Adversity among youth experiencing homelessness: A latent class analysis

Child Abuse & Neglect · 2026-05-07

Predictors of Opioid Misuse and Abuse Among Pregnant Women in the US

Pain Management Nursing · 2025-12-21

INTRODUCTION: Opioid misuse and abuse during pregnancy can adversely affect maternal and infant outcomes. Factors that drive the burden of opioid misuse and abuse are multifaceted and understudied. This study sought to explore predictors of opioid misuse and abuse among pregnant women in the United States. METHODS: Secondary data analysis of the National Survey on Drug Use and Health (NSDUH) data from 2015-2019 was performed. The primary outcomes were past-year opioid misuse, past-month misuse, and past-year opioid abuse. Data analysis included weight-adjusted univariate, bivariate, and multivariable logistic regression. RESULTS: The pooled weighted sample comprised 2,258,599 pregnant women. The prevalence of past-year misuse, past-month misuse, and past-year opioid abuse were 5.2%,1.0%, and 0.9%, respectively. Older age and higher household income were protective against past-year misuse. The odds of past-year misuse were lower for pregnant women in their third trimester. Non-Hispanic Black Americans and Hispanics had lower odds of past-year misuse compared to non-Hispanic Whites. However, Non-Hispanic Native Hawaiian /Other Pacific Islanders reported higher odds of past-year misuse; yet lower sample sizes of minority groups may have affected the findings. Good health and excellent health status were protective against past-year misuse. Older age was protective against past-month misuse. Lower odds of past-year opioid abuse were observed in non-Hispanic Black women compared to non-Hispanic White women. CONCLUSION: The findings underscore the need for interventions targeting younger pregnant women, women in early pregnancy, from low-income households, who are non-Hispanic Native Hawaiian /Other Pacific Islanders, and women with poor health to mitigate adverse maternal and fetal outcomes.

LGBTQ+ identity and its association with inflammation and cellular immune function

Brain Behavior and Immunity · 2025-02-24 · 3 citations

Self-identification among lesbian, gay, transgender, queer, and other sexual minorities (LGBTQ+) is complex and multifaceted, yet few studies have examined its impact on immune parameters. The National Couples' Health and Time Study (NCHAT) is a nationally-representative cohort of 3,642 adult main respondents, ages 20 to 60 years, who are married or cohabiting, among whom 45 % self-identify as a non-heterosexual identity. Biological data were collected from a subset in the NCHAT Stress Biology study (NCHAT-BIO). The current analyses focus on data from 289 participants in NCHAT-BIO who identified as a non-heterosexual identity. Participants self-reported demographic, mental health, and LGBTQ+ identity items. Finger stick dried blood spot (DBS) sampling was self-administered by participants and assayed for C-reactive protein (CRP), interleukin-6 (IL-6), and antibodies against Epstein-Barr virus (EBV). Multivariable regression analyses were used to assess the relationship between each of the biomarkers and: 1) individual LGBTQ+ identity items and 2) latent profiles of LGBTQ+ identity items. Models were adjusted for demographic factors and other confounders. Among those assigned female at birth, a greater sense of pride in one's LGBTQ+ identity was associated with lower EBV antibody levels. Among those assigned male at birth, greater desire to keep one's identity private was associated with elevated CRP while those who would choose to be straight or wish they were heterosexual had elevated levels of IL-6. Meanwhile, being proud of one's LGBTQ+ identity predicted lower IL-6. These results provide novel evidence from a large sample that internalized stigma related to one's LGBTQ+ identity is associated with elevated inflammation and poorer cellular immune function while identity affirmation is associated with reduced inflammation. Future research should aim to develop and target both behavioral and biomedical interventions aimed at reducing health disparities among sexual minority populations.

Aging Concerns Related to Sexuality and Gender: HIV Prevention and Healthy Aging

AIDS and Behavior · 2025-01-24 · 1 citations

Assessing Inflammatory Biomarkers at the Intersection of Marijuana and PrEP Use: Preliminary Findings From the NCHAT-BIO Study

JAIDS Journal of Acquired Immune Deficiency Syndromes · 2025-09-04

INTRODUCTION: Past research has shown that inflammation is reduced among marijuana-using HIV-negative people but not those living with HIV. We take this work a step further by assessing differences based on pre-exposure prophylaxis (PrEP) use among HIV-negative individuals. METHODS: National Couple's Health and Time is a nationally representative cohort study of 3642 adult respondents who are married or cohabiting. Their ages range from 20 to 60 years with 45% self-identifying as nonheterosexual. Biologic data (n = 573; C-reactive protein [CRP], interleukin-6 [IL-6], and Epstein Barr virus [EBV] antibody levels) were collected through finger stick dried blood spots as part of National Couple's Health and Time-BIO, a substudy. Participants self-reported demographic characteristics, PrEP use, and marijuana use. Multivariable regression analyses were used to assess the relationship between these variables and each of the measured biomarkers, adjusting for known confounders. RESULTS: In adjusted models, neither lifetime nor current PrEP use was associated with CRP, IL-6, or EBV antibody levels. Moreover, marijuana use did not differ among those who used PrEP versus those who did not. Among PrEP users, those who reported marijuana use had lower CRP than those who did not (B = -2.31; 95% CI: -4.23 to -0.40). Among non-PrEP users, no association was observed between marijuana use and CRP. CONCLUSIONS: The current preliminary data suggest inflammation is reduced among PrEP users who also use marijuana, but the same is not true among non-PrEP users. These findings may suggest that PrEP increases inflammation that is then partially mitigated by the individual cannabinoids or cannabidiols found in marijuana, although more research is needed to confirm this hypothesis.

Sexual minority stress and epigenetic aging

Brain Behavior and Immunity · 2025-01-31 · 7 citations

• Among 32 bisexual women, the rate of epigenetic aging was 13% faster than expected in a chronological year (via DunedinPACE). • They were, on average, 8.67 years older biologically than their chronological age (GrimAge2). • Internalized homonegativity and anti-bisexual experiences were risk factors for accelerated aging. • Identity centrality, identity affirmation, and friend support were protective factors. • Sexual minority stress mattered more than depression, anxiety, and loneliness. Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ + ) individuals have poorer mental and physical health than heterosexuals, and bisexuals fare worse than individuals who identify as lesbian and gay. However, data on stress biology among sexual minorities are critically insufficient. The current pilot study utilized data from 32 bisexual women – a subset of the National Couples’ Health and Time Study – who completed questionnaires and provided blood samples to index biological aging from DNA methylation data (DunedinPACE, GrimAge2). The mean DunedinPACE score was 1.13 (SD = 0.18), which outpaced chronological aging by 13 % (p < 0.001). Likewise, bisexual women in this sample were, on average, 8.67 (SD = 5.96) years older biologically per GrimAge2 as compared to their chronological age. In covariate adjusted models, those reporting greater internalized homonegativity exhibited significantly greater epigenetic age acceleration (GrimAge2: p = 0.01; DunedinPACE: p = 0.041). Those who reported more frequent anti-bisexual experiences also showed accelerated GrimAge2 (p = 0.023). In contrast, those who reported stronger identity centrality (p = 0.017), stronger identity affirmation (p = 0.029), and more friend support (p = 0.018) – a critical type of support for LGBTQ + individuals – had slower GrimAge2. Depressive symptoms, anxiety and loneliness were not associated with GrimAge2 or DunedinPACE. Results suggest that bisexual women are at risk for accelerated aging, and those who have less internal and external affirmation of their sexual identity may be most at risk.

When and for whom is enacted stigma associated with alcohol and cannabis use at the event level among sexual and gender minority older adults?

Psychology of Addictive Behaviors · 2025-07-14

OBJECTIVE: Sexual and gender minorities (SGM) are at elevated risk for alcohol and cannabis use disorders compared to cisgender, heterosexual individuals. This has been attributed to the unique stressors that SGM experience (SGM stress); however, recent studies have found mixed evidence for a link between SGM stress and substance use. The present study tests an integrated theoretical model derived from minority stress theory and the multistage model of substance use to explain these mixed findings. METHOD: We used data from a 30-day ecological momentary assessment study of substance use among 109 SGM older adults (50+) to examine whether event-level associations between enacted stigma and alcohol and cannabis use, quantity consumed, and consequences are dependent on an individual's typical pattern of substance use (e.g., frequency, coping motives, and substance use disorder symptoms). RESULTS: Findings indicate that, at the event level, enacted stigma was associated with increased likelihood of alcohol use among those who had a probable alcohol use disorder. Further, SGM with more alcohol use disorder/cannabis use disorder symptoms and who used alcohol to cope were more likely to engage in heavier cannabis use and experienced more alcohol consequences when they experienced enacted stigma. However, several other moderations were not significant, contrary to hypotheses. CONCLUSIONS: Findings provide partial support for an integrated theoretical model incorporating minority stress theory and the multistage model of substance use. Findings suggest that alcohol and cannabis use disorder interventions for SGM would benefit from addressing minority stress. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Shared and Unique Effects of Enacted Stigma Based on Sexual Identity, Age, and Race/Ethnicity Among a Sample of Sexual and Gender Minority Older Adults

Behavior Therapy · 2025-06-14

Numerous daily diary studies have demonstrated that sexual minority enacted stigma is associated with elevated same-day anxious/depressed affect. Despite the multiple marginalized identities held by many sexual and gender minorities (SGM), studies have rarely examined other types of enacted stigma (e.g., racism, ageism) experienced by SGM at the daily level. Further, it is unclear whether enacted stigma based on different identities have similar or distinct effects on anxious/depressed affect. The current study aimed to examine the effect of experiencing enacted stigma based on any marginalized identity on anxious/depressed affect (i.e., a common enacted stigma effect) and to determine if specific types of enacted stigma have unique effects above and beyond this common enacted stigma effect. We utilized ecological momentary assessment data from a sample of SGM older adults (50+ in age; 38% people of color). Experiencing any type of enacted stigma was associated with elevated anxious/depressed affect during the same observation. No specific types of enacted stigma predicted anxious/depressed affect above and beyond the common enacted stigma effect. Among SGM of color, experiencing multiple types of enacted stigma during the same observation was associated with additional anxious/depressed affect, but this did not generalize to the full sample. Results suggest that enacted stigma has a concurrent effect on anxious/depressed affect regardless of the targeted identity and specific types of enacted stigma do not have additional effects. This has potential implications for future research on effects of enacted stigma at the daily level, particularly among samples with multiple marginalized identities.

Self-Reported Diagnosis of Autism Is Associated With a Lower Likelihood of HIV Testing

JAIDS Journal of Acquired Immune Deficiency Syndromes · 2024-08-05 · 1 citations

ABSTRACT: Sexuality and sexual risk behaviors among autistic adults are often overlooked, resulting in inadequate sexual education courses and a reliance on peers or the internet as primary sources of information. Here, we plan to begin to fill this gap by assessing HIV and sexually transmitted infection (STI) outcomes among autistic adults. Data come from the 2007 NHIS data set, the only nationally representative and publicly available data set to host measures of HIV and autism alongside one another (and the only year of this survey to do so). Survey-weighted models were used to examine the association between self-reported measures of HIV/STIs and self-reported autism diagnosis. Compared with those who had not been told that they have autism, participants with an autism diagnosis had lower odds of ever having an HIV test in their lifetime (adjusted odds ratio [aOR] = 0.05; 95% confidence interval [CI]: 0.01 to 0.26). No association was observed between autism diagnosis and plans for an HIV test within the next year, nor did any autistic adults report testing positive for any STI within the past 5 years. These results suggest that further research is needed among the autism spectrum disorder community, particularly in terms of achieving the US goal of ending the HIV epidemic by 2030.

Assessing the relationship between mental health and AUDIT score among older sexual and gender minorities

Alcohol · 2024-12-25 · 1 citations