The experiences and support needs of people with intellectual disabilities who identify as LGBT: A review of the literature

BackgroundPeople who identify as lesbian, gay, bisexual and transgender (LGBT) can face many challenges in society including accessing education, care and support appropriate to individual needs. However, there is a growing and evolving evidence base about the specific needs of people with intellectual disabilities (ID) in this regard.AimsThe aim of this review was to explore the experiences of people with ID who identified as LGBT through an examination of studies that addressed their views and highlighted specific issues, concerns and service responses.Methods and proceduresA comprehensive search of relevant databases from February 1995 to February 2015 was conducted. Studies were identified that met specific criteria that included: empirical peer reviewed studies, the use of recognised research methods and focused on people with ID whom identified as LGBT. The search yielded 161 papers in total. The search was narrowed and 37 papers were screened using rigorous inclusion and exclusion criteria. Finally, 14 papers were considered suitable for the review.Outcomes and resultsThe data were analysed and key themes identified that included accessing health services, gender and sexual identity, attitudes of people with ID regarding their LGBT status, and education, supports and therapeutic interventions.Conclusions and implicationsThere is a need for service providers and carers to be more responsive to the concerns of people with ID who identify as LGBT to improve their health and well-being by reducing stigma and discrimination and by increasing awareness of their care and support needs. The implications are discussed in terms of policy, education, research and practice developments.     

LGBT healthcare disparities: What progress have we made?

Nearly fifteen years have passed since this author’s publication which examined the depth of education and training for medical students and practicing physicians specific to clinical competence in the care of lesbian and gay patients in the United States. Since then, there has been an explosion of research gains which have shed a steady light on the needs and disparities of lesbian and gay healthcare. This rich literature base has expanded to include bisexual and transgender (LGBT) healthcare in peer-reviewed journals. Despite these research gains underscoring a call for action, there continues to be a dearth of cultural competency education and training for healthcare professionals focused on clinical assessment and treatment of LGBT patients. This article will focus exclusively on the current status of medical and nursing education and training specific to clinical competence for LGBT healthcare. We are long overdue in closing the clinical competency gap in medical and nursing education to reduce the healthcare disparities within the LGBT community.     

Awareness of and intention to use an online sexually transmitted and blood-borne infection testing service among gay and bisexual men in British Columbia,two years after implementation

ObjectivesThis study assessed gay, bisexual, and other men who have sex with men’s (GBMSM) awareness of and intention to use GetCheckedOnline, an online sexually transmitted and blood-borne infection (STBBI) testing service.MethodsA cross-sectional study was conducted two years after launch among GBMSM > 18 years of age in British Columbia, Canada. Participants were recruited through community venues, clinics, websites, and apps.ResultsOf 1272 participants, 32% were aware of GetCheckedOnline. Gay identity, regularly testing at an STBBI clinic, being out to one’s healthcare provider, attending GBMSM community venues, and frequent social media use were associated with awareness. Among participants who were aware but had not used GetCheckedOnline, knowing GetCheckedOnline users, using social media, not knowing where else to test, and not wanting to see a doctor were associated with intention to use GetCheckedOnline.ConclusionEarly promotion of GetCheckedOnline resulted in greater awareness among those connected to GBMSM.     

萍乡市男男同性恋性病艾滋病哨点监测结果分析

目的了解男同人群的性相关危险因素特点,找出有效的途径或策略,进一步有效控制艾滋病的流行。方法问卷调查与实验室检测。结果总共监测310名男同,其中酒吧会所监测占30.97%,网络监测占69.03%;90%被监测男同是高中以上文化程度;最近一年患性病的占14.19%;310人当中HIV感染者8例,感染率为2.58%;网络招募人中HIV感染为3.27%。艾滋病知识知晓率为98.71%;有将近15%的感染者有过商业性行为(包括3名感染者);有商业性行为的男男同性恋艾滋病感染率与没有商业性行为的男男同性恋的艾滋病感染率两者比较有明显差异;与女性发生性关系的时候有三分之一不使用安全套,每次都会使用的不到一半,最近一次与女性发生性关系有三分之一没有使用安全套。结论男同容易将艾滋病性病进行婚内、外传播;男同存在掌握相关HIV防治知识与实际防范结果背离现象;网络加大了男同交往的频率和范围,也加大了艾滋病传播风险;同性商业性行为风险性更高;男同的双性性关系及无保护性性交在艾滋病传播中起到一个非常重要的桥梁作用;今后要把宣传干预重点放在双性恋、男性性商业服务人群、男同配偶或性伴、甚至青年妇女、青年学生身上。     

参与式交流策略与男同性恋艾滋病易感行为改变的实践

目的：通过利用参与式交流的社会理论，去探索男-男性关系人群的有效的行为改变模式。方法：研究以不同形式的同伴教育方式，进行行为改变的分阶段横断面跟踪调查的控制测量设计。351名男同性恋者的非随机样本被设计为前后对照的3个组：“自我促进组”，“社会促进组”和未实施干预的“对照组”以评估干预效果。结果：采用参与式交流策略对促进男-男性关系人群安全性实践有着非常显著的效果。结论：回应艾滋病流行，行为改变策略，必须超越流行病学、公共卫生、心理学和一般社会学基础上的传媒干预模式，而特别强调目标人群的主体性地参与的策略，以通过发展文化适当性，提高干预的效果。这一过程几乎在所有国家的艾滋病防治运动中，进行着尝试与实践。     

Gay, Lesbian and Bisexual (GLB) Children: Implications for Early Childhood Development Professionals

This paper focuses on the issues of gay, lesbian, and bisexual children from the perspective of early child development professionals. Early child development professionals' response to children's sexual curiosity conveys to them important messages — either positive or negative — about themselves as sexual beings. Positive responses lay the foundation for sexual health by helping children feel good about being male or female, gay, lesbian, or bisexual, and good about adults in their lives who help them understand their confusion. Background information about homosexuality and bisexu-ality in American society, needs of gay, lesbian and bisexual children, and strategies and challenges in personnel, curriculum, policies, and parental involvement will be included.     

广州市区男同性恋者性别角色与精神健康状况

目的:了解男同性恋人群性别角色与精神健康的关系。方法:采用同伴推动抽样法收集男同性恋样本,调查采用自填问卷一对一的方式进行。按年龄、性别和受教育程度1:1配对对照组,最终收回有效样本420对。结果:χ~2检验结果显示,男同性恋组与对照组在生活满意度、耻辱感、自尊感、社会支持、男性化、女性化、现在是否有固定伴侣、过去6个月内是否有过临时伴侣、过去12个月是否有性病史、抑郁、焦虑、应激、亲密关系暴力、自杀意念等各项指标差异均有统计学意义;420名男同性恋者当中,抑郁、焦虑、应激水平较高,29.3%在过去1年内有过自杀的想法,36.5%遭遇过亲密关系暴力。控制了其他变量后,性别角色是男同性恋者抑郁、焦虑、应激、自杀及遭遇亲密关系暴力的危险因素。结论:性别角色是男同性恋人群精神健康的一个重要影响因素,在进行心理危机干预过程中有必要考虑其性别角色。     

Trends in Agreements Between Regular Partners Among Gay Men in Sydney,Melbourne and Brisbane,Australia

Between 1998 and 2007, 51,449 Gay Community Periodic Survey questionnaires were completed in Sydney, Melbourne and Brisbane, Australia. These included 23,424 where the respondents reported currently being in a relationship with a regular male partner. About 90% of men with a regular partner had been tested for HIV, and about three quarters had tested HIV-negative. Between 1998 and 2007 there was an increase in the proportion of men in HIV-negative seroconcordant relationships. About three quarters of men with a regular partner had negotiated an agreement about sex within their relationship. There was little change over time in the likelihood of having negotiated such agreements. There were, however, changes over time in the nature of these negotiated agreements: Over time, more men in HIV-discordant relationships permitted unprotected anal intercourse with their regular partners (P-trend < .001); among men in HIV-negative concordant relationships, an increasing proportion required a monogamous arrangement with their regular partner (P-trend < .001); and over time, fewer men in general required consistent condom use with casual partners (P-trend < .001). Some of these changes in negotiated agreements represent an increase in the potential risk of HIV transmission.