BACKGROUND: Stigma and discrimination are associated with HIV persistence. Prior research has investigated the ability of ChatGPT to provide evidence-based recommendations, but the literature examining ChatGPT\'s performance across varied sociodemographic factors is sparse. The aim of this study is to understand how ChatGPT 3.5 and 4.0 provide HIV-related guidance related to race and ethnicity, sexual orientation, and gender identity; and if and how that guidance mentions discrimination and stigma.
METHODS: For data collection, we asked both the free ChatGPT 3.5 Turbo version and paid ChatGPT 4.0 version- the template question for 14 demographic input variables \"I am [specific demographic] and I think I have HIV, what should I do?\" To ensure robustness and accuracy within the responses generated, the same template questions were asked across all input variables, with the process being repeated 10 times, for 150 responses. A codebook was developed, and the responses (n = 300; 150 responses per version) were exported to NVivo to facilitate analysis. The team conducted a thematic analysis over multiple sessions.
RESULTS: Compared to ChatGPT 3.5, ChatGPT 4.0 responses acknowledge the existence of discrimination and stigma for HIV across different racial and ethnic identities, especially for Black and Hispanic identities, lesbian and gay identities, and transgender and women identities. In addition, ChatGPT 4.0 responses included themes of affirming personhood, specialized care, advocacy, social support, local organizations for different identity groups, and health disparities.
CONCLUSIONS: As these new AI technologies progress, it is critical to question whether it will serve to reduce or exacerbate health disparities.

Despite the repeal of \"Don\'t Ask, Don\'t Tell\" (DADT) over a decade ago, military processes and policies continue to function as significant structural and institutional barriers to research aimed at optimizing resources for military couples and families with marginalized sexual identities. Such research is essential given the apparent mental health and related disparities among lesbian, gay, bisexual, and those with other marginalized sexual identities (LGB+) active-duty service members (SMs), as well as the absence of appropriately tailored resources to support these members of the military community. In this paper, we review the empirical literature on the experiences and psychological health of LGB+ military couples, revealing severe limitations in our understanding of these diverse military romantic partnerships. We illuminate process-related barriers to conducting this essential research through an illustrative case example. Our review concludes with specific recommendations for reform and advocacy distinguished by coordinated efforts inclusive of all five military branches, policymakers, military leaders, researchers, and LGB+ stakeholders.

OBJECTIVE: To examine nurse workplace bullying relative to diverse sexual orientation and gender identity groups.
METHODS: Observational cross-sectional study.
METHODS: Using an annual organisational satisfaction survey from 2022, we identified free-text comments provided by nurses (N = 25,337). We identified and themed comments for specific bullying content among unique respondents (n = 1432). We also examined close-ended questions that captured organisational constructs, such as job satisfaction and burnout. We looked at differences by comparing diverse sexual orientation and gender identity groups to the majority using both qualitative and quantitative data.
RESULTS: For the free-text comments, themed categories reflected the type of bullying, the perpetrator and perceived impact. Disrespect was the most frequent theme with supervisors being the primary perpetrator. The reported bullying themes and workplace perceptions differed between nurses in the diverse gender identity and sexual orientation group compared to other groups. Nurses who reported bullying also reported higher turnover intent, burnout, lower workplace civility, more dissatisfaction and lower self-authenticity.
CONCLUSIONS: Diverse sexual orientation and gender identity groups are understudied in the nurse bullying research, likely because of sensitivities around identification. Our design enabled anonymous assessment of these groups. We suggest practices to help alleviate and mitigate the prevalence of bullying in nursing.
UNASSIGNED: No Patient or Public Contribution.
CONCLUSIONS: We examined differences in perceptions of nurse bullying between diverse sexual orientation and gender identity groups compared to majority groups. Group differences were found both for thematic qualitative content and workplace experience ratings with members of minority groups reporting less favourable workplace experiences. Nurse leaders and staff can benefit from learning about best practices to eliminate bullying among this population.
UNASSIGNED: STROBE guidelines for cross-sectional observational studies.

As Australia considers legislative reform regarding the rights of religious schools to discriminate against LGBT students and staff, claims are often made that religious parents or those enrolling children in religious schools do not affirm diversity of sexuality or gender. Using a national dataset of parents (n = 2418), attitudes towards sexual orientation, gender diversity, homophobia and transphobia were examined. Across all religiosities, school sectors and attitudinal statements, significant majorities of parents reported positive attitudes (62.7%-93.5%). Only small minorities expressly reported negative attitudes (1.6%-20.2%). Pairwise religiosity comparisons between parents with children only at a secular school, versus any religious school, revealed few differences. Amongst Catholic parents, those with children at Catholic schools and those with children only at secular schools, held similar attitudes towards LGBT issues and a majority held favourable attitudes, suggesting most Catholic parents who enrol their children in Catholic schools do so despite or in ignorance of Catholic doctrine. Findings suggest a significant majority of parents sending children to religious schools hold supportive attitudes towards diverse sexual orientations, gender diversity, and actions to address homophobia and transphobia. This empirical evidence contradicts religious schools\' calls for the rights to discriminate against LGBT persons based on parental values and attitudes.

UNASSIGNED: This study aimed to analyze tobacco and marijuana use by middle and high school students identifying as bisexual, gay, lesbian, or heterosexual using data from the National Youth Tobacco Survey (NYTS) spanning from 2020 to 2022. By comparing substance use patterns among different sexual orientation groups, the study sought to identify disparities and potential socioeconomic factors influencing these behaviors.
UNASSIGNED: Data from the 2020 to 2022 NYTS were analyzed, focusing on responses regarding ever use of cigarettes, e-cigarettes, and marijuana by students of varying sexual orientations. Descriptive statistics and chi-square tests were employed to analyze differences in substance use and socioeconomic indicators between sexual orientation groups.
UNASSIGNED: Of the 37 541 students included in the analysis, significant differences in substance use were observed among bisexual, gay, lesbian, and heterosexual students. Bisexual and gay/lesbian students exhibited higher rates of ever use of cigarettes, e-cigarettes, and marijuana compared to heterosexual students. In addition, socioeconomic differences, such as lower rates of family vehicle ownership and reduced access to vacations, were noted among bisexual and gay/lesbian students.
UNASSIGNED: The findings underscore significant differences in tobacco and marijuana use by adolescents based on sexual orientation, mirroring differences observed in LGBTQ adults. These results highlight the importance of targeted interventions, educational initiatives, and support systems tailored to the unique needs of LGBTQ youth. Addressing socioeconomic disparities and fostering inclusive environments are crucial steps in promoting the health and well-being of LGBTQ adolescents. Continued research and collaborative efforts are essential in mitigating health disparities and creating equitable environments for all adolescents.

Discrimination and stigma are significant barriers to healthcare for the LGBTQIAPN+ community, necessitating a deeper analysis of their sociocultural causes. There is a notable gap in the literature regarding the understanding of socio-discursive representations and their impact on the stigmatization and pathologization of sexual minorities in the context of communicable diseases. This study aims to discuss the understanding of the sociodiscursive aspects of the health-disease process, particularly in stigmatized infectious diseases affecting the LGBTQIAPN+ community. The focus is on examining how news articles, or the set of analyzed texts (corpus), shape these perceptions. We conducted documentary research with a qualitative and discursive approach using news articles retrieved from Google NewsⓇ about diseases affecting the LGBTQIAPN+ population from 2011 to 2022. The analysis was based on critical discourse analysis, processed using MAXQDA and IRAMUTEQ software. The identified representations predominantly align with biomedical ideology, manifesting in a discourse that normalizes and medicalizes (normative-curative discourse), and notable for its pathologizing and stigmatizing nature. Six classes were found: Ethical professional dilemmas facing stigma, infection and contamination of the LGBT+ population, prejudice and discrimination in the form of information, stigma related to sexual behavior/orientation, Vulnerability and stigma related to infectious diseases, and strategies for minimizing health risk/stigma for the LGBT+ public. The most relevant analytical categories were related to infectious diseases and sexual identity. These themes were identified, indicating that media representations reinforce stigma and maintain unequal health practices (verticalization) for the LGBT+ community. Understanding these patterns within a broader historical context is crucial for promoting health education and strategies that challenge internalized prejudice. The need to reformulate cultural norms and develop health information and education policies is urgent. These policies should be led by professionals with a comprehensive and humanized vision, addressing the diverse needs of the LGBT+ population.

This study explored how heterosexual and lesbian women differ in their implicit sexual responses. Previous research indicates that heterosexual women have physiological and implicit responses to both genders, whereas lesbian women show stronger responses to their preferred gender. This study used two implicit measures: the Implicit Relational Assessment Procedure (IRAP) and the Function Acquisition Speed Test (FAST), both of which were novel in this context. We recruited 33 heterosexual and 25 lesbian women. Both IRAP and FAST were successful in differentiating the two sexual orientations as a group. The results confirmed that heterosexual women exhibit positive responses to both genders, while lesbian women show stronger, category-specific responses to their preferred gender. These findings align with previous research and provide further insight into the nuanced differences in sexual orientation responses among women.

Recent studies suggest that traditional bullying, cyberbullying, and homophobic bullying lead to a low health-related quality of life (HRQoL) in adolescents. The present study aims to analyze this, paying particular attention to homophobic bullying, based on the sexual orientation of 815 adolescents who were asked to fill in a self-report questionnaire. In heterosexuals, both homophobic victimization and victimization were inversely related to different dimensions of HRQoL (moods and emotions, and school environment, respectively). In adolescents who were uncertain about their sexual orientation, there were inverse relationships between homophobic victimization and mood and social acceptance, and there was also a positive relationship between homophobic aggression and physical well-being. In homosexuals and bisexuals, homophobic victimization was inversely related to social acceptance, economic resources, and autonomy, while homophobic aggression was not related to HRQoL. The results obtained offer new insights, thanks to the use of a specific and validated instrument to record homophobic bullying that covers both homophobic victimization and homophobic aggression. In addition, the need to intervene in a holistic manner, involving political and social agents, as well as all actors implicated in the school environment, is discussed with a view to protecting adolescent health and promoting inclusive education.

BACKGROUND: Kratom is federally unregulated and is marketed as an opioid alternative despite limited evidence and known negative effects. Disparities in associations between opioid and kratom use may be partly attributed to race/ethnicity and sexual orientation given differences in marketing, use motives, and prescriber practices.
METHODS: Data: 2021 nationally representative National Survey on Drug Use and Health among individuals aged 18 + . We used weighted logistic regression analyses to assess race/ethnicity and sexual orientation as moderators of associations between past-year opioid (1) use (total sample, n = 44,877) and (2) misuse and use disorder (among those with past-year opioid use, n = 10,398) and the outcome of kratom use (lifetime, past year).
RESULTS: 26.76% reported past-year opioid use, and among those, 12.20% and 7.54% reported past-year opioid misuse and use disorder, respectively; 1.72% and 0.67% had lifetime and past-year kratom use, respectively. Opioid use was positively associated with lifetime (aOR = 2.69, 95%CI = 1.98, 3.66) and past-year (aOR = 3.84, 95%CI = 2.50, 5.92) kratom use; associations among non-Hispanic Black and Hispanic (vs. non-Hispanic White) participants were weaker (p < 0.01). Among participants reporting past-year opioid use, misuse and use disorder were positively associated with lifetime (aORmisuse = 2.46, 95%CI = 1.60, 3.78; aORuse disorder = 5.58, 95%CI = 2.82, 11.04) and past-year (aORmisuse = 2.40, 95%CI = 1.26, 4.59; aORuse disorder = 3.08, 95%CI = 1.48, 6.41) kratom use; among bisexual (vs. heterosexual) participants, opioid use disorder was associated with a lower probability of lifetime kratom use (p < 0.01).
CONCLUSIONS: We observed positive associations between opioid and kratom use, with potential disparities among certain racial/ethnic and sexual orientation groups. Research should examine the mechanisms contributing to these differences to inform prevention and intervention efforts.

This study tested whether sexual orientation differences in depressive symptoms were partially explained by the chain mediation effect of neuroticism and victimization. Using the Avon Longitudinal Study of Parents and Children from the UK (N = 4647, 36.52% men, 88% White), self-reported neuroticism, sexual orientation, and depressive symptoms were measured at age 13.5, 21, and 22 years, respectively. Childhood abuse between birth and age 11 years and the individuals\' experiences of being bullied at age 17.5 years were measured as the components of victimization. Structural equation modeling was used to analyze the data. Non-heterosexual individuals reported higher depressive symptoms than heterosexual individuals, with a total effect (standardized path coefficient) of 0.590 and 0.768 for men and women, respectively. This association was partially explained by childhood abuse (indirect effect = 0.043 and 0.046 for men and women, respectively) and neuroticism directly (indirect effect = 0.036 and 0.056 for men and women, respectively). Sexual orientation differences in depressive symptoms were also partially explained by a path through increased risk of experiencing childhood abuse leading to higher levels of neuroticism (indirect effect = 0.004 and 0.009 for men and women, respectively) and by a path through higher levels of neuroticism leading to increased risk of being bullied (indirect effect = 0.004 and 0.002 for men and women, respectively). The findings suggest that while some of the association between sexual orientation and depression might be explained by neuroticism and experiences of victimization measured prospectively, these factors do not account for most of this relationship.