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Garnering an In-depth Understanding of Men Who Have Sex with Men in Chennai, India: A Qualitative Analysis of Sexual Minority Status and Psychological Distress

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Abstract

Men who have sex with men (MSM) in India are a hidden and largely understudied population, and have an HIV prevalence 17 times higher than that of the general Indian population. Experiences of social marginalization and negative psychosocial conditions occur concurrent to HIV risk among Indian MSM. To better understand the contextual variables driving HIV risk and inform intervention development, five focus groups (n = 46) and nine key informant interviews were conducted with 55 MSM in Chennai in 2010. NVivo software was used to code the transcripts, and data were analyzed using qualitative descriptive analysis methodology. Participants described sources of psychological distress and low self-worth related to gender non-conformity and sexual minority status. These included stigma from society, pressure to marry, lack of familial acceptance, childhood sexual abuse, and the imperative to keep sexual minority status a secret. Participants’ personal evaluations revealed that self-acceptance may be an important resilience factor that can shield these psychosocial and HIV risk factors. In promoting health-seeking behavioral changes for Indian MSM at an individual level, our findings point to the potential strength of strategies that focus on self-acceptance of one’s sexual minority identity to foster better psychosocial and overall health.

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Acknowledgments

This project was supported by the Indo-U.S. Joint Working Group on Prevention of Sexually Transmitted Diseases and HIV/AIDS through U.S. National Institute of Mental Health grant #R21 MH085314-01 (Steven A. Safren, PI) and Indian Council of Medical Research grant #Indo-U.S./41/2007-ECD-II (Beena Thomas, PI).

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Authors and Affiliations

  1. Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Behavioral Medicine, 1 Bowdoin Square, 7th Floor, Boston, MA, 02114, USA

    Matthew J. Mimiaga & Steven A. Safren

  2. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Matthew J. Mimiaga

  3. The Fenway Institute, Fenway Health, Boston, MA, USA

    Matthew J. Mimiaga, Elizabeth F. Closson, Kenneth H. Mayer & Steven A. Safren

  4. National Institute for Research in Tuberculosis, Chennai, India

    Beena Thomas

  5. Division of Infectious Diseases, Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, MA, USA

    Kenneth H. Mayer

  6. Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA

    Kenneth H. Mayer & Theresa Betancourt

  7. Sahodaran, Chennai, India

    Sunil Menon

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  1. Matthew J. Mimiaga
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  2. Elizabeth F. Closson
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  3. Beena Thomas
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  7. Steven A. Safren
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Correspondence to Matthew J. Mimiaga.

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Mimiaga, M.J., Closson, E.F., Thomas, B. et al. Garnering an In-depth Understanding of Men Who Have Sex with Men in Chennai, India: A Qualitative Analysis of Sexual Minority Status and Psychological Distress. Arch Sex Behav 44, 2077–2086 (2015). https://doi.org/10.1007/s10508-014-0369-0

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