The 2016 Municipal Equality Index rated Augusta, the largest city in the Central Savannah River Area (CSRA), as one of the least lesbian, gay, bisexual, and transgender (LGBT) friendly cities in America. To understand the context of our region in relation to LGBT wellness, we conducted the first LGBT health needs assessment of the CSRA, assessing physical and mental health status and health care needs and experiences in the community. Participants (N = 436) were recruited using venue and snowball sampling and completed an anonymous online survey. Overall, the health problems experienced (i.e., obesity, depression) were not uniformly experienced across sexual orientation and gender identity; some groups experienced significantly higher rates of these conditions than others. Similarly, transgender individuals in particular reported higher rates of negative experiences with health care providers. Regional and national dissemination of these findings is critical to reducing health disparities and improving wellness of our local LGBT community.

In comparison to their heterosexual peers, lesbian, gay, and bisexual (LGB) student-athletes encounter substantial challenges during their intercollegiate and professional athletic careers including detrimental stereotypes, harassment, and discrimination. Such non-inclusive environments promoted throughout the current Western culture of sport are notably associated with higher incidences of mental health and substance use disorders among LGB athletes across youth, collegiate, and professional sports. There have been significant gains at the collegiate level to address LGB-inclusive practices aimed towards administrators, educators, coaches, and student-athletes; however, there is currently no literature that addresses the unique role of the sports medicine team. As first-line healthcare providers for student-athletes, sports medicine physicians and athletic trainers are uniquely positioned to support collegiate LGB athletes through affirming sexual identity, recognizing distinctive health risks, and advocating inclusivity within the athletic training room. By examining major themes of concern among current LGB student-athlete experiences across the unique setting of US colleges and universities, this review article aims to further identify opportunities for sports medicine providers to promote positive health outcomes and improve the overall wellness of collegiate LGB student-athletes.

Transgender and gender nonconforming (TGNC) individuals experience hardship and mistreatment. These experiences may contribute to mental health disparities faced by this community, including suicidality. The present study examined the associations between physical- and sexual-violence victimization, homelessness, perception of safety, and suicidality among TGNC participants (N = 70) in an LGBTQ health needs assessment of the Central Savannah River Area. Half of the participants endorsed a history of sexual violence victimization and 41.4% endorsed a history of partner physical violence. Just under one-third (30.3%) of the sample endorsed a history of homelessness. Over half of the sample (52.9%) endorsed a suicidal ideation history, while over one-third (37.1%) of the sample endorsed a suicide attempt history. Sexual violence victimization was significantly correlated with suicidal ideation and attempt history. Hierarchical regression models including sexual violence victimization, homelessness, and perception of safety significantly predicted histories of both suicidal ideation and suicide attempts; however, perception of safety was the only significant independent stressor in the models with suicidal ideation and suicide attempt as outcome variables. TGNC suicidality is a complex problem with multiple risk factors. Interventions that adopt an approach that helps to address intra- and interpersonal, social, familial, and community factors may be useful.

Depression is prevalent in Multiple Sclerosis (MS) and impacts treatment adherence. Depression screening may be a useful mechanism to identify Blacks at risk for depression in an MS setting, as they frequently experience more disabling MS disease and also may be less likely than Whites to be accurately diagnosed with depression, which can further impact MS disease and diminish quality of life. The purpose of this study was to compare the clinical presentation (e.g. psychiatric histories, current symptoms, and provider treatment recommendations) of Black and White MS patients identified as at risk for depression using a validated depression screening instrument. Secondary analysis of an archival chart data-set of 279 MS patients (90 Blacks) indicated that Black patients were less likely than Whites to have a past mental health diagnosis (X(2) = 12.794, p < .001), prior experience with psychotropics (X(2) = 11.394, p < .001), or be prescribed psychotropics at the time of screening (X(2) = 10.225, p < .001). No differences in depression scores were observed between Black and White patients. Approximately 44% of patients received provider treatment recommendations following a positive screening with no between group differences in the likelihood of receiving at least one recommendation. Consistent with the literature, our Black patient sample was less likely than Whites to have a history of mental health diagnosis or to have been treated with psychotropics. Although more research is needed, screening programs for depression in MS may facilitate access to services for all MS patients while reducing health disparities in Black American patients and removing barriers to early intervention and ongoing care.

Purpose: Stigma negatively impacts quality of life for individuals with multiple sclerosis. Availability of instruments to assess levels of stigma are crucial for monitoring and targeted intervention. The study aims to adapt the Reece Stigma Scale for use with this specific population and examine its reliability and validity. Methods: The scale was administered the 137 participants included in a larger study on identity and multiple sclerosis. Validity was evaluated utilizing the Downing model, as well as assessing potentially related constructs, including adherence, depression, anxiety, quality of life, self-efficacy, and post-traumatic growth. Results: Principal component analysis revealed a one factor solution with excellent internal consistency. Additional construct support offered evidence that higher levels of stigma are related to lower adherence and self-management efficacy, higher levels of anxiety and depressive symptoms, as well as more dissatisfaction with quality of life. Conclusions: This study provides preliminary support for an adapted version of the Reece Stigma Scale, specific to the multiple sclerosis population. The validation data suggests strong psychometric properties. Our findings underscore the clinical importance of measuring and addressing stigma among these patients, with the potential to improve medical (i.e., adherence), psychological (i.e., depression and anxiety), and quality of life outcomes.