Who has the worst attitudes toward sexual minorities? Comparison of transphobia and homophobia levels in gender dysphoric individuals, the general population and health care providers

LAY SUMMARY The purpose of this study was to learn more about the smoking habits of U.S. Veterans compared with the rest of the population and to find the best ways to help Veterans quit smoking. This study found that Veterans tend to smoke more than the general population and that some groups of Veterans smoke more than others. When helping Veterans to quit smoking, health care providers should use approaches that are based on evidence, such as cognitive behavioral therapy, cognitive processing therapy, mindfulness-based stress reduction, and biofeedback in addition to the traditional 3A cessation model (ask, advise, refer).

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The role of country-level structural stigma on sexual orientation disclosure and discrimination in health care settings among lesbian, gay, and bisexuals across Europe

European Journal of Public Health ◽

10.1093/eurpub/ckz185.467 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

R Bränström ◽

J E Pachankis

Keyword(s):

Health Care ◽

Sexual Orientation ◽

Health Care Providers ◽

Sexual Minority ◽

Sexual Minorities ◽

Care Providers ◽

Health Care Settings ◽

Country Level ◽

Disclosure Of Sexual Orientation ◽

Sexual Orientation Disclosure

Abstract Background The national climate surrounding sexual minorities (i.e., those self-identifying as lesbian, gay, or bisexual [LGB]) varies greatly worldwide. Recent Cross-European studies have shown that country-level structural stigma is a strong determinant of sexual minority individuals health risk behaviors and mental health. The consequences of the significant country-level variation in structural stigma on sexual minorities’ experiences of health care discrimination and disclosure of sexual orientation to health care providers have not been previously investigated. Methods In 2012, 86 000 sexual minority individuals (aged 18 years and older) from all 28 European Union countries responded to questions concerning discrimination in health care settings and sexual orientation disclosure to health care providers (EU LGBT survey). Structural stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of sexual minority acceptance among citizens of each country. Results Disclosure of sexual orientation to health care providers were much more common in low stigma coutries (e.g., the Netherlands, Sweden, UK) compared to high stigma coutries (e.g., Lithuania, Latvia, Slovakia). Experiences of discrimination in health care settings were more common among LGB indiviudals who were open about their sexual orientaiton and increased by degree of country-level structural stigma. Conclusions Disclosure of sexual orientation and experiences of discrimination in health care settings varies greatly among LGB individuals in Europe largely due to structural stigma surrounding sexual minorities. Main messages These findings highlight the importance of eliminating legislation, policies, and national attitudes that promote the unequal treatment of sexual minorities in currently unsupportive European countries.

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Iranian general populations' and health care providers' preferences for benefits and harms of statin therapy for primary prevention of cardiovascular disease

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-020-01304-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Hassan Saadati ◽

Hamid Reza Baradaran ◽

Goodarz Danaei ◽

Afshin Ostovar ◽

Farzad Hadaegh ◽

...

Keyword(s):

Health Care ◽

Cardiovascular Diseases ◽

Primary Prevention ◽

General Population ◽

Statin Therapy ◽

Health Care Providers ◽

Urban Areas ◽

Block Design ◽

Healthcare Providers ◽

Care Providers

Abstract Background The use of statins for primary prevention of cardiovascular diseases is associated with different benefit and harm outcomes. The aime of this study is how important these outcomes are for people and what people's preferences are. Methods We conducted a preference-eliciting survey incorporating a best–worst scaling (BWS) instrument in Iran from June to November 2019. The relative importance of 13 statins-related outcomes was assessed on a sample of 1085 participants, including 913 general population (486 women) and 172 healthcare providers from the population covered by urban and rural primary health care centers. The participants made trade-off decisions and selected the most and least worrisome outcomes concurrently from 13 choice sets; each contains four outcomes generated using the balanced incomplete block design. Results According to the mean (SD) BWS scores, which can be (+ 4) in maximum and (− 4) in minimum, in the general population, the most worrisome outcomes were severe stroke (3.37 (0.8)), severe myocardial infarction (2.71(0.7)), and cancer (2.69 (1.33)). While myopathy (− 3. 03 (1.03)), nausea/headache (− 2.69 (0.94)), and treatment discontinuation due to side effects (− 2.24 (1.14)) were the least worrisome outcomes. Preferences were similar between rural and urban areas and among health care providers and the general population with overlapping uncertainty intervals. Conclusion The rank of health outcomes may be similar in various socio-cultural contexts. The preferences for benefits and harms of statin therapy are essential to assess benefit-harm balance when recommending statins for primary prevention of cardiovascular diseases.

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HP-03-008 Transphobia and homophobia levels in gender dysphoric individuals, general population and health care providers

Journal of Sexual Medicine ◽

10.1016/j.jsxm.2016.03.118 ◽

2016 ◽

Vol 13 (5) ◽

pp. S124 ◽

Cited By ~ 2

Author(s):

A.D. Fisher ◽

G. Castellini ◽

E. Fanni ◽

H. Casale ◽

M. Tagliagambe ◽

...

Keyword(s):

Health Care ◽

General Population ◽

Health Care Providers ◽

Care Providers

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PS-01-001 Transphobia and homophobia levels in gender dysphoric individuals, general population and health care providers

Journal of Sexual Medicine ◽

10.1016/j.jsxm.2017.03.073 ◽

2017 ◽

Vol 14 (4) ◽

pp. e107

Author(s):

G. Castellini ◽

J. Ristori ◽

A. Fisher ◽

J. Ristori ◽

H. Casale ◽

...

Keyword(s):

Health Care ◽

General Population ◽

Health Care Providers ◽

Care Providers

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Knowledge Gaps among Patients and Providers in HPV-Related Oropharyngeal Cancer: A Systematic Review

Otolaryngology ◽

10.1177/0194599820908596 ◽

2020 ◽

Vol 162 (5) ◽

pp. 612-621 ◽

Cited By ~ 2

Author(s):

Sean M. Parsel ◽

Blair M. Barton ◽

Sydney Beatty ◽

Paul L. Friedlander

Keyword(s):

Health Care ◽

General Population ◽

Health Care Providers ◽

English Language ◽

Human Subjects ◽

Controlled Trial ◽

Meta Analysis ◽

Case Series ◽

Primary Outcome Measure ◽

Care Providers

Objective To describe the level of knowledge of human papillomavirus (HPV) and HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) among the general population and health care providers. Data Sources Systematic search was performed on December 20, 2018, using MEDLINE (1966 to December 2018), EMBASE (1975 to December 2018), Web of Science (1900 to December 2018), and CENTRAL (1996 to December 2018) databases. English-language literature involving human subjects was used, and studies were limited to case series, case-control, cohort, and randomized controlled trial designs. Review Methods Studies were included if they assessed knowledge of HPV and HPV-associated OPSCC. The primary outcome measure was the knowledge of HPV-associated OPSCC among the general population and with health care providers. Meta-analysis of proportions was attempted using random-effects model. The PRISMA guidelines were used for accuracy of reporting. Results Thirty-two studies were included with 17,288 participants. There was a high degree of heterogeneity preventing completion of a meta-analysis. Knowledge of HPV and HPV-associated OPSCC varied between the general population and health care providers. The proportion of the general population and health care providers with knowledge of HPV ranged from 16% to 75% and 21% to 84%, respectively. Knowledge of HPV-associated OPSCC was greater in health care providers and ranged from 22% to 100% compared with the general population, which ranged from 7% to 57%. Conclusion There is a knowledge gap of HPV-associated OPSCC for both the general population and health care providers. Additional education may not only increase awareness but may also result in prevention and earlier detection.

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Between Private and Public: AIDS, Health Care Capitalism, and the Politics of Respectability in 1980s America

Journal of American Studies ◽

10.1017/s0021875818000518 ◽

2018 ◽

Vol 54 (1) ◽

pp. 159-183

Author(s):

JONATHAN BELL

Keyword(s):

Health Care ◽

Health Care Providers ◽

Reagan Administration ◽

Access To Health Care ◽

Sexual Minorities ◽

Opportunistic Infections ◽

Task Force ◽

Care Providers ◽

Health Crisis ◽

Aids Crisis

The AIDS crisis in the US in the 1980s radically transformed the relationship between sexual minorities and capitalism. Opportunistic infections given free rein in human bodies by HIV rendered employees visible to employers and to health care providers as an economic risk, and set the stage for battles between health capitalists, politicians, and AIDS activists over access to health care. Health capitalism in 1980s America was both an arena of integration of queer Americans into mainstream society and also a political cul-de-sac, blunting the radical possibilities of sexual politics that were alive in the years before the AIDS crisis. In this article I focus on activist groups, primarily ACT UP, Gay Men's Health Crisis, National Gay Rights Advocates, and National Gay and Lesbian Task Force, and the liberal politicians who led legislative battles at federal and state level to force the health care system to respond to AIDS. In shifting our gaze from the Reagan administration and the religious right as the primary foils to AIDS activism, we can gain new insights into the direction of liberal politics in an era of supposed conservative ascendancy. An understanding of how AIDS activists and their allies negotiated questions of health access suggests that health care activism was in part a marker of class privilege, as gay activists and liberal Democrats openly embraced a medical model for sexual minorities that lifted them above the stigma of a public welfare system and integrated them further into heteronormative capitalism.

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An Integrative Theoretical Framework for HPV Vaccine Promotion Among Male Sexual Minorities

American Journal of Men s Health ◽

10.1177/1557988316652937 ◽

2016 ◽

Vol 12 (5) ◽

pp. 1409-1420 ◽

Cited By ~ 11

Author(s):

Christopher W. Wheldon ◽

Ellen M. Daley ◽

Eric R. Walsh-Buhi ◽

Julie A. Baldwin ◽

Alan G. Nyitray ◽

...

Keyword(s):

Health Care ◽

Sexual Orientation ◽

Health Care Providers ◽

Hpv Vaccine ◽

Sexual Minorities ◽

Behavioral Control ◽

Hpv Vaccination ◽

Perceived Threat ◽

Perceived Behavioral Control ◽

Care Providers

The objective of the current study was to quantify the behavioral intentions of young adult male sexual minorities (MSM) to initiate human papillomavirus (HPV) vaccination and test an integrative model of HPV vaccine decision making. Participants were 575 MSM who were residing in the United States and were between ages 18 and 26 years. Standard direct and indirect measures of attitudes, perceived norms, and perceived behavioral control were employed to explain variation in behavioral intention. Additional background factors—such as concealment of one’s sexual identity, suspicion of health care provider competence in LGBT health issues, perceived threat, and information orientation—were also included in the model. The final model fit the data well and identified a set of salient attitudinal and control beliefs as the strongest determinants of intention ( R2 = .38). Perceived threat and information orientation were positively correlated with HPV-related beliefs. Perceived threat was higher among men infected with HIV and lower among men in monogamous relationships. Self-efficacy, as an indirect measure of perceived behavioral control, was inversely related to the general tendency to conceal aspects of one’s sexual orientation and a suspicion of health care providers. Bisexual identified men were more likely to conceal their sexual orientation and be more suspicious of health care providers. In this study, a number of modifiable determinants of HPV vaccine intentions—both psychosocial and environmental—were identified and have implications for targeted and tailored behavioral interventions to promote HPV vaccination among MSM.

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Different Perceptions Exist Between Health Care Providers and the General Population Regarding the Importance of Findings on Additional Imaging for Trauma Consults

The American Surgeon ◽

10.1177/0003134820940249 ◽

2020 ◽

Vol 86 (7) ◽

pp. 830-836

Author(s):

Andrew L. Plaster ◽

Emily R. Faulks ◽

Jacob N. Gillen ◽

Allison N. Tegge ◽

Miguel A. Matos ◽

...

Keyword(s):

Health Care ◽

General Population ◽

Health Care Providers ◽

Clinical Importance ◽

Rib Fractures ◽

Trauma Patients ◽

Care Providers ◽

Linear Modeling ◽

Public Data ◽

Additional Imaging

Background Approximately one-third of additional imaging for trauma consults results in the discovery of new injuries. No studies have addressed the perception of these findings in non-health care providers. Our hypothesis was that significant differences in perception of the importance of injuries would exist between health care providers (HCPs) and the general population. Methods Six standardized scenarios were developed detailing common new injury findings on additional imaging in trauma consults. Demographics as well as information regarding the significance of findings, potential for change in care, and the importance of patient notification were collected. Surveys were electronically distributed to HCPs in our system and the public. Data analysis was performed with generalized linear modeling. Results A total of 339 public and 129 HCP surveys were returned. HCPs included attending staff, residents, and advanced care providers from a variety of specialties. Significant differences in perception were found in traumatic brain injury, spine fractures, and rib fractures, with HCPs rating most findings as less clinically important than the general population, while rating patient notification as more important. Perceived importance decreased with increased age in the general population. Increasing HCP age or length in practice did not significantly affect perception of clinical importance, except for rib fractures. Discussion Differences in perception exist regarding the significance of additional injuries between HCPs and the general population. Perceptions of the general population also change with age. Decisions to pursue additional imaging in trauma patients should include consideration of these differences in perception to help support quality patient-centered care.

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