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Session Abstract Abstract Session Global, International, and/or Transnational LGBT Public Health Hui Xie, MPH, Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8) Abstract School-based violence among adult gay men (GM) and transgender women (TW) living in Lima, Peru Elisa Juarez Chavez, MD, MSPH1, Erin Cooney, MSPH, CPH2, Angela Bayer, PhD3, Alberto Hidalgo, MSSc4, Jorge Sanchez, MD, MPH5 and Tonia Poteat, PhD2, (1)Johns Hopkins School of Public Health, Baltimore, MD, (2)Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (3)Universidad Peruana Cayetano Heredia, Lima, Peru, (4)Centro de Promoción y Defensa de los Derechos Sexuales y Reproductivos- PROMSEX, Lima, Peru, (5)Asociación Civil Impacta Salud y Educación, Barranco, Lima, Peru APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8) Background: The goal of this study was to explore school-based violence during childhood and adolescence among adult gay men (GM) and transgender women (TW) living in Lima, Peru. This qualitative research was intended to inform violence prevention interventions in Peruvian schools. Methods: Qualitative data collection was conducted between July and October 2016 in Lima, Peru. Four focus group discussions (FGD) took place with GM (n=21) and one with TW (n=9). Additionally, 11 in-depth interviews (IDI) with GM and 14 with TW were conducted. Results: The primary risk factors for experiencing bullying were being perceived as feminine and not conforming to masculine stereotypes. A proximal trigger of violence reported by nearly all participants was refusal to play soccer with male classmates. A significant proportion of TW reported experiencing sexual violence in the school setting (male bathrooms, specifically). The perpetrators tended to be male peers who were a few years older than the victims. In terms of bullying, teachers were not perceived as protective allies, but rather, were identified as perpetrators of homophobic and transphobic violence. Their lack of action also condoned violence from students. Female peers were described as a source of comfort and protection against bullying. Conclusions: Teachers and students should be made aware of the impact of homophobic and transphobic bullying and violence. Prevention interventions should ally teachers’ responsibility to intervene and address these issues. Schools should promote activities that are not grounded in gender roles. Also, the importance of having all-gender bathrooms in the schools is highlighted here. Diversity and culture Planning of health education strategies, interventions, and programs Public health or related education Public health or related research Social and behavioral sciences Abstract Health Disparities among Lesbian, Gay, & Bisexual Adults in South Korea: A nationwide survey with 2,341 LGB adults Horim Yi, MSW1, Hyemin Lee, MPH1, Jooyoung Park, MPH1, Bokyoung Choi, BSN, RN2 and Seung-Sup Kim, MD, MPH, ScD3, (1)Korea University, Seoul, Korea, Republic of (South), (2)Korea university, Seoul, Korea, Republic of (South), (3)Graduate School of Korea University, Seoul, Korea, Republic of (South) APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8) Background This study aims to investigate health disparities among lesbian, gay, and bisexual (LGB) adults in South Korea, where public acceptance toward sexual minorities remains low. Our research team has conducted Rainbow Connection Project I - Korean Lesbian, Gay, & Bisexual Adults’ Health Study (2016), which is the largest nationwide cross-sectional survey about health of LGB people in South Korea. Methods The survey included 2,341 Korean LGB adults. We measured poor self-rated health, musculoskeletal pain, suicidal ideation, and depressive symptoms (CES-D 20) through self-reports. Age- and gender- standardized prevalence ratios (SPR) were estimated to compare the prevalence of health outcomes between survey participants and general population that had participated in the three nationally representative surveys (e.g. Korean National Health & Nutrition Examination Survey VI). Results Korean LGB adults had poor self-rated health, poor mental health, and higher risk of musculoskeletal pain than did general population. 19.0% of LGB adults reported poor self-rated health, which is higher than the general population (SPR=1.54, 95%CI: 1.40, 1.59). Prevalence of depressive symptoms and suicidal ideation among LGB adults were 54.0% and 34.6%, respectively. Compared to the general population, depressive symptoms (SPR=4.76, 95%CI: 4.50, 5.04) and suicidal ideation (SPR=7.51, 95%CI: 7.00, 8.05) were significantly more common among LGB adults. 34.8% of LGB adults had back pain, which is higher than that of the general population (SPR=3.91, 95%CI: 3.64, 4.19); similar trends were observed regarding upper and lower limb pains. Conclusions These results suggest that interventions are needed to address health disparities of Korean LGB adults. Advocacy for health and health education Epidemiology Public health or related research Social and behavioral sciences Abstract Sociocultural Contexts of Sex Work among Mak Nyah (Transgender Women) in Kuala Lumpur, Malaysia Tooru Nemoto, PhD1, Rebecca de Guzman, Ph.D.1, Yik Koon Teh, Ph.D.2, Mariko Iwamoto, M.A.1 and Jamie Fuega, MPH1 (1)Public Health Institute, Oakland, CA, (2)National Defense University of Malaysia, Kuala Lumpur, Malaysia APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8) Background: In Malaysia, transgender women (who created the term “mak nyah” to counter derogatory representations of them) are a highly stigmatized and persecuted group. Mak nyah have little to no access to gender-affirming health care and encounter widespread societal stigma, employment discrimination, persecution by Islamic religious authorities, and police harassment. Violence, HIV risk, and criminalization are further compounded for mak nyah who engage in sex work. Methods: We conducted in-depth, semi- structured qualitative interviews with 24 mak nyah sex workers to explore their experiences with: family and community; sex work environments; health needs and barriers to care; gender identity; religion and religious persecution; interactions with police; and substance use. We adapted grounded theory and qualitative descriptive methods to analyze these and other themes that emerged. Mak nyah were recruited to this study through our collaboration with a local AIDS service organization. Results: These narratives of mak nyah illustrate a complex web of mutually reinforcing vulnerabilities. They faced hyper-visibility in public settings where they endured routine intimidation and harassment, and near-invisibility when seeking access to and information about hormone use and other health needs. Faced with these and other injustices, many mak nyah engaged in an informal network of support with peers and allies. Conclusions: We need to quantitatively investigate sociocultural factors that elevate risks among mak nyah and integrate results with those of the current study. Future public health interventions for mak nyah must incorporate a human rights agenda. Program planning Social and behavioral sciences Abstract Adolescent victimization of anti-gay bullying is related to adulthood depressive symptoms and suicidal ideation among LGB in South Korea: A life-course perspective approach Jooyoung Park, MPH1, Ji-Hwan Kim, BHS1, Jaehong Yoon1 and Seung-Sup Kim, MD, MPH, ScD2, (1)Korea University, Seoul, Korea, Republic of (South), (2)Graduate School of Korea University, Seoul, Korea, Republic of (South) APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8) Background: Little research has been conducted to examine the relationship between adolescent victimization of anti-gay bullying (AVAB) and adulthood mental health among LGB people. Method: To examine the association between AVAB and adulthood mental health, we conducted a nationwide survey of 2,250 LGB adults in South Korea, entitled the Rainbow Connection Project I. Participants were categorized as following; 1) never experienced, 2) bullied for sexual orientation and gender expression, 3) bullied for other reasons (sex, age, nationality and race, family’s socioeconomic status, appearance, and disability). Depressive symptoms (CES-D 20) over the past week and suicidal ideation over the past 12 months were measured. Furthermore, we examined how the association between AVAB and adulthood mental health was changed when we additionally adjusted for social violence experience (i.e., physical, verbal, and sexual abuse) which could be relevant mediators between twos. Results: Compared to LGB adults never experienced bullying in adolescence, people bullied for sexual orientation and gender expression were more likely to report adulthood depressive symptoms (OR 1.82, 95% CI: 1.39-2.39) and suicidal ideation (OR 1.59, 95% CI: 1.21-2.09). These findings remained statistically significant when we additionally adjusted for social violence experience since 19 years old. We found similar results in the analysis with other reasons. Conclusion: This study suggests that AVAB was associated with poor adulthood mental health. To our knowledge, this is the first research to examine the association between AVAB and adulthood mental health among LGB in Asian countries. Assessment of individual and community needs for health education Planning of health education strategies, interventions, and programs Public health or related laws, regulations, standards, or guidelines Public health or related organizational policy, standards, or other guidelines Public health or related public policy Social and behavioral sciences .
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