Examining How Health Navigation Affects Mental Health Among Gay, Bisexual, and Other Men Who Have Sex with Men Living with Human Immunodeficiency Virus in Guatemala

Abstract

Gay, bisexual, and other men who have sex with men (GBMSM) are disproportionately affected by mental health problems and human immunodeficiency virus (HIV). Health navigation has the potential to improve both HIV and mental health outcomes; however, few studies have measured the impact of navigation on mental health among people living with HIV. We analyzed longitudinal data from a sociobehavioral survey and navigation monitoring system with GBMSM living with HIV in Guatemala (n = 346) that participated in a 12-month differentiated care intervention. We examined relationships between navigation characteristics (frequency, duration, mode of interactions, and level of emotional, instrumental, and informational navigation support) and anxiety and depression using fixed-effects regression. We also examined if these relationships were moderated by baseline social support. We found that as navigation interactions increased, anxiety significantly improved [B = -0.03, standard error (SE) = 0.01 p = 0.05]. Participants who received high levels of informational navigator support also experienced a significant improvement in anxiety compared with those receiving low levels of informational support (B = -0.81, SE = 0.40, p = 0.04). Unexpectedly, we found that as the proportion of in-person navigation interactions increased, anxiety worsened (B = 1.12, SE = 0.54, p = 0.04). No aspects of navigation were significantly associated with depression and baseline social support did not moderate the relationship between navigation and anxiety and depression. To improve the mental health of key populations affected by HIV, health navigation programs should prioritize frequent interaction and informational navigation support for clients with anxiety while considering other strategies that specifically target reducing depressive symptoms, including other cost-effective modalities, such as mobile apps.

“They treat us as equals, they guide us”: peer navigation for HIV care engagement with men who have sex with men and transgender women in Lima, Peru

“…Consistente con métodos cualitativos, es decir, los resultados hallados no son generalizables a todo usuario con VIH, pero son similares a lo encontrado, por ejemplo, en otros estudios sobre programas de navegación con HG en Guatemala y con poblaciones de origen latino en EE. UU que incluían HG y MT (32,33) . Los usuarios que se entrevistaron para el presente estudio estaban vinculados a la atención médica, por lo que no tenemos evidencia de las percepciones de HSH y MT que no se vincularon o abandonaron el cuidado.…”

Integrating HIV and Mental Health Services for Black Gay, Bisexual, and Other Men Who Have Sex with Men Living with HIV: Findings from the STYLE 2.0 Intervention

“…Similar results were reported by a health navigator intervention among MSM in Guatemala, which also found that clients who required more support from navigators and external sources experienced worse HIV and mental health outcomes. 57 Additional research is needed to determine if and how integrated HIV and behavioral health services can ensure that individuals who are referred to external services receive the support they need to achieve and maintain viral suppression.…”

HIV Treatment and Mental Health Outcomes Among Gay, Bisexual, and Other Men Who Have Sex With Men Living With HIV in a Pilot Multicomponent Intervention in Guatemala City

“…Navigation interactions occurred in person, through phone conversations, and through virtual texting/chatting. Additional details of the navigation component are described elsewhere (Alvis-Estrada et al, 2021; Davis, Angeles, et al, 2021).…”

“…We used monitoring data from the study psychologist and the navigation monitoring system to create measures of intervention participation (Alvis-Estrada et al, 2021; Davis, Angeles, et al, 2021).…”