Search Results (527)

This scoping review synthesises the current literature to explore the related concepts of victim blaming and bystander intervention in the context of image-based sexual abuse. Image-based sexual abuse refers to the creation, taking and distribution of non-consensual intimate images, including the threat to share or distribute. The databases Web of Science, ASSIA, ProQuest Dissertation & Theses and Scopus were searched in August 2024, with an updated search being conducted in December 2025. A supplementary search was conducted in Google Scholar, along with a hand search of four key journals within the topic area. The search focused on five geographical locations that share a common cultural background (UK, USA, Canada, New Zealand, and Australia). A total of 31 studies and reviews were included. The main findings were that: (a) there is limited research in relation to bystander intervention in the context of image-based sexual abuse; (b) there are no studies that examine the relationship between victim blaming and bystander intervention; (c) there appears to be a gendered dimension in relation to the phenomena (victim blaming and bystander intervention), which is reflected in the literature around image-based sexual abuse; (d) accountability and victim blaming are increased when a victim–survivor has created the images/videos themselves; (e) research within this area neglects the experiences of diverse communities, specifically sexual and gender minority people; and (f) there appears to be a disregard to capture the experiences of men who are victim–survivors, irrespective of sexual identity. Full article

Human papillomavirus (HPV) is one of the most widespread sexually transmitted infections globally, whose persistent infection plays a major role in causing cervical cancer. Vaccination is therefore a key prevention strategy. Using a gender-stratified dynamic transmission model tailored to a Tunisian case, we investigate the impact of bivalent HPV vaccination. The proposed model accounts for partial cross-immunity and captures both direct and indirect effects of female-only vaccination. We derive the basic reproduction number and the corresponding herd immunity threshold, and a global sensitivity analysis shows that vaccine coverage, efficacy, and cross-protection are strong drivers of transmission reduction. Their combined effects on disease spread are quantified by varying these parameters across biologically relevant ranges. An optimal control problem was formulated and analyzed using Pontryagin’s Maximum Principle to minimize persistent infections and cancer cases while limiting vaccination effort. Three vaccination scenarios are compared: an ideal case with full vaccine availability and two resource-constrained cases with respective maximum coverage rates of $100\%$ and $80\%$. The numerical simulations revealed that the optimal strategy under unconstrained conditions can achieve significant suppression of infection, persistence, and cancer. Under constrained effort, the optimal control still achieves substantial reductions in disease burden, with minor differences in dynamics and speed of immunity buildup. Our results highlight the effectiveness of female-only HPV vaccination in providing both direct and indirect protection. They also emphasize the importance of sustained coverage in constrained settings. Full article

Background: Young adult sexual minority men (SMM) disproportionately experience childhood interpersonal trauma. The Dimensional Model of Adversity and Psychopathology (DMAP) framework proposes that exposure to threat (i.e., emotional, physical, and sexual abuse) and deprivation (e.g., physical and emotional neglect) are differentially linked to adult psychopathology. Studies of predominantly heterosexual samples have revealed emotion regulation and mindfulness as mechanisms linking childhood trauma to mental health and health risk behaviors in adulthood. However, the influence of emotion regulation (ER) or mindfulness as associated with exposure to threat vs. deprivation has not been examined among SMM in adulthood. Objective: This study explored the relationships between childhood threat/deprivation and mental health and health risk behaviors among SMM with ER and mindfulness as mediators. Participants and Setting: The sample consisted of 317 SMM (M_age = 26.70; SD = 3.87; ages 18–35; 59.3% White) recruited from the community. Methods: Childhood experiences of threat and deprivation were assessed via the Childhood Trauma Questionnaire; ER difficulties and dispositional mindfulness were assessed using self-report. Mental health behaviors were assessed using a composite score consisting of self-reported depressive, anxiety, PTSD symptoms, and suicidality. Health risk behavior score included the Sexual Compulsivity Scale, Alcohol Use Disorders Identification Test, and smoking history (Y/N). Results: Threat and deprivation were both positively correlated with mental health and health risk behaviors. Threat was associated with both mental health and health risk behaviors via emotion regulation (ER) difficulties. Deprivation was associated with these outcomes through both ER difficulties and mindfulness. Conclusions: Treatment aimed at bolstering ER and mindfulness skills among those with histories of abuse and deprivation, respectively, may help reduce psychopathology risk among SMM. Full article

Heavy episodic drinking (HED) is prevalent in young adulthood, yet its relationship with psychosocial well-being remains complex. This study examines the association between HED and perceived social isolation among young adults and tests whether this relationship varies by sexual orientation. Using pooled, nationally representative data from the 2022 and 2024 Health Information National Trends Survey (HINTS), this study analyzed adults aged 18–29 (N = 723). Perceived social isolation was measured using the PROMIS Social Isolation Short Form. Weighted multivariable linear regression models assessed interactions between sexual orientation and HED occasions (0 vs. 1+), adjusting for sociodemographic variables and psychological distress. 45.5% reported HED. Lesbian/gay (B = 5.62, SE = 0.58, p < 0.001) and bisexual (B = 1.66, SE = 0.34, p < 0.001) young adults reported higher isolation than straight peers; HED was inversely associated with isolation (B = −1.71, SE = 0.20, p < 0.001). A significant interaction indicated that among lesbian/gay young adults, heavy drinking was associated with lower perceived isolation (B = −5.77, SE = 0.98, p < 0.001). Interventions should account for the social meanings of alcohol use to avoid unintentionally increasing isolation among sexual minoritized populations. Full article

Workplace harassment of transgender employees remains pervasive and understudied. In this narrative review of 63 studies over the past 25 years, we summarize the literature on transgender workplace harassment. We focus on its prevalence and forms. Individual, organizational and cultural factors contribute to its occurrence; psychological and occupational outcomes; and strategies to reduce or prevent harassment. We find that harassment often extends beyond traditional definitions; includes misgendering, deadnaming, and the questioning or outright denial of one’s gender identity; and is particularly pervasive in masculinity contest cultures. These experiences are associated with both negative well-being of transgender employees and less effectiveness of the organizations that employ them, though more causal evidence is needed. We also highlight critical conceptual and methodological gaps to guide future research. Much of the existing research on LGBTQ+ employees in the workplace has focused primarily on sexual minorities, leaving the unique experiences of gender minorities invisible. Further, an intersectional lens is needed, as harassment experiences of trans women, trans men, and nonbinary people may differ in significant ways. Finally, we identify strategies to improve workplace climate including both top-down formal policy and bottom-up interpersonal behaviors. Full article

Internet gaming disorder (IGD) and nonmedical prescription drug use (NMPDU) are prevalent, co-occurring concerns among young adults. Although prior research links problematic gaming and substance misuse, few studies have examined this relationship in non-college populations or whether student status modifies this association. This study examined the relationship between Gaming Addiction Scale (GAS) score and NMPDU among 1022 Rhode Island young adults aged 18 to 25. In the total sample, 44.6% identified as cisgender heterosexual female, 42.4% as sexual or gender minority (SGM), and 13.0% as cisgender heterosexual male. Multivariable logistic regression estimated the adjusted association between GAS scores and NMPDU, and an interaction term between GAS and student status was tested. Overall, 12.1% reported lifetime NMPDU. Higher GAS scores were associated with increased odds of NMPDU (adjusted odds ratio [AOR] = 1.05; 95% confidence interval [CI]: 1.01–1.09). Student status alone was not significantly associated with NMPDU; however, a significant interaction was observed between GAS and student status (AOR = 1.09, 95% CI: 1.01–1.18, p = 0.031). Higher GAS scores were positively associated with NMPDU, with student status strengthening this association. Findings support screening for problematic gaming, particularly among students, and integrated prevention strategies addressing both behavioral and substance-related risks. Full article

Background: Epididymo-orchitis can be caused by sexually transmitted pathogens, including Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium, or entero-bacteria. The aim of this study was to explore the demographics, microbiological findings, and treatment outcomes of patients presenting to a tertiary sexual health clinic with epididymo-orchitis. Methods: We reviewed the clinical notes of 200 randomly selected patients seen in the clinic with a diagnosis of epididymo-orchitis between 2021 and 2025. We extracted data on demographics, microbiological findings, follow-up, and clinical response rate to treatment. Results: The median age was 33 years (Interquartile range (IQR) = 24–44), 97 (49%) identified as MSM, 11 (6%) were living with HIV (all MSM), and 55 out of the 86 HIV-negative MSM (64%) were using HIV pre-exposure prophylaxis. In total, 35 (18%, 95% confidence intervals = 12.5–23.5%) people were diagnosed with a causative organism: 17 (9%) C. trachomatis, 10 (5%) N. gonorrhoeae, 7 (4%) M. genitalium, 3 (2%) Escherichia coli. Overall, 91 out of 200 (46%) had a documented partner notification plan. Conclusions: A minority of men attending our sexually transmitted infection clinic with clinical epididymo-orchitis have positive microbiology, including M. genitalium. More work is needed to understand the clinical pathophysiology of epididymo-orchitis to streamline treatment algorithms. Full article

Suicidal behaviors constitute a major global public health problem, with sexual minority groups showing a higher risk of engaging in such behaviors. This study aimed to analyze the influence of hopelessness, life satisfaction, and spirituality on suicide risk according to self-reported sexual orientation. A total of 532 individuals participated (M = 31.15 years, SD = 12.002). Of these, 39.8% identified as heterosexual, 34.2% as gay or lesbian individuals, and 25.9% as bisexual. Participants were assessed using the Plutchik Suicide Risk Scale, Beck’s Hopelessness Scale, the Beliefs and Values Scale, and Diener’s Satisfaction with Life Scale. The results indicate that 52.9% of bisexual participants and 41.2% of gay and lesbian participants presented a high suicide risk, compared with 15.6% of heterosexual participants. Individuals with a high suicide risk reported higher levels of hopelessness (p < 0.001), lower levels of life satisfaction (p < 0.001), and similar levels of spirituality. The proportion of variance explained in suicide risk was 42.8% among bisexual participants, 34.2% among gay and lesbian participants, and 29.9% among heterosexual participants. Hopelessness predicted a similar proportion of across groups (β = 0.446 in heterosexuals, β = 0.447 in gays and lesbians, and β = 0.457 in bisexuals). Life satisfaction showed a protective predictive effect, with β = −0.241 in bisexual participants, followed by gay and lesbian participants (β = −0.186) and heterosexual participants (β = −0.137). Spirituality was significant only among gay and lesbian participants (β = 0.133) and bisexual participants (β = 0.214). Sexual minority groups exhibited a higher risk of suicide, with life satisfaction—but not spirituality—acting as a protective factor. Full article

Background/Objectives: Sexual minority (SM) adults experience higher cigarette smoking prevalence and poorer cessation outcomes than heterosexual adults, yet few empirically supported cessation programs are tailored to SM populations. In addition, the social and behavioral determinants of smoking disparities among SM remain understudied. A clearer understanding of factors associated with cessation in this population is necessary to inform targeted interventions. This study examined predictors of smoking cessation over a one-year period among sexual minority adults. Methods: Data were drawn from Waves 6 and 7 of the Population Assessment of Tobacco and Health (PATH) Study. Complex Samples logistic regression models assessed whether baseline smoking intensity, nicotine dependence, race, income, education, psychological distress, and quality of life predicted cessation one year later. An eight-category intersectional variable combined race, sex, and sexual orientation. Results: Smoking intensity and psychological distress were among the strongest predictors of cessation outcomes. Lower income and non-White race were also associated with reduced cessation likelihood. Cessation outcomes varied significantly across the combined race by sex by sexual orientation groups, with White heterosexual men exhibiting the most favorable cessation profile. Several other groups demonstrated reduced likelihood of quitting after accounting for smoking intensity, nicotine dependence, socioeconomic factors, psychological distress, and quality of life. Conclusions: Smoking cessation disparities operate across intersecting social identities. Behavioral dependence, socioeconomic disadvantages, and psychological distress collectively shape cessation outcomes. Effective interventions should address nicotine dependence within the broader structural and mental health contexts influencing racially and sexually minoritized populations. Full article

Little research has examined how often biomedical trainees encounter mistreatment in a single day or how such momentary experiences may undermine engagement in training. To address this gap, we investigated the prevalence and short-term consequences of daily sexual harassment, racial mistreatment, and incivility among graduate students and post-doctoral fellows in U.S. biomedical programs. In Study 1, 404 National Institutes of Health-funded trainees completed a two-wave survey assessing mistreatment, mood, and program attitudes across two 24 h periods separated by 10 days. On either day, 36.9% of participants experienced or observed at least one mistreatment episode, with no differences by gender or underrepresented minority status. Day 1 mistreatment was significantly negatively associated with program attitudes 10 days later, suggesting short-term derailment effects. In Study 2, 21 participants responded to true accounts of peers’ mistreatment to describe their emotional reactions and expectations of mentors. Trainees reported anger, disgust, and betrayal, and emphasized the need for mentors to acknowledge these harms, intervene appropriately, and offer support. This study provides the first evidence of single-day mistreatment prevalence among biomedical health trainees and demonstrates that even brief exposures can degrade training program attitudes. Findings underscore the need for improved mentor training and institutional resources to protect and support trainees. Full article

Background/Objectives: Adverse childhood experiences (ACEs), including physical and sexual abuse, are significantly associated with long-term health issues, particularly among socially disadvantaged populations. The study examines the social determinants of health, such as poverty, racial inequities, and limited access to care, to assess their association with adverse childhood experiences, including exposure to physical violence and sexual abuse. Methods: We performed multivariable logistic regression analyses using data from the 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) (n = 8227) to examine associations between selected ACEs and key social determinants of health (SDOH). Results: Our results indicated that a lack of emotional and social support was associated with increased odds of witnessing parental violence (AOR = 2.00) and physical abuse (AOR = 1.90). Absence of food insecurity was associated with lower odds of witnessing parental violence (AOR = 0.65), unwanted sexual touching (AOR = 0.77), and forced sex (AOR = 0.63). Similarly, not reporting transportation barriers was associated with lower odds across ACE outcomes (AORs ranging from 0.54 to 0.65). Sexual and gender minority individuals exhibited substantially higher odds of childhood sexual abuse (AORs = 3.64–5.56). Hispanic ethnicity was associated with increased odds of physical abuse (AOR = 1.47), and older adults (ages 45–64) had greater odds of experiencing forced sex (AORs = 2.08–2.48). These findings highlight complex relationships between SDOH and early trauma. Conclusions: Trauma-informed public health strategies must address structural inequities and strengthen emotional and material support for vulnerable populations. Full article

Background: Cancer screening disparities remain understudied, particularly among underrepresented groups at the county level. This study compared the use of preventive breast and colorectal cancer screening services between sexual and gender minority (SGM) adults and cisgender heterosexual adults in Missouri. Methods: The 2022 Missouri County-Level Study, a probabilistic survey of health-related behaviors in each county, was used to estimate breast and colorectal cancer (BC and CRC) screening prevalence. Screening prevalence was calculated using weighted samples, and regression models were used to adjust for demographic composition and age eligibility for both cancer sites. Results: Compared to cisgender heterosexual adults (n = 48,257), SGM adults (n = 2801) were significantly younger and more likely to reside in urban areas and be employed. Statewide, county-representative prevalence of breast cancer screening in the last 2 years was 75.6%, and colorectal cancer screening (i.e., colonoscopy in the last 10 years or sigmoidoscopy in the last 5 years) was 63.1%. In age-adjusted models for BC screening for participants (ages 40–74), age had a curvilinear association, increasing at younger ages but declining in later years. For CR screening (ages 45–75), age showed a strong, stable, positive effect. SGM adults had similar odds of breast cancer screening; however, for CRC, SGM adults had higher odds of ever being screened but similar odds to cisgender heterosexual adults of up-to-date screening. Differences largely reflect eligibility windows and initiation versus maintenance dynamics. Conclusions: In this large sample of Missouri county residents, breast cancer and colorectal cancer screening rates were comparable between SGM adults and cisgender heterosexual adults for up-to-date screening probability. Improving statewide cancer prevention will require addressing the broader structural and regional barriers that suppress screening uptake across Missouri communities. Impact: These findings demonstrate the importance of using age-appropriate, guideline-aligned analyses to accurately assess cancer screening equity and avoid overstating disparities among SGM populations. By identifying where differences do not exist, this work helps focus resources on the structural and regional barriers that continue to limit cancer prevention for all Missourians. Full article

Background: Migration and place of birth are increasingly recognised as social determinants of health among sexual minority populations. Among men who have sex with men (MSM), being born outside the country of residence may shape access to healthcare, community resources, and social capital networks. In Japan, however, little is known about how being born outside Japan is associated with social capital, health behaviours, and mental health among MSM. Methods: Data were drawn from a large cross-sectional online survey conducted in 2025 of 8150 MSM living in Japan, recruited via community-based in-person outreach and targeted geo-social networking application advertisements. Multivariable logistic regression analyses examined associations between country of birth and social, behavioural, and health-related outcomes. Results: Foreign-born MSM were younger and more concentrated in the Greater Tokyo metropolitan region. Being born outside Japan was associated with higher odds of HIV testing across all timeframes and higher levels of both gay and heterosexual social capital. Foreign-born MSM were also more likely to have disclosed their sexuality to friends and family. However, they were less likely to be aware of LGBT or HIV prevention organisations, despite higher participation once engaged. No differences were observed in suicidal ideation or unprotected anal intercourse with casual partners, although foreign-born MSM were more likely to report unmet need for mental health care. Conclusions: Foreign-born MSM in Japan demonstrate strong engagement in HIV prevention and higher social capital, alongside persistent barriers to community awareness and mental health service access. These findings highlight the importance of addressing structural and informational barriers and supporting community-based organisations to improve equitable health and wellbeing outcomes among MSM in Japan. Full article

Introduction. Entering higher education represents a significant and challenging stage, marked by substantial changes that impact students’ well-being, mental health, and academic performance. These challenges can be particularly intensified for lesbian, gay, or bisexual (LGB) students, who are frequently subject to minority stress. In this context, few studies have focused on aspects associated with the well-being of these students. This study aimed to assess well-being, mental health, optimism, motivation, and academic performance according to students’ sexual orientation, as well as the main predictors of well-being in both groups. Method. The sample comprised 285 higher education Portuguese students, of whom 129 were heterosexual and 156 were LGB, aged between 18 and 69 years. Results. The results revealed that the LGB students showed significantly lower levels of optimism, but higher levels of academic performance and mental health, compared to heterosexual students. Among LGB students, optimism stood out as one of the main predictors of well-being, while mental health stood out among heterosexual students. Conclusions. The results highlight the need for more inclusive university environments and psychological interventions focused on promoting optimism to reduce the impact of minority stress and promote the well-being and academic retention of LGB students. More studies are needed that consider the diverse sexual orientations of university students. Full article

Background/Objectives: Hybrid breast reconstruction (HBR), which combines implant-based reconstruction with autologous fat grafting (lipofilling), has emerged as a promising approach for improving both aesthetic and functional outcomes following mastectomy. This study aimed to evaluate patient-reported outcomes using the BREAST-Q questionnaire before and after lipofilling, focusing on aesthetic satisfaction, physical well-being, and quality of care. Methods: This before–after study included patients who underwent prepectoral implant-based reconstruction followed by one session of lipofilling between November 2024 and May 2025. The BREAST-Q questionnaire was administered preoperatively and at three months postoperatively. Statistical analyses were conducted to compare changes across aesthetic, functional, and care-related domains. Results: A total of 96 patients completed both pre- and postoperative questionnaires. Statistically significant improvements (p < 0.01) were observed in most aesthetic and psychosocial parameters, including satisfaction with breast appearance (Q1), psychosocial well-being (Q2), sexual well-being (Q4), and satisfaction with surgical outcomes (Q5). Physical symptoms such as discomfort (Q3) decreased significantly postoperatively. Satisfaction with medical care remained high, with minor improvements noted. No oncologic recurrences were reported. Conclusions: Hybrid breast reconstruction using fat grafting after implant placement offers significant benefits in terms of aesthetics, symptom relief, and patient satisfaction. It is a safe and effective procedure that can be widely integrated into clinical practice, provided that patient selection and technique are carefully considered. Full article