- Email: [email protected]
Psychosocial Correlates of Idiopathic Gynecomastia in Young Males: Preliminary Findings From a Mixed-Methods Study
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Poster Symposia / 60 (2017) S21eS38
or counseling on one’s sex life (60%), one-on-one counseling and support around PrEP use (59%), text-based support for PrEP use (55%), access to group-based adherence support for PrEP use (54%), not having to pay for PrEP (52%) or go to the regular doctors to get PrEP (50%). Conclusions: Despite relatively high levels of interest, PrEP use among homeless young adults remains low in part due to a lack of PrEP knowledge, HIV risk awareness, and comfort with pills. Youth identified wrap-around services such as counseling, free sexual health screening, and text-based support as facilitators of PrEP uptake. This research identifies potential facilitators and barriers to PrEP uptake in homeless young adults. A larger nationally representative sample of homeless young adults will inform enhanced PrEP uptake. Sources of Support: Greater Houston Community Foundation. 45. PSYCHOSOCIAL CORRELATES OF IDIOPATHIC GYNECOMASTIA IN YOUNG MALES: PRELIMINARY FINDINGS FROM A MIXED-METHODS STUDY Cara C. Young, PhD, RN 1, Cara C. Young, PhD, RN 1, Lynn Rew, MSN 1, Jason T. Yediares, MSN 1, Robert Caridi, MD 2. 1
The University of Texas at Austin; 2Westlake Plastic Surgery.
Purpose: Idiopathic gynecomastia (IGM), the overgrowth of male breast tissue, represents a serious psychosocial challenge for many adolescent and young adult males; however, very few studies have investigated the psychosocial factors associated with this condition. The purpose of this analysis is to examine psychosocial factors that affect young males with IGM before surgical intervention for breast reduction. Methods: A mixed-methods prospective study is in progress. Longitudinal quantitative and qualitative data are being collected (pre-operation, one month post-operation, 6 months post-operation) from males (ages 15-35) who seek surgical breast reduction for IGM. Participants completed standardized measures: quality of life (SF-36), self-esteem (Rosenberg), Satisfaction with Life Scale, and Adolescent Body Image Satisfaction Scale. Open-ended questions during the pre-operation survey probed the lived experience of having IGM. Descriptive statistics were evaluated for all quantitative data, and Spearman’s correlations assessed the relationships among variables owing to the skewed nature of score distributions. Content analysis of qualitative data yielded meaning units and theme generation. Results: Participants (N¼29) range in age from 19 to 36 (M ¼ 28.55, SD ¼ 5.31) and are predominantly Caucasian (69%). The majority (62%) first noticed breast tissue development during childhood and early adolescence (i.e., <15 years), almost 80% report being teased about the size of their breasts. Mean scores on the SF-36 subscales indicated participants struggle with lack of energy and fatigue (M ¼ 59.6, SD ¼ 19.49) and emotional well-being (M ¼ 70.14, SD ¼ 18.62). Participants reporting decreased emotional well-being also reported less life satisfaction (rs ¼ .520, p ¼ .005), poorer body image satisfaction (rs ¼ .468, p ¼ .014), and decreased self-esteem (rs ¼ .664, p <. 001). Decreased self-esteem was also statistically significantly correlated with deficits in physical functioning (rs ¼ .639, p < .001), emotional problems related to role limitations (rs ¼ .561, p ¼ .002), concerns with social functioning (rs ¼ .560, p ¼ .002), life dissatisfaction (rs ¼ .669, p < .001), and body image dissatisfaction (rs ¼ .498, p ¼ .008). A primary theme of shame emerged across qualitative data. Participants reported various methods for hiding
the condition or withdrawing from activities (e.g., swimming, team sports) where this might be discovered by others. Consistent with this theme was the subtheme of information- and help-seeking in private through online searches. Participants searched for homeopathic remedies, exercises, and medications to improve their condition, however, all attempts were reported as unsuccessful. Additional themes included fearing rejection, distancing, and preventing full participation in society. Conclusions: These cross-sectional results reveal IGM has detrimentally impacted the physical and mental health of participants. The primary themes of shame, fear of rejection, distancing, and preventing full participation highlight how these emotions then affect participation in physical and sexual activities. These preliminary findings coupled with the knowledge of the early onset of this disorder suggest a need for more aggressive assessment and intervention protocols when identified by adolescent healthcare providers. Forthcoming longitudinal findings will further explore the impact of surgical correction on the mental and physical well-being of these participants. Sources of Support: N/A. 46. LINKS BETWEEN CHILDHOOD AND ADOLESCENT RELATIONSHIPS AMONG YOUNG WOMEN IPV SURVIVORS WHO HAVE SEX WITH WOMEN Allison K. Muzzey, BA 1, Elizabeth Miller, MD, PhD, FSAHM 2, Sarah Zelazny, BA 2, Heather McCauley, ScD 3. 1
Indiana University School of Medicine; 2University of Pittsburgh School of Medicine; 3Michigan State University.
Purpose: Young women who have sex with women (YWSW) are at high risk of intimate partner violence (IPV), but little is known about the links between childhood and adolescent relationships and whether they differ by sexual orientation. We describe links between childhood and adolescent relationships among YWSW with histories of IPV, comparing those with a sexual minority (SM) identity and without SM identity to identify potential differences in victimization patterns which may inform interventions to improve the health of YWSW. Methods: Data were 26 semi-structured interviews generating retrospective accounts of childhood and adolescent relationships with YWSW survivors of IPV (aged 22-32). Participants were recruited from urban family-planning clinics in Western Pennsylvania as part of a randomized controlled trial; women were eligible if they endorsed physical or sexual IPV and a sexual history with women. We analyzed data using categorical and thematic analysis methods. Three broad areas were identified (childhood, adolescent relationships, links between childhood and adolescent relationships), which informed line-by-line coding of transcripts, allowing themes to emerge within these broad categories. Interviews were sorted to allow for comparison between YWSW without SM identity (i.e. behaviorally only) and YWSW with SM identity (i.e. lesbian or bisexual). Two coders coded interviews separately, compared, and reconciled codes. Results: YWSW without SM identity described sex with other women as experimentation or at the insistence of male partners, stories which included more shame, justification for the same-sex sexual experience, and descriptions of feeling manipulated. Conversely, YWSW with SM identity described being generally open to relationships with other women. Both groups commonly described two distinct areas in childhood context: 1) adverse
Poster Symposia / 60 (2017) S21eS38
or counseling on one’s sex life (60%), one-on-one counseling and support around PrEP use (59%), text-based support for PrEP use (55%), access to group-based adherence support for PrEP use (54%), not having to pay for PrEP (52%) or go to the regular doctors to get PrEP (50%). Conclusions: Despite relatively high levels of interest, PrEP use among homeless young adults remains low in part due to a lack of PrEP knowledge, HIV risk awareness, and comfort with pills. Youth identified wrap-around services such as counseling, free sexual health screening, and text-based support as facilitators of PrEP uptake. This research identifies potential facilitators and barriers to PrEP uptake in homeless young adults. A larger nationally representative sample of homeless young adults will inform enhanced PrEP uptake. Sources of Support: Greater Houston Community Foundation. 45. PSYCHOSOCIAL CORRELATES OF IDIOPATHIC GYNECOMASTIA IN YOUNG MALES: PRELIMINARY FINDINGS FROM A MIXED-METHODS STUDY Cara C. Young, PhD, RN 1, Cara C. Young, PhD, RN 1, Lynn Rew, MSN 1, Jason T. Yediares, MSN 1, Robert Caridi, MD 2. 1
The University of Texas at Austin; 2Westlake Plastic Surgery.
Purpose: Idiopathic gynecomastia (IGM), the overgrowth of male breast tissue, represents a serious psychosocial challenge for many adolescent and young adult males; however, very few studies have investigated the psychosocial factors associated with this condition. The purpose of this analysis is to examine psychosocial factors that affect young males with IGM before surgical intervention for breast reduction. Methods: A mixed-methods prospective study is in progress. Longitudinal quantitative and qualitative data are being collected (pre-operation, one month post-operation, 6 months post-operation) from males (ages 15-35) who seek surgical breast reduction for IGM. Participants completed standardized measures: quality of life (SF-36), self-esteem (Rosenberg), Satisfaction with Life Scale, and Adolescent Body Image Satisfaction Scale. Open-ended questions during the pre-operation survey probed the lived experience of having IGM. Descriptive statistics were evaluated for all quantitative data, and Spearman’s correlations assessed the relationships among variables owing to the skewed nature of score distributions. Content analysis of qualitative data yielded meaning units and theme generation. Results: Participants (N¼29) range in age from 19 to 36 (M ¼ 28.55, SD ¼ 5.31) and are predominantly Caucasian (69%). The majority (62%) first noticed breast tissue development during childhood and early adolescence (i.e., <15 years), almost 80% report being teased about the size of their breasts. Mean scores on the SF-36 subscales indicated participants struggle with lack of energy and fatigue (M ¼ 59.6, SD ¼ 19.49) and emotional well-being (M ¼ 70.14, SD ¼ 18.62). Participants reporting decreased emotional well-being also reported less life satisfaction (rs ¼ .520, p ¼ .005), poorer body image satisfaction (rs ¼ .468, p ¼ .014), and decreased self-esteem (rs ¼ .664, p <. 001). Decreased self-esteem was also statistically significantly correlated with deficits in physical functioning (rs ¼ .639, p < .001), emotional problems related to role limitations (rs ¼ .561, p ¼ .002), concerns with social functioning (rs ¼ .560, p ¼ .002), life dissatisfaction (rs ¼ .669, p < .001), and body image dissatisfaction (rs ¼ .498, p ¼ .008). A primary theme of shame emerged across qualitative data. Participants reported various methods for hiding
the condition or withdrawing from activities (e.g., swimming, team sports) where this might be discovered by others. Consistent with this theme was the subtheme of information- and help-seeking in private through online searches. Participants searched for homeopathic remedies, exercises, and medications to improve their condition, however, all attempts were reported as unsuccessful. Additional themes included fearing rejection, distancing, and preventing full participation in society. Conclusions: These cross-sectional results reveal IGM has detrimentally impacted the physical and mental health of participants. The primary themes of shame, fear of rejection, distancing, and preventing full participation highlight how these emotions then affect participation in physical and sexual activities. These preliminary findings coupled with the knowledge of the early onset of this disorder suggest a need for more aggressive assessment and intervention protocols when identified by adolescent healthcare providers. Forthcoming longitudinal findings will further explore the impact of surgical correction on the mental and physical well-being of these participants. Sources of Support: N/A. 46. LINKS BETWEEN CHILDHOOD AND ADOLESCENT RELATIONSHIPS AMONG YOUNG WOMEN IPV SURVIVORS WHO HAVE SEX WITH WOMEN Allison K. Muzzey, BA 1, Elizabeth Miller, MD, PhD, FSAHM 2, Sarah Zelazny, BA 2, Heather McCauley, ScD 3. 1
Indiana University School of Medicine; 2University of Pittsburgh School of Medicine; 3Michigan State University.
Purpose: Young women who have sex with women (YWSW) are at high risk of intimate partner violence (IPV), but little is known about the links between childhood and adolescent relationships and whether they differ by sexual orientation. We describe links between childhood and adolescent relationships among YWSW with histories of IPV, comparing those with a sexual minority (SM) identity and without SM identity to identify potential differences in victimization patterns which may inform interventions to improve the health of YWSW. Methods: Data were 26 semi-structured interviews generating retrospective accounts of childhood and adolescent relationships with YWSW survivors of IPV (aged 22-32). Participants were recruited from urban family-planning clinics in Western Pennsylvania as part of a randomized controlled trial; women were eligible if they endorsed physical or sexual IPV and a sexual history with women. We analyzed data using categorical and thematic analysis methods. Three broad areas were identified (childhood, adolescent relationships, links between childhood and adolescent relationships), which informed line-by-line coding of transcripts, allowing themes to emerge within these broad categories. Interviews were sorted to allow for comparison between YWSW without SM identity (i.e. behaviorally only) and YWSW with SM identity (i.e. lesbian or bisexual). Two coders coded interviews separately, compared, and reconciled codes. Results: YWSW without SM identity described sex with other women as experimentation or at the insistence of male partners, stories which included more shame, justification for the same-sex sexual experience, and descriptions of feeling manipulated. Conversely, YWSW with SM identity described being generally open to relationships with other women. Both groups commonly described two distinct areas in childhood context: 1) adverse