in studies on sexual health. This review thus highlights a need for consensus and consistency in applying identity labels in future research, as well as the importance of promoting identity-affirming language that is sensitive to the variations in self-labeling preferences among nonheterosexually identified persons.
With regard to the five core content areas, topics related to sexual health emerged as the most prominent concern among the population of focus. Nearly every article in this review addressed some aspect of sexual behavior and related health outcomes, most notably HIV, condom use, and sexual activity. In contrast, HIV stigma was only Large ebony dating sexual encounters in two articles, even though many researchers have suggested that stigma related to HIV may be a fundamental driving force behind the epidemic Maulsby et al. Researchers have stressed the universal importance of addressing these topics in the effort to combat HIV, as they have major implications for HIV transmission, treatment, and prevention World Health Organization, Many important general sexual health subtopics were seldom addressed across the articles in this review, including experiences of sexual violence, which only appeared in two articles.
Sexual assault and intimate partner violence are both vitally important concerns with serious consequences for the health and well-being of survivors. Online partner seeking was also addressed sparingly, though this area of study for GBMSM is relatively new.
Both of these topics will have important implications in the development of culturally tailored interventions targeting Black YGBMSM and will be critical for researchers to continue investigating in greater depth. Sexual positioning was the most commonly occurring general sexual health subtopic in this review. In one study, researchers reported that Latino participants were ificantly more likely to have engaged in receptive anal sex when compared with Black participants; in another, researchers noted that Black participants were more likely than White participants to have engaged in receptive anal sex in their most recent sexual encounter with a causal partner Halkitis et al.
The distinction between casual versus primary partners i. The diversity of findings on sexual positioning and relationship type, as well as the implications of these findings for sexual health risk and well-being, suggests that continued research is needed on these Large ebony dating sexual encounters topics. The literature base may be further improved by the inclusion of studies with a dominant focus on relationships and dating, and that explore the negotiation and of these processes, as such topics have received less attention in the literature on Black YGBMSM.
Along with research on sexual health and HIV, sexual orientation identity was also prominently featured in this review and ed for nearly a third of all psychosocial functioning content codes. This finding gives further credence that sexuality and sexual expression remain the dominant focus of research addressing the health and well-being of Black YGBMSM.
While studies that explore identity are inherently meaningful for a population that is oppressed on the basis of identity, it is equally important to acknowledge intersecting identities, as well as the different dimensions of health and experiences that make up the diverse lives of Black YGBMSM.
The lack of an intersectional approach to exploring identity reflects an area of great opportunity for researchers, as intersectionality provides a theoretical framework that is inherently suitable for research examining multiple axes of oppression for marginalized groups Bowleg, Such an approach may enhance the knowledge of the unique developmental trajectories of Black YGBMSM, and may inform directions for future research and tailored health promotion initiatives for this population.
In terms of other psychosocial functioning issues covered in this review, social support was modestly represented, with 10 articles reporting data on the topic. Both health-promoting and health-harming outcomes related to social support were explored across articles. Issues related to social support among Black YGBMSM will be an essential area for investigators concerned with psychosocial functioning and well-being to continue to explore. Researchers may want to consider the social contexts of Black YGBMSM on future studies that address social support, paying particular attention to situations that deny or limit opportunities to secure support from friends, family, or community members.
In addition to social support, depression was also modestly represented in the review, having been discussed across 10 different articles. Many researchers reported that high rates of depressive symptomology was common among this population Hightow-Weidman, Phillips, et al. Both academia and popular media have been filled with passionate discourse around these topics—owing in large part to the increased media coverage of suicides among LGBT youth, which were often a result of bullying and harassment Hatzenbuehler, ; Henkin, All four articles in this review that discussed suicide drew data from predominantly Black and Latino samples, and each of them noted that participants reported high rates of ever having made a plan to attempt suicide or ever having made an actual suicide attempt Hightow-Weidman, Jones, et al.
Three of these articles, however, used the same data set, in effect leaving only two unique samples from which data were collected that addressed suicide. Overall, this review indicates that there is a paucity of research that addresses psychosocial functioning among Black YGBMSM, as well as critical mortality outcomes such as suicide. Given the severe nature of these topics and the high rates of negative health outcomes reported, researchers should examine these issues in future studies on Black YGBMSM health.
While many of the articles in the review included content on substance use, the majority of these articles included data on the use of drugs other than alcohol or tobacco. It will be important for researchers to continue to monitor these associations, and for public health practitioners to address substance use when deing and implementing interventions for this population. Although alcohol use was adequately represented in this review, there was a diverse range of findings and discussion on the use of alcohol across articles.
No article in the review included any discussion on alcohol use outside of the context of HIV risk. Given such variedthe association of alcohol use on health behaviors and outcomes warrants closer attention in future studies on Black YGBMSM. Content on tobacco use was poorly represented in the review as no article meeting the inclusion criteria included data on this topic.
Researchers with a primary focus in health disparities related to cigarette and tobacco use may consider developing studies that target this population specifically. Content on substance abuse was also poorly represented in the review. The deficit of data included on substance abuse may be an extension of the overall shortage of data on psychosocial functioning, as the rates of comorbidity between substance abuse and a of clinical outcomes—including depression and suicide—has been well established Merikangas et al.
Researchers may consider developing studies that focus on clinical samples of Black YGBMSM who are actively participating in treatment for addiction to better capture data on substance abuse and dependence that may otherwise be elusive in samples drawn from the general population.
This review suggests that studies on health service delivery and receipt, as well as health insurance, are underdeveloped in the literature targeting Black YGBMSM. From the articles collected, the from studies on the quality and accessibility of health care appear to be mixed. In one study, researchers reported that Black YGBMSM were more likely to receive prevention and counseling services from their providers as well as report greater use of and satisfaction with their health care providers Behel et al. Other studies, however, reported that some Black YGBMSM experience difficulties in trusting providers and perceive a lack of respect on the part of providers Magnus, Jones, et al.
This is especially important given the shifting landscape of biomedical treatment and prevention options for HIV. Therefore, the investigators consider it essential for researchers to take these factors into when developing future studies that address health care for Black YGBMSM. Of these sociostructural factors, social and environmental context was the most commonly occurring topic, with 19 articles collecting data on a diverse range of subtopics within this area.
Despite the fact that stigma was measured as a stand-alone variable in only two articles, discussions across the studies in this review highlighted the pervasiveness of stigma on the basis of sexual behavior or orientation within different social settings. Researchers should thus aim to pursue school-based recruitment strategies as well as examine community, peer, and family contextual factors in future studies on Black YGBMSM health. In addition, few articles included data on sexual networks, which is another noteworthy shortcoming in the literature.
These restrictions may be partially governed by social determinants of health, such as racial prejudice, or may be a function of selective in-group race preferences Berry et al. Future studies should therefore investigate the ways in which race and racism are associated with the health outcomes of Black YGBMSM, paying special attention to how other contextual variables—such as social networks, communities, and broader social structures—are also associated with health.
Overall, this review of the literature reveals an exceedingly sparse of articles addressing Black YGBMSM health between and At a total of 54 articles, an approximate average of two articles per year during this time span have been published that meet the criteria for this review.Large ebony dating sexual encounters
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