Using an intersectionality-based approach to evaluate mental health services use among gay, bisexual and other men who have sex with men in Montreal, Toronto and Vancouver

Author:

Marbaniang IvanORCID,Moodie Erica E. M.,Latimer Eric,Skakoon-Sparling Shayna,Hart Trevor A.,Grace Daniel,Moore David M.,Lachowsky Nathan J.,Jollimore Jody,Lambert Gilles,Zhang TerriORCID,Dvorakova Milada,Cox Joseph,

Abstract

Abstract Aims To cope with homonegativity-generated stress, gay, bisexual and other men who have sex with men (GBM) use more mental health services (MHS) compared with heterosexual men. Most previous research on MHS among GBM uses data from largely white HIV-negative samples. Using an intersectionality-based approach, we evaluated the concomitant impact of racialization and HIV stigma on MHS use among GBM, through the mediating role of perceived discrimination (PD). Methods We used baseline data from 2371 GBM enrolled in the Engage cohort study, collected between 2017 and 2019, in Montreal, Toronto and Vancouver, using respondent-driven sampling. The exposure was GBM groups: Group 1 (n = 1376): white HIV-negative; Group 2 (n = 327): white living with HIV; Group 3 (n = 577): racialized as non-white HIV-negative; Group 4 (n = 91): racialized as non-white living with HIV. The mediator was interpersonal PD scores measured using the Everyday Discrimination Scale (5-item version). The outcome was MHS use (yes/no) in the prior 6 months. We fit a three-way decomposition of causal mediation effects utilizing the imputation method for natural effect models. We obtained odds ratios (ORs) for pure direct effect (PDE, unmediated effect), pure indirect effect (PIE, mediated effect), mediated interaction effect (MIE, effect due to interaction between the exposure and mediator) and total effect (TE, overall effect). Analyses controlled for age, chronic mental health condition, Canadian citizenship, being cisgender and city of enrolment. Results Mean PD scores were highest for racialized HIV-negative GBM (10.3, SD: 5.0) and lowest for white HIV-negative GBM (8.4, SD: 3.9). MHS use was highest in white GBM living with HIV (GBMHIV) (40.4%) and lowest in racialized HIV-negative GBM (26.9%). Compared with white HIV-negative GBM, white GBMHIV had higher TE (OR: 1.71; 95% CI: 1.27, 2.29) and PDE (OR: 1.68; 95% CI: 1.27, 2.24), and racialized HIV-negative GBM had higher PIE (OR: 1.09; 95% CI: 1.02, 1.17). Effects for racialized GBMHIV did not significantly differ from those of white HIV-negative GBM. MIEs across all groups were comparable. Conclusions Higher MHS use was observed among white GBMHIV compared with white HIV-negative GBM. PD positively mediated MHS use only among racialized HIV-negative GBM. MHS may need to take into account the intersecting impact of homonegativity, racism and HIV stigma on the mental health of GBM.

Publisher

Cambridge University Press (CUP)

Reference83 articles.

1. Inter-group and intraminority-group discrimination experiences and the coping responses of Latino sexual minority men living with HIV;MacCarthy;Annals of LGBTQ Public and Population Health,2021

2. Intersectional microaggressions and social support for LGBTQ persons of color: A systematic review of the Canadian-based empirical literature;Sadika;Journal of GLBT Family Studies,2020

3. Racial differences in physical and mental health: Socio-economic status, stress and discrimination;Williams;Journal of Health Psychology,1997

4. Government of Canada (2023c) Police-reported hate crime in Canada, 2021. https://www150.statcan.gc.ca/n1/pub/11-627-m/11-627-m2023026-eng.htm (accessed 12 April 2023 ).

5. Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons;Burgess;Journal of LGBT Health Research,2007

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