Proximal and distal minority stressors and mental health among young gay and bisexual men and other men who have sex with men (GBMSM) in Kisumu, Kenya

Abstract

Young gay and bisexual men and other men who have sex with men (GBMSM) inKenya experience pervasive intersectional stigma and discrimination, contribut-ing to elevated levels of negative mental health symptoms. Grounded in theMinority Stress Model, this paper explores associations of proximal and distalminority stressors with three types of negative mental health outcomes amongyoung HIV‐negative GBMSM (n = 63) between the ages of 19–34 who partici-pated in a pilot trial of a sexual health intervention. Using the PHQ‐9, GAD‐7,and PC‐PTSD‐5 screening measures, levels of clinically significant symptoms werereported as follows: 15.8% depressive symptoms, 12.7% anxiety symptoms, 31.7%posttraumatic stress symptoms. Results from stepwise linear regression analysessuggest that GBMSM‐related stigma (distal stressor) was the strongest correlatefor all three mental health outcomes, and concealment motivation (proximalstressor) was an additional significant correlate only in the depressive symptomsmodel. These findings should be viewed with caution and seen as initial obser-vations given the small sample which limits our interpretations of the findings.Structural‐level interventions are needed to decrease GBMSM's exposure tointersectional stigma and discrimination, such as decriminalization of same‐sexsexual activity, as well as individual and group‐level interventions that assistGBMSM with improving their adaptive coping strategies.