“When you talk it out … you will feel like the burden has somehow gone down, you will feel light”: Social Support Received by Gay, Bisexual, and Other Men Who Have Sex with Men in Western Kenya

Abstract

Gay and bisexual men and other men who have sex with men (GBMSM) experience many sexual orientation-related stressors that negatively influence physical and mental health, making it imperative to understand their experiences of resilience-promoting resources such as social support. We utilized qualitative and participatory methodologies to examine sources of social support and types of social support received by GBMSM in Western Kenya through in-depth interviews with 60 GBMSM, including both peer educators and community members. GBMSM received emotional, informational, and instrumental support from six different relationship types: friends and peer groups, family of origin, sexual and romantic partners, healthcare providers, peer educators, and other people including work colleagues and police officers. A key finding from this study is the centrality of sexuality-specific support across all sources and types of support. Implications for clinics and LGBTQ organizations, policy, and future research are discussed.

“You’ll Be Chased Away”: Sources, Experiences, and Effects of Violence and Stigma among Gay and Bisexual Men in Kenya

“…Findings from this study could also be used to inform resilience-promotion interventions based on the identification of interpersonal and institutional resources from which Kenyan gay and bisexual men are not receiving adequate support. For example, peer support is beneficial for well-being [33,42], but participants in this study described significant challenges to maintaining strong friendships (i.e., being cut off by friends after coming out). As such, an intervention designed to strengthen the social connections of Kenyan gay and bisexual men could buffer the impact of stigma from other sources, as described by the Minority Stress Model [19].…”

“…In line with this approach, conceptual 'outliers' are not silenced but rather presented in the findings along with themes discussed by a larger majority of participants to ensure that all voices are included [35,39]. This analytic approach has been utilized in other studies focused on the lived experiences of gay and bisexual men in Kenya [27,33].…”

“…The socio-ecological model is a useful tool for the conceptualization of the multifaceted stigma faced by Kenyan gay and bisexual men, as well as the resilience assets and resources which may serve as a buffer between this stigma and associated negative health outcomes [18,[30][31][32]. Examining elements of stigma or resilience at different socioecological levels not only provides a deeper understanding of the phenomenon, but also may facilitate the creation of interventions which target specific levels to improve health outcomes [27,33]. For example, Harper et al [30] found that perceived social support was associated with condom use and higher self-esteem among GBMSM in western Kenya.…”

“…In addition to a socio-ecological approach, a qualitative phenomenological approach is used to focus directly on the voices and experiences of community members. Qualitative approaches have been used in other studies and reports on the health of Kenyan GBMSM and have highlighted the impact of topics such as access to affirming healthcare [34], intrapersonal resilience assets [27], social and familial support [33,34], and interpersonal violence [1,2]. This paper is unique in that the combined socio-ecological, qualitative, and phenomenological approaches will identify areas for intervention at the interpersonal and institutional levels by identifying sources of stigma and describing the manifestations and effects of this stigma in the lives of community members.…”

Listening to the Voices of Gay and Bisexual Men and Other Men Who Have Sex with Men in Kenya: Recommendations for Improved HIV Prevention Programming

“…Research focused on HIV prevention for GBMSM in Kenya suggests that engagement with community-based organizations and GBMSM Community Members can improve the effectiveness of these efforts (Graham et al, 2018;Doshi et al, 2021). Young GBMSM in Kenya often experience limited social support yet experience intense social and structural stigma (Kunzweiler et al, 2018;Jadwin-Cakmak et al, 2022). In order for these various health promotion efforts to be the most effective, they need to actively engage young GBMSM in their development and execution.…”