Background: South Asian gay, bisexual, queer men (SA GBQM) who have migrated to Canada report racism and homophobia negatively impacting their sexual health. Quantitative data on associations between discrimination and sexually transmitted infection (STI) testing are missing for this population. Objective: Examine associations between migration histories, discrimination, and recent STI testing among SA GBQM in Canada. Methods: We conducted a pooled analysis of Sex Now 2019 and 2021 – online, national, cross-sectional surveys of GBQM (n=18,277). We restricted analyses to SA GBQM and created modified Poisson regression models (adjusted for age, income, education, disability, and HIV pre-exposure prophylaxis use) to determine the direct, indirect, interaction, and combined effects of migration histories (born in Canada versus not) and past-year discrimination (racism, homophobia, or both) on recent STI testing using the Bauer-Scheim approach in this intersectional community-engaged study. Results: Among 469 SA GBQM, 34% were born in Canada and 39% were recently tested for STIs (52% among those born in Canada versus 33% for those not). Of the full SA GBQM sample, 65% experienced racism, 34% experienced homophobia, and 31% experienced both. Recent STI testing was higher among SA GBQM born in Canada [unadjusted prevalence ratio: 1.39 (95%CI:1.17-1.67)]. The adjusted association between migration histories and recent STI testing in the following models were statistically significant (p<.05): 1.40 (1.05-1.88; direct effect), 1.28 (1.01-1.61; indirect effect–racism), 2.07 (1.18-3.63; interaction–racism), 1.82 (1.11-2.99; interaction–homophobia), and 2.16 (1.17-3.98; interaction–both). Conclusion: Anti-oppressive training could improve STI testing for immigrant SA GBQM in Canada by addressing racism and homophobia.

Background: Black, same gender loving men (SGLM) living with HIV face daily intersectional discrimination that impacts their psychological health. While there is extensive literature exploring the psychological effects of overt discrimination, the impact of invisibility, or the feeling of nonexistence in social spaces, remains underexplored. Thus, this study examined longitudinal associations between daily invisibility and depressive symptoms, anxiety symptoms, and emotion regulation difficulties among Black SGLM living with HIV.

Method: We conducted a 14-day daily diary study with 34 Black SGLM living with HIV. Participants completed daily self-report assessments measuring depressive and anxiety symptoms, emotion regulation difficulties, and experiences of intersectional stigma, including feeling invisible within social spaces. We used dynamic structural equation modeling to analyze the longitudinal association between invisibility and next-day psychological health. The models controlled for previous-day intersectional stigma and psychological outcomes and the reciprocal association from psychological outcomes to later invisibility.

Results: Participants reported feeling invisible on 25% of days. Models showed significant positive associations from invisibility to depressive (𝛾 = 0.17, 95% CI= [0.08, 0.27]) and anxiety (𝛾 = 0.18, 95% CI= [0.06, 0.29]) symptoms. There was not a significant association with emotion regulation difficulties (𝛾 = 0.05, 95% CI= [-0.02, 0.12]).

Conclusion: Findings show that feeling invisible was prevalent and impactful for the psychological health of Black SGLM living with HIV. Researchers and clinicians dedicated to reducing mental health inequities facing these men should prioritize assessing and addressing this understudied form of intersectional stigma.

Background and Objectives

Existing literature have provided limited and inconsistent findings regarding disparities in mental health and mental health care utilization within racial and ethnic subgroups of sexual and gender minority adolescents (SGMA). This study aimed to investigate racial and ethnic disparities in mental health and mental health care utilization among SGMA.

Methods

Data from a large national sample of SGMA who participated in the 2022 LGBTQ National Teen Survey (N = 9,691) were analyzed. The risk of depression and anxiety was assessed using the Patient Health Questionnaire-4. Mental health care utilization was classified as: (1) received; (2) wished for but not received (indicating unmet mental health care needs); (3) neither wished for nor received.

Results

Compared to White SGMA, Black/African American SGMA were less likely to be at risk for anxiety (adjusted prevalence ratio [APR]=0.89, 95% confidence intervals [CIs]= 0.82-0.97). No significant racial and ethnic disparities in depression were observed among SGMA. Regarding mental health care utilization, Asian (adjusted relative risk ratio [ARRR]=2.07, 95% CIs=1.62-2.64), Black/African American (ARRR=1.80, 95% CIs=1.41-2.28), and Hispanic/Latine SGMA (ARRR=1.32, 95% CIs=1.16-1.51) were more likely to report unmet mental health care needs than White SGMA.

Conclusion

Despite the lack of major and consistent racial and ethnic differences in anxiety and depression risk documented in our sample, Asian, Black/African American, and Hispanic/Latine SGMA were more likely to have unmet mental health care needs than their White counterparts. This finding highlights the need to address barriers to mental health care for racial and ethnic minority SGMA.

In 2023, loneliness was declared an epidemic by the United States Surgeon General. The COVID-19 pandemic further exacerbated this threat to public health. A review of the literature identified no studies that explored the threat of loneliness among Black and Latino sexual minority men (BLSMM). The purpose of this study is to explore the experience of loneliness and isolation among BLSMM living in California and New York during the COVID-19 pandemic. In this qualitative descriptive study, we utilized in-depth, individual, semi-structured interviews as the primary source for data collection. Data were collected between August 2021 and December 2022 from 41 participants in California and New York. Interviews were recorded, transcribed verbatim, and analyzed using thematic content analysis. Participants ranged in age from 19-65 years, majority identifying as male (93%). Black participants comprised majority of the sample (73%), with Latinos accounted for 25%. Participants narratives revealed the COVID-19 quarantine measures exacerbated loneliness and isolation, which increased anxiety and depression. Quarantine measures limited participants ability to seek mental health support. In order to alleviate the effects of loneliness and isolation, many participants engaged in virtual social gatherings with friends and family or sought intimate connections with potential partners via web-based dating/“hook-up” applications. The desire for intimate connections resulted in engagement in high-risk sexual behaviors. These findings suggest that BLSMM experience loneliness due to COVID-19 quarantine measures, which significantly impacted their mental health. Further research is needed to explore these issues and to identify potential interventions to mitigate loneliness among this population.