Regarding interventions for SGMY, this review identified 9 interventions for mental health, 2 for substance use, and 1 for violence victimization. CONTEXT: Compared with cisgender (nontransgender), heterosexual youth, sexual and gender minority youth (SGMY) experience great inequities in substance use, mental health problems, and violence victimization, thereby making them a priority population for interventions. OBJECTIVE: To systematically review interventions and their effectiveness in preventing or reducing substance use, mental health problems, and violence victimization among SGMY. DATA SOURCES: PubMed, PsycINFO, and Education Resources Information Center. STUDY SELECTION: Selected studies were published from January 2000 to 2019, included randomized and nonrandomized designs with pretest and posttest data, and assessed substance use, mental health problems, or violence victimization outcomes among SGMY. DATA EXTRACTION: Data extracted were intervention descriptions, sample details, measurements, results, and methodologic rigor. RESULTS: With this review, we identified 9 interventions for mental health, 2 for substance use, and 1 for violence victimization. One SGMY-inclusive intervention examined coordinated mental health services. Five sexual minority–specific interventions included multiple state-level policy interventions, a therapist-administered family-based intervention, a computer-based intervention, and an online intervention. Three gender minority–specific interventions included transition-related gender-affirming care interventions. All interventions improved mental health outcomes, 2 reduced substance use, and 1 reduced bullying victimization. One study had strong methodologic quality, but the remaining studies’ results must be interpreted cautiously because of suboptimal methodologic quality. LIMITATIONS: There exists a small collection of diverse interventions for reducing substance use, mental health problems, and violence victimization among SGMY. CONCLUSIONS: The dearth of interventions identified in this review is likely insufficient to mitigate the substantial inequities in substance use, mental health problems, and violence among SGMY.

Background: Adverse life experiences (ALE; e.g., discrimination and sexual abuse) may contribute to cardiovascular disease (CVD) risk in sexual minority women (SMW), but few studies have tested whether ALE explain the association of sexual identity with cardiovascular health (CVH) markers in women. Objective: To examine sexual identity differences in CVH among women and the role of ALE. Methods: In the Epidemiologic Study of Risk in Women (ESTHER), we used multinomial logistic regression to assess sexual identity differences [SMW vs. heterosexual women (reference group)] in CVH markers (ideal vs. poor; intermediate vs. poor) using the American Heart Association’s Life’s Simple 7 and the total score. Next, we tested whether the association of sexual identity with the total CVH score was attenuated by traditional CVD risk factors or ALE. Results: The sample consisted of 867 women (395 heterosexual, 472 SMW). SMW were more likely to have experienced discrimination (p<0.001) and lifetime sexual abuse (p<0.001) than heterosexual women. SMW were also less likely to meet ideal CVH criteria for current tobacco use (AOR 0.43, 95% CI = 0.24–0.73) or intermediate CVH criteria for body mass index (AOR 0.60, 95% CI = 0.40–0.92). SMW had a lower cumulative CVH score (B(SE)= −0.35(0.14), p<0.01) than heterosexual women. This difference was not explained by traditional CVD risk factors or ALE. Conclusions: Smoking, body mass index, and fasting glucose accounted for much of the CVH disparity due to sexual identity, but those differences were not explained by ALE. Health behavior interventions tailored to SMW should be considered.

Syndemic production theory has been used to explore HIV transmission risk or infections but has not been used to investigate prevention behavior, or with large samples of non-Whites. This analysis is the first to explore the impact of syndemic factors on previous six-month HIV screening behavior among US Black MSM. Data from Promoting Our Worth, Equality and Resilience (POWER) were analyzed from 3294 participants using syndemic variable counts and measures of interaction/synergy. Syndemic variables included: past three-month poly-drug use, depression, last year intimate partner violence, HIV risk and problematic binge drinking. BMSM reporting two syndemic factors were more likely to report screening (AOR = 1.37, 95% CI 1.04–1.80; p = 0.028) with no significant associations for three or more conditions. Measures of joint effect revealed that there were synergies among depression, problematic binge drinking and poly-drug use but these psychosocial factors cannot entirely explain testing patterns and excess disease burden among BMSM.

Introduction: Living conditions and socioeconomic status are the significant determinants of oral health. The research goal was to analyze the dietary habits of 12-year-old children in Sarajevo, Bosnia-Hercegovina. Another goal was to investigate the differences in food cariogenicity of children living under different socioeconomic conditions and to determine their relationship with the oral health. Materials and methods: The sample included 109 children, classified in groups of high, average and low socioeconomic status. Based on the survey and examination, data on nutrition and caries experience (DMFT index) were obtained. Results: There was a difference in dietary habits between children living under different conditions. Children of high socioeconomic status (SES) had a more favorable number of daily meals comparing to children of low socioeconomic status. The average DMFT index, as a measure of caries experience of 12-year-old children amounted 4.8(±3.2). Children of high socioeconomic status had significantly lower caries experience than those from average and low statuses (high SES DMFT 3,60±2,84SD vs. middle SES DMFT 5,28±3,83SD and low SES DMFT 5,47±2,53SD; p<0.05). Corresponding Author: Amila Zukanović Department of Preventive and Pediatric Dentistry School of Dental Medicine, University of Sarajevo Bolnička 4, 71 000 Sarajevo, Bosnia and Herzegovina e-mail: amila.zukanovic@hotmail.com Socioeconomic condition and dietary habits in relation to oral health in 12-year-old children from Sarajevo, Bosnia-Hercegovina

Background: Dental fear and anxiety (DFA) are present worldwide globally, as well as in children. These psychological clinical entities in its progressive phase lead to avoiding of dentists and dental appointments, and consequtive impairments of oral health. If we ignore these facts, we would have the strenghtening of this relationship in a way of further oral health impairments and lost of dental hard and soft tissues, as well as appearance of dental phobia as the most negative form of psychological reaction to dental stimuli. Original CFSS-DS scale and its modifications, as the most used instruments for evaluation of DFA presence so far, showed various disadvantages. These were the reasons why we wanted to design new psychometric instrument for better evaluation of DFA presence in children compared to evaluation which the existed scales could offer nowadays, in a form of the Modified Version of CFSS-DS scale (CFSS-DS-mod scale). Materials and methods: There were 809 schoolchildren from 8 cities of Bosnia and Herzegovina aged 9-12 years that participated in the study. There was one school per city where the schoolchildren answered to the questions from the CFSS-DS-mod scale. Results: 636 schoolchildren correctly answered to the scale questions. The CFSS-DS-mod scale showed excellent internal consistency reliability values (with Cronbach α>0.9), and also validity results (mostly over 60% of explained variance of obtained results) with two-dimensional concept of DFA presence. Conclusion: The CFSS-DS-mod scale represents good psychometric instrument for evaluation of the DFA presence in 9-12 year old schoolchildren in Bosnia and Herzegovina. Some of normative values of this psychometric instrument should be determined, in order to expand its usage in children.

OBJECTIVE The aim of this study was to assess caries prevalence and severity in preschool children in the Federation of Bosnia and Herzegovina. In addition, the relationship between the frequency and clinical types of early childhood caries and behavioral factors, oral hygiene and eating habits were assessed. SUBJECTS AND METHODS An oral health survey was performed in line with the World Health Organization methodology and criteria. The research consisted of clinical examinations of children to determine dentition status, oral hygiene and severity of caries distribution according to Wyne's classification. Information about behavioral factors was collected by means of a questionnaire administered to parents/guardians. RESULTS The sample consisted of a total of 165 preschool children aged 3-5 years. Mean dmft (decay, missing, filled teeth index for primary dentition) was 6.79. The percentage of caries-free children was 17.0%. The results showed a statistically significant correlation between oral hygiene and eating habits, and also the frequency and types of early childhood caries. CONCLUSION The present study demonstrates high caries prevalence in preschool children in the Federation of Bosnia and Herzegovina. Community based preventive programs should be developed and urgently implemented, in order to achieve the WHO goals, improve oral and general health, thus improving the quality of life of these populations.

Purpose: The aim of this study was to assess knowledge and attitude of dentists in Bosnia and Herzegovina (BH) regarding signs and symptoms of child abuse and neglect (CAN), reporting procedure and level of education. Methods: Data were collected through a self-administrated structured questionnaire adopted and modified from previous studies. It was administrated to 300 dentists out of which a total number of 210 subjects were in final sample for statistical analyses. Response rate was seventy percent. Descriptive statistics, Chi-square and Kruskal-Wallis H test were used to analyze statistical differences in responses. The level of significance was set at p<0.05. Results: Dentists in BH are very rarely provided (80%) with training related to recognition and reporting of CAN. Sixty six percent of dentists had never suspected CAN in their practice. Only nine percent of dentists would report suspicious of CAN. Prevailing reasons for not reporting suspected case of CAN was lack of knowledge of the reporting procedure (43%), and combination of indicated answers that never had a case and lack of knowledge about the procedure (31%). Conclusion: Results of this study suggest that dentists need an effective education to increase their knowledge and awareness of all aspects of CAN.

Objectives To estimate the number of men who have sex with men and women who are HIV-positive in the United States, and to compare HIV prevalence rates between men who have sex with men and women, men who have sex with men only, and men who have sex with women exclusively. Methods Following PRISMA guidelines, we conducted a systematic review and meta-analysis of reports referencing HIV prevalence and men who have sex with men and women. We searched PubMed and Ovid PsycINFO for peer-reviewed, U.S.-based articles reporting on HIV prevalence among men who have sex with men and women. We conducted event rate, effect size, moderation and sensitivity analyses. Results We estimate that 1.0% of U.S. males are bisexually-behaving, and that 121,800 bisexually-behaving men are HIV-positive. Men who have sex with men and women are less than half as likely to be HIV-positive as men who have sex with men only (16.9% vs. 33.3%; OR = 0.41, 95% CI: 0.31, 0.54), but more than five times as likely to be HIV-positive as men who have sex with women exclusively (18.3% vs. 3.5%; OR = 5.71, 95% CI: 3.47, 9.39). They are less likely to engage in unprotected receptive anal intercourse than men who have sex with men only (15.9% vs. 35.0%; OR = 0.36, 95% CI: 0.28, 0.46). Men who have sex with men and women in samples with high racial/ethnic minority proportions had significantly higher HIV prevalence than their counterparts in low racial/ethnic minority samples. Conclusions This represents the first meta-analysis of HIV prevalence in the U.S. between men who have sex with men and women and men who have sex with men only. Data collection, research, and HIV prevention and care delivery specifically tailored to men who have sex with men and women are necessary to better quantify and ameliorate this population’s HIV burden.