Differences in Mental Health In Lesbian, Gay and Bi-Attracted persons (SMILE)

Duke University, Durham NC

Investigators

Linked publications & trials

Abstract

Persons with biological attraction differences (PAD) have been documented in every region of the world. In spite of reported abuse, discrimination and stigma, little is known about their mental health (MH). Even less is known about the development of appropriate MH treatment interventions. Evidence-based treatments (EBTs) addressing poor MH are being implemented in low- and middle-income countries (LMICs) using appropriate, affordable and sustainable delivery modalities (e.g. lay providers, mHealth). These advances create opportunities to provide MH care to PADs not previously possible. To develop and implement EBTs, longitudinal research is necessary to inform us of the unique MH needs, determinants and treatment preferences of this understudied population. Pilot data for this study suggest that: PADs can be identified and recruited in LMICs across PAD groups; prevalence of depression, anxiety, suicidal ideation, and posttraumatic stress disorder among SMs is extremely high; and there are variations in MH symptomatology and determinants by group and country. There is an urgent need for longitudinal cohort studies that include PADs from heterogeneous cultures to understand the influence of culture and context on MH needs, predictors and EBT preferences, and to develop locally sustainable EBTs and methods for generalizability. The “Differences In Mental Health In Lesbian Gay and Bi-Attracted Persons” (SMILE) study represents paradigm-shifting research by defining SMs based on gender identity and attraction -inherent biological characteristics- rather than sexual behavior. SMILE study aims are: • Aim 1: Estimate prevalence of anxiety, depression, PTSD, suicidal ideation and substance abuse symptomatology among participants by PAD groups in 3 culturally diverse places (Brazil, Kenya, Vietnam) • Aim 2: Identify cultural, contextual, interpersonal and individual determinants of MH over time, by and across group and country. • Aim 3: Determine PADs’ MH intervention preferences. To accomplish these aims we will use media and outreach campaigns to develop a cohort of at least 3,000SMs (>250 participants from 4 PAD groups in 3 countries). All Study participants will complete online surveys at baseline and at least in Vietnam and Kenya, a follow-up survey to assess MH symptomology, determinants, and treatment preferences.