“I can literally spill my guts and be 100% honest and it helped”: Narratives of Mental Health Service Utilization Among Young Black Gay and Bisexual Men Living with HIV Restricted; Files Only

Johnson, Zoe (Fall 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/8w32r702f?locale=en


Young, Black, gay, bisexual, and other men who have sex with men (YB-GBMSM) living with HIV, experience a high burden of mental health concerns, yet underutilize mental health care services. This study qualitatively explored mental health care pathways, including motivations, experiences, and barriers to care, to understand why mental health care service utilization and engagement remain low. We conducted a secondary analysis of 23 in-depth interviews with YB-GBMSM who previously utilized mental health care services using a narrative approach. We found that YB-GBMSM follow different pathways to utilize mental health care service. YB-GBMSM in our study were motivated to seek care due to several life stressors and events and reported overall positive experiences with the care they received. However, they faced significant barriers related to stigma, financial constraints, and logistics (housing and transportation) which influenced utilization and continued engagement in mental health care services. Our conclusions discuss implications for future research and suggestions for improving mental health service utilization and engagement among YB-GBMSM.

Table of Contents


Chapter 1: Introduction and Literature Review.. 1

Mental Health and HIV 1

Mental Health of YB-GBMSM 2

Mental Health Service Utilization Among YB-GBMSM 4

Perceptions and Barriers 5

Experiences in Care 8

Problem Statement 8

Purpose Statement 9

Definition of Terms 9

Chapter 2: Manuscript 10

Introduction. 13

Methods 15

Qualitative Approach and Study Population 15

Sampling and Recruitment Strategies 15

Data Collection 15

Procedures 16

Data Analysis 17

Results 17

Motivations for Seeking Mental Health Care 18

Formal Evaluation 18

Catharsis 19

Navigating Adversity 19

Interpersonal Relationships 20

HIV Diagnosis 23

Experience in Care 28

Freedom from Judgement 28

Confidentiality and Trust 28

Barriers to Care 29

Stigma 29

Low Perceived Need 30

Financial Constraints 30

Logistics 31

Discussion 31

Chapter 3: Conclusion and Public Health Implications 37

References 38

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