Community Perceptions of Mental Health Care among Young, Black Gay and Bisexual Men Who Have Sex with Men Living with HIV in Atlanta, Georgia Pubblico
Varraveto, Michelle (Spring 2022)
Abstract
Background: Young, Black, gay, bisexual, and other men who have sex with men (YB-GBMSM) are disproportionately affected by HIV in Atlanta. With YB-GBMSM being at high risk for disengagement on the HIV Care Continuum (HIV-CoC) and being less likely to be aware of their HIV diagnoses, they are also less likely to receive the benefits of the Care Continuum, including treatment and access to resources. However, little is known about how mental health (MH) symptoms and disorders impact the MH of YB-GBMSM specifically. This issue is complicated by racial and sexual identity and the subsequent stigmas and stereotypes that come with being Black and gay in America. Within this framework, we sought to explore community perceptions of seeking MH care among YB-GBMSM living with HIV in Atlanta.
Methods: 40 in-depth qualitative interviews were conducted with YB-GBMSM (ages 18-29) living with HIV in Atlanta. Participants were recruited through street outreach, clinic-based recruitment, and social media efforts. Domains of the interview guide included: (1) descriptive/narrative context questions, (2) phenomenon clarification questions, and (3) questions structured around domains of Andersen’s model of health service utilization: predisposing factors, enabling factors, and need. A thematic analysis approach was used for coding and qualitative analysis.
Results: Most participants expressed a desire to seek out MH care, but several mentioned the lack of knowledge around MH resources. Out of 40 participants, only 2 discussed their positive experiences with utilizing MH resources. Participants cited stigma as a major influence on why people living with HIV are hesitant to openly discuss their MH issues or receive treatment. Some participants felt that there was more stigma attached to being Black and gay, especially when compared to other races and genders. Another major influences included cultural norms within families that discouraged seeking professional MH care. Further, Participants stated how having a social support system through family, friends, or a positive community positively impacted their MH. Finally, the majority of participants discussed how their racial and sexual identities impacted the way they handled their MH issues.
Conclusion: Many YB-GBMSM living with HIV in Atlanta are interested in MH care. Our findings support continued investment in YB-GBMSM MH. This research could serve to mitigate these barriers and assist them in both accessing and utilizing health care resources, like therapy, to deal with MH issues.
Table of Contents
TABLE OF CONTENTS
CHAPTER 1: INTRODUCTION.................................................1
INTRODUCTION AND RATIONALE.........................................1
PROBLEM STATEMENT ..........................................................3
STATEMENT OF PURPOSE ......................................................3
RESEARCH QUESTIONS..........................................................4
SIGNIFICANCE STATEMENT....................................................4
CHAPTER 2: LITERATURE REVIEW..........................................5
EPIDEMIOLOGY OF HIV AMONG YB-GBMSM……………….........5
HIV AND RACIAL DISPARITIES ................................................6
BARRIERS TO MENTAL HEALTH AND HIV TREATMENT………....6
MENTAL HEALTH RISKS AMONG YB-GBMSM ...........................7
COMMUNITY PERCEPTIONS AROUND MENTAL HEALTH CARE..8
CHAPTER 3: MANUSCRIPT.......................................................11
STUDENT CONTRIBUTION.......................................................11
ABSTRACT ...............................................................................12
INTRODUCTION.......................................................................13
METHODS ...............................................................................16
CONTEXT.................................................................................16
PARTICIPANT AND SAMPLE .....................................................16
PROCEDURES………………………………………………………….....….17
INSTRUMENTS……………………………………………………..…….....17
DATA ANALYSIS...............................................................18
ETHICAL CONSIDERATIONS…………………………..………….18
RESULTS ..................................................................................19
MENTAL HEALTH STIGMA.........................................................19
STIGMA ...........................................................................19
RACE ...............................................................................20
SUPPORT SYSTEMS………………………………………………....21
LACK OF KNOWLEDGE………………………………………………22
PRIORITIZATION OF PHYSICAL OVER MENTAL HEALTH....24
DISCUSSION..............................................................................25
LIMITATIONS ............................................................................27
CONCLUSIONS ..........................................................................27
CHAPTER 4: RECOMMENDATIONS..............................................28
REFERENCES..............................................................................32
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