Kathy Trang1, An Thanh Ly2, Le Xuan Lam3, Carolyn A Brown4, Margaret Q To5, Patrick S Sullivan4, Carol M Worthman6, Le Minh Giang3, Tanja Jovanovic7. 1. Institute of Human Development and Social Change, New York University, New York, NY, United States. Electronic address: kt2455@nyu.edu. 2. Australian Research Center in Sex, Health and Society, LaTrobe University, Melbourne, Australia; Department of Global Health, School of Preventive Medicine and Public Health, Hanoi Medical University, Viet Nam. 3. Center for Training and Research on Substance Abuse-HIV, Hanoi Medical University, Ha Noi, Viet Nam. 4. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States. 5. Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, United States. 6. Department of Anthropology, Emory University, Atlanta, GA, United States. 7. Department of Psychiatry and Behavioral Neuroscience, School of Medicine, Wayne State, University, Detroit, MI, United States.
Abstract
INTRODUCTION: Globally, men who have sex with men (MSM) experience a disproportionate burden of mental health issues. While HIV service providers may possess the skills and relationships to provision mental health and psychosocial support (MHPSS) to this population, task-sharing models that integrate MHPSS into HIV contexts remain limited. The aim of this study was to explore the sociodemographic, psychological, and structural factors operant at the client and HIV service provider levels that shape MHPSS access and burden among MSM and opportunities for integration in Vietnam. METHODS: Between June and August 2018, semi-structured interviews were conducted with 20 MSM and 13 service providers at out-patient clinics (OPCs) and community-based organizations (CBOs) in Hanoi, Vietnam. Interviews explored participants' understandings of and experiences with the signs, causes, and appropriate treatments for mental health concerns; and perceived barriers to MHPSS integration in HIV contexts. Data were coded thematically and analyzed in MAXQDA. RESULTS: Most MSM did not view their mental distress as constituting illness or as warranting clinical attention. Specifically, terms like "mental illness" were often associated with being "crazy" or immoral, while symptoms of distress were interpreted as having to do with everyday difficulties associated with being MSM and/or HIV-positive. Due to mental health stigma, MSM were reluctant to access services while service providers were similarly reluctant to query about needs. Few service providers knew where to refer patients for MHPSS, and none had done so previously. Most service providers reported lacking the human capital, expertise, and funding to address MHPSS needs. CONCLUSIONS: Our findings suggest that aside from mental health stigma, future integration strategies must address competing demands and incentivization structures, limitations in existing mental health infrastructure and funding, misperceptions around MHPSS needs and symptoms, and opportunities to streamline MHPSS with existing CBO activities to strengthen community wellbeing.
INTRODUCTION: Globally, men who have sex with men (MSM) experience a disproportionate burden of mental health issues. While HIV service providers may possess the skills and relationships to provision mental health and psychosocial support (MHPSS) to this population, task-sharing models that integrate MHPSS into HIV contexts remain limited. The aim of this study was to explore the sociodemographic, psychological, and structural factors operant at the client and HIV service provider levels that shape MHPSS access and burden among MSM and opportunities for integration in Vietnam. METHODS: Between June and August 2018, semi-structured interviews were conducted with 20 MSM and 13 service providers at out-patient clinics (OPCs) and community-based organizations (CBOs) in Hanoi, Vietnam. Interviews explored participants' understandings of and experiences with the signs, causes, and appropriate treatments for mental health concerns; and perceived barriers to MHPSS integration in HIV contexts. Data were coded thematically and analyzed in MAXQDA. RESULTS: Most MSM did not view their mental distress as constituting illness or as warranting clinical attention. Specifically, terms like "mental illness" were often associated with being "crazy" or immoral, while symptoms of distress were interpreted as having to do with everyday difficulties associated with being MSM and/or HIV-positive. Due to mental health stigma, MSM were reluctant to access services while service providers were similarly reluctant to query about needs. Few service providers knew where to refer patients for MHPSS, and none had done so previously. Most service providers reported lacking the human capital, expertise, and funding to address MHPSS needs. CONCLUSIONS: Our findings suggest that aside from mental health stigma, future integration strategies must address competing demands and incentivization structures, limitations in existing mental health infrastructure and funding, misperceptions around MHPSS needs and symptoms, and opportunities to streamline MHPSS with existing CBO activities to strengthen community wellbeing.
Authors: Antonio Lora; Robert Kohn; Itzhak Levav; Ryan McBain; Jodi Morris; Shekhar Saxena Journal: Bull World Health Organ Date: 2011-10-31 Impact factor: 9.408
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Authors: Brent D Fulton; Richard M Scheffler; Susan P Sparkes; Erica Yoonkyung Auh; Marko Vujicic; Agnes Soucat Journal: Hum Resour Health Date: 2011-01-11
Authors: Kathy Trang; Lam X Le; Carolyn A Brown; Margaret Q To; Patrick S Sullivan; Tanja Jovanovic; Carol M Worthman; Le Minh Giang Journal: JMIR Form Res Date: 2022-01-27