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Sexual minority youth with dark skin use indoor tanning at unexpected rates

Rates of indoor tanning use by non-heterosexual, black, male teenagers have been found to be nearly as high as those of heterosexual, white females of the same age group, according to findings published in JAMA Dermatology (Dec. 26, 2016, online ahead of print).

“Contrary to popular thought, racial and ethnic minorities engage in indoor tanning and it appears to be particularly concentrated among sexual-minority adolescent boys,” said lead researcher Aaron Blashill, PhD, an assistant professor of psychology at San Diego State University in California, speaking in a press release from the university.

The paper utilized data from the 2015 Youth Risk Behavior Survey, a U.S. nation-wide survey of health risk behaviours among 9th- to 12th-grade public and private school students.

According to the authors, past studies show that non-heterosexual minority males have an extremely high prevalence rate of skin cancer—as much as twice that of heterosexual males. The cause of this elevated risk was unclear, so the authors set out to see if there was an association with indoor tanning behaviour.

They found that among black participants, the main effects on risk of indoor tanning were sexual orientation (odds ratio [OR], 4.48; 95% confidence interval [CI] 2.50–8.00, p<0.001) and sex (OR, 2.63, 95% CI 1.03–6.61, p=0.04), with sexual minorities and males reporting elevated indoor tanning. The main effect among Hispanic participants was sexual orientation (OR 3.92, 95% CI, 1.78–8.63, p<0.01), with sexual minorities reporting elevated indoor tanning.

While it may seem strange for dark-skinned individuals to engage in indoor tanning, Dr. Blashill said that confusion comes from a misunderstanding of the motivation for tanning.

“Many only think of indoor tanning as something people do to darken their skin, so the idea that a black individual would tan at all is hard for some to grasp,” he said. “But if we think of indoor tanning as a coping strategy, then the findings begin to make more sense.” UV exposure can induce relaxation through the release of natural opioids in the brain, Dr. Blashill noted. Therefore non-heterosexual black and Hispanic teenage boys may use indoor tanning as a tool to regulate psychological distress arising from discrimination, prejudice, and victimization based on their sexual orientation, race, or ethnicity.

Dr. Blashill is working on a follow-up study to evaluate the indoor tanning habits of 14- to 35-year-old sexual-minority males in San Diego county to identify whether a similar phenomenon exists among college-aged and young adults.

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