abstract: 'Scant empirical research from Asia has addressed the impact of COVID-19

  on sexual minority health. We aimed to explore and understand the impact

  of COVID-19 on income security, mental health, HIV risk and access to

  health services among men who have sex with men (MSM) in India. We

  conducted a concurrent mixed methods study from April to June 2020,

  including a cross-sectional survey and in-depth semi-structured

  interviews with MSM recruited from three non-governmental organisations

  providing HIV prevention services in Chandigarh, India. We examined the

  associations of sexual minority stressors (sexual stigma, internalised

  homonegativity), economic stressors, and stress due to social

  distancing, with depression and anxiety, HIV risk, and access to health

  services. Survey findings (n = 132) indicated that internalised

  homonegativity and stress related to social distancing were

  significantly associated with depressive and anxiety symptoms. Results

  also showed reduced access to condoms, HIV testing and counselling

  services. Qualitative findings (n = 10) highlighted adverse economic

  impacts of COVID-19, including loss of employment/wages and engaging in

  survival sex work, which contributed to psychological distress and HIV

  risk. The COVID-19 pandemic has resulted in considerable psychological

  and financial distress among low socioeconomic status MSM in India,

  including those involved in sex work - communities already marginalised

  in economic, family and healthcare sectors. Structural interventions to

  improve access to mental health and HIV services and decrease financial

  burden are critical to mitigate the impact of COVID-19.'
affiliation: 'Chakrapani, V (Corresponding Author), Ctr Sexual \& Hlth Res \& Policy
  C SHaRP, Chennai, India.

  Chakrapani, V (Corresponding Author), Humsafar Trust, Mumbai, India.

  Chakrapani, Venkatesan, Ctr Sexual \& Hlth Res \& Policy C SHaRP, Chennai, India.

  Newman, Peter A., Univ Toronto, Factor Inwentash Fac Social Work, Toronto, ON, Canada.

  Sebastian, Aleena, Natl Inst Adv Studies NIAS, Bangalore, India.

  Chakrapani, Venkatesan; Rawat, Shruta, Humsafar Trust, Mumbai, India.

  Mittal, Sandeep, Chandigarh State AIDS Control Soc CSACS, Targeted Intervent, Chandigarh,
  India.

  Gupta, Vanita, Chandigarh State AIDS Control Soc CSACS, Chandigarh, India.

  Kaur, Manmeet, Postgrad Inst Med Educ \& Res PGIMER, Chandigarh, India.'
article-number: '2144087'
author: Chakrapani, Venkatesan and Newman, Peter A. and Sebastian, Aleena and Rawat,
  Shruta and Mittal, Sandeep and Gupta, Vanita and Kaur, Manmeet
author-email: venkatesan.chakrapani@gmail.com
author_list:
- family: Chakrapani
  given: Venkatesan
- family: Newman
  given: Peter A.
- family: Sebastian
  given: Aleena
- family: Rawat
  given: Shruta
- family: Mittal
  given: Sandeep
- family: Gupta
  given: Vanita
- family: Kaur
  given: Manmeet
da: '2023-09-28'
doi: 10.1080/26410397.2022.2144087
eissn: 2641-0397
files: []
journal: SEXUAL AND REPRODUCTIVE HEALTH MATTERS
keywords: MSM; COVID-19; depression; anxiety; social distancing; income security
keywords-plus: 'TRANSGENDER WOMEN; MINORITY STRESS; HIV; MSM; DEPRESSION; BARRIERS;

  CHENNAI; RISK; PREVALENCE; INSIGHTS'
language: English
month: DEC 31
number: '1'
number-of-cited-references: '45'
orcid-numbers: 'Newman, Peter A/0000-0003-0444-5915

  Chakrapani, Venkatesan/0000-0001-9998-9135

  SEBASTIAN, ALEENA/0000-0002-2049-4445'
papis_id: e2a4e236dea3c0b0925b3939cf3080c0
ref: Chakrapani2022mentalhealth
researcherid-numbers: 'Newman, Peter A/P-7056-2019

  sebastian, aleena/AAX-6970-2020

  Chakrapani, Venkatesan/P-8056-2014

  '
times-cited: '1'
title: 'Mental health, economic well-being and health care access amid the COVID-19
  pandemic: a mixed methods study among urban men who have sex with men in India'
type: Article
unique-id: WOS:000894095800001
usage-count-last-180-days: '0'
usage-count-since-2013: '1'
volume: '30'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2022'