FRESH AIR (Focused Research to Enhance Social Health Among Individuals in the Rainbow)

Lesbian, gay, bisexual, and trans individuals have higher incidence of smoking than the general population. However, little research exists to examine the reasons for this disparity. FRESH AIR aims to understand the theory-based predictors of tobacco use, as well as other health behaviors, including diet and physical activity, among lesbian, gay, bisexual, and queer adults. The project will involve a national online sample as well as a Houston-based sample. For the Houston-based sample, we will collect additional health markers, such as salivary cortisol, body mass index, and blood pressure. This project is led by Drs. Nathan Grant Smith and Lorraine R. Reitzel (co-PIs) with collaboration from Dr. Ezemenari Obasi, all faculty members in the University of Houston Department of Psychological, Health, and Learning Sciences.

Bisexual Identity: Implications for Mental and Sexual Health

This project represents collaborative work between Dr. Nathan Grant Smith (University of Houston), Dr. Lori Ross (Center for Addiction and Mental Health, Toronto) and Dr. Jonathan Mohr (University of Maryland, Washington, DC). Bisexual men represent a population that is under-represented in research. Studies often pool samples of bisexual men together with those of gay men despite possible differences between the two groups. Indeed, recent studies have shown that bisexual men have different patterns of mental health outcomes and sexual behaviors than gay, lesbian, or heterosexual individuals. The reasons for these differences are not well understood due to the paucity of research on bisexual men. Our team will examine whether popular theories used to explain mental health and sexual risk behavior in gay men also apply to bisexual men. The theories under study are: the minority stress theory, the syndemic theory, the theory of planned behavior, and the health belief model. Using a multiplicity of theories will allow us to determine which theory better explains the health disparities found in other studies between bisexual men and other men. The results of the proposed research will have important implications for identifying resilience factors and tailoring interventions to bisexual men.

This project is funded by the Institute of Gender and Health of the Canadian Institutes of Health Research.

Minority Stress and Career Indecision Among LGB College Students

According to minority stress theory (Meyer, 2003), sexual minority individuals are at risk for a higher level of chronic stress due to their sexual minority status. This stress is related to discrimination and stigma, and affects an individual’s self-concept and how the individual relates to others in the world. There is a scarcity of research examining how the experience of minority stress in the lesbian, gay, and bisexual (LGB) community relates to the career decision-making process. The current study seeks to examine how minority stress influences career indecision in LGB college students. Specifically, the minority stress variables of internalized heterosexism, outness, concealment, and discrimination experiences will be examined in relation to four factors representing career indecision: neuroticism, choice/commitment anxiety, lack of readiness, and interpersonal conflict. Social support and community affiliation will be examined as moderators in the relationship between minority stress and career indecision. This study will be conducted by CORE alumna Colleen Martin and CORE member Kate Winderman, and will be sponsored by Dr. Nathan Grant Smith.

Bisexual Body Image and Ideals

Body image dissatisfaction, or negative appraisal of one's body, is a well-researched concept in the literature and is associated with negative outcomes including substance abuse and eating disordered behavior (Bosley, 2011; Brewster et al., 2014; Mereish, O’Cleirigh, & Bradford, 2014; Pinkasavage, Arigo, & Schumacher, 2015). However, gaps exist in determining the specific processes associated with the body image dissatisfaction of bisexual individuals. Bisexual individuals must navigate body image appearance norms (social expectations for individuals' bodies) from two cultures: that of the heterosexual culture and that of the gay/lesbian culture, and examining the ease of bisexual individuals in navigating these norms (bicultural self-efficacy). This study assesses the relationships involved in a proposed moderated mediation model of this relationship, measures to be used, and expected results found from structural equation modeling of participant responses. This project is being conducted by Brooke King and Dan Soltis under the supervision of Dr. Nathan Grant Smith.

Project PRIDE (Promoting Resilience In Discriminatory Environments)

Project PRIDE is a sex-positive group intervention for young gay and bisexual men who are HIV-negative or serostatus unsure. The intervention focuses on helping participants successfully cope with anti-gay/bisexual discrimination and develop positive gay/bisexual identities. The primary goals of Project PRIDE are to decrease HIV risk behaviors and to increase psychological well-being. This project is a collaboration between Drs. Nathan Grant Smith (University of Houston) and Trevor A. Hart (Ryerson University and University of Toronto), with collaboration from Drs. Martin Blain (l'Université du Québec à Montreal) and Barry Adam (University of Windsor). Initial results suggest that Project PRIDE is a feasible intervention with the potential to impact rates of unprotected anal intercourse, substance use, and mental health outcomes. We are currently analyzing data and will begin disseminating results of the pilot test soon. We plan to conduct a randomized controlled trial to test the efficacy of Project PRIDE.

This project is funded by the Institute of Infection and Immunity of the Canadian Institutes of Health Research.

OUR PrEP (Offering Understanding for Relationships using Pre-exposure Prophylaxis)

HIV-serodiscordant couples, in which one partner is positive and one is negative, face unique relationship challenges. Couples may have concerns such as health risk to the negative partner and fertility issues. Truvada, a new drug approved by the FDA in 2012, presents a possible solution to such challenges. Truvada is used as pre-exposure prophylaxis (PrEP) to greatly reduce the risk of HIV transmission in the negative partner. Whereas the impact on relationships of antiretroviral treatments taken by the positive partner has been examined, there is limited research on the impact of PrEP on relationships. The primary goal of OUR PrEP is to understand the decision making process in using PrEP among different-sex and same-sex couples. The effects of PrEP on relationships will also be investigated. This study is a collaboration between Dr. Nathan Grant Smith (University of Houston), Dr. David Seal (Tulane University), and CORE member E. Charli Washington.

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