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      “Moving from one environment to another, it doesn’t automatically change everything”. Exploring the transnational experience of Asian-born gay and bisexual men who have sex with men newly arrived in Australia

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          Abstract

          Asian-born gay, bisexual and other men who have sex with men (gbMSM) who are newly arrived in Australia are at a higher risk of acquiring HIV than Australian-born gbMSM. We used a social constructionist framework to explore HIV knowledge and prevention strategies used by newly-arrived Asian-born gbMSM. Twenty four Asian-born gbMSM, aged 20–34 years, attending Melbourne Sexual Health Centre, who arrived in Australia in the preceding five years, participated in semi-structured, face-to-face interviews. Interviews were recorded, transcribed verbatim and analysed thematically. Participants described hiding their sexual identities in their country of origin, particularly from family members, due to fear of judgement and discrimination resulting from exposure to sexual identity and HIV related stigma in their countries of origin, although some were open to friends. Despite feeling more sexual freedom and acceptance in Australia, many were still not forthcoming with their sexual identity due to internalised feelings of stigma and shame. Exposure to stigma in their country of origin led many to report anxiety around HIV testing in Australia due to a fear of testing positive. Some described experiencing racism and lack of acceptance in the gay community in Australia, particularly on dating apps. Fear of discrimination and judgement about their sexual identity can have a significant impact on Asian-born gbMSM living in Australia, particularly in terms of social connectedness. Additionally, HIV-related stigma can contribute to anxieties around HIV testing. Our data highlights the potential discrimination Asian-born gbMSM face in Australia, which has implications for social connectedness, particularly with regard to LGBTQI communities and HIV testing practices. Future studies should determine effective strategies to reduce sexual identity and HIV-related stigma in newly-arrived Asian-born gbMSM.

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          Using thematic analysis in psychology

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            Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

            Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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              Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.

              Ilan Meyer (2003)
              In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: Project administrationRole: Writing – review & editing
                Role: Project administrationRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: Project administrationRole: Writing – review & editing
                Role: Formal analysisRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                20 November 2020
                2020
                : 15
                : 11
                : e0242788
                Affiliations
                [1 ] Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
                [2 ] Central Clinical School, Monash University, Melbourne, VIC, Australia
                [3 ] The Kirby Institute, University of New South Wales, Sydney, Australia
                [4 ] Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
                [5 ] Department of General Practice, University of Melbourne, VIC, Australia
                University of Toronto, CANADA
                Author notes

                Competing Interests: NM, EPFC and JJO have received a research grant from Gilead Pharmaceuticals to conduct this investigator-initiated study. Gilead Pharmaceuticals had no input in the research plan, recruitment, analysis or decision to publish the paper. EPFC is supported by an Australian National Health and Medical Research Council (NHMRC) Emerging Leadership Investigator Grant (GNT1172873). JJO is supported by an Australian NHMRC Early Career Fellowship Grant (APP1104781). JEB is supported by an Australian Research Council Discovery Early Career Researcher Award (DECRA) Fellowship (DE200100049). All other authors have no conflicts of interest to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                ‡ These authors are joint senior authors on this work

                Author information
                https://orcid.org/0000-0001-6920-7710
                https://orcid.org/0000-0003-1766-0657
                Article
                PONE-D-20-17766
                10.1371/journal.pone.0242788
                7678978
                33216802
                4ec9c584-30fb-467e-961f-71b6c060d2fb
                © 2020 Phillips et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 10 June 2020
                : 10 November 2020
                Page count
                Figures: 0, Tables: 4, Pages: 30
                Funding
                This study was funded by Gilead Pharmaceuticals research fellowship. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. https://gileadfellowship.com.au/.
                Categories
                Research Article
                Biology and Life Sciences
                Microbiology
                Medical Microbiology
                Microbial Pathogens
                Viral Pathogens
                Immunodeficiency Viruses
                HIV
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Pathogens
                Microbial Pathogens
                Viral Pathogens
                Immunodeficiency Viruses
                HIV
                Biology and Life Sciences
                Organisms
                Viruses
                Viral Pathogens
                Immunodeficiency Viruses
                HIV
                Biology and Life Sciences
                Organisms
                Viruses
                Immunodeficiency Viruses
                HIV
                Biology and life sciences
                Organisms
                Viruses
                RNA viruses
                Retroviruses
                Lentivirus
                HIV
                Biology and Life Sciences
                Microbiology
                Medical Microbiology
                Microbial Pathogens
                Viral Pathogens
                Retroviruses
                Lentivirus
                HIV
                Medicine and Health Sciences
                Pathology and Laboratory Medicine
                Pathogens
                Microbial Pathogens
                Viral Pathogens
                Retroviruses
                Lentivirus
                HIV
                Biology and Life Sciences
                Organisms
                Viruses
                Viral Pathogens
                Retroviruses
                Lentivirus
                HIV
                People and Places
                Geographical Locations
                Oceania
                Australia
                Biology and Life Sciences
                Psychology
                Sexual Identity
                Social Sciences
                Psychology
                Sexual Identity
                Medicine and Health Sciences
                Diagnostic Medicine
                Virus Testing
                Medicine and health sciences
                Diagnostic medicine
                HIV diagnosis and management
                Social Sciences
                Sociology
                Social Discrimination
                Racial Discrimination
                Medicine and health sciences
                Public and occupational health
                Preventive medicine
                HIV prevention
                Social Sciences
                Anthropology
                Cultural Anthropology
                Religion
                Social Sciences
                Sociology
                Religion
                Custom metadata
                Due to the small sample size and the interview transcripts containing sensitive and potentially identifying information, the ethics committee have not approved public release of this type of data. Interested researchers may contact Emily Bingle at the Alfred Hospital Ethics Committee if they would like access to the data: research@ 123456alfred.org.au , quoting project 222/19.

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