Diverse Rates of Depression Among Men Who Have Sex with Men (MSM) Across India: Insights from a Multi-site Mixed Method Study

Tomori, Cecília; McFall, Allison M.; Srikrishnan, Aylur K.; Mehta, Shruti H.; Solomon, Sunil S.; Anand, Sam; Vasudevan, Canjeevaram K.; Solomon, Suniti; Celentano, David D.

doi:10.1007/s10461-015-1201-0

Cited by 50 publications

(61 citation statements)

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“…Existing literature shows MSM and transgenders/ hijras are vulnerable to mental health issues and physical violence from families, sexual partners and legal authorities and that this can be a barrier to PrEP (Chakrapani, Newman, Shunmugam, Logie, & Samuel, 2015; Mimiaga et al, 2013; Sivasubramanian. et al, 2011; Thomas et al, 2011; Thomas et al, 2009b; Tomori et al, 2016). These factors could further invisibilize Indian MSM and trangenders/ hijras , adding to their HIV vulnerability by increasing their closetedness.…”

Section: Introductionmentioning

confidence: 98%

“…Indian Men who have sex with men (MSM) and transgenders/ hijras are disproportionately impacted by HIV due to limited awareness of HIV, socio-cultural stigma associated with same-sex attraction and gender nonconformity (Kumta et al, 2010; National AIDS Control Organization, 2011; Thomas et al, 2011; Tomori et al, 2016) and criminalization (“Koushal v NAZ Foundation,” 2013). Existing literature shows MSM and transgenders/ hijras are vulnerable to mental health issues and physical violence from families, sexual partners and legal authorities and that this can be a barrier to PrEP (Chakrapani, Newman, Shunmugam, Logie, & Samuel, 2015; Mimiaga et al, 2013; Sivasubramanian.…”

Section: Introductionmentioning

confidence: 99%

“…In India, much of the HIV intervention research and practice has focused on MSM and transgenders/ hijras with more traditional identities and who meet male sex partners offline (Kumta et al, 2010; Mimiaga et al, 2013; Safren et al, 2006; Setia et al, 2006; Sivasubramanian et al, 2011; Thomas et al, 2011; Thomas et al, 2009a; Tomori et al, 2016). There is less focus on MSM with emerging gay/bisexual identities, who are also potentially more likely to meet men on virtual cruising sites, their mostly higher income and education potentially affording them access to the internet and mobile technology.…”

Section: Introductionmentioning

confidence: 99%

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Sexual identity and behavior in an online sample of Indian men who have sex with men

et al. 2016

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Indian men who have sex with men are disproportionately impacted by HIV. While prevention efforts to date have focused on men who visit drop-in centers or physical cruising sites, little is known about men who are meeting sexual partners on virtual platforms. This paper explores issues related to sexual identity and sexual behaviors in an online sample of men who identified as gay (n=279) or bisexual (n=123). There were significant differences in outedness between the two groups, with 48% of bisexually-identified men reporting that they were out to “no one” and 82% stating that they present themselves as heterosexual to family and friends. Corresponding rates for gay-identified men were 15% and 41%, respectively (both p <0.001). Twenty-nine percent of bisexually-identified men reported being married, compared to only 3% of the gay-identified men (p< 0.001). Bisexually-identified men were also more likely to report having exclusively insertive anal sex (49% vs 30% p< 0.001), while gay-identified men were more likely to report exclusively receptive anal sex (41% vs 13% p< 0.0001). Rates of unprotected anal sex in the two groups was similar, however married men were significantly more li kely to report unprotected vaginal sex (76% vs 35%, p <0.012). Positive attitudes toward unprotected anal sex and lower self-efficacy were associated with sexual risk in both groups, however, substance use was associated with sexual risk only among bisexually-identified men. These findings show that a large proportion of Indian bisexually-identified men lead closeted lives, especially in their interactions with friends and family, with the vast majority presenting as heterosexual. The lower condom use with wives may be due to societal pressures to have children. The results suggest that bisexually-identified men may benefit from targeted programs and non-directive, non-judgmental individual or couples counseling which emphasizes condom use with both male and female partners.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sexual identity and behavior in an online sample of Indian men who have sex with men

et al. 2016

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“…A qualitative study with sexual minority women found that isolation, anxiety, high substance use, and suicidal thoughts were common themes in these women's experiences. 35 Prevalence rates for depression, substance abuse and dependence, anxiety, and other psychiatric conditions from varied studies [36][37][38][39][40][41][42][43][44][45][46][47][48][49] are described in Table 1. Badgett 25 stated that in the absence of studies providing a comparable estimate for non-LGBTQIA+ people in India, the population prevalence of a condition can be used as a benchmark.…”

Section: Prevalence Of Mental Health Conditionsmentioning

confidence: 99%

What Do We Know About LGBTQIA+ Mental Health in India? A Review of Research From 2009 to 2019

Wandrekar¹,

Nigudkar²

2020

Journal of Psychosexual Health

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Background: The period from 2009 to 2019 has seen a lot of conversation about issues of LGBTQIA+ (lesbian, gay, bisexual, transgender, queer/ questioning, intersex, asexual, and others) individuals in India, but they continue to be a group showing poor health equity. Objective: This descriptive content review attempted to explore 5 questions: what is the nature of existing research on mental health of LGBTQIA+ individuals, what are the pathways that contribute to mental health issues, whether the existing health facilities mitigate or facilitate these pathways, what are the interventions proposed for this group, and what are the gaps in research that can be addressed in the next decade. Method: “Mental health aspects” were described as variables relevant to understanding individuals’ cognitions, emotions, and behavior. We searched for literature in online journal databases, in archives of the most prominent journals, on websites of prominent LGBTQIA+ organizations, and through cross-referencing of papers obtained. The data were abstracted and coded into themes and subthemes. We found 22 reviews and reports, 4 viewpoints and comments, 7 editorials, 1 conference proceeding, and 60 original articles. Conclusions: Prevalence studies reveal that LGBTQIA+ individuals were found to show high rates of mental health concerns, and that the adapted minority stress model may be a crucial pathway for the same. Lived experiences, factors related to mental well-being, and societal attitudes have also been studied. Intervention studies are relatively fewer, and certain subgroups of LGBTQIA+ identities are less represented in research. Gaps in research were identified and recommendations for research in the coming decade were proposed.

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“…While male-to-male sexual contact is common and may not be considered homosexuality (Asthana & Oostvogels, 2001; Khan, 2001; Verma & Collumbien, 2004), identifying as a homosexual and gender non-conformity in behavior or appearance continues to be highly stigmatized (Logie, Newman, Chakrapani, & Shunmugam, 2012; Mimiaga et al, 2014; Sivasubramanian et al, 2011; B. Thomas et al, 2012; Thomas et al, 2009; Tomori et al, 2015). Moreover, cultural norms of masculinity demand marriage to a woman and the procreation of children, leading many MSM to marry and keep their sexual behavior hidden (Asthana & Oostvogels, 2001; Chakrapani, Boyce, & Dhanikachalam, 2011; Chakrapani, Newman, Shunmugam, & Dubrow, 2011; Kumta et al., 2010; Mimiaga et al, 2014; A.…”

Section: Introductionmentioning

confidence: 99%

Friends, Sisters, and Wives: Social Support and Social Risks in Peer Relationships Among Men Who Have Sex With Men (MSM) in India

Tomori

Srikrishnan

Ridgeway

et al. 2016

AIDS Education and Prevention

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Globally men who have sex with men (MSM) are at high risk for HIV. Many HIV-prevention efforts rely on community outreach and mobilization to engage MSM. This study examines peer relationships and their potential role in HIV-prevention through 31 focus group discussions (FGDs) and 121 in-depth interviews (IDIs) with 363 MSM across 15 sites in India. Results indicate that MSM receive social support in friendships, sex-worker collaborations, constructed kin relationships, and romantic partnerships. Access to these relationships, however, is uneven across MSM, and can carry risks of disclosure of same-sex behavior and exclusion based on HIV-positive status. Positive peer relationships can serve as the basis of community empowerment, education and couple-based interventions for MSM, and peer counselors can also provide a buffer against the social risks of peer relationships and facilitate linkage to care and continued engagement in treatment. These insights can improve HIV-interventions for MSM in India and elsewhere.

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Diverse Rates of Depression Among Men Who Have Sex with Men (MSM) Across India: Insights from a Multi-site Mixed Method Study

Cited by 50 publications

References 59 publications

Sexual identity and behavior in an online sample of Indian men who have sex with men

Sexual identity and behavior in an online sample of Indian men who have sex with men

What Do We Know About LGBTQIA+ Mental Health in India? A Review of Research From 2009 to 2019

Friends, Sisters, and Wives: Social Support and Social Risks in Peer Relationships Among Men Who Have Sex With Men (MSM) in India

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