Mental health in 2020 for men who have sex with men in the United States

Abstract

Despite continued advances in HIV prevention and treatment, gay and bisexual men and other men who have sex with men (MSM) remain the population most impacted by HIV/AIDS in the US and many other Western countries. Additionally, MSM are disproportionately affected by various psychological problems, including depression, distress, trauma and substance use. These challenges frequently co-occur, and are associated with higher rates of behaviours related to HIV acquisition and transmission, HIV infection, and, for those living with HIV/AIDS, lower levels of treatment engagement. Moreover, racial disparities exist among MSM in the US; for example, young African American MSM bear a disproportionate burden of the continuing HIV epidemic, likely related to disparate HIV prevalence in partner pools as well as long-standing structural inequities. In this review, the mental health challenges facing MSM primarily in the US, related to HIV and STI prevention and across the HIV care cascade, including HIV diagnosis, engagement and retention in care, and antiretroviral adherence, are illustrated. Disparities among MSM including racial and ethnic, age-related and structural barriers associated with HIV prevention and treatment, as well as current interventions, are also described. Moving forward towards 2020, resources will be needed to assess and implement scalable intervention strategies to address psychological and social barriers to HIV and STI risk reduction and treatment for MSM, with a particular focus on the most vulnerable subpopulations. As access to prevention and treatment strategies expand, and new breakthroughs continue to emerge, behavioural strategies will continue to be needed to reduce risk and increase uptake and engagement among MSM most at risk through 2020 and beyond.

Alcohol and cocaine use among Latino and African American MSM in 6 US cities

“…Other studies have documented high rates of depression, distress and post-traumatic stress disorder (PTSD) among MSM populations (Marshall et al, 2015a; McCabe, Hughes, Bostwick, West, & Boyd, 2009; Rutledge et al, 2016). Thus, there is a growing consensus that many MSM face co-occurring mental health and substance use disorders which warrant integrated treatment approaches (Batchelder, Saften, Mitchell, Ivardic, & O'Cleirigh, 2017). Furthermore, the increased HIV burden, both in terms of HIV risk and HIV acquisition, among AA MSM and LMSM may exacerbate the vulnerability to mental health problems (Bedoya, Mimiaga, Beauchamp, et al, 2012).…”

2020, sexually transmissible infections and HIV in gay, bisexual and other men who have sex with men

“…5 Despite GBM having a large burden of HPV disease, it is unlikely they will see the same benefits as those seen in heterosexuals. Oncogenic HPV has all but disappeared in heterosexuals in Australia, and similar marked falls in HPV-related cancers will likely follow.…”

“…Another factor that is operating against effective STI and HIV control is the high prevalence of mental health problems 5 among some GBM attributed to sexual minority stress. In addition to being a significant health problem in its own right, poor mental health is associated with HIV acquisition, as well as lower treatment uptake.…”

A tale of two epidemics: gay men's mental health and the biomedicalisation of HIV prevention and care in Toronto

“…HIV is considered to be an essential factor behind GBM mental health disparities (Batchelder et al . ).…”

“…These mental health disparities are even greater amongst GBM living with HIV (Batchelder et al . , Heywood and Lyons ). GBM remain disproportionately affected by HIV, representing over half (55.5%) of the HIV incidence in Canada in 2016 (Public Health Agency of Canada ).…”