A Qualitative Study on Unmet Mental Health Needs of Indian Human Immunodeficiency Virus-positive Men Who Have Sex with Men

Abstract

Background: The prevalence of human immunodeficiency virus (HIV) infection in the population of men who have sex with men (MSM) in India is higher than that of the general population, making them one of the high-risk population groups. This subgroup is also at a higher risk for mental disorders, substance use, and stigma due to their MSM status. There is a paucity of data about this in the Indian HIV-positive MSM subgroup. Aim: The study aimed to explore the understanding of “mental health” among MSM living with HIV and bring forth their unmet mental health needs. Methods: The study used a qualitative design with purposive sampling. Seven people living with HIV from a randomly selected antiretroviral therapy center in Mumbai, who identified as MSM, participated in the study. Data were collected through focus group discussion, audio recorded with consent, and then a thematic analysis of the transcript was done. Results: The responses were summarized into four broad categories – mental health problems, psychosocial and economic problems, philosophical conflicts, and coping strategies. The categories further generated multiple themes. Themes such as worries about the illness, fear of impending death, low self-esteem, stigma around HIV and homosexuality, and perceived and experienced discrimination were recurrent. Mental illness was perceived as an additional burden to their already existing health problem. Conclusion: This study provided a deeper understanding of the unmet mental health needs and psychosocial challenges faced by the HIV-infected Indian MSM. It may help the policymakers of the country to modify the existing health and social benefit schemes.