Two Northwestern University-affiliated researchers presented a webinar Nov.9 about the impact of the COVID-19 pandemic on youth in minoritized communities in the United States, among them youths in the LGBTQ+ community.
The webinar was part of a scientific series from the Sexual and Gender Minority Research Office, a branch of the National Institutes of Health (NIH).
Gregory Phillips II, an assistant professor at the Feinberg School of Medicine, and Megan Ruprecht, a research study coordinator at Northwestern's Institute for Sexual and Gender Minority Health and Wellbeing, discussed two projects they led analyzing the impacts of COVID-19 on minoritized youth.
First, Phillips described a study on COVID-19 that he led with Ruprecht. Sparse data initially existed about COVID-19's impacts on sexual and gender minority (SGM) populations, so Phillips and Ruprecht's investigative team began their research to study those impacts.
Between April and August, the team surveyed 932 adults living in the U.S. or a U.S. territory who identified as SGM or living with HIV. The survey led to papers in LGBT Health and Transgender Health that discussed vaccination willingness or hesitation and differences in COVID-19 impacts by gender identity, respectively.
Other papers in progress as a result of the COVID-19 impacts survey focus on HIV status, anxiety and depression, intersectional approaches and substance use in relation to COVID-19.
"We knew that we wanted to actually have an impact on COVID-19 awareness and outcomes among sexual and gender minority populations," Phillips said, so the team was "happy to hear" that they received funding for a second project through the NIH.
In late 2020, the NIH launched the Rapid Acceleration of Diagnostics, or RADx, initiative to generate innovative COVID-19 testing approaches and strategies. A subset of this initiative, RADx-Underserved Populations (RADx-UP), aimed to understand and reduce COVID-19 disparities through social and behavioral research.
"We know we're one of maybe only two or three funded RADx sub-grantees who are really focused and dedicated to sexual and gender minority populations," Phillips said.
Phillips and Ruprecht are currently leading the RADx-UP project, the Youth and Young Adults COVID-19 study. The study aims to understand disparities in COVID-19 prevention and outcomes among youth and young adults, with a focus on racial and ethnic minorities and sexual and gender minorities, Ruprecht said. A second aim is to develop a health messaging intervention for minoritized youth and young adults based on the data.
The study is underway and has collected data from 950 participants, 73% of the team's total goal of 1,250 participants. So far, all 50 states and Puerto Rico are represented. Ruprecht added that they will conduct in-depth interviews with a subset of 40 participants.
While study criteria only requires that participants be between the ages of 14-24, live in the U.S. or a U.S. territory and speak English, Ruprecht said the team wanted to oversample LGBTQ and BIPOC youth to ensure an accurate understanding of disparities. She added that their community partners were essential in the effort.
Study partners include two LGBTQ+ youth-serving organizations, Broadway Youth Center and CenterLink program YouthLink, along with an Indigenous-led research and evaluation firm, Bowman Performance Consulting.
Survey questions cover COVID-19 testing, vaccination and impacts. Ruprecht shared some preliminary findings from the data.
Regarding COVID-19 impacts, 11.5% of participants reported a severe change in income or employment, 9.1% reported severe stress in the family, and 33.2% reported severe stress related to the pandemic, Ruprecht said.
The team noticed a "really interesting phenomenon" with stigmatization, she added. Many LGBTQ+ youth and young adults experienced greater stigmatization due to being forced into unaccepting home environments or lacking the social support provided by community spaces or school. But others said quarantine provided an opportunity to escape marginalization, particularly high school students.
"I think this just really demonstrates the complexity of how stigma operates within its population, and how important context is. In either case, whether folks found themselves in environments with greater or lesser levels of stigmatization during the pandemic, we see the need to push for safe and affirming spaces for youth and young adults," Ruprecht said.
The project results also emphasize the need for structural support and intervention for many of the issues impacting LGBTQ+ youth, Ruprecht said: safe and secure environments, health care access and material needs.
The study's preliminary findings also indicate that the pandemic made healthcare more difficult to access, including transition-related, general and mental health care.
Ruprecht said the next steps for the project are to develop a messaging intervention based on youth feedback and propose a cohort study of these youth and young adults to evaluate the long-term impacts of COVID-19.