Health-care providers hold biases based on

sexual orientation, study says

Findings highlight need for more training of

providers in cultural sensitivity

University of Washington Health Sciences/UW Medicine

In the first study that looks at a variety of health-care providers and their implicit attitudes towards lesbian women and gay men, researchers found there is widespread implicit bias toward lesbian women and gay men. The study finds that moderate to strong implicit preferences for straight people over lesbian and gay people are widespread among heterosexual providers.

Learn about the unique stress and
traumas faced by LGBTQ youth.

Findings highlight need for more training of providers in cultural sensitivity

University of Washington Health Sciences/UW Medicine

In the first study that looks at a variety of health-care providers and their implicit attitudes towards lesbian women and gay men, researchers found there is widespread implicit bias toward lesbian women and gay men. The study finds that moderate to strong implicit preferences for straight people over lesbian and gay people are widespread among heterosexual providers.

In the first study that looks at a variety of healthcare providers and their implicit attitudes towards lesbian women and gay men, researchers found there is widespread implicit bias toward lesbian women and gay men.

The study, "Health care providers' implicit and explicit attitudes toward lesbian women and gay men," published in the American Journal of Public Health finds that moderate to strong implicit preferences for straight people over lesbian and gay people are widespread among heterosexual providers. Also lesbian and gay health providers expressed implicit and explicit preferences for lesbian and gay people over straight people. Bisexual providers were found to have mixed preferences, mental health providers held the weakest implicit bias for heterosexual people over lesbian and gay people and nurses held the strongest implicit bias for heterosexual people over lesbian and gay people.

In short, healthcare providers, similar to others in society, hold a bias for people who shared their own sexual identity.

Lead researcher, Janice Sabin, UW research associate professor in biomedical informatics and medical education, said that clinical care of the LGBT population is a somewhat neglected area in curriculum in nursing, medicine and other areas of healthcare education.

"We want all providers to be proficient in treating diverse populations, including the LGBT population," she said.

Rachel G. Riskind with the Department of Psychology at Guilford College in Greensboro, N.C., and Brian A. Nosek with the Department of Psychology at the University of Virginia in Charlottesville, were co-authors on the study.

Researchers used results from the Sexuality Implicit Association Test developed to assess presence of implicit bias towards either heterosexual or homosexual individuals. The test captured demographic data and implicit association test results for more than 200,000 participants between May 2006 and December 2012. Test takers were asked to indicate their explicit preferences towards heterosexual, lesbian and gay people by endorsing statements ranging from "I strongly prefer straight people to gay people to "I strongly prefer gay people to straight people." The study categorized healthcare respondents by their profession ¬¬¬-- medical doctor, nurse, mental health provider, other treatment provider or non-provider --to assess attitudes specifically from healthcare providers.

Test takers voluntarily accessed the Sexuality Implicit Association Test on Project Implicit, a non-profit organization founded in 1998 by three scientists -- Tony Greenwald (University of Washington), Mahzarin Banaji (Harvard University), and Brian Nosek (University of Virginia). Project Implicit provides a "virtual laboratory" for collecting data on the Internet in a mission to educate the public about hidden biases or thoughts and feelings outside of conscious awareness and control.

Sabin said, "training for healthcare providers about treating sexual minority patients is an area in great need of attention."

"For healthcare organizations that aim to serve these populations, these data suggest an opportunity to examine methods likely to mitigate implicit biases, such as eliminating discretion from decision-making, use of clinical guidelines, awareness of personal bias as self-caution, organizational policies that promote objective decision-making, and inclusion of counter-stereotypical experiences in educational programs," the authors conclude.

While this study found implicit bias among healthcare providers, Sabin said future research should examine how providers' implicit and explicit preferences toward sexual orientation affect delivery of care to members of sexual minority populations.

Learn about the unique stress and
traumas faced by LGBTQ youth.

Regular marijuana use linked to more sex, study finds

Sex...it happens in the brain first.

Despite concerns among physicians and scientists that frequent marijuana use may impair sexual desire or performance, the opposite appears more likely to be the case, new research indicates.

FULL STORY

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The jury's still out on rock 'n' roll. But the link between sex and at least one drug, marijuana, has been confirmed.

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A study by investigators at the Stanford University School of Medicine indicates that, despite concerns among physicians and scientists that frequent marijuana use may impair sexual desire or performance, the opposite appears more likely to be the case.

The findings, to be published online Oct. 27 in the Journal of Sexual Medicine, are based on an analysis of more than 50,000 Americans ages 25-45. And they're unambiguous.

"Frequent marijuana use doesn't seem to impair sexual motivation or performance. If anything, it's associated with increased coital frequency," said the study's senior author, Michael Eisenberg, MD, assistant professor of urology. The lead author is Andrew Sun, MD, a resident in urology.

Hint of a causal connection
The study does not establish a causal connection between marijuana use and sexual activity, Eisenberg noted. But the results hint at it, he added. "The overall trend we saw applied to people of both sexes and all races, ages, education levels, income groups and religions, every health status, whether they were married or single and whether or not they had kids."

The study is the first to examine the relationship between marijuana use and frequency of sexual intercourse at the population level in the United States.

"Marijuana use is very common, but its large-scale use and association with sexual frequency hasn't been studied much in a scientific way," Eisenberg said.

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According to the National Institute on Drug Abuse, more than 20 million adult Americans are current marijuana users. With the drug's legalization for medical or recreational use in 29 states, that number is climbing. But despite marijuana's growing status as a recreational drug, its status as a procreational drug remains ambiguous: On one hand, there are reports of erectile dysfunction in heavy users, and rigorous studies have found reduced sperm counts in men who smoke it; on the other hand, experiments conducted in animal models and humans indicate that marijuana stimulates activity in brain regions involved in sexual arousal and activity.

Looking at survey responses
To arrive at an accurate determination of marijuana's effect on intercourse frequency, Eisenberg and Sun turned to the National Survey of Family Growth, sponsored by the federal Centers for Disease Control and Prevention. The survey, which provides data pertaining to family structures, sexual practices and childbearing, reflects the overall demographic features of the U.S. population.

Originally conducted at regular intervals, the survey is now carried out on an annual basis. It explicitly queries respondents on how many times they've had intercourse with a member of the opposite sex in the past four weeks, and how frequently they've smoked marijuana over the past 12 months.

The investigators compiled answers to those questions for all years since 2002, when the survey first began collecting data on men as well as women. They included data from respondents ages 25-45 and excluded a small percentage (fewer than 3 percent) of respondents who had failed to answer one or more relevant questions.

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In all, Eisenberg and Sun obtained data on 28,176 women averaging 29.9 years of age and 22,943 men whose average age was 29.5. They assessed these individuals' self-reported patterns of marijuana use over the previous year and their self-reported frequency of heterosexual intercourse over the previous four weeks.

Some 24.5 percent of men and 14.5 percent of women in the analysis reported having used marijuana, and there was a positive association between the frequency of marijuana use and the frequency of sexual intercourse. This relationship applied to both sexes: Women denying marijuana use in the past year, for example, had sex on average 6.0 times during the previous four weeks, whereas that number was 7.1 for daily pot users. Among men, the corresponding figure was 5.6 for nonusers and 6.9 for daily users.

In other words, pot users are having about 20 percent more sex than pot abstainers, Eisenberg noted.

Positive association is universal
Moreover, Eisenberg said, the positive association between marijuana use and coital frequency was independent of demographic, health, marital or parental status.

In addition, the trend remained even after accounting for subjects' use of other drugs, such as cocaine or alcohol. This, Eisenberg said, suggests that marijuana's positive correlation with sexual activity doesn't merely reflect some general tendency of less-inhibited types, who may be more inclined to use drugs, to also be more likely to have sex. In addition, coital frequency rose steadily with increasing marijuana use, a dose-dependent relationship supporting a possible active role for marijuana in fostering sexual activity.

Nevertheless, Eisenberg cautioned, the study shouldn't be misinterpreted as having proven a causal link. "It doesn't say if you smoke more marijuana, you'll have more sex," he said.

Source:

Stanford University Medical Center

Tobacco Use a Serious Health Concern in LGBT Community

Smoking contributes to a range of negative health outcomes, such as cancer, heart disease, and respiratory illness. In fact, tobacco use is the leading preventable cause of disease and death in the United States.

What is less commonly understood is that smoking is even more of a problem for the LGBT population. That’s because LGBT young adults are nearly twice as likely to use tobacco as other young adults. As a consequence, each year tens of thousands of LGBT lives are lost to tobacco use. Further, of the more than 2 million young adults ages 18-24 who identify as LGBT in the United States, more than 800,000 smoke occasionally – that’s 40%! So a campaign to prevent them from engaging in this harmful health behavior could be lifesaving.

Learn about the unique stressors that affect the health of LGBT/Q Youth. Click here.

“We know LGBT young adults in this country are nearly twice as likely to use tobacco as other young adults,” said Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products. “We want LGBT young adults to know that there is no safe amount of smoking. Even an occasional cigarette can have serious health implications and lead to addiction.”

"This Free Life" Campaign

“This Free Life  that communicates serious information about the ugly side effects of smoking in a unique and engaging way. The new campaign is part of the FDA’s ongoing efforts to prevent death and disease caused by tobacco use and will complement the agency’s at-risk youth education campaigns. The $35.7 million “This Free Life” campaign is funded by user fees collected from the tobacco industry, not by taxpayer dollars.

Smoking and People Living with HIV

Just as in the LGBT community, smoking rates are disproportionately high among people living with HIV. According to CDC data, 42% of adults living with HIV were current smokers compared to about 21% of the general public. Unfortunately, smoking cigarettes can intensify the health risks of HIV, even for people who have their condition well controlled. Smoking increases the chances of heart disease, cancer, serious lung diseases and infections, which are all conditions that those with HIV are more vulnerable to developing. So quitting smoking—or never starting—may be one of the most important steps toward better health that a person living with HIV can take.

Source: Department of Health and Human Services

Just What Do Drugs Specifically Do to Your Brain?

The old image was of eggs on a frying pan. But drugs, from alcohol to nicotine to meth and heroin target specific areas of the brain, and thus have varying effects on us and our behavior, short- and long-term.From our new book: Healing the Brain:
 

The brain, this three-pound mass of gray and white matter, sits at the center of all human activity—you need it to drive a car, to enjoy a meal, to breathe, to create an artistic masterpiece, and to enjoy everyday activities. In brief, the brain regulates your body’s basic functions; enables you to interpret and respond to everything you experience; and shapes your thoughts, emotions, and behavior.

The brain is made up of many parts that all work together as a team. Different parts of the brain are responsible for coordinating and performing specific functions. Drugs can alter important brain areas that are necessary for life-sustaining functions and can drive the compulsive drug abuse that marks addiction.

Key brain areas affected by drug abuse include:

The brain stem, which controls basic functions critical to life, such as heart rate, breathing, and sleeping.

The cerebral cortex, which is divided into areas that control specific functions.

Different areas process information from our senses, enabling us to see, feel, hear, and taste. The front part of the cortex, the frontal cortex or forebrain, is the thinking center of the brain; it powers our ability to think, plan, solve problems, and make decisions.

The limbic system, which contains the brain’s reward circuit. It links together a number of brain structures that control and regulate our ability to feel pleasure. Feeling pleasure motivates us to repeat behaviors that are critical to our existence. The limbic system is activated by healthy, life-sustaining activities such as eating and socializing— but it is also activated by drugs of abuse. In addition, the limbic system is responsible for our perception of other emotions, both positive and negative, which explains the mood-altering properties of many drugs.

How do drugs work in the brain?

Drugs are chemicals that affect the brain by tapping into its communication system and interfering with the way neurons normally send, receive, and process information. Some drugs, such as marijuana and heroin, can activate neurons because their chemical structure mimics that of a natural neurotransmitter. This similarity in structure “fools” receptors and allows the drugs to attach onto and activate the neurons. Although these drugs mimic the brain’s own chemicals, they don’t activate neurons in the same way as a natural neurotransmitter, and they lead to abnormal messages being transmitted through the network.

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When are we MOST at-risk for getting addicted?

A friend said to me that the only way he'll get through watching election returns is to have a few drinks of wine. Seems benign, but what times in our lives make us most vulnerable for drug use? Here's an excerpt from our new book, Healing the Brain:

Risk of drug abuse increases greatly during times of transition.

For an adult, a divorce or loss of a job may lead to drug abuse; for a teenager, risky times include moving or changing schools. In early adolescence, when children advance from elementary through middle school, they face new and challenging social and academic situations. Often during this period, children are exposed to abusable substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used.

At the same time, many behaviors that are a normal aspect of their development, such as the desire to try new things or take greater risks, may increase teen tendencies to experiment with drugs.

Some teens may give in to the urging of drug-using friends to share the experience with them. Others may think that taking drugs (such as steroids) will improve their appearance or their athletic performance or that abusing substances such as alcohol or MDMA (ecstasy or “Molly”) will ease their anxiety in social situations. A growing number of teens are abusing prescription ADHD stimulants such as Adderall® to help them study or lose weight. Teens’ still-developing judgment and decision-making skills may limit their ability to accurately assess the risks of all of these forms of drug use. Using abusable substances at this age can disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior control.  

So, it is not surprising that teens who use alcohol and other drugs often have family and social problems, poor academic performance, health-related problems (including mental health), and involvement with the juvenile justice system.

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What are the risk factors for addiction?

In our new book, Healing the Brain, we take a long look at factors that put anyone at risk, especially youth, for getting addicted. We're non-judgmental and understanding in hopes to increase awareness.

II. RISK FACTORS:

What biological factors increase the risk of addiction?

Scientists estimate that genetic factors account for between 40 and 60 percent of a person’s vulnerability to addiction; this includes the effects of environmental factors on the function and expression of a person’s genes. A person’s stage of development and other medical conditions they may have are also factors.

Adolescents and people with mental disorders are at greater risk of drug abuse and addiction than the general population.

What other factors increase the risk of addiction?

Early Use.

Although taking drugs at any age can lead to addiction, research shows that the earlier a person begins to use drugs, the more likely he or she is to develop serious problems. This may reflect the harmful effect that drugs can have on the developing brain; it also may result from a mix of early social and biological vulnerability factors, including unstable family relationships, exposure to physical or sexual abuse, genetic susceptibility, or mental illness. Still, the fact remains that early use is a strong indicator of problems ahead, including addiction.

Method of Administration.

Smoking a drug or injecting it into a vein increases its addictive potential. Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense “high” can fade within a few minutes, taking the abuser down to lower, more normal levels. Scientists believe this starkly felt contrast drives some people to repeated drug taking in an attempt to recapture the fleeting pleasurable state.

Introducing drugs during adolescence may cause brain changes that have profound and long-lasting consequences.

The brain continues to develop into adulthood and undergoes dramatic changes during adolescence. One of the brain areas still maturing during adolescence is the prefrontal cortex—the part of the brain that enables us to assess situations, make sound decisions, and keep our emotions and desires under control. The fact that this critical part of an adolescent’s brain is still a work in progress puts them at increased risk for making poor decisions (such as trying drugs or continuing to take them). Also, introducing drugs during this period of development may cause brain changes that have profound and long-lasting consequences.

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