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Intuitive eating is defined as being connected to internal hunger, satiety, and appetitive cues and flexibly using these cues to determine when, what, and how much to eat. The Intuitive Eating Scale-2 (IES-2) is a widely used measure of facets of intuitive eating. However, the scale has shown unstable factor structure in several validation studies and there is a lack of studies investigating the measurement invariance of the IES-2 beyond sex. We aimed to evaluate the psychometric properties of the IES-2, testing several factor structures among Brazilian and U.S. samples of men and women; to test measurement invariance across country of origin, ethnicity, sex, and sexual orientation; and to evaluate its internal consistency. Three models of the latent structure of the IES-2 were tested using confirmatory factor analyses (CFA) in a total of 1072 young adults (452 Brazilians and 620 Americans), aged 18-35 years. Results demonstrated that only a 3-factor solution with 11 items of the IES-2 showed adequate fit to the data for both countries. This model demonstrated scalar invariance across sex and sexual orientation, but only configural invariance was found across country of origin and ethnicity. Good internal consistencies were found for both the Brazilian and American samples. The present study provides support for a 3-factor solution with 11 items of the IES-2, to Brazilian and American samples. The study also offers evidence of internal consistency, and invariance between sex (i.e., male and female) and sexual orientation (i.e., heterosexual participants and sexual minority participants).

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Transgender women (TGW) and men who have sex with other men (MSM) often encounter disparities in accessing HIV testing, leading to delayed diagnoses and worse prognoses. We analysed barriers and facilitators for accessing HIV rapid testing by TGW and MSM in Brazil, 2004-2023. Citations were included whether the study population consisted of individuals aged ≥18y old, and studies addressed HIV testing and have been conducted in Brazil. The study protocol was based on Joanna Briggs' recommendations for scoping reviews. We included 11 studies on TGW and 17 on MSM. The belief that one is not at risk of contracting HIV infection, fear expressed in different ways (e.g. lack of confidentiality) and younger age were the main barriers. Feeling at risk for HIV infection, curiosity, and favourable characteristics of the setting where the testing takes place were cited as the main facilitators. Barriers and facilitators specifically for HIV self-testing included, respectively, concerns about conducting the test alone vs. autonomy/flexibility. Brazil is unlikely to achieve the UN' 95-95-95 goal without minimising testing disparities. Combating prejudice against TGW and MSM in testing settings, along with educational campaigns and transparent protocols to ensure confidentiality, can help increase HIV testing among these populations.

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BACKGROUND: The use of stimulants and other substances with the purpose of enhancing, maintaining, and prolonging sexual activity is known as sexualized substance use. Also known as chemsex, this pattern of use has been mainly explored in high-income countries. The aim of this article was to assess the feasibility, acceptability, and usefulness of a community- evidence-based harm reduction intervention among Mexican gay, bisexual, and other men who have sex with men (gbMSM) adults who reported sexualized stimulant use in the past 6 months and who were not enrolled in any psychosocial treatment. METHODS: The in-person intervention was designed in partnership with gbMSM who used substances. It consisted of 39 harm reduction strategies before, during, and after episodes of use. The components of the intervention were health and self-care, safety, and psychopharmacology. The intervention was delivered at a university campus, a public recreational space, and an HIV public clinic. Feasibility to deliver the intervention was assessed based on enrolment and completion rates; acceptability through a 28-item, 5-point Likert scale (140 max.) constructed and validated for the Mexican population with good reliability coefficients; usefulness through a 5-point Likert scale ("not useful"-"very useful") for each of the 39 strategies; and potential behavioral change by subtracting the likelihood of implementing each strategy minus the frequency of use of the technique before the intervention. RESULTS: Participants (n = 19; recruitment rate = 35.2%; completion rate = 84.2%) rated the intervention as acceptable with a mean score of 121.6 (SD = 7.5). The highest potential for behavioral change was regarding the use of information about the half-life of stimulants, polysubstance use, and overdose prevention. CONCLUSIONS: This intervention is feasible when provided within public health services where potential participants are already in contact. Harm reduction strategies need to surpass sexually transmitted infections prevention and HIV care and focus on substance use and mental health strategies.

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Muscle Dysmorphia (MD) and its psychological impacts on women, especially within sexual minorities, are still relatively understudied. The objective of this study was to compare the relationship of MD symptoms and psychological distress between heterosexual women and lesbian/bisexual women. Our sample consisted of 479 Brazilian cisgender women from the community, aged between 18 and 70 years (M = 32.78; SD = 10.45). Among them, 327 (68.27 %) identified as heterosexual, 134 (27.98 %) as bisexual, and 18 (3.76 %) as lesbian. To ensure there was no bias due to measurement error, the psychometric properties of the instruments in the sample were tested, and invariance between the groups was assessed. t-tests, structural equation modeling, and latent profile analyses were conducted to comprehend the differences between the groups. The results indicated significant differences and a greater severity of MD symptoms and distress for lesbian/bisexual women. The implications of these results are discussed, emphasizing the need for further exploration of MD studies within sexual minorities.

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Latino/x sexual minority males (SMM) continue to be disproportionately impacted by health inequities. This study aims to understand the lived experience of Puerto Rican (PR) SMM related to how intersectional microaggressions influence health-related risk and protective factors. Young adult (ages 21-30) PR SMM from San Juan, Puerto Rico, completed a bilingual in-depth individual interview (14 in Spanish and 1 in English). A thematic analysis based on the original language of the interviews was conducted using NVivo. Six prominent themes were identified through the data analysis: (1) religious microaggressions, being gay is bad because God doesn't like it; (2) gender microaggressions, gay is not good because it's not for men; (3) sexuality microaggressions, this one is a homosexual, coming out as a sexual minority; (4) trans microaggressions, drag queens create an illusion; (5) internalized microaggressions, battling with internalized homophobia; and (6) mitigating microaggressions, establishing a supportive community. Findings suggest that multiple forms of microaggressions based on the intersectionality of sexuality and gender manifest from straight as well as gay communities. PR SMM demonstrated their resiliency by assessing interactions with others to mitigate risks and enhance supportive networks.

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LGBTQ+ people tend to experience prejudice, stigma, and discrimination, which increases their risk of developing mental health difficulties. Support networks, including companion animals, can be used to cope with these challenges. We performed a systematic review of studies related to the effects of human-animal interactions on the LGBTQ+ population. The review included 18 empirical studies; the findings showed that participants tended to view companion animals as family members, as well as providers of love, acceptance, and social support. Thus, companion animals could alleviate stress and increase resilience. However, certain costs were also cited and, under some circumstances, poorer health was observed. The results are discussed considering three unique aspects of the "LGBTQ+ people-animal bond": (1) it promotes self-acceptance, (2) provides a sense of protection against sexuality-based stigma and social acts of aggression based on sex or gender, and (3) exposes animal guardians requesting animal care services to potential discrimination. By characterizing the LGBTQ+ people-animal bond, more effective responses to meet their needs and promote inclusion may be achieved.

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This study aimed to examine the difference in therapy satisfaction between lesbian, gay, and bisexual + (LGB +) individuals and heterosexual individuals, and to identify the association between therapy satisfaction and the perception of knowledge and attitudes of their last therapist among the LGB + participants. Through an exploratory design with a comparative group, 125 LGB + and 75 heterosexual participants were recruited online by availability. Results indicate that the participants' sexual orientation has no significant relation on therapy satisfaction. However, there was a significant positive association between satisfaction with therapy and the LGB + participants' perception that their therapist demonstrated knowledge and positive attitudes. This research highlights the importance for continuous education and curriculum efforts on LGB + issues.

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Despite high levels of muscularity concerns among sexual-minority men, most of the existing literature on the drive for muscularity and muscle dysmorphia focuses on heterosexual men and has mainly been conducted in Western and English-speaking regions. The present study aimed to evaluate the psychometric properties of the Drive for Muscularity Scale (DMS) and the Muscle Dysmorphic Disorder Inventory (MDDI) in Brazilian cisgender gay and bisexual adult men who were 18-50 years old. We evaluated the factor structure of both measures using a two-step, split-sample exploratory (EFA; n = 704) and confirmatory (CFA; n = 705) factor-analytic approach, which supported the original three-factor structure of the MDDI and resulted in a reduced two-factor solution with 13 items for the DMS. Convergent validity was supported through associations of the DMS and the MDDI with eating disorder symptoms, body-ideal internalization, self-objectification beliefs and behaviors, and body appreciation measures. Additionally, we found good internal consistency, and test-retest reliability of both measures. Results support the validity and reliability of the DMS and the MDDI in Brazilian cisgender gay and bisexual adult men and will support future studies exploring these constructs in Brazilian sexual-minority men.

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This paper aimed to review the literature regarding the impact of discrimination on substance use disorders among Sexual Minorities (SM), with a focus on alcohol, opioids, stimulants, polydrug use, chemsex, cannabis and tobacco, as well as inequalities in the access to health care services. It is alarmingly clear that SM report higher rates of morbidity if compared to the general population. Health care delivery inequalities have also been reported in this special population. Also, the lack of data from low- and middle-income countries on substance use among SM is a major concern. Certainly, discrimination play a key-role among leading factors to substance abuse, continued use, disorders, and lower levels of preventive and treatment interventions. However, it may be difficult to estimate the impact of discrimination because of the lack of research data and different methodologies of literature studies. Moreover, SM are differently categorized and defined and evidences may be not comparable between studies. There is an urgent need of strategic guidelines and research investments aimed at prioritizing these populations disproportionately impacted by substance use. Equity-oriented policies and programs can facilitate opportunities and decrease substance use in these vulnerable subgroups, including community- and peer-led initiatives and nonjudgmental and inclusive health services.

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Abstract Introduction There are few reports on mental health among the lesbian, gay, bisexual, and transgender (LGBT) population in the context of COVID-19, especially in South America. Objective To describe the prevalence of symptoms associated with mental health disorders, as well as to analyze the risk of their occurrence, in different groups of the Chilean LGBT population in the context of COVID-19. Method A total of 1,181 LGBT people, ranged from 18 to 64 years participated in an online survey, using the Depression Anxiety Stress Scales-DASS-21. The central tendency measures were analyzed, then cut-off points were used to establish prevalence according to sex and sexual orientation. Finally, the probability of symptoms was analyzed using odds ratio. Results Lower levels of mental health were identified among the bisexual and other sexual orientations (pansexual, demisexual, asexual, etc.) population as compared with gays and lesbians, finding a greater presence of depressive symptoms (p = .000), anxious (p = .000) and related to stress (p<.001). Similarly, bisexual women are more likely to present symptoms associated with mental health disorders than men, as lesbians do, as compared with gays in the case of anxiety. Gays are at a higher risk of stress than lesbians. Discussion and conclusion Even though the pandemic affected the entire population, results give evidence of disparities among the various LGBT communities, showing the need to focus on preventive interventions and the implications of increased risk in bisexual population, particularly women, who are affected by various cross discriminations.

Resumen Introducción Existen pocos reportes sobre la salud mental en poblaciones de lesbianas, gays, bisexuales y transexuales (LGBT) en el contexto del COVID-19, especialmente en Sudamérica. Objetivo Describir la prevalencia de síntomas asociados a problemas de salud mental, así como analizar su riesgo de ocurrencia en diferentes grupos de población LGBT chilena en el contexto de la pandemia del COVID-19. Método Participaron en una encuesta en línea un total de 1,181 personas LGBT, con edades comprendidas entre los 18 y los 64 años, quienes completaron el cuestionario DASS-21 (del inglés Depression Anxiety Stress Scales). Primero se analizaron las medidas de tendencia central, luego se estableció la prevalencia según sexo y orientación sexual y finalmente se analizó la probabilidad de presentar síntomas mediante el odss ratio. Resultados Se identificaron menores niveles de salud mental en la población bisexual y otras orientaciones sexuales (pansexual, demisexual, asexual, etc.), en comparación con gays y lesbianas, debido a una mayor presencia de sintomatología depresiva (p = .000), ansiosa (p = .000) y vinculada al estrés (p<.001). Asimismo, las mujeres bisexuales fueron más propensas que los hombres a presentar síntomas asociados a trastornos de salud mental, al igual que las lesbianas, en comparación con los gays en el caso de la ansiedad. Los gays tienen un mayor riesgo de estrés que las lesbianas. Discusión y conclusión Aun cuando la pandemia afectó a toda la población, los resultados evidencian las disparidades entre las distintas comunidades LGBT, mostrando la necesidad de centrarse en las intervenciones preventivas y las implicaciones de un mayor riesgo en la población bisexual, especialmente en las mujeres, que se ven afectadas por diversas discriminaciones cruzadas.