Advertisement

Substance Use and Depression Among Recently Migrated African Gay and Bisexual Men Living in the United States

  • Adedotun Ogunbajo
  • Chukwuemeka Anyamele
  • Arjee J. Restar
  • Curtis Dolezal
  • Theodorus G. M. SandfortEmail author
Original Paper

Abstract

Immigrant African gay and bisexual men (GBM) are at risk for substance use and adverse mental health outcomes due to negative experiences in home and host countries. Little is known about correlates of substance use and mental health outcomes in this population. We explored pre- and post-migratory factors associated with substance use and depression in recently migrated African GBM. Participants (N = 70) were recruited between July and November 2015 in NYC. Eligible participants were administered a structured questionnaire. Correlates of substance use and depression were identified using bivariate and multivariable analyses. Factors independently associated with current substance use were age, openness about sexual orientation, homophobic experiences in home country, forced sex in home country, current housing instability, and internalized homophobia. Factors independently associated with depression were post-traumatic stress disorder symptoms and alcohol use. Substance use and depression were associated with negative experiences in home and host country.

Keywords

African gay and bisexual immigrants Substance use Mental health Immigrant health 

Notes

Acknowledgements

The research team would like to acknowledge the brave participants who shared their stories and experiences with us. This research was supported by an HIV Center Pilot grant and a National Institute of Mental Health (NIMH) center grant (P30-MH43520; principal investigator [PI]: Robert H. Remien, PhD). Dr. Anyamele is supported by an NIMH training grant (T32-MH19139 Behavioral Sciences Research in HIV Infection; PI: Theodorus G.M. Sandfort, PhD). Mr. Ogunbajo contributions to this paper were supported by NIMH (R25-MH083620; PI: Amy Nunn, PhD), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (P2C-HD041020; PI: Susan Short, PhD), and the Robert Wood Johnson Foundation Health Policy Research Scholars Program.

Compliance with Ethical Standards

Conflict of interest

No competing financial interests exist.

References

  1. 1.
    Gambino CP, Trevelyan EN, Fitzwater, JT. The foreign-born population from Africa. 2008–2012. 2014: US Department of Commerce, Economic and Statistics Administration, US Census Bureau.Google Scholar
  2. 2.
    Hopkinson RA, Keatley E, Glaeser E, Erickson-Schroth L, Fattal O, Sullivan MN. Persecution experiences and mental health of LGBT asylum seekers. J Homosex. 2017;64(12):1650–66.PubMedCrossRefGoogle Scholar
  3. 3.
    Alessi EJ, Kahn S, Chatterji S. ‘The darkest times of my life’: recollections of child abuse among forced migrants persecuted because of their sexual orientation and gender identity. Child Abuse Negl. 2016;51:93–105.PubMedCrossRefGoogle Scholar
  4. 4.
    Alessi EJ, Kahn S, Van Der Horn R. A qualitative exploration of the premigration victimization experiences of sexual and gender minority refugees and asylees in the United States and Canada. J Sex Res. 2017;54(7):936–48.PubMedCrossRefGoogle Scholar
  5. 5.
    Alessi EJ, Kahn S, Woolner L, Van Der Horn R. Traumatic stress among sexual and gender minority refugees from the Middle East, North Africa, and Asia who fled to the European Union. J Trauma Stress. 2018.  https://doi.org/10.1002/jts.22346.PubMedCrossRefGoogle Scholar
  6. 6.
    Sandfort T, Anyamele C, Dolezal C. Correlates of sexual risk among recent gay and bisexual immigrants from Western and Eastern Africa to the USA. J Urban Health. 2017;94:330–8.PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    Bhugra D. Migration and mental health. Acta Psychiatr Scand. 2004;109(4):243–58.PubMedCrossRefGoogle Scholar
  8. 8.
    Kirmayer LJ, Narasiah L, Munoz M, Rashid M, Ryder AG, Guzder J, Hassan G, Rousseau C, Pottie K. Common mental health problems in immigrants and refugees: general approach in primary care. Can Med Assoc J. 2011;183(12):E959–67.CrossRefGoogle Scholar
  9. 9.
    Johnson TP, Vangeest JB, Cho YI. Migration and substance use: evidence from the US National Health Interview Survey. Subst Use Misuse. 2002;37(8–10):941–72.PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Grant BF, Stinson FS, Hasin DS, Dawson DA, Chou SP, Anderson K. Immigration and lifetime prevalence of DSM-IV psychiatricdisorders among mexican americans and non-Hispanic whites in the United States: results from the national epidemiologic survey on alcohol and relatedconditions. Arch Gen Psychiatry. 2004;61(12):1226–33.CrossRefGoogle Scholar
  11. 11.
    Gee GC, Ryan A, Laflamme DJ, Holt J. Self-reported discrimination and mental health status among African descendants, Mexican Americans, and other Latinos in the New Hampshire REACH 2010 Initiative: the added dimension of immigration. Am J Public Health. 2006;96(10):1821–8.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Blake SM, Ledsky R, Goodenow C, O’donnell L. Recency of immigration, substance use, and sexual behavior among Massachusetts adolescents. Am J Public Health. 2001;91(5):794–8.PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Venters H, Adekugbe O, Massaquoi J, Nadeau C, Saul J, Gany F. Mental health concerns among African immigrants. J Immigr Minor Health. 2011;13(4):795–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Bourque F, van der Ven E, Malla A. A meta-analysis of the risk for psychotic disorders among first- and second-generation immigrants. Psychol Med. 2011;41(5):897–910.PubMedCrossRefGoogle Scholar
  15. 15.
    Meyer IH, Frost DM. Minority stress and the health of sexual minorities. In: Patterson CJ, D’Augelli AR, editors. Handbook of psychology and sexual orientation. Oxford: Oxford University Press; 2013. pp. 252–66.Google Scholar
  16. 16.
    Meyer IH. Minority stress and mental health in gay men. J Health Soc Behav. 1995;36:38–56.PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    McCabe SE, Bostwick WB, Hughes TL, West BT, Boyd CJ. The relationship between discrimination and substance use disorders among lesbian, gay, and bisexual adults in the United States. Am J Public Health. 2010;100(10):1946–52.PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Lea T, de Wit J, Reynolds R. Minority stress in lesbian, gay, and bisexual young adults in Australia: associations with psychological distress, suicidality, and substance use. Arch Sex Behav. 2014;43(8):1571–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Carroll A, Mendos LR. State-sponsored homophobia. Geneva: Ilga; 2017.Google Scholar
  20. 20.
    Kohut A, Wike R, Bell J, Horowitz JM, Simmons K, Stokes B, Poushter J, Ponce A, Gross EM, Barker C. The global divide on homosexuality. Washington, DC: Pew Research Center; 2013. p. 4.Google Scholar
  21. 21.
    Thoreson R, Cook S. Nowhere to turn: blackmail and extortion of LGBT people in Sub-Saharan Africa. New York: International Gay and Lesbian Human Rights Commission; 2011.Google Scholar
  22. 22.
    Baral S, Trapence G, Motimedi F, Umar E, Iipinge S, Dausab F, Beyrer C. HIV prevalence, risks for HIV infection, and human rights among men who have sex with men (MSM) in Malawi, Namibia, and Botswana. PLoS ONE. 2009;4(3):e4997.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Randazzo TJ. Social and legal barriers. Sexual orientation and asylum in the United States. In: Luibhèd E, Cantù L Jr., editors. Queer migrations. Sexuality, U.S. citizenship and border crossings. Minneapolis: University of Minnesota Press; 2005. pp. 30–60.Google Scholar
  24. 24.
    Casado BL, Hong M, Harrington D. Measuring migratory grief and loss associated with the experience of immigration. Res Soc Work Pract. 2010;20(6):611–20.CrossRefGoogle Scholar
  25. 25.
    Casado BL, Leung P. Migratory grief and depression among elderly Chinese American immigrants. J Gerontol Soc Work. 2002;36(1–2):5–26.CrossRefGoogle Scholar
  26. 26.
    Hershberger SL, D’augelli AR. The impact of victimization on the mental health and suicidality of lesbian, gay, and bisexual youths. Dev Psychol. 1995;31(1):65–74.CrossRefGoogle Scholar
  27. 27.
    Dandona L, Dandona R, Gutierrez JP, Kumar GA, McPherson S, Bertozzi SM, Asci FPP Study Team. Sex behaviour of men who have sex with men and risk of HIV in Andhra Pradesh, India. Aids 2005;19(6):611–9.PubMedCrossRefGoogle Scholar
  28. 28.
    Burgard SA, Seefeldt KS, Zelner S. Housing instability and health: findings from the Michigan Recession and Recovery Study. Soc Sci Med. 2012;75(12):2215–24.PubMedCrossRefGoogle Scholar
  29. 29.
    Sandfort T, Bos H, Knox J, Reddy V. Gender nonconformity, discrimination, and mental health among black South African men who have sex with men: A further exploration of unexpected findings. Arch Sex Behav. 2016;45(3):661–70.PubMedCrossRefGoogle Scholar
  30. 30.
    Lang AJ, Wilkins K, Roy-Byrne PP, Golinelli D, Chavira D, Sherbourne C, Rose RD. Bystritsky A, Sullivan G, Craske MG. Abbreviated PTSD Checklist (PCL) as a guide to clinical response. Gen Hosp Psychiatry. 2012;34(4):332–8.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Arch Intern Med. 1998;158(16):1789–95.PubMedCrossRefGoogle Scholar
  32. 32.
    Monahan PO, Shacham E, Reece M, Kroenke K, Ong’or WO, Omollo O, Yebei VN, Ojwang C. Validity/reliability of PHQ-9 and PHQ-2 depression scales among adults living with HIV/AIDS in western Kenya. J Gen Intern Med. 2009;24(2):189–97.PubMedCrossRefGoogle Scholar
  33. 33.
    First MB, Spitzer RL, Gibbon M, Williams JB. Structured clinical interview for DSM-IV axis I disorders. New York: New York State Psychiatric Institute; 1995.Google Scholar
  34. 34.
    Tobin KE, Yang C, King K, Latkin CA, Curriero FC. Associations between drug and alcohol use patterns and sexual risk in a sample of African American men who have sex with men. AIDS Behav. 2016;20(3):590–9.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Freeman P, Walker BC, Harris DR, Garofalo R, Willard N, Ellen JM. Adolescent Trials Network for HIV/AIDS Interventions 016b Team. Methamphetamine use and risk for HIV among young men who have sex with men in 8 US cities. Arch Pediatr Adolesc Med. 2011;165(8):736–40.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Shoptaw S, Weiss RE, Munjas B, Hucks-Orti C, Young SD, Larkins S, Victorianne GD, Gorbach PM. Homonegativity, substance use, sexual risk behaviors, and HIV status in poor and ethnic men who have sex with men in Los Angeles. J Urban Health. 2009;86(1):77–92.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Stall R, Paul JP, Greenwood G, Pollack LM, Bein E, Crosby GM, Mills TC, Binson D, Coates TJ, Catania JA. Alcohol use, drug use and alcohol-related problems among men who have sex with men: The Urban Men’s Health Study. Addiction 2001;96(11):1589–601.PubMedCrossRefGoogle Scholar
  38. 38.
    Sandfort TGM, Bos H, Reddy V. Gender expression and mental health in Black South African men who have sex with men: further explorations of unexpected findings. Arch Sex Behav. 2018;47(8):2481–90.PubMedCrossRefGoogle Scholar
  39. 39.
    Tafuma TA, Merrigan MB, Okui LA, Lebelonyane R, Bolebantswe J, Mine M, Chishala S, Moyo S, Thela T, Rajatashuvra A. HIV/sexually transmitted infection prevalence and sexual behavior of men who have sex with men in 3 districts of Botswana: Results from the 2012 biobehavioral survey. Sex Transm Dis. 2014;41(8):480–5.PubMedCrossRefGoogle Scholar
  40. 40.
    McAdams-Mahmoud A, Stephenson R, Rentsch C, Cooper H, Arriola KJ, Jobson G, De Swardt G, Struthers H, McIntyre J. Minority stress in the lives of men who have sex with men in Cape Town, South Africa. J Homosex. 2014;61(6):847–67.PubMedCrossRefGoogle Scholar
  41. 41.
    Alessi EJ, Kahn S. A framework for clinical practice with sexual and gender minority asylum seekers. Psychol Sex Orientat Gend Divers. 2017;4(4):383–91.CrossRefGoogle Scholar
  42. 42.
    Edwards JR. Homosexuals and immigration: developments in the United States and abroad. Washington, DC: CIS Backgrounder; 1999. pp. 1–7.Google Scholar
  43. 43.
    Keyes EF, Kane CF. Belonging and adapting: mental health of Bosnian refugees living in the United States. Issues Ment Health Nurs. 2004;25(8):809–31.PubMedCrossRefGoogle Scholar
  44. 44.
    Alessi EJ. Resilience in sexual and gender minority forced migrants: a qualitative exploration. Traumatology 2016;22(3):203–13.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Behavioral and Social SciencesBrown University School of Public HealthProvidenceUSA
  2. 2.HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute and Columbia UniversityNew YorkUSA

Personalised recommendations