UC San Diego

Rationale: Sexual minority men (SMM; e.g., men who identify as gay/bisexual and/or report same-gender attraction/sexual behavior) are disproportionately affected by internalizing disorders and symptoms (e.g., anxiety and depressive disorders/symptoms) in comparison to their heterosexual male peers. Hispanic/Latinx SMM may be especially burdened by internalizing disorders/symptoms due to decreased access to culturally competent health care, stigma surrounding mental disorders, and stress from within the SMM community. Patient navigation (PN) is a partnership-based, individualized intervention that focuses on decreasing barriers to health care. Patient navigation for pre-exposure prophylaxis (PrEP)—a medication taken to prevent HIV infection—could reduce internalizing symptoms of anxiety and depression among Hispanic/Latinx SMM by providing social support. Design: This study used secondary data analysis to examine the impact of PN on internalizing symptom outcomes through six-month follow-up (6MFU) among a sample of Hispanic/Latinx SMM between the ages of 18 and 29 years (N = 57). Data analyzed were from a randomized controlled trial investigating the efficacy of a PN intervention (versus usual care) to assist Hispanic/Latinx SMM at high risk for HIV infection with accessing PrEP. Hispanic/Latinx SMM peer patient navigators were utilized to provide culturally competent care and decrease social stigma. Usual care consisted of written information about PrEP, sexual health and HIV prevention services, and how to access care. It was hypothesized that the PN condition would be associated with decreased internalizing symptoms and that the effect would be mediated by two social support constructs at three-month follow-up: emotional support and informational support. Data were analyzed using two analytic approaches: 1) cross-lagged panel models, and 2) latent difference scores. Results: The PN condition was not associated with a significant decrease in internalizing symptoms at 6MFU and the effect was not mediated through social support. Conclusion: Results may be related to the floor effect of internalizing symptoms at baseline, analyses that assumed changes in social support were occurring within the first three months of the study, and variability in the frequency of using PN services. Future studies would benefit from gathering data at additional time points and selecting participants with higher internalizing symptoms and/or lower social support.