Mental Health, Substance Use, and HIV Prevention Among Gay and Bisexual Men Among Kenya

Gay and bisexual men and other men who have sex with men (GBMSM) are disproportionately impacted by human immunodeficiency virus (HIV) in Kenya, and elsewhere in Sub-Saharan Africa. GBMSM face unique mental health (MH) and substance use barriers that negatively influence their ability to protect themselves from HIV. To examine the relationship between mental health/substance use and their potential influence on HIV prevention among GBMSM we conducted a secondary data analysis of qualitative data from the Uzima Bora research study. This study focused on the integration of mental health/substance use and HIV-related services for GBMSM living in Kisumu Kenya. Respondents shared that mental health and substance use challenges were associated with deprioritizing HIV prevention among GBMSM through four main thematic areas; (a) depression and loneliness, (b) substance use, (c) discriminatory stress, and (d) internalized homonegativity. These themes were identified after a thorough analysis of participants' responses from community charrettes. The findings from this analysis highlight the importance of addressing mental health and substance use challenges when conducting HIV prevention activities. The co-occurrence of mental health and substance use behaviors must be addressed together to improve HIV prevention strategies for GBMSM in Kenya.