Using a probability sample of 912 Latino gay and bisexual men at bars in 3 U.S. cities (Los Angeles, Miami, New York), this study examines how participation in difficult sexual situations with interpersonal (e.g., wanting to please partner) and circumstantial constraints (e.g., sex in partner's home) may explain associations between dimensions of intimate partner violence (IPV) and HIV sexual risk behavior (unprotected anal intercourse with nonmonogamous partner). Findings suggest that all IPV types contribute to greater participation in sexual situations with circumstantial constraints, and that psychological and sexual IPV are also associated with higher likelihood of unprotected receptive anal intercourse with a nonmonogamous partner. Circumstantial constraints fully mediate the difference attributable to psychological IPV and partially mediate the difference attributable to sexual IPV. Intimacy concerns were unrelated to either IPV or HIV risk behavior. Results suggest HIV prevention and research should investigate immediate circumstances of the sexual encounter that may make engaging in HIV sexual risk behavior more likely.

The purpose of this research was to compare differences in the experiences of gay men and lesbian women who describe experiences of depression or depressed mood. The 2 main research questions were how do descriptions of depression and daily life differ between gay males and lesbian females. To this end, Weblogs containing narratives of 19 gay men and 19 lesbian women were coded, analyzed, and compared using qualitative content analysis methods. Differences in described sources of depression and responses to depression, but not features of depression were found. Women and men also differed with respect to their main priorities; their descriptions of social interactions, social issues, reflections, and emotions; and a number of other daily life experiences. Findings were discussed with respect to implications for treatment and prevention of depression among sexual minorities.

Nonheterosexually identified (NHI) women may be present, but not accounted for, in HIV and sexually transmitted infection (STI) prevention interventions. This study used quantitative and qualitative methods to examine the sexual risk behaviors and intervention needs of NHI women in Protect and Respect, a safer sex intervention for HIV-positive women. Study participants (n=32) were predominantly Black, low income, and between 28 and 51 years old. Although NHI participants were more likely than heterosexual participants (p < .05) to report obtaining their income from sex work, hustling, or selling drugs; and having a higher median number of male sex partners, qualitative analyses revealed that the intervention often neglected NHI women's experiences and unique safer sex needs. Heterosexist HIV and STI prevention programs may hinder NHI women's ability to protect themselves and their partners from reinfection and infection respectively. We discuss the implications of our research for future HIV/AIDS and STI research, services and interventions for NHI women.

While research examining healthcare experiences of sexual minority individuals is growing, thus far research has been limited on lesbian gender identity and its relationship to physical and mental health. This study explores access to and experiences of healthcare with a sample of 516 butch and femme identified lesbian and bisexual women. In comparison to femme-identified women, it was found that butch women had routine gynecological examinations significantly less frequently, perceived poorer treatment in healthcare settings, were more likely to be out within healthcare settings, placed more importance on securing LGBT-positive healthcare practitioners, and had more difficulty finding LGBT-positive medical doctors. No differences were found for mental health. The results suggest that butch women may be more at risk for physical health concerns than femme women, in particular those illnesses that can be prevented or treated with regular gynecological care (e.g., uterine or cervical cancer). Implications of the study include greater awareness among healthcare professionals of sexual minority gender identity in addition to sexual identity, and more support for butch-identified women to access vital healthcare services.

Several decades of research show that lesbians are at risk for hazardous drinking. Compared with heterosexual women, lesbians are less likely to abstain from drinking, less likely to decrease their alcohol consumption as they age, and more likely to report alcohol-related problems. Stress associated with lesbian identity and reliance on lesbian or gay bars for socialization and support are frequently posited--but largely untested--explanations for lesbians' heightened risk. Results from general population studies indicate that patterns of alcohol use established early in the life-course or during life transitions influence later alcohol use and alcohol-related problems. Further, heavy-drinking peers, availability of alcohol, and drinking in particular social contexts--such as at bars and parties--are believed to contribute to heavier drinking and to alcohol-related problems. To better understand lesbians' risks for hazardous drinking, we examined relationships between retrospective accounts of drinking patterns and drinking contexts in the early stages of lesbian identity development and current drinking outcomes in a large sample of adult lesbians. Findings suggest that early drinking patterns and drinking contexts influence later alcohol use and have important implications for risk reduction and prevention among lesbians.

Research into antigay violence has been limited by a lack of attention to issues of gender presentation. Understanding gender nonconformity is important for addressing antigay prejudice and hate crimes. We assessed experiences of gender-nonconformity-related prejudice among 396 Black, Latino, and White lesbian, gay, and bisexual individuals recruited from diverse community venues in New York City. We assessed the prevalence and contexts of prejudice-related life events and everyday discrimination using both quantitative and qualitative approaches. Gender nonconformity had precipitated major prejudice events for 9% of the respondents and discrimination instances for 19%. Women were more likely than men to report gender-nonconformity-related discrimination but there were no differences by other demographic characteristics. In analysis of events narratives, we show that gender nonconformity prejudice is often intertwined with antigay prejudice. Our results demonstrate that both constructs should be included when addressing prejudice and hate crimes targeting lesbian, gay, bisexual, and transgender individuals and communities.

Sexually transmitted infections (STIs) are a significant health issue for lesbian and bisexual women. Older age and having a history of sexual intercourse with males are primary risk factors for STIs among this population. However, little research has been conducted to assess sexual risk among lesbian and bisexual college women exclusively. A cross-sectional Internet survey was conducted with 230 self-identified lesbian and bisexual female college students to examine their sexual risk and to determine with which, if any, STIs they had ever been diagnosed. Eight percent of lesbian and bisexual college women reported ever being diagnosed with an STI; the human papillomavirus, bacterial vaginosis, and genital herpes accounted for 84% of STI cases. Number of lifetime sex partners was significantly associated with an STI diagnosis among this population. Older age, engaging in penile-vaginal intercourse with a male (lifetime), and younger age at first same-sex experience were significantly associated with a greater number of lifetime sex partners. Results may be useful to sexual health programs targeting lesbian and bisexual college women and/or their providers.

A great amount of social science research has supported the positive correlation between heterosexuals' belief in the free choice model of homosexuality and homophobia. Heterosexuals who believe gay, lesbian, bisexual, and transgender (GLBT) persons consciously choose their sexual orientation and practice a lifestyle conducive to that choice are much more likely to possess discriminatory, homophobic, homonegative, and heterosexist beliefs. In addition, these individuals are less likely to support gay rights initiatives such as nondiscrimination policies or same-sex partner benefits in the workplace or hate crime enhancement legislation inclusive of GLBT persons. Although researchers have demonstrated this phenomenon in the general population, none have specifically assessed it in the nursing workforce. The purpose of this study was to examine registered nurses' overall levels of homophobia and attitudes toward a workplace policy protective of gays and lesbians. These variables were then correlated with belief in the free choice model of homosexuality. Results indicated that belief in the free choice model of homosexuality was the strongest predictor of homophobia in nurses. Implications for nursing leadership and management, nursing education, and future research are discussed.

A national sample of 295 transgender adults and their nontransgender siblings were surveyed about demographics, perceptions of social support, and violence, harassment, and discrimination. Transwomen were older than the other 4 groups. Transwomen, transmen, and genderqueers were more highly educated than nontransgender sisters and nontransgender brothers, but did not have a corresponding higher income. Other demographic differences between groups were found in religion, geographic mobility, relationship status, and sexual orientation. Transgender people were more likely to experience harassment and discrimination than nontransgender sisters and nontransgender brothers. All transgender people perceived less social support from family than nontransgender sisters. This is the first study to compare trans people to nontrans siblings as a comparison group.

Few population-based surveys in the United States include sexual orientation as a demographic variable. As a result, estimating the proportion of the U.S. population that is gay, lesbian, or bisexual (GLB) is a substantial challenge. Prior estimates vary widely, from 1-21%. In 2001, questions on sexual orientation and sexual behavior were added to the Massachusetts Behavioral Risk Factor Surveillance System (MA BRFSS) and have been asked continually since that time. The purpose of this study was to determine the prevalence of adults in Massachusetts identifying as GLB and providing a demographic description of this group. The study also examined the correlation of reported sexual behavior and sexual identity within this group. Overall, 1.9% of Massachusetts adults identified as gay or lesbian and 1.0% of Massachusetts adults identified as bisexual. Of those identifying as gay or lesbian, 95.4% reported sexual behavior concordant with this identification, and 99.4% of respondents identifying as heterosexual reported behavior concordant with heterosexual sexual orientation. Among those reporting a GLB sexual orientation, men were more likely than women to identify as gay, and women were more likely than men to identify as bisexual. Younger adults (18-25 years old) were more likely than people in other age groups to identify as bisexual. Respondents with 4 or more years of education were more likely to identify as gay or lesbian than those in all other education categories. The addition of sexual orientation to population-based surveys will allow for research on the health of GLB adults and provide critical information for those charged with the creation of public policy regarding sexual orientation.

This study investigated protective effects of circumcision in a sample of immigrant Latino men who have sex with men (MSM). A survey in Portuguese, Spanish, or English was administered with computer-assisted self-interview technology with audio enhancement (A-CASI) to 482 MSM from Brazil (n=146), Colombia (n=169), and the Dominican Republic (n=167), living in the New York metropolitan area. Logistic regression revealed that after controlling for age, income, education, having had syphilis, having done sex work, and preferring the receptive role in anal intercourse, uncircumcised men were almost twice as likely to be HIV-positive as circumcised men. Follow-up analyses revealed, however, that the protective effects occurred only among the group of Colombian men.

Sex work is a significant risk for HIV and sexually transmitted infection (STI) among men who have sex with men (MSM); however, there is a dearth of knowledge about how to reduce risk in this group. MSM sex workers (N = 32) completed a semistructured qualitative interview and a close-ended quantitative assessment. Analyses focused on themes relevant to intervention development. Participants reported an average of 46 male sex partners in the prior 12 months; 31% of participants were HIV-infected. Male sex workers frequently used substances during sex and had elevated levels of psychological distress. Qualitative findings suggest that trauma-informed mental health and substance abuse treatment, ready access to HIV/STI testing and treatment and condoms/informational materials, support groups to address isolation/loneliness, skill-building for risk reduction with sex partners, and paid incentives as add-ons to effective behavior change interventions may be valuable intervention components. Targeting consumers of paid/exchanged sex may assist with changing community norms regarding the practice of transactional sex. Multipronged interventions to decrease sexual risk taking among male sex workers would also benefit from addressing the unique socioeconomic and legal needs of this population.

This article concentrates on the influence of determinants of mental health on a lesbian, gay, and bisexual (LGB) population in Flanders. Our sample is drawn from the Zzzip survey, and contains 2,280 LGBs, of whom 1,565 are men and 715 are women. The traditional social stress model outlines the influence of general stressors on stress (Pearlin, 1989). Meyer (1995) has expanded Pearlin's model to include the concept of minority stress. This study focuses on aspects of personal characteristics and social structural arrangements. Our study confirms the importance of age and education as relevant determinants for mental health. Additionally, although most research establishes sex differences in depression, this study does not find significant differences in depression between men and women. In women, sexual identity is a significant determinant of depressive score, but we do not find the same in men. Finally, both general and minority stressors, especially the internal stressors, are found to have an important effect on depressive outcomes.

This study explored the reported processes, conditions, and consequences of lesbian and heterosexual female smoking and relapse to understand the reasons for elevated lesbian smoking rates. Using grounded theory techniques, we conducted semistructured, face-to-face interviews with an ethnically diverse sample of 35 lesbian and 35 heterosexual female participants in Northern California. We found minority stress/sexual stigma to be an additional, unique cause of negative emotions and stress reported by 75% of lesbian participants, leading to smoking and relapse. Implications for smoking cessation programs tailored to lesbians are discussed.