The association between minority stress and oppression in the lives of men who have sex with men in Cape Town, South Africa Open Access

Abstract

The association between minority stress and oppression in the lives of
men who have sex with men in Cape Town, South Africa

By Ayesha McAdams-Mahmoud

Objectives: The objectives of this study were to determine the extent to which a sample of men who have sex with men (MSM) in Cape Town, South Africa have experienced factors related to minority stress and explore how those experiences were associated with their identity formations, relationships and coping strategies.
Methods: Twenty-two MSM ages 18 to 55 who lived or worked in Cape Town participated in semi-structured in-depth interviews and completed questionnaires about their experiences with prejudicial events, internalized homophobia, perceived discrimination, and coping strategies. Descriptive statistics and phenomenological thematic analysis were used to summarize findings.
Findings: MSM in Cape Town are affected by societal oppression, which has external and internal manifestations resulting in minority stress. Survey results revealed that internalized homophobia, violence and trauma levels were low while concealment behaviors and perceived stigma and discrimination levels were high among study participants. Interview results demonstrated that race, culture, religion, economic status, and environmental setting may determine the degree to which minority stress is experienced. Participants with low socioeconomic status, black Xhosas, white Afrikaners, and coloured Muslims reported having more experiences with incidents of direct prejudicial events and hiding their sexual preference in public settings when compared to other participants. Minority stress impacts aspects of respondents' sexual relationships, identity formations, coping strategies, mental wellness, and overall comfort in navigating the city. Coping strategies for managing these stressful experiences were diverse. The work of existent and emerging MSM support networks is promising, but is insufficient for meeting the mental health needs of these growing, diverse communities.
Conclusions: This study suggests that inclusive policy changes, like gay marriage rights, have had limited impact on discriminatory attitudes and behaviors toward sexual minorities at institutional and individual levels in Cape Town. The lack of research on this topic and the diversity within South African MSM communities demand further exploration of these experiences to develop tailored, successful, and comprehensive mental health promotion, stigma reduction, risk prevention, and sexual minority support interventions.

Table of Contents

TABLE OF CONTENTS

LIST OF FIGURES

GLOSSARY OF TERMS & ACRONYMS

CHAPTER ONE: INTRODUCTION
1
BACKGROUND
1
OBJECTIVES AND AIMS
6
STUDY SETTING
6
STUDY SIGNIFICANCE
6
THEORETICAL FRAMEWORK
9
SUMMARY
10
CHAPTER TWO: LITERATURE REVIEW
11
INTRODUCTION
11
SOCIOPOLITICAL REALITIES FOR MSM
12
MSM, STIGMA, AND MENTAL HEALTH OUTCOMES
18
MSM AND COPING STRATEGIES
28
CONCLUSION
31
CHAPTER THREE: METHODS
32
INTRODUCTION
32
RECRUITMENT & DATA COLLECTION
33
ETHICS & CONSENT
34
ANALYSIS
42
CHAPTER FOUR: RESULTS
44
INTRODUCTION
44
FINDINGS BY RESEARCH QUESTION
46
CONCLUSION
65
CHAPTER FIVE: DISCUSSION
66
INTRODUCTION
66
ESTABLISHING FINDINGS IN THEORETICAL CONTEXT
67
LIMITATIONS
71
IMPLICATIONS
73
RECOMMENDATIONS FOR FUTURE RESEARCH
75
CONCLUSION
76
REFERENCES

APPENDICES

APPENDIX A: QUESTIONNAIRE
vi
APPENDIX B: IN-DEPTH INTERVIEW QUESTION GUIDE
x

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Psychology, Social Health Sciences, Mental Health
Keyword	South Africa homophobia Minority Stress MSM oppression Mental Health
Committee Chair / Thesis Advisor	Jacob Arriola, Kimberly R, Emory University
Committee Members	Stephenson, Robert, Emory University Cooper, Hannah, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs International Non-governmental organization (e.g., CARE, Inc.) Hospital or other health care provider

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