Mental health problems, including anxiety and depression, are a common comorbidity among gay, bisexual and other men who have sex with men (GBMSM) living with HIV. Informed by social support theory, health navigation is a strengths-based intervention that has been demonstrated to improve HIV care outcomes. The purpose of this study was to explore how health navigation influences the mental health of GBMSM living with HIV. We analyzed longitudinal qualitative in-depth interviews conducted with GBMSM (n = 29) in a 12-month multi-component intervention to improve HIV care outcomes, including health navigation. We used narrative and thematic analytic approaches to identify salient themes, including if and how themes changed over time. Participants described that navigator support helped them maintain good mental health, prevent crises and respond to crises. Navigator support included providing motivational messaging, facilitating participants' control over their health and improving access to care, which aided with supporting mental health. Navigators also responded to acute crises by providing guidance for those newly diagnosed with HIV and support for those experiencing critical life events. Participants emphasized the importance of feeling heard and valued by their navigators and gaining hope for the future as key to their wellbeing. In conclusion, health navigation may be an effective intervention for promoting mental health among GBMSM living with HIV. Additional research is needed to examine mediating pathways between navigation and mental health, including informational support, or if navigator support moderates the relationship between stressors and mental health outcomes for GBMSM.
This year marks the 30th anniversary of AIDS Education and Prevention. As we approach the United Nations goal of ending the AIDS epidemic by 2030, it is a useful time to reflect on and learn from history. In the United States, no such endeavor can be successful without addressing the specific context of Black men who have sex with men. In this commentary I highlight factors that led us to a state in which Black MSM represent approximately a quarter of all people living with HIV in the United States. I also look back at the power of activism during the beginning of the HIV epidemic. Using Black Lives Matter as a contemporary framework, I highlight natural linkages between activism 30 years ago, its incarnation and relationship to public health today, and its promise as the way forward in achieving the elimination of AIDS for Black MSM by 2030.
The Continuing Development of Health Disparities Research on Lesbian, Gay, Bisexual, and Transgender Individuals Affiliation Ron Stall PhD, MPH, Derrick D. Matthews PhD, MPH, M. Reuel Friedman PhD, MPH, Suzanne Kinsky PhD, MPH, James E. Egan PhD, MPH, Robert W. S. Coulter MPH, John R. Blosnich PhD, MPH, and Nina Markovic PhDAll of the authors are with the Center for LGBT Health Research, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Ron Stall, Suzanne Kinsky, James E. Egan, and Robert W. S. Coulter are also with the Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh. Derrick D. Matthews and M. Reuel Friedman are also with the Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh. John R. Blosnich is also with US Department of Veterans Affairs Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh. Nina Markovic is also with the Department of Dental Public Health, School of Dental Medicine, University of Pittsburgh.CopyRightCorrespondence should be sent to Ron Stall, Director of the Center for LGBT Health Research and Associate Chair for Science Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, 130 De Soto St, Pittsburgh, PA 15261 (e-mail: [email protected]edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints" link.CONTRIBUTORSAll authors contributed equally to this editorial. https://doi.org/10.2105/AJPH.2016.303183 Accepted: March 07, 2016 Published Online: April 06, 2016
Introduction The large number of key populations in China who would benefit from HIV pre-exposure prophylaxis (PrEP) in the context of limited health system capacity and public awareness will pose challenges for timely PrEP scale-up, suggesting an urgent need for innovative and accessible interventions. This study aims to develop and pilot test a theory-informed, tailored mobile phone intervention that was codeveloped by young gay men, HIV clinicians and public health researchers to increase engagement in PrEP education and initiation among Chinese gay, bisexual and other men who have sex with men (GBMSM), who bear a disproportionate burden of HIV infections and remain underserved in the healthcare system. Methods and analysis This two-phase study includes a formative assessment using in-depth interviews (N=30) and a 12-week experimental pilot study using a two-arm randomised controlled trial design (N=70). The primary intervention is delivered through a WeChat-based mini-app (a program built into a Chinese multipurpose social media application) developed by young GBMSM from a 2019 crowdsourcing hackathon. Using mixed methods, we will further investigate the specific needs and concerns among GBMSM in terms of using PrEP as an HIV prevention strategy, how their concerns and PrEP use behaviours may change with exposure to the mini-app intervention during the study period and how we can further refine this intervention tool to better meet GBMSM’s needs for broader implementation. Ethics and dissemination This study and its protocols have been reviewed and approved by the Institutional Review Boards of the University of North Carolina at Chapel Hill, USA (19-3481), the Guangdong Provincial Dermatology Hospital, China (2020031) and the Guangzhou Eighth People’s Hospital, China (202022155). Study staff will work with local GBMSM community-based organisations to disseminate the study results to participants and the community via social media, workshops and journal publications. Trial registration number The study was prospectively registered on clinicaltrials.gov ( NCT04426656 ) on 11 June 2020.
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