Kate L. Collier

School Environment and the Mental Health of Sexual Minority Youths: A Study Among Dutch Young Adolescents

OBJECTIVES We examined whether structural elements of the school environment, in particular cultural pluralism and consistency and clarity of school rules and expectations of students, could mitigate the risk for mental health problems among young sexual minority adolescents. METHODS Data were collected in 2008 by means of a computer-based questionnaire completed at school by 513 young Dutch adolescents (12-15 years old) during regular class times. Eleven percent of these students, who were enrolled in 8 different schools, reported having at least some feelings of same-sex attraction. RESULTS Adolescents with same-sex attractions in schools where rules and expectations were experienced as less consistent and clear reported significantly more mental health problems than their peers with no same-sex attractions in the same schools. Such differences were absent in schools where rules and expectations were experienced as more consistent and clear. There were no such effects of cultural pluralism. CONCLUSIONS Our results suggest that schools with consistent and clear rules and expectations mitigate the risk for mental health problems among students with same-sex attractions and underscore the importance of structural measures for the health of sexual minority youth.

‘They think that gays have money’: gender identity and transactional sex among Black men who have sex with men in four South African townships

Transactional sex has not been studied much among men who have sex with men in Africa. Consequently, little is understood about attitudes towards the practice, the circumstances that give rise to it or how transactional sex relationships are managed. We conducted in-depth interviews with 81 Black men aged 20–44 from four low-resourced townships in Tshwane, South Africa. We found that transactional sex was a widely used strategy for initiating and sustaining relationships with regular and casual partners, and was motivated by both the need for subsistence and for consumption. Alcohol-based exchanges in particular provided men in the townships with a covert and safe platform to communicate erotic, sexual and romantic attraction to other men, and bars and other drinking places were a popular venue for meeting potential sexual partners. The majority of ‘feminine-identifying’ men had engaged in transactional sex as the providers of money and material goods compared to men who identified as either ‘masculine’ or as ‘both masculine and feminine’. Surprisingly, however, this did not necessarily give them greater control in these relationships. Our study provides an initial foray into a complex sociosexual phenomenon and suggests that gender identity is an important construct for understanding transactional sex relationships among men in Africa.

HIV Testing Practices of South African Township MSM in the Era of Expanded Access to ART

AbstractWhile men who have sex with men (MSM) in Africa are at high risk for HIV infection, few of those already infected know their status. Effectively promoting frequent HIV testing—of increasing importance with the expanding accessibility of antiretroviral treatment—requires an understanding of the testing practices in this population. To understand men’s HIV testing practices, including their behavior, experiences, and perceptions, we conducted in-depth interviews with 81 black South African MSM (ages 20–39), purposively recruited from four townships. Many men in the sample had tested for HIV. While ever having tested seemed to facilitate repeat testing, men still expressed a high level of discomfort with testing. It was common to test after having engaged in risky behavior, thus increasing anxiety about testing that was already present. Fear that they might test HIV positive caused some men to avoid testing until they were clearly sick, and others to avoid testing completely. HIV testing may increase in this population if it becomes a routine practice, instead of being driven by anxiety-inducing incidents. Mobilization through social support might facilitate frequent testing while education about current treatment options is needed. ResumenAunque la población de hombres que tienen sexo con hombres (HSH) en África corre un alto riesgo de infección del VIH, pocos de ellos que ya están infectados con el virus conocen su diagnóstico. Promover exitosamente el uso de la prueba del VIH frecuente y regularmente—una práctica de creciente importancia con la mayor disponibilidad de los tratamientos antiretrovirales—requiere un entendimiento de las prácticas de esta población en relación a la prueba. Para entender las prácticas de la prueba del VIH en hombres, incluyendo sus comportamientos, experiencias y percepciones, llevamos a cabo entrevistas en profundidad con 81 HSH negros sudafricanos de 20 a 39 años de edad, intencionalmente reclutados de cuatro localidades (townships). Al parecer, muchos de los hombres se habían hecho la prueba. Aunque el hecho de haberse hecho la prueba parece facilitar la repetición de esta, los hombres expresaron altos niveles de incomodidad. Fue común hacerse la prueba después de haber tenido conductas de riesgo, así aumentando la ansiedad sobre la prueba ya existente. El temor de tener un resultado de VIH-positivo causó que algunos hombres postergaran la prueba hasta que estuvieran claramente enfermos y a otros que evitaran someterse a ella por completo. Convertir a la prueba de VIH en una práctica rutinaria, en vez de un acto estimulado por incidentes coyunturales y altamente preocupantes, probablemente incrementará el uso de la prueba entre esta población. Una movilización a través del apoyo social podría facilitar el uso frecuente de la prueba.

Attitudes Toward Lesbians and Gays Among American and Dutch Adolescents

Attitudes toward lesbians and gays vary across national populations, and previous research has found relatively more accepting attitudes in the Netherlands as compared to the United States. In this study, we compared beliefs about and attitudes toward lesbians and gays in samples of Dutch and American heterosexual adolescents, utilizing survey data from 1,080 American adolescents (mean age = 15.86 years) attending two schools and from 1,391 Dutch adolescents (mean age = 16.27 years) attending eight schools. Findings indicated the Dutch participants were more tolerant of lesbians and gays, after adjusting for the gender, age, and racial/ethnic minority status of the participants. However, between-country differences were attenuated by accounting for the beliefs about lesbians and gays that participants used to justify their attitudes. American participants were more likely to justify their attitudes using beliefs related to social norms and religious opposition, while the Dutch participants were more likely to justify their attitudes using beliefs related to individual rights and the biological/genetic basis of homosexuality. The results suggest that the relative importance of particular beliefs about lesbians and gays to attitudes at the group level may be context dependent but also that certain beliefs are salient to attitudes across national contexts.

Breakage is the norm: use of condoms and lubrication in anal sex among Black South African men who have sex with men.

Abstract This paper explores condom use and lubrication practices among Black men who have sex with men in South African townships. Results are from 81 in-depth individual interviews conducted among a purposive sample from four townships surrounding Pretoria as part of a larger qualitative study. Awareness that condoms should be used to have safer anal sex was ubiquitous. Fewer men reported that lubricants should be used to facilitate anal intercourse. Partner pressure and partner distrust were the most common barriers cited for not using condoms and lubricants. Knowledge about condom-lubricant compatibility was rare. Condom problems were a norm, with widespread expectations of condom failure. Men’s subjectivities – their perceptions of and preferences for specific brands, types and flavours of condoms and lubricants – influenced engagement with such safer-sex technologies. However, what was available in these settings was often neither what men needed nor preferred. Findings show the need to enhance access to appropriate and comprehensive: safer-sex supplies, health services and health education, and underline the importance of efforts to develop targeted programmes relevant to experiences of men who have sex with men in the South African context.

Schoolklimaat en psychische gezondheid bij seksuele minderheidsjongeren: Een studie onder Nederlandse jonge adolescenten

Het huidige onderzoek bekeek of structurele elementen van schoolklimaat een positieve samenhang kunnen hebben met het psychisch welbevinden van seksuele minderheidsleerlingen. Hierbij werden de psychische problemen van seksuele minderheidsleerlingen vergeleken met seksuele meerderheidsleerlingen.In het bijzonder werd gekeken naar de rol van consistentieen duidelijkheid van schoolregels en verwachtingen en aandacht voor cultureel pluralisme op de school. Data werd verzameld in 2008 door middel van een computervragenlijst die op 8 middelbare scholen werd ingevuld door 513 Nederlandse leerlingen (12-15 jaar). 11% van deze leerlingen rapporteerde een bepaalde mate van aantrekking tot personen van dezelfde sekse (seksuele minderheidsleerlingen). Seksuele minderheidsleerlingen op scholen waar regels en verwachtingen als minder consistent en duidelijk werden ervaren rapporteerden significant meer angst, woede en somatisatiedan leeftijdsgenoten die niet tot een seksuele minderheid behoorden.Soortgelijke verschillen werden niet gevonden op scholen waar regels en verwachtingen als meer consistent en duidelijk werden ervaren. De resultaten laten zien dat een schoolmilieu met consistente en duidelijke regels en verwachtingen samenhangt met een beter psychisch welbevinden voor leerlingen die op grond van hun gevoelens voor hetzelfde geslacht tot een seksuele minderheid behoren. De resultaten impliceren dat seksuele minderheidsjongerenbelang kunnen hebben bij structurele factoren en algemenemaatregelen op school.