Ethan Morgan

Objective: Sexual minority populations are growing, experience elevated physical and mental health risks, and have unique stressor exposures. However, biopsychosocial research on sexual minority individuals at the population level remains limited. Addressing this gap, we launched the National Couples’ Health and Time Stress Biology Study (NCHAT-BIO), the first US-based study focused on stress biology within a large, diverse sample of married/cohabiting sexual minority and heterosexual adults. NCHAT-BIO capitalized on the unique opportunity of NCHAT, a population-representative US sample which intentionally oversampled sexual minority respondents. Methods: NCHAT-BIO was approved by The Ohio State University and Gallup Institutional Review Boards. A total of 950 participants completed at-home dried blood spot (DBS) collection with return by mail. After exclusions, 787 respondent samples were assayed: 44.5% sexual minority, 56.9% assigned female at birth, 55.3% who identified as women, 25% with non-White racial identity, and mean age=42.69 (SD=10.19). Samples were analyzed for interleukin-6 (IL-6), C-reactive protein (CRP), and Epstein Barr Virus (EBV) antibodies. Final analytic samples were: IL-6 (n=452), CRP (n=663), EBV (n=647, including n=84 EBV negative). These biomarker data can be merged with rich NCHAT survey responses, time diaries with an embedded Experience Sampling Method (ESM) component, and contextual state- and county-level indicators. Dissemination: Wave 1 NCHAT-BIO data have been deposited at ICPSR for public release; the current report should be cited in future empirical manuscripts using these data. Wave 1 NCHAT survey data are also at ICPSR, and the two archives will be linked to facilitate integrated use. Future Directions: Whole blood data collection from Wave 3 NCHAT participants will begin in 2026. Planned assays, which will also become publicly available, include IL-6, CRP, and epigenetic aging (per DNA methylation).

Within the next 20 years, there will be older adults in the USA than there will be children, a historic first (U.S. Census Bureau, 2018). Among this aging population, sexual and gender minorities (...

Background: Sexual and gender minorities (SGMs) remain disproportionately affected by HIV and bacterial sexually transmitted infections (STIs). Despite the efficacy of pre-exposure prophylaxis (PrEP) for HIV prevention and the emerging promise of doxycycline post-exposure prophylaxis (doxy-PEP) for STI prevention, awareness, uptake, and persistence remain limited. Objectives: In this qualitative, we study explored client perspectives on barriers and facilitators influencing the use of same-day PrEP and doxy-PEP to inform strategies for broader implementation in primary care. Informed by the stages of the PrEP Care Continuum and the levels of the SGM Health Disparities Framework, we sought to better understand the barriers and facilitators at each stage of the clinical continuum (i.e., awareness, uptake, and persistence) and at various levels of influence (i.e., individual, interpersonal, community, and societal). Methods: Four virtual focus groups with 26 SGM clients with experience using PrEP and/or doxy-PEP were conducted. Data were analyzed using deductive thematic analysis guided by the PrEP Care Continuum and the SGM Framework. Results: Consistent barriers to uptake and persistence exist, including health care access, cost, stigma, and discriminatory clinical encounters. Participants highlighted the burden of the current medical model, which involves multiple procedural steps and frequent health care visits. Facilitators included community support, targeted social media messaging, and affirming providers. Notably, participants drew motivation from historical and communal narratives, including the legacy of the HIV/AIDS epidemic, and emphasized the need for visible public and political support for biomedical prevention. Discussion: The results underscore the importance of integrating client-informed approaches to improve biomedical prevention delivery. To advance HIV and STI prevention among SGMs, there is a critical need for culturally tailored education to support increasing awareness and flexible clinical models to support the uptake and persistence in care. PrEP and doxy-PEP are vital, synergistic tools that require coordinated strategies in primary care, to expand access and address persistent health disparities and end the HIV and STI epidemics.

Introduction: Past research has shown that inflammation is reduced among marijuana-using HIV-negative people but not those living with HIV. We take this work a step further by assessing differences based on pre-exposure prophylaxis (PrEP) use among HIV-negative individuals. Methods: National Couple's Health and Time is a nationally representative cohort study of 3642 adult respondents who are married or cohabiting. Their ages range from 20 to 60 years with 45% self-identifying as nonheterosexual. Biologic data (n = 573; C-reactive protein [CRP], interleukin-6 [IL-6], and Epstein Barr virus [EBV] antibody levels) were collected through finger stick dried blood spots as part of National Couple's Health and Time-BIO, a substudy. Participants self-reported demographic characteristics, PrEP use, and marijuana use. Multivariable regression analyses were used to assess the relationship between these variables and each of the measured biomarkers, adjusting for known confounders. Results: In adjusted models, neither lifetime nor current PrEP use was associated with CRP, IL-6, or EBV antibody levels. Moreover, marijuana use did not differ among those who used PrEP versus those who did not. Among PrEP users, those who reported marijuana use had lower CRP than those who did not (B = −2.31; 95% CI: −4.23 to −0.40). Among non-PrEP users, no association was observed between marijuana use and CRP. Conclusions: The current preliminary data suggest inflammation is reduced among PrEP users who also use marijuana, but the same is not true among non-PrEP users. These findings may suggest that PrEP increases inflammation that is then partially mitigated by the individual cannabinoids or cannabidiols found in marijuana, although more research is needed to confirm this hypothesis.