Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA.
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
AIDS Patient Care STDS. 2021 Jan;35(1):9-14. doi: 10.1089/apc.2020.0202. Epub 2020 Dec 21.
Young Black gay, bisexual, and other men who have sex with men (YB-GBMSM) face multiple psychosocial stressors, and are disproportionately impacted by HIV. Mental health care engagement is a promising avenue for addressing these disparities. To date, rates of mental health service utilization have not been examined specifically in this population. We conducted a retrospective cohort study among YB-GBMSM receiving care in a Ryan White-funded HIV care center that includes co-located HIV and mental health services. Of 435 unique YB-GBMSM patients, mental health concerns were identified in = 191 (43.9%). Depressive symptoms were the most common concerns identified, followed by substance use, anxiety, and trauma. Among patients with identified mental health concerns who were not previously in mental health care, 79.1% were referred to mental health care, 56.3% set an appointment with a mental health provider, 40.5% were linked to mental health care (attended an initial visit), and 19.6% remained engaged in mental health care. Younger YB-GBMSM (age 18-24 years), who received care in a more integrated pediatric/adolescent part of the center, were more likely to have an appointment set once a concern was identified ( = 7.17; = 0.007). Even in a setting with co-located HIV and mental health care services, we found significant gaps in engagement at each stage of a newly described mental health care continuum. Implications for intervention at the provider and systems levels are discussed.
年轻的黑人男同性恋、双性恋和其他与男性发生性关系的男性（YB-GBMSM）面临着多种社会心理压力，并且不成比例地受到艾滋病毒的影响。心理健康护理的参与是解决这些差异的一个有前途的途径。迄今为止，尚未专门在这一人群中检查心理健康服务的利用率。我们在一个接受 Ryan White 资助的艾滋病毒护理中心接受护理的 YB-GBMSM 中进行了一项回顾性队列研究，该中心包括艾滋病毒和心理健康服务的联合服务。在 435 名独特的 YB-GBMSM 患者中，有 191 名（43.9%）确定了心理健康问题。最常见的问题是抑郁症状，其次是药物使用、焦虑和创伤。在有确定的心理健康问题且以前没有接受过心理健康护理的患者中，79.1%被转介到心理健康护理，56.3%与心理健康提供者预约，40.5%与心理健康护理联系（接受了首次就诊），19.6%继续接受心理健康护理。年龄在 18-24 岁的年轻 YB-GBMSM（年龄在 18-24 岁），在中心更整合的儿科/青少年部分接受护理，一旦确定存在问题，更有可能预约（=7.17；=0.007）。即使在 HIV 和心理健康护理服务联合的环境中，我们也发现了在新描述的心理健康护理连续体的每个阶段的参与度存在显著差距。讨论了在提供者和系统层面进行干预的意义。
