Exploring Minority Stress Outcomes Following Receipt of Motivational Interviewing Among Sexual Minority Men with Histories of Sexual Trauma

Minority stress contributes to worse mental health among sexual minority men (SMM). However, minority stress measurement is absent from most clinical trials and rarely examined as a treatment outcome. For this study, we analyzed data from an existing comparative effectiveness trial of group-based, peer-delivered Motivational Interviewing (MI) using the standard protocol versus MI plus affirmative care for trauma and minority stress (MI+AC). Participants (N = 354) were sexual trauma-exposed SMM who screened positive for depression at baseline, randomized 1:1 MI (n = 178) or MI+AC (n = 176). Minority stress was assessed at baseline, posttreatment, and two- and four-month follow-up. We did not observe any significant time by treatment condition interactions, suggesting similar effects between treatment conditions. However, significant main effects of time suggest significant decreases in expected discrimination and expected rejection from family as well as increases in internalized homophobia toward others in both treatment conditions. Peer-delivered MI may contribute to reductions in certain proximal minority stress processes among SMM with sexual trauma. Future research should assess minority stress as a primary outcome, and as a potential mechanism of change regarding other primary psychiatric outcomes.