Lance Keene | New York University (original) (raw)

Papers by Lance Keene

Health Equity , 2024

Young sexual minority adults experience high rates of heterosexist discrimination. The use of sub... more Young sexual minority adults experience high rates of heterosexist discrimination. The use of substances has been documented as a form of coping with discrimination. While mindfulness has been used to address experiences of discrimination and the use of substances, respectively, few studies have explored whether mindfulness can lower the negative effects of discrimination on substance use. The purpose of this study is to examine the association between heterosexist discrimination and substance use in young adult sexual minority men (YASMM), and if dispositional mindfulness can moderate this relationship. Methods: Logistic regression analysis was used to examine the association of heterosexist discrimination and cigarette, e-cigarette, and hazardous drinking in a sample of YASMM (18-35 years old; n = 325) from a national survey. A two-way interaction analysis was also implemented to evaluate if dispositional mindfulness moderated this relationship. Results: Heterosexist discrimination was associated with increased odds of cigarette use (adjusted odds ratio [aOR] = 1.06; 95% confidence interval [CI]: 1.03, 1.08) and e-cigarette use (aOR = 1.03; 95% CI: 1.01, 1.05). Higher scores of dispositional mindfulness moderated the relationship between heterosexist discrimination and hazardous drinking, indicating a weakening effect with higher scores of dispositional mindfulness. Conclusion: Mindfulness may decrease the negative effects of heterosexist discrimination on hazardous drinking among YASMM. Health Equity Implications: Researchers and practitioners should consider incorporating mindfulness as a component to their intervention to help YASMM deal with stressors engendered by discrimination, which may prevent hazardous drinking as a coping mechanism at a younger age.

Journal of Adolescent Health, 2023

Lesbian, gay, bisexual, transgender, and queer-identified (LGBTQ) youth of color face poorer psyc... more Lesbian, gay, bisexual, transgender, and queer-identified (LGBTQ) youth of color face poorer psychosocial health outcomes than their non-LGBTQ peers. Research suggests school-based and community activities promote psychosocial health for LGBTQ youth, but study samples are predominantly White. This study tested whether school enrollment and seven community activities were associated with LGBTQ community connectedness, happiness, and health among Black and Latinx LGBTQ youth. Methods: This study used a subsample of Black and Latinx LGBTQ adolescents and young adults (N ¼ 472) from the Social Justice Sexuality project. Mean differences in study variables were examined across intersectional racial/gender identity categories. Multiple regression analyses assessed the association of school enrollment and community activities with psychosocial health outcomes, accounting for covariates. Results: Social activities for LGBTQ people (ß ¼ 0.19) and LGBTQ people of color (POC; ß ¼ 0.15) were associated with greater LGBTQ connectedness. While moderate religious services attendance (ß ¼ À0.13) was associated with lower LGBTQ connectedness, high attendance was associated with greater happiness (ß ¼ 0.13) and health (ß ¼ 0.12). Social activities for LGBTQ-POC (ß ¼ 0.13) were also associated with better health. School enrollment was not significantly associated with any outcomes and Latinx transgender and diverse youth had the lowest happiness and health. Discussion: Social activities for LGBTQ people and LGBTQ-POC may play a role in the social connectedness and health of Black and Latinx LGBTQ youth, while frequent religious service attendance may support health and happiness. Schools and faith institutions should ensure their institutions are welcoming to LGBTQ youth. Public health workers might facilitate the involvement and inclusion of LGBTQ youth, while policy should support funding for community activities.

Journal of Racial and Ethnic Health Disparities, 2021

Black sexual minority men (BSMM) in the USA navigate a range of factors that may influence the ex... more Black sexual minority men (BSMM) in the USA navigate a range of factors that may influence the extent to which they disclose or conceal their sexual identity in various social contexts. To date, few studies have investigated the correlates of sexual identity disclosure or concealment among BSMM across multiple life domains. Guided by a minority stress perspective and intersectionality, we analyzed data from N = 809 BSMM who participated in the Social Justice Sexuality Survey. We conducted ordinary least squares regression to examine the relative weight of perceptions of homophobia, religiosity, LGBT community connectedness, racial identity salience, and sexual identity salience on disclosure of sexual identity in six social-relational contexts: (1) family, (2) friends, (3) neighbors, (4) religious community, (5) work, and (6) online. Findings indicate that BSMM disclosed their sexual identity unevenly across social-relational contexts. Notably, LGBTQ community connectedness and sexual identity importance were consistent predictors of sexual identity disclosure across contexts. In contrast, perceptions of homophobia were not related to sexual identity disclosure, suggesting that other factors may be more salient for BSMM when deciding to disclose their sexual identity. Finally, bisexual men consistently reported lower levels of sexual identity disclosure relative to gay men in all six contexts. Study findings have important implications for future research on sexual identity disclosure with diverse samples of BSMM.

Culture, Health & Sexuality, 2020

Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV tran... more Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV transmission in high-risk groups. Despite ongoing social marketing to increase PrEP awareness, few studies have evaluated public responses. This paper contextualises negative responses to Chicago's PrEP4Love campaign. In February 2016, a sexpositive ad campaign called PrEP4Love was launched online and throughout public spaces in Chicago. A gender and sexuality inclusive campaign, PrEP4Love is intended to be culturally responsive and sex positive, while retaining a focus on risk reduction. Advertisements prominently feature Black sexual minority men, and Black transgender women, and were strategically placed in diverse Chicago neighbourhoods. In response, there were 212 new callers to the PrEPLine during the two-month study period. Negative responses were concerned with: negatively depicting Black homosexuality (4), general anti-LGBTQ comments (7), adverse effects on children (6), sexually explicit nature (5), and general stigmatisation of racial minorities (4). Discussion focuses on sex-positive frameworks, normalising intimacy, stigma and historical mistrust of medical and pharmaceutical institutions, and the social meanings of biomedical prevention technologies (e.g. PrEP) in relation to dominant norms of sexuality and gender. This study is the first to investigate public responses to a sex-positive PrEP campaign. More studies of PrEP social marketing are needed to evaluate targeted public health campaigns to guide future PrEP promotion strategies.

Health Education & Behavior, 2021

Black and Latino sexual minority men (BLSMM) scholars are well positioned to draw on their unique... more Black and Latino sexual minority men (BLSMM) scholars are well positioned to draw on their unique perspectives and expertise to address the health status and life opportunities (HSLO) of BLSMM. Increasingly, research related to the positionality of scholars of color suggests that the scholar’s stance in relation to the community being researched has important implications for the research. Despite growing recognition of the importance of scholar positionality, limited attention has been paid to the relationship between scholar-of-color positionality and improving HSLO trajectories of BLSMM. Furthermore, extant literature fails to specify the mechanisms by which scholar-of-color positionality can improve HSLO among BLSMM. This article seeks to fill this gap in research by arguing that an inadequate consideration of scholar positionality in health and life opportunity research has important implications for the HSLO of BLSMM. A multilevel, mediational model addressing factors at the m...

Journal of Gay & Lesbian Social Services, 2017

Blackgay men must navigate identities and stigmas related to being gay and Black, and report high... more Blackgay men must navigate identities and stigmas related to being gay and Black, and report higher HIV incidence relative to their white male counterparts although they report lower rates of drug use and risky sexual behaviors. This study examined whether closeness to the gay or Black community correlated with HIV related risk and protective behaviors. Data were drawn from uConnect, a population-based cohort study of YBMSM on Chicago's South Side. The sample consists of 618 Black MSM ranging in age from 16-29. Cross sectional measures for this study include Black and gay community closeness, drug use, sexual risk behaviors, HIV testing and health promotion behaviors. Closeness with the gay community was associated with greater PrEP knowledge as well as participating in health promotion programs along with higher rates of transactional sex and having sex under the influence of substances, and increased odds of selfreported HIV seropositivity. Involvement in the Black community was associated with lower odds of reporting being HIV positive. Findings suggest that programs and initiatives are needed to help promote the positive aspects of the Black and gay communities, while minimizing the negative correlates of such involvements.

BACKGROUND Pre-exposure prophylaxis (PrEP) is an effective but under-utilized method for preventi... more BACKGROUND Pre-exposure prophylaxis (PrEP) is an effective but under-utilized method for preventing HIV transmission in communities vulnerable to HIV. Public health campaigns aimed at increasing PrEP awareness and access have little evaluation data. OBJECTIVE We have evaluated Chicago’s PrEP campaign, PrEP4Love (P4L), a campaign that uses health-equity and sex-positivity approaches to information dissemination. METHODS PrEP4Love launched in February, 2016 and remains an active campaign today. The analysis period for this paper was from the launch date in February, 2016- May 15th, 2016. Our analysis reviews the online reach through views on social media platforms (Facebook and Instagram), “smart ads,” or ads served to individuals across a variety of web platforms based on their demographics and browsing history, and PrEP4Love website clicks. RESULTS 40,913,560 unique views were generated across various social media platforms. Users clicked on PrEP4Love ads 0.06 percent of the time. 3...

Pediatrics, 2020

Latino adolescents are disproportionately affected by teenage pregnancy, sexually transmitted inf... more Latino adolescents are disproportionately affected by teenage pregnancy, sexually transmitted infections, and HIV, persistent sexual and reproductive health (SRH) disparities that represent a national public health concern. Despite progress nationally, Latina adolescents continue to exhibit above-average teenage pregnancy, birth, and repeat birth rates. 1 Particularly concerning are the 17% increase in reportable sexually transmitted infections among 10-to 19year-old Latino adolescents since 2014 and the 6% rise in new HIV diagnoses among 13-to 19-year-old Latino adolescents between 2016 and 2017 alone. 2-4 Given these statistics, research is needed to strengthen the evidence on programs to reduce Latino adolescent SRH disparities.

Journal of Adolescent Health , 2023

Lesbian, gay, bisexual, transgender, and queer-identified (LGBTQ) youth of color face poorer psyc... more Lesbian, gay, bisexual, transgender, and queer-identified (LGBTQ) youth of color face poorer psychosocial health outcomes than their non-LGBTQ peers. Research suggests school-based and community activities promote psychosocial health for LGBTQ youth, but study samples are predominantly White. This study tested whether school enrollment and seven community activities were associated with LGBTQ community connectedness, happiness, and health among Black and Latinx LGBTQ youth. Methods: This study used a subsample of Black and Latinx LGBTQ adolescents and young adults (N ¼ 472) from the Social Justice Sexuality project. Mean differences in study variables were examined across intersectional racial/gender identity categories. Multiple regression analyses assessed the association of school enrollment and community activities with psychosocial health outcomes, accounting for covariates. Results: Social activities for LGBTQ people (ß ¼ 0.19) and LGBTQ people of color (POC; ß ¼ 0.15) were associated with greater LGBTQ connectedness. While moderate religious services attendance (ß ¼ À0.13) was associated with lower LGBTQ connectedness, high attendance was associated with greater happiness (ß ¼ 0.13) and health (ß ¼ 0.12). Social activities for LGBTQ-POC (ß ¼ 0.13) were also associated with better health. School enrollment was not significantly associated with any outcomes and Latinx transgender and diverse youth had the lowest happiness and health. Discussion: Social activities for LGBTQ people and LGBTQ-POC may play a role in the social connectedness and health of Black and Latinx LGBTQ youth, while frequent religious service attendance may support health and happiness. Schools and faith institutions should ensure their institutions are welcoming to LGBTQ youth. Public health workers might facilitate the involvement and inclusion of LGBTQ youth, while policy should support funding for community activities.

International Journal of Environmental Research and Public Health, 2021

Sexual health communication warrants greater attention as it may help to reduce the rates of HIV ... more Sexual health communication warrants greater attention as it may help to reduce the rates of HIV incidence among youth. A growing body of literature suggests that conversations about sexual health among Black and Latino youth may serve as a potential strategy for HIV prevention. The current study investigates whether sexual health communication—in particular, conversations about sexual health and HIV—influences Black and Latino youth’s personal agency regarding their role in achieving an HIV-free generation. For this secondary data analysis, we used the National Survey of Teens and Young Adults on attitudes towards HIV/AIDS (n = 701). Participants included youth between the ages 15 and 24, and the average was 20 years. We used a multiple regression analysis to examine whether sexual health communication contributed to youth knowledge and awareness of (1) the national plan for EHE, and (2) their role in ending the epidemic”. (1) knowledge and awareness of the national plan for EHE, a...

Journal of Community Practice, 2015

ABSTRACT Organizations serving lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities... more ABSTRACT Organizations serving lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities provide services aimed at improving the health and well-being of LGBTQ people, yet may face limited resources and community support in nonmetropolitan communities. This study seeks to understand LGBTQ individuals’ motivations for becoming and staying involved in nonmetropolitan LGBTQ organizations. Data collection methods included interviews, participant observation, and focus groups. Six categories of motivations emerged: (1) to access support and resources; (2) to establish an LGBTQ community; (3) to be generative; (4) to affirm identity; (5) to support an LGBTQ organization; and (6) to combine one’s personal and professional lives.

Pediatrics , 2020

Latino adolescents are disproportionately affected by teenage pregnancy, sexually transmitted inf... more Latino adolescents are disproportionately affected by teenage pregnancy, sexually transmitted infections, and HIV, persistent sexual and reproductive health (SRH) disparities that represent a national public health concern. Despite progress nationally, Latina adolescents continue to exhibit above-average teenage pregnancy, birth, and repeat birth rates. 1 Particularly concerning are the 17% increase in reportable sexually transmitted infections among 10-to 19year-old Latino adolescents since 2014 and the 6% rise in new HIV diagnoses among 13-to 19-year-old Latino adolescents between 2016 and 2017 alone. 2-4 Given these statistics, research is needed to strengthen the evidence on programs to reduce Latino adolescent SRH disparities.

International Journal of Environmental Research and Public Health , 2021

Sexual health communication warrants greater attention as it may help to reduce the rates of HIV ... more Sexual health communication warrants greater attention as it may help to reduce the rates of HIV incidence among youth. A growing body of literature suggests that conversations about sexual health among Black and Latino youth may serve as a potential strategy for HIV prevention. The current study investigates whether sexual health communication—in particular, conversations about sexual health and HIV—influences Black and Latino youth’s personal agency regarding their role in achieving an HIV-free generation. For this secondary data analysis, we used the National Survey of Teens and Young Adults on attitudes towards HIV/AIDS (n = 701). Participants included youth between the ages 15 and 24, and the average was 20 years. We used a multiple regression analysis to examine whether sexual health communication contributed to youth knowledge and awareness of (1) the national plan for EHE, and (2) their role in ending the epidemic”. (1) knowledge and awareness of the national plan for EHE, and (2) role in ending the epidemic. The final multiple regression model was statistically significant [R2 = 0.16 F (12, 701) = 001, p < 0.001] for both outcomes. Study results found that sexual health communication was positively related to Black and Latino youth’s awareness of efforts to end the HIV epidemic (EHE) and their belief that they could play a role in achieving EHE. In addition, HIV stigma influenced personal agency and whether youth were aware of efforts to achieve EHE. Our results demonstrated that openly communicating about sexual health and HIV may contribute to a sense of personal agency among Black and Latino youth. In addition, understanding whether sexual health communication contributes to a sense of personal agency among youth may inform HIV prevention efforts to achieve the goals set forth by the national EHE plan for the U.S.

Health Education & Behavior, 2021

Black and Latino sexual minority men (BLSMM) scholars are well positioned to draw on their unique... more Black and Latino sexual minority men (BLSMM) scholars are well positioned to draw on their unique perspectives and expertise to address the health status and life opportunities (HSLO) of BLSMM. Increasingly, research related to the positionality of scholars of color suggests that the scholar's stance in relation to the community being researched has important implications for the research. Despite growing recognition of the importance of scholar positionality, limited attention has been paid to the relationship between scholar-of-color positionality and improving HSLO trajectories of BLSMM. Furthermore, extant literature fails to specify the mechanisms by which scholar-of-color positionality can improve HSLO among BLSMM. This article seeks to fill this gap in research by arguing that an inadequate consideration of scholar positionality in health and life opportunity research has important implications for the HSLO of BLSMM. A multilevel, mediational model addressing factors at the micro-level (i.e., intrapersonal resources)-BLSMM scholars' personal commitments to BLSMM communities, cultural knowledge and expertise, and shared life experiences; meso-level (i.e., scholar and affected community interactions)historical membership, mutual interdependency and trust, and community and organizational gatekeeping; and macrolevel (i.e., national policies and priorities regarding BLSMM)-national priorities regarding the health and social welfare of BLSMM, allocation of BLSMM research and program funding, societal sentiment, and national investment in the workforce development of BLSMM scholars and clinicians are detailed. In conclusion, we identify recommendations and strategies for advancing scientific, programmatic, and policy efforts, aimed at improving HSLO among communities of BLSMM.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) organizations are spaces in which LGBTQ in... more Lesbian, gay, bisexual, transgender, and queer (LGBTQ) organizations are spaces in which LGBTQ individuals can access support and community, yet they have received little empirical attention, particularly outside urban areas. Given the benefits of LGBTQ community involvement, this study examined the barriers to involvement in nonmetropolitan LGBTQ organizations. Three qualitative methods were employed: interviews, focus groups, and participant observation sessions. Thematic analyses identified eight barriers originating within the individual (managing one's LGBTQ identity, individual characteristics), organization (lack of diversity, group dynamics, lack of awareness of programs, workplace/school climate), and community (size, hostility). Implications for reducing barriers in nonmetropolitan LGBTQ organizations are discussed.

Journal of Racial and Ethnic Health Disparities, 2021

Black sexual minority men (BSMM) in the USA navigate a range of factors that may influence the ex... more Black sexual minority men (BSMM) in the USA navigate a range of factors that may influence the extent to which they disclose or conceal their sexual identity in various social contexts. To date, few studies have investigated the correlates of sexual identity disclosure or concealment among BSMM across multiple life domains. Guided by a minority stress perspective and intersectionality, we analyzed data from N = 809 BSMM who participated in the Social Justice Sexuality Survey. We conducted ordinary least squares regression to examine the relative weight of perceptions of homophobia, religiosity, LGBT community connectedness, racial identity salience, and sexual identity salience on disclosure of sexual identity in six social-relational contexts: (1) family, (2) friends, (3) neighbors, (4) religious community, (5) work, and (6) online. Findings indicate that BSMM disclosed their sexual identity unevenly across social-relational contexts. Notably, LGBTQ community connectedness and sexual identity importance were consistent predictors of sexual identity disclosure across contexts. In contrast, perceptions of homophobia were not related to sexual identity disclosure, suggesting that other factors may be more salient for BSMM when deciding to disclose their sexual identity. Finally, bisexual men consistently reported lower levels of sexual identity disclosure relative to gay men in all six contexts. Study findings have important implications for future research on sexual identity disclosure with diverse samples of BSMM.

Culture, Health, & Sexuality , 2020

Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV tran... more Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised
method for preventing HIV transmission in high-risk groups. Despite
ongoing social marketing to increase PrEP awareness, few studies have
evaluated public responses. This paper contextualises negative
responses to Chicago’s PrEP4Love campaign. In February 2016, a sex
positive ad campaign called PrEP4Love was launched online and
throughout public spaces in Chicago. A gender and sexuality inclusive
campaign, PrEP4Love is intended to be culturally responsive and sex
positive, while retaining a focus on risk reduction. Advertisements
prominently feature Black sexual minority men, and Black transgender
women, and were strategically placed in diverse Chicago neighbour
hoods. In response, there were 212 new callers to the PrEPLine during
the two-month study period. Negative responses were concerned with:
negatively depicting Black homosexuality (4), general anti-LGBTQ com-
ments (7), adverse effects on children (6), sexually explicit nature (5),
and general stigmatisation of racial minorities (4). Discussion focuses on
sex-positive frameworks, normalising intimacy, stigma and historical
mistrust of medical and pharmaceutical institutions, and the social
meanings of biomedical prevention technologies (e.g. PrEP) in relation
to dominant norms of sexuality and gender. This study is the first to
investigate public responses to a sex-positive PrEP campaign. More
studies of PrEP social marketing are needed to evaluate targeted public
health campaigns to guide future PrEP promotion strategies.

#PrEP4Love: An Evaluation of a Sex-Positive HIV Prevention Campaign, 2019

Background: Pre-exposure prophylaxis (PrEP) is an effective but underutilized method for preventi... more Background: Pre-exposure prophylaxis (PrEP) is an effective but underutilized method for preventing HIV transmission in communities vulnerable to HIV. Public health campaigns aimed at increasing PrEP awareness and access have less evaluation data.

Objective: The aim of this study was to evaluate Chicago’s PrEP campaign, PrEP4Love (P4L), a campaign that uses health equity and sex-positivity approaches for information dissemination.

Methods: P4L launched in February 2016 and remains an active campaign to date. The analysis period for this paper was from the launch date in February 2016 through May 15, 2016. Our analysis reviews the Web-based reach of the campaign through views on social media platforms (Facebook and Instagram), smart ads, or ads served to individuals across a variety of Web platforms based on their demographics and browsing history, and P4L website clicks.

Results: In total, 40,913,560 unique views were generated across various social media platforms. A total of 24,548 users clicked on P4L ads and 32,223,987 views were received from smart ads. The 3 most clicked on ads were STD Signs & Symptoms—More Information on STD Symptoms, HIV & AIDS Prevention, and HIV Prevention Medication. An additional 6,970,127 views were gained through Facebook and another 1,719,446 views through Instagram. There was an average of 182 clicks per day on the P4L website.

Conclusions: This is the first study investigating public responses to a health equity and sex-positive social marketing campaign for PrEP. Overall, the campaign reached millions of individuals. More studies of PrEP social marketing are needed to evaluate the relationship of targeted public health campaigns on stigma and to guide future PrEP promotion strategies.

Existing research finds that LGBTQ youth of color are overrepresented in the child welfare and ju... more Existing research finds that LGBTQ youth of color are overrepresented in the child welfare and juvenile justice systems. Structural racism and LGBTQ stigma likely increase the risk of that LGBTQ youth of color will enter these systems. Once in the system, LGBTQ youth of color tend to remain longer and face an elevated risk of discrimination and violence compared to other groups of youth. However, scholars in this collection of working papers find that more research and data are needed to fully understand the experiences and needs of LGBTQ youth of color in the child welfare and juvenile justice systems and to prevent harm and promote positive outcomes for youth in the systems. The report also provides recommendations for future research to address the gaps in knowledge.

The Williams Institute at UCLA School of Law,, 2019

Health Equity , 2024

Young sexual minority adults experience high rates of heterosexist discrimination. The use of sub... more Young sexual minority adults experience high rates of heterosexist discrimination. The use of substances has been documented as a form of coping with discrimination. While mindfulness has been used to address experiences of discrimination and the use of substances, respectively, few studies have explored whether mindfulness can lower the negative effects of discrimination on substance use. The purpose of this study is to examine the association between heterosexist discrimination and substance use in young adult sexual minority men (YASMM), and if dispositional mindfulness can moderate this relationship. Methods: Logistic regression analysis was used to examine the association of heterosexist discrimination and cigarette, e-cigarette, and hazardous drinking in a sample of YASMM (18-35 years old; n = 325) from a national survey. A two-way interaction analysis was also implemented to evaluate if dispositional mindfulness moderated this relationship. Results: Heterosexist discrimination was associated with increased odds of cigarette use (adjusted odds ratio [aOR] = 1.06; 95% confidence interval [CI]: 1.03, 1.08) and e-cigarette use (aOR = 1.03; 95% CI: 1.01, 1.05). Higher scores of dispositional mindfulness moderated the relationship between heterosexist discrimination and hazardous drinking, indicating a weakening effect with higher scores of dispositional mindfulness. Conclusion: Mindfulness may decrease the negative effects of heterosexist discrimination on hazardous drinking among YASMM. Health Equity Implications: Researchers and practitioners should consider incorporating mindfulness as a component to their intervention to help YASMM deal with stressors engendered by discrimination, which may prevent hazardous drinking as a coping mechanism at a younger age.

Journal of Adolescent Health, 2023

Lesbian, gay, bisexual, transgender, and queer-identified (LGBTQ) youth of color face poorer psyc... more Lesbian, gay, bisexual, transgender, and queer-identified (LGBTQ) youth of color face poorer psychosocial health outcomes than their non-LGBTQ peers. Research suggests school-based and community activities promote psychosocial health for LGBTQ youth, but study samples are predominantly White. This study tested whether school enrollment and seven community activities were associated with LGBTQ community connectedness, happiness, and health among Black and Latinx LGBTQ youth. Methods: This study used a subsample of Black and Latinx LGBTQ adolescents and young adults (N ¼ 472) from the Social Justice Sexuality project. Mean differences in study variables were examined across intersectional racial/gender identity categories. Multiple regression analyses assessed the association of school enrollment and community activities with psychosocial health outcomes, accounting for covariates. Results: Social activities for LGBTQ people (ß ¼ 0.19) and LGBTQ people of color (POC; ß ¼ 0.15) were associated with greater LGBTQ connectedness. While moderate religious services attendance (ß ¼ À0.13) was associated with lower LGBTQ connectedness, high attendance was associated with greater happiness (ß ¼ 0.13) and health (ß ¼ 0.12). Social activities for LGBTQ-POC (ß ¼ 0.13) were also associated with better health. School enrollment was not significantly associated with any outcomes and Latinx transgender and diverse youth had the lowest happiness and health. Discussion: Social activities for LGBTQ people and LGBTQ-POC may play a role in the social connectedness and health of Black and Latinx LGBTQ youth, while frequent religious service attendance may support health and happiness. Schools and faith institutions should ensure their institutions are welcoming to LGBTQ youth. Public health workers might facilitate the involvement and inclusion of LGBTQ youth, while policy should support funding for community activities.

Journal of Racial and Ethnic Health Disparities, 2021

Black sexual minority men (BSMM) in the USA navigate a range of factors that may influence the ex... more Black sexual minority men (BSMM) in the USA navigate a range of factors that may influence the extent to which they disclose or conceal their sexual identity in various social contexts. To date, few studies have investigated the correlates of sexual identity disclosure or concealment among BSMM across multiple life domains. Guided by a minority stress perspective and intersectionality, we analyzed data from N = 809 BSMM who participated in the Social Justice Sexuality Survey. We conducted ordinary least squares regression to examine the relative weight of perceptions of homophobia, religiosity, LGBT community connectedness, racial identity salience, and sexual identity salience on disclosure of sexual identity in six social-relational contexts: (1) family, (2) friends, (3) neighbors, (4) religious community, (5) work, and (6) online. Findings indicate that BSMM disclosed their sexual identity unevenly across social-relational contexts. Notably, LGBTQ community connectedness and sexual identity importance were consistent predictors of sexual identity disclosure across contexts. In contrast, perceptions of homophobia were not related to sexual identity disclosure, suggesting that other factors may be more salient for BSMM when deciding to disclose their sexual identity. Finally, bisexual men consistently reported lower levels of sexual identity disclosure relative to gay men in all six contexts. Study findings have important implications for future research on sexual identity disclosure with diverse samples of BSMM.

Culture, Health & Sexuality, 2020

Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV tran... more Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV transmission in high-risk groups. Despite ongoing social marketing to increase PrEP awareness, few studies have evaluated public responses. This paper contextualises negative responses to Chicago's PrEP4Love campaign. In February 2016, a sexpositive ad campaign called PrEP4Love was launched online and throughout public spaces in Chicago. A gender and sexuality inclusive campaign, PrEP4Love is intended to be culturally responsive and sex positive, while retaining a focus on risk reduction. Advertisements prominently feature Black sexual minority men, and Black transgender women, and were strategically placed in diverse Chicago neighbourhoods. In response, there were 212 new callers to the PrEPLine during the two-month study period. Negative responses were concerned with: negatively depicting Black homosexuality (4), general anti-LGBTQ comments (7), adverse effects on children (6), sexually explicit nature (5), and general stigmatisation of racial minorities (4). Discussion focuses on sex-positive frameworks, normalising intimacy, stigma and historical mistrust of medical and pharmaceutical institutions, and the social meanings of biomedical prevention technologies (e.g. PrEP) in relation to dominant norms of sexuality and gender. This study is the first to investigate public responses to a sex-positive PrEP campaign. More studies of PrEP social marketing are needed to evaluate targeted public health campaigns to guide future PrEP promotion strategies.

Health Education & Behavior, 2021

Black and Latino sexual minority men (BLSMM) scholars are well positioned to draw on their unique... more Black and Latino sexual minority men (BLSMM) scholars are well positioned to draw on their unique perspectives and expertise to address the health status and life opportunities (HSLO) of BLSMM. Increasingly, research related to the positionality of scholars of color suggests that the scholar’s stance in relation to the community being researched has important implications for the research. Despite growing recognition of the importance of scholar positionality, limited attention has been paid to the relationship between scholar-of-color positionality and improving HSLO trajectories of BLSMM. Furthermore, extant literature fails to specify the mechanisms by which scholar-of-color positionality can improve HSLO among BLSMM. This article seeks to fill this gap in research by arguing that an inadequate consideration of scholar positionality in health and life opportunity research has important implications for the HSLO of BLSMM. A multilevel, mediational model addressing factors at the m...

Journal of Gay & Lesbian Social Services, 2017

Blackgay men must navigate identities and stigmas related to being gay and Black, and report high... more Blackgay men must navigate identities and stigmas related to being gay and Black, and report higher HIV incidence relative to their white male counterparts although they report lower rates of drug use and risky sexual behaviors. This study examined whether closeness to the gay or Black community correlated with HIV related risk and protective behaviors. Data were drawn from uConnect, a population-based cohort study of YBMSM on Chicago's South Side. The sample consists of 618 Black MSM ranging in age from 16-29. Cross sectional measures for this study include Black and gay community closeness, drug use, sexual risk behaviors, HIV testing and health promotion behaviors. Closeness with the gay community was associated with greater PrEP knowledge as well as participating in health promotion programs along with higher rates of transactional sex and having sex under the influence of substances, and increased odds of selfreported HIV seropositivity. Involvement in the Black community was associated with lower odds of reporting being HIV positive. Findings suggest that programs and initiatives are needed to help promote the positive aspects of the Black and gay communities, while minimizing the negative correlates of such involvements.

BACKGROUND Pre-exposure prophylaxis (PrEP) is an effective but under-utilized method for preventi... more BACKGROUND Pre-exposure prophylaxis (PrEP) is an effective but under-utilized method for preventing HIV transmission in communities vulnerable to HIV. Public health campaigns aimed at increasing PrEP awareness and access have little evaluation data. OBJECTIVE We have evaluated Chicago’s PrEP campaign, PrEP4Love (P4L), a campaign that uses health-equity and sex-positivity approaches to information dissemination. METHODS PrEP4Love launched in February, 2016 and remains an active campaign today. The analysis period for this paper was from the launch date in February, 2016- May 15th, 2016. Our analysis reviews the online reach through views on social media platforms (Facebook and Instagram), “smart ads,” or ads served to individuals across a variety of web platforms based on their demographics and browsing history, and PrEP4Love website clicks. RESULTS 40,913,560 unique views were generated across various social media platforms. Users clicked on PrEP4Love ads 0.06 percent of the time. 3...

Pediatrics, 2020

Latino adolescents are disproportionately affected by teenage pregnancy, sexually transmitted inf... more Latino adolescents are disproportionately affected by teenage pregnancy, sexually transmitted infections, and HIV, persistent sexual and reproductive health (SRH) disparities that represent a national public health concern. Despite progress nationally, Latina adolescents continue to exhibit above-average teenage pregnancy, birth, and repeat birth rates. 1 Particularly concerning are the 17% increase in reportable sexually transmitted infections among 10-to 19year-old Latino adolescents since 2014 and the 6% rise in new HIV diagnoses among 13-to 19-year-old Latino adolescents between 2016 and 2017 alone. 2-4 Given these statistics, research is needed to strengthen the evidence on programs to reduce Latino adolescent SRH disparities.

Journal of Adolescent Health , 2023

Lesbian, gay, bisexual, transgender, and queer-identified (LGBTQ) youth of color face poorer psyc... more Lesbian, gay, bisexual, transgender, and queer-identified (LGBTQ) youth of color face poorer psychosocial health outcomes than their non-LGBTQ peers. Research suggests school-based and community activities promote psychosocial health for LGBTQ youth, but study samples are predominantly White. This study tested whether school enrollment and seven community activities were associated with LGBTQ community connectedness, happiness, and health among Black and Latinx LGBTQ youth. Methods: This study used a subsample of Black and Latinx LGBTQ adolescents and young adults (N ¼ 472) from the Social Justice Sexuality project. Mean differences in study variables were examined across intersectional racial/gender identity categories. Multiple regression analyses assessed the association of school enrollment and community activities with psychosocial health outcomes, accounting for covariates. Results: Social activities for LGBTQ people (ß ¼ 0.19) and LGBTQ people of color (POC; ß ¼ 0.15) were associated with greater LGBTQ connectedness. While moderate religious services attendance (ß ¼ À0.13) was associated with lower LGBTQ connectedness, high attendance was associated with greater happiness (ß ¼ 0.13) and health (ß ¼ 0.12). Social activities for LGBTQ-POC (ß ¼ 0.13) were also associated with better health. School enrollment was not significantly associated with any outcomes and Latinx transgender and diverse youth had the lowest happiness and health. Discussion: Social activities for LGBTQ people and LGBTQ-POC may play a role in the social connectedness and health of Black and Latinx LGBTQ youth, while frequent religious service attendance may support health and happiness. Schools and faith institutions should ensure their institutions are welcoming to LGBTQ youth. Public health workers might facilitate the involvement and inclusion of LGBTQ youth, while policy should support funding for community activities.

International Journal of Environmental Research and Public Health, 2021

Sexual health communication warrants greater attention as it may help to reduce the rates of HIV ... more Sexual health communication warrants greater attention as it may help to reduce the rates of HIV incidence among youth. A growing body of literature suggests that conversations about sexual health among Black and Latino youth may serve as a potential strategy for HIV prevention. The current study investigates whether sexual health communication—in particular, conversations about sexual health and HIV—influences Black and Latino youth’s personal agency regarding their role in achieving an HIV-free generation. For this secondary data analysis, we used the National Survey of Teens and Young Adults on attitudes towards HIV/AIDS (n = 701). Participants included youth between the ages 15 and 24, and the average was 20 years. We used a multiple regression analysis to examine whether sexual health communication contributed to youth knowledge and awareness of (1) the national plan for EHE, and (2) their role in ending the epidemic”. (1) knowledge and awareness of the national plan for EHE, a...

Journal of Community Practice, 2015

ABSTRACT Organizations serving lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities... more ABSTRACT Organizations serving lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities provide services aimed at improving the health and well-being of LGBTQ people, yet may face limited resources and community support in nonmetropolitan communities. This study seeks to understand LGBTQ individuals’ motivations for becoming and staying involved in nonmetropolitan LGBTQ organizations. Data collection methods included interviews, participant observation, and focus groups. Six categories of motivations emerged: (1) to access support and resources; (2) to establish an LGBTQ community; (3) to be generative; (4) to affirm identity; (5) to support an LGBTQ organization; and (6) to combine one’s personal and professional lives.

Pediatrics , 2020

Latino adolescents are disproportionately affected by teenage pregnancy, sexually transmitted inf... more Latino adolescents are disproportionately affected by teenage pregnancy, sexually transmitted infections, and HIV, persistent sexual and reproductive health (SRH) disparities that represent a national public health concern. Despite progress nationally, Latina adolescents continue to exhibit above-average teenage pregnancy, birth, and repeat birth rates. 1 Particularly concerning are the 17% increase in reportable sexually transmitted infections among 10-to 19year-old Latino adolescents since 2014 and the 6% rise in new HIV diagnoses among 13-to 19-year-old Latino adolescents between 2016 and 2017 alone. 2-4 Given these statistics, research is needed to strengthen the evidence on programs to reduce Latino adolescent SRH disparities.

International Journal of Environmental Research and Public Health , 2021

Sexual health communication warrants greater attention as it may help to reduce the rates of HIV ... more Sexual health communication warrants greater attention as it may help to reduce the rates of HIV incidence among youth. A growing body of literature suggests that conversations about sexual health among Black and Latino youth may serve as a potential strategy for HIV prevention. The current study investigates whether sexual health communication—in particular, conversations about sexual health and HIV—influences Black and Latino youth’s personal agency regarding their role in achieving an HIV-free generation. For this secondary data analysis, we used the National Survey of Teens and Young Adults on attitudes towards HIV/AIDS (n = 701). Participants included youth between the ages 15 and 24, and the average was 20 years. We used a multiple regression analysis to examine whether sexual health communication contributed to youth knowledge and awareness of (1) the national plan for EHE, and (2) their role in ending the epidemic”. (1) knowledge and awareness of the national plan for EHE, and (2) role in ending the epidemic. The final multiple regression model was statistically significant [R2 = 0.16 F (12, 701) = 001, p < 0.001] for both outcomes. Study results found that sexual health communication was positively related to Black and Latino youth’s awareness of efforts to end the HIV epidemic (EHE) and their belief that they could play a role in achieving EHE. In addition, HIV stigma influenced personal agency and whether youth were aware of efforts to achieve EHE. Our results demonstrated that openly communicating about sexual health and HIV may contribute to a sense of personal agency among Black and Latino youth. In addition, understanding whether sexual health communication contributes to a sense of personal agency among youth may inform HIV prevention efforts to achieve the goals set forth by the national EHE plan for the U.S.

Health Education & Behavior, 2021

Black and Latino sexual minority men (BLSMM) scholars are well positioned to draw on their unique... more Black and Latino sexual minority men (BLSMM) scholars are well positioned to draw on their unique perspectives and expertise to address the health status and life opportunities (HSLO) of BLSMM. Increasingly, research related to the positionality of scholars of color suggests that the scholar's stance in relation to the community being researched has important implications for the research. Despite growing recognition of the importance of scholar positionality, limited attention has been paid to the relationship between scholar-of-color positionality and improving HSLO trajectories of BLSMM. Furthermore, extant literature fails to specify the mechanisms by which scholar-of-color positionality can improve HSLO among BLSMM. This article seeks to fill this gap in research by arguing that an inadequate consideration of scholar positionality in health and life opportunity research has important implications for the HSLO of BLSMM. A multilevel, mediational model addressing factors at the micro-level (i.e., intrapersonal resources)-BLSMM scholars' personal commitments to BLSMM communities, cultural knowledge and expertise, and shared life experiences; meso-level (i.e., scholar and affected community interactions)historical membership, mutual interdependency and trust, and community and organizational gatekeeping; and macrolevel (i.e., national policies and priorities regarding BLSMM)-national priorities regarding the health and social welfare of BLSMM, allocation of BLSMM research and program funding, societal sentiment, and national investment in the workforce development of BLSMM scholars and clinicians are detailed. In conclusion, we identify recommendations and strategies for advancing scientific, programmatic, and policy efforts, aimed at improving HSLO among communities of BLSMM.

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) organizations are spaces in which LGBTQ in... more Lesbian, gay, bisexual, transgender, and queer (LGBTQ) organizations are spaces in which LGBTQ individuals can access support and community, yet they have received little empirical attention, particularly outside urban areas. Given the benefits of LGBTQ community involvement, this study examined the barriers to involvement in nonmetropolitan LGBTQ organizations. Three qualitative methods were employed: interviews, focus groups, and participant observation sessions. Thematic analyses identified eight barriers originating within the individual (managing one's LGBTQ identity, individual characteristics), organization (lack of diversity, group dynamics, lack of awareness of programs, workplace/school climate), and community (size, hostility). Implications for reducing barriers in nonmetropolitan LGBTQ organizations are discussed.

Journal of Racial and Ethnic Health Disparities, 2021

Black sexual minority men (BSMM) in the USA navigate a range of factors that may influence the ex... more Black sexual minority men (BSMM) in the USA navigate a range of factors that may influence the extent to which they disclose or conceal their sexual identity in various social contexts. To date, few studies have investigated the correlates of sexual identity disclosure or concealment among BSMM across multiple life domains. Guided by a minority stress perspective and intersectionality, we analyzed data from N = 809 BSMM who participated in the Social Justice Sexuality Survey. We conducted ordinary least squares regression to examine the relative weight of perceptions of homophobia, religiosity, LGBT community connectedness, racial identity salience, and sexual identity salience on disclosure of sexual identity in six social-relational contexts: (1) family, (2) friends, (3) neighbors, (4) religious community, (5) work, and (6) online. Findings indicate that BSMM disclosed their sexual identity unevenly across social-relational contexts. Notably, LGBTQ community connectedness and sexual identity importance were consistent predictors of sexual identity disclosure across contexts. In contrast, perceptions of homophobia were not related to sexual identity disclosure, suggesting that other factors may be more salient for BSMM when deciding to disclose their sexual identity. Finally, bisexual men consistently reported lower levels of sexual identity disclosure relative to gay men in all six contexts. Study findings have important implications for future research on sexual identity disclosure with diverse samples of BSMM.

Culture, Health, & Sexuality , 2020

Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised method for preventing HIV tran... more Pre-exposure prophylaxis (PrEP) is an effective yet under-utilised
method for preventing HIV transmission in high-risk groups. Despite
ongoing social marketing to increase PrEP awareness, few studies have
evaluated public responses. This paper contextualises negative
responses to Chicago’s PrEP4Love campaign. In February 2016, a sex
positive ad campaign called PrEP4Love was launched online and
throughout public spaces in Chicago. A gender and sexuality inclusive
campaign, PrEP4Love is intended to be culturally responsive and sex
positive, while retaining a focus on risk reduction. Advertisements
prominently feature Black sexual minority men, and Black transgender
women, and were strategically placed in diverse Chicago neighbour
hoods. In response, there were 212 new callers to the PrEPLine during
the two-month study period. Negative responses were concerned with:
negatively depicting Black homosexuality (4), general anti-LGBTQ com-
ments (7), adverse effects on children (6), sexually explicit nature (5),
and general stigmatisation of racial minorities (4). Discussion focuses on
sex-positive frameworks, normalising intimacy, stigma and historical
mistrust of medical and pharmaceutical institutions, and the social
meanings of biomedical prevention technologies (e.g. PrEP) in relation
to dominant norms of sexuality and gender. This study is the first to
investigate public responses to a sex-positive PrEP campaign. More
studies of PrEP social marketing are needed to evaluate targeted public
health campaigns to guide future PrEP promotion strategies.

#PrEP4Love: An Evaluation of a Sex-Positive HIV Prevention Campaign, 2019

Background: Pre-exposure prophylaxis (PrEP) is an effective but underutilized method for preventi... more Background: Pre-exposure prophylaxis (PrEP) is an effective but underutilized method for preventing HIV transmission in communities vulnerable to HIV. Public health campaigns aimed at increasing PrEP awareness and access have less evaluation data.

Objective: The aim of this study was to evaluate Chicago’s PrEP campaign, PrEP4Love (P4L), a campaign that uses health equity and sex-positivity approaches for information dissemination.

Methods: P4L launched in February 2016 and remains an active campaign to date. The analysis period for this paper was from the launch date in February 2016 through May 15, 2016. Our analysis reviews the Web-based reach of the campaign through views on social media platforms (Facebook and Instagram), smart ads, or ads served to individuals across a variety of Web platforms based on their demographics and browsing history, and P4L website clicks.

Results: In total, 40,913,560 unique views were generated across various social media platforms. A total of 24,548 users clicked on P4L ads and 32,223,987 views were received from smart ads. The 3 most clicked on ads were STD Signs & Symptoms—More Information on STD Symptoms, HIV & AIDS Prevention, and HIV Prevention Medication. An additional 6,970,127 views were gained through Facebook and another 1,719,446 views through Instagram. There was an average of 182 clicks per day on the P4L website.

Conclusions: This is the first study investigating public responses to a health equity and sex-positive social marketing campaign for PrEP. Overall, the campaign reached millions of individuals. More studies of PrEP social marketing are needed to evaluate the relationship of targeted public health campaigns on stigma and to guide future PrEP promotion strategies.

Existing research finds that LGBTQ youth of color are overrepresented in the child welfare and ju... more Existing research finds that LGBTQ youth of color are overrepresented in the child welfare and juvenile justice systems. Structural racism and LGBTQ stigma likely increase the risk of that LGBTQ youth of color will enter these systems. Once in the system, LGBTQ youth of color tend to remain longer and face an elevated risk of discrimination and violence compared to other groups of youth. However, scholars in this collection of working papers find that more research and data are needed to fully understand the experiences and needs of LGBTQ youth of color in the child welfare and juvenile justice systems and to prevent harm and promote positive outcomes for youth in the systems. The report also provides recommendations for future research to address the gaps in knowledge.

The Williams Institute at UCLA School of Law,, 2019

LGBTQ Youth of Color Impacted by the Child Welfare and Juvenile Justice systems, 2019

Arredondo, M. & Suarez, M. (2019). System-involved LGBTQ Youth of Color: Ecological Determinants ... more Arredondo, M. & Suarez, M. (2019). System-involved LGBTQ Youth of Color: Ecological Determinants K-12 Schooling. In K. J. Conron & B. D. M. Wilson (Eds.), A Research Agenda to Reduce System Involvement and Promote Positive Outcomes with LGBTQ Youth of Color Impacted by the Child Welfare and Juvenile Justice Systems (pp. 21-26). Los Angeles, CA: The Williams Institute. Available: https://williamsinstitute.law.ucla.edu/wp-content/uploads/LGBTQ-Youth-of-Color-July-2019-3.pdf