{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T11:39:14Z","timestamp":1784547554074,"version":"3.55.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,11,28]],"date-time":"2021-11-28T00:00:00Z","timestamp":1638057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Cooperative Agreement with the Universidad del Valle de Guatemala","award":["1U01GH001003-05"],"award-info":[{"award-number":["1U01GH001003-05"]}]},{"name":"Fogarty International Center of the National Institutes of Health","award":["D43TW009343"],"award-info":[{"award-number":["D43TW009343"]}]},{"name":"University of California Global Health Institute"},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Mental health problems, including anxiety and depression, are a common comorbidity among gay, bisexual and other men who have sex with men (GBMSM) living with HIV. Informed by social support theory, health navigation is a strengths-based intervention that has been demonstrated to improve HIV care outcomes. The purpose of this study was to explore how health navigation influences the mental health of GBMSM living with HIV. We analyzed longitudinal qualitative in-depth interviews conducted with GBMSM (n = 29) in a 12-month multi-component intervention to improve HIV care outcomes, including health navigation. We used narrative and thematic analytic approaches to identify salient themes, including if and how themes changed over time. Participants described that navigator support helped them maintain good mental health, prevent crises and respond to crises. Navigator support included providing motivational messaging, facilitating participants\u2019 control over their health and improving access to care, which aided with supporting mental health. Navigators also responded to acute crises by providing guidance for those newly diagnosed with HIV and support for those experiencing critical life events. Participants emphasized the importance of feeling heard and valued by their navigators and gaining hope for the future as key to their wellbeing. In conclusion, health navigation may be an effective intervention for promoting mental health among GBMSM living with HIV. Additional research is needed to examine mediating pathways between navigation and mental health, including informational support, or if navigator support moderates the relationship between stressors and mental health outcomes for GBMSM.<\/jats:p>","DOI":"10.1093\/heapro\/daab188","type":"journal-article","created":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T20:13:46Z","timestamp":1636402426000},"source":"Crossref","is-referenced-by-count":7,"title":["\u2018She showed me a new path, a way forward\u2019: exploring how navigation influences mental health among Guatemalan gay and bisexual men living with HIV"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7056-427X","authenticated-orcid":false,"given":"Dirk A","family":"Davis","sequence":"first","affiliation":[{"name":"Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina , 135 Dauer Drive Chapel Hill, NC 27599-7400, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E","family":"Muessig","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina , 135 Dauer Drive Chapel Hill, NC 27599-7400, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick D","family":"Matthews","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina , 135 Dauer Drive Chapel Hill, NC 27599-7400, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Angeles","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina , 135 Dauer Drive Chapel Hill, NC 27599-7400, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luz","family":"McNaughton-Reyes","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina , 135 Dauer Drive Chapel Hill, NC 27599-7400, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Guzm\u00e1n","sequence":"additional","affiliation":[{"name":"HIV Central America Regional Program, Center for Health Studies, Universidad del Valle de Guatemala , 18 Avenida 11-95, Zona 15, Vista Hermosa III, Guatemala City, Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanny","family":"Northbrook","sequence":"additional","affiliation":[{"name":"US Center for Disease Control and Prevention (CDC) Central America Region , 11 calle 15-79, Zona 15, Vista Hermosa III, Guatemala City, Guatemala"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Barrington","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina , 135 Dauer Drive Chapel Hill, NC 27599-7400, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,11,28]]},"reference":[{"key":"2023100214391147800_daab188-B1","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1080\/09540121.2020.1734173","article-title":"A mobile application to monitor mode, content and duration of health navigation services for people living with HIV in Guatemala","volume":"33","author":"Alvis-Estrada","year":"2021","journal-title":"AIDS Care"},{"key":"2023100214391147800_daab188-B2","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s10461-021-03240-w","article-title":"Probing the processes: longitudinal qualitative research on social determinants of HIV","volume":"25","author":"Barrington","year":"2021","journal-title":"AIDS and Behavior"},{"key":"2023100214391147800_daab188-B3","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1353\/hpu.2016.0160","article-title":"HIV diagnosis, linkage to care, and retention among men who have sex with men and transgender women in Guatemala City","volume":"27","author":"Barrington","year":"2016","journal-title":"Journal of Health Care for the Poor and Underserved"},{"key":"2023100214391147800_daab188-B4","author":"Barrington","year":"2020"},{"key":"2023100214391147800_daab188-B5","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1071\/SH16083","article-title":"Mental health in 2020 for men who have sex with men in the United States","volume":"14","author":"Batchelder","year":"2017","journal-title":"Sexual Health"},{"key":"2023100214391147800_daab188-B6","doi-asserted-by":"crossref","first-page":"e135","DOI":"10.2196\/jmir.5066","article-title":"Fundamentals for future mobile-health (mHealth): a systematic review of mobile phone and web-based text messaging in mental health","volume":"18","author":"Berrouiguet","year":"2016","journal-title":"Journal of Medical Internet Research"},{"key":"2023100214391147800_daab188-B7","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/S0140-6736(16)30781-4","article-title":"The global response to HIV in men who have sex with men","volume":"388","author":"Beyrer","year":"2016","journal-title":"The Lancet"},{"key":"2023100214391147800_daab188-B8","doi-asserted-by":"crossref","first-page":"S49","DOI":"10.1089\/apc.2007.9987","article-title":"HIV System Navigation: an emerging model to improve HIV care access","volume":"21","author":"Bradford","year":"2007","journal-title":"AIDS Patient Care and STDS"},{"key":"2023100214391147800_daab188-B9","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.cpr.2016.11.005","article-title":"Anxiety symptoms and disorders among adults living with HIV and AIDS: a critical review and integrative synthesis of the empirical literature","volume":"51","author":"Brandt","year":"2017","journal-title":"Clinical Psychology Review"},{"key":"2023100214391147800_daab188-B10","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1080\/09540121.2015.1028882","article-title":"\u201cShe makes me feel that I\u2019m not alone\u201d: linkage to Care Specialists provide social support to people living with HIV","volume":"27","author":"Broaddus","year":"2015","journal-title":"AIDS Care"},{"key":"2023100214391147800_daab188-B11","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1089\/apc.2017.0048","article-title":"Fostering a \u201cfeeling of worth\u201d among vulnerable HIV populations: the role of Linkage to Care Specialists","volume":"31","author":"Broaddus","year":"2017","journal-title":"AIDS Patient Care and STDS"},{"key":"2023100214391147800_daab188-B12","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1521\/aeap.2017.29.6.554","article-title":"\u201cOh, I\u2019m Not Alone\u201d: experiences of HIV-positive men who have sex with men in a health navigation program to promote timely linkage to care in Guatemala City","volume":"29","author":"Davis","year":"2017","journal-title":"AIDS Education and Prevention"},{"key":"2023100214391147800_daab188-B13","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1089\/apc.2021.0008","article-title":"Examining how health navigation affects mental health among gay, bisexual and other men who have sex with men living with HIV in Guatemala","volume":"35","author":"Davis","year":"2021","journal-title":"AIDS Patient Care and STDS"},{"key":"2023100214391147800_daab188-B14","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s10461-018-2050-4","article-title":"\u201cI don\u2019t have to do this all by myself\u201d: systems navigation to ensure continuity of HIV care for persons leaving prison","volume":"23","author":"Fuller","year":"2019","journal-title":"AIDS and Behavior"},{"key":"2023100214391147800_daab188-B15","doi-asserted-by":"crossref","DOI":"10.4135\/9781526441867","volume-title":"Analysing Qualitative Data","author":"Gibbs","year":"2018"},{"key":"2023100214391147800_daab188-B16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-016-1954-1","article-title":"Analyzing longitudinal qualitative data: the application of trajectory and recurrent cross-sectional approaches","volume":"9","author":"Grossoehme","year":"2016","journal-title":"BMC Research Notes"},{"key":"2023100214391147800_daab188-B17","author":"Guardado Escobar","year":"2017"},{"key":"2023100214391147800_daab188-B18","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1097\/COH.0000000000000399","article-title":"The future of digital games for HIV prevention and care","volume":"12","author":"Hightow-Weidman","year":"2017","journal-title":"Current Opinion in HIV and AIDS"},{"key":"2023100214391147800_daab188-B19","doi-asserted-by":"crossref","first-page":"e34","DOI":"10.2196\/publichealth.8923","article-title":"A Gamified Smartphone App to support engagement in care and medication adherence for HIV-positive young men who have sex with men (AllyQuest): development and pilot study","volume":"4","author":"Hightow-Weidman","year":"2018","journal-title":"JMIR Public Health and Surveillance"},{"key":"2023100214391147800_daab188-B20","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.2105\/AJPH.2011.300210","article-title":"Public health nursing case management for women receiving temporary assistance for needy families: a randomized controlled trial using community-based participatory research","volume":"101","author":"Kneipp","year":"2011","journal-title":"American Journal of Public Health"},{"key":"2023100214391147800_daab188-B21","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1093\/heapro\/day109","article-title":"Mental health navigation\u2014a model","volume":"35","author":"Knesek","year":"2020","journal-title":"Health Promotion International"},{"key":"2023100214391147800_daab188-B22","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.2196\/games.5687","article-title":"Epic allies: development of a gaming app to improve antiretroviral therapy adherence among young HIV-positive men who have sex with men","volume":"4","author":"LeGrand","year":"2016","journal-title":"JMIR Serious Games"},{"key":"2023100214391147800_daab188-B23","doi-asserted-by":"crossref","first-page":"e183","DOI":"10.2196\/mhealth.9283","article-title":"An mHealth intervention to improve young gay and bisexual men\u2019s sexual, behavioral, and mental health in a structurally stigmatizing national context","volume":"6","author":"Lelu\u0163iu-Weinberger","year":"2018","journal-title":"JMIR MHealth and Uhealth"},{"key":"2023100214391147800_daab188-B24","first-page":"461","volume-title":"Handbook of Emergent Methods","author":"Maxwell","year":"2008"},{"key":"2023100214391147800_daab188-B25","doi-asserted-by":"crossref","first-page":"38","DOI":"10.2307\/2137286","article-title":"Minority stress and mental health in gay men","volume":"36","author":"Meyer","year":"1995","journal-title":"Journal of Health and Social Behavior"},{"key":"2023100214391147800_daab188-B26","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1037\/0033-2909.129.5.674","article-title":"Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence","volume":"129","author":"Meyer","year":"2003","journal-title":"Psychological Bulletin"},{"key":"2023100214391147800_daab188-B27","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1080\/17441692.2019.1671984","article-title":"Sex work, discrimination, drug use and violence: a pattern for HIV risk among transgender sex workers compared to MSM sex workers and other MSM in Guatemala","volume":"15","author":"Miller","year":"2020","journal-title":"Global Public Health"},{"key":"2023100214391147800_daab188-B28","doi-asserted-by":"crossref","first-page":"2557","DOI":"10.1097\/QAD.0000000000001987","article-title":"Is HIV patient navigation associated with HIV care continuum outcomes?","volume":"32","author":"Mizuno","year":"2018","journal-title":"AIDS (London, England)"},{"key":"2023100214391147800_daab188-B29","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1080\/13691058.2020.1718212","article-title":"\u201cThere are no other options for us because of who we are\u201d: employment and retention in care among gay and bisexual men and transgender women living with HIV in Guatemala","volume":"23","author":"Munson","year":"2021","journal-title":"Culture, Health & Sexuality"},{"key":"2023100214391147800_daab188-B30","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1007\/s10461-013-0462-8","article-title":"Moderate levels of depression predict sexual transmission risk in HIV-infected MSM: a longitudinal analysis of data from six sites involved in a \u201cprevention for positives\u201d study","volume":"17","author":"O\u2019Cleirigh","year":"2013","journal-title":"AIDS and Behavior"},{"key":"2023100214391147800_daab188-B32","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1093\/heapro\/dau013","article-title":"The ecology of sexual health of sexual minorities in Guatemala City","volume":"30","author":"Rhodes","year":"2015","journal-title":"Health Promotion International"},{"key":"2023100214391147800_daab188-B33","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1177\/1524839919875727","article-title":"Client perspectives and experiences with HIV patient navigation in the United States: a qualitative meta-synthesis","volume":"21","author":"Roland","year":"2020","journal-title":"Health Promotion Practice"},{"key":"2023100214391147800_daab188-B34","first-page":"32","volume-title":"The Coding Manual for Qualitative Researchers","author":"Salda\u00f1a","year":"2009","edition":"1st edition."},{"key":"2023100214391147800_daab188-B35","volume-title":"The Oxford Handbook of Sexual and Gender Minority Mental Health2","author":"Silvestrini","year":"2020"},{"key":"2023100214391147800_daab188-B36","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/hiv.12726","article-title":"Depression and all-cause mortality risk in HIV-infected and HIV-uninfected US veterans: a cohort study","volume":"20","author":"So-Armah","year":"2019","journal-title":"HIV Medicine"},{"key":"2023100214391147800_daab188-B37","doi-asserted-by":"crossref","first-page":"S49","DOI":"10.1089\/apc.2014.0279","article-title":"Experiences of women of color with a nurse patient navigation program for linkage and engagement in HIV care","volume":"29","author":"Sullivan","year":"2015","journal-title":"AIDS Patient Care and STDs"},{"key":"2023100214391147800_daab188-B38","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1097\/QAD.0000000000001287","article-title":"Effects of depression and anxiety on antiretroviral therapy adherence among newly diagnosed HIV-infected Chinese MSM","volume":"31","author":"Tao","year":"2017","journal-title":"AIDS (London, England)"},{"key":"2023100214391147800_daab188-B39","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1007\/s11904-014-0220-1","article-title":"Depression and adherence to antiretroviral therapy in low-, middle- and high-income countries: a systematic review and meta-analysis","volume":"11","author":"Uthman","year":"2014","journal-title":"Current HIV\/AIDS Reports"},{"key":"2023100214391147800_daab188-B40","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s13722-017-0076-y","article-title":"Acceptability of a mobile health intervention to enhance HIV care coordination for patients with substance use disorders","volume":"12","author":"Westergaard","year":"2017","journal-title":"Addiction Science & Clinical Practice"},{"key":"2023100214391147800_daab188-B41","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1002\/pon.2019","article-title":"Can a tailored telephone intervention delivered by volunteers reduce the supportive care needs, anxiety and depression of people with colorectal cancer? A randomised controlled trial","volume":"21","author":"White","year":"2012","journal-title":"Psychooncology"},{"key":"2023100214391147800_daab188-B42","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1080\/09540121.2020.1739205","article-title":"Intersectional stigma and psychosocial well-being among MSM living with HIV in Guangxi, China","volume":"32","author":"Yang","year":"2020","journal-title":"AIDS Care"},{"key":"2023100214391147800_daab188-B43","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1353\/hpu.2019.0060","article-title":"\u201cNo Estas Solo\u201d: navigation programs support engagement in HIV care for Mexicans and Puerto Ricans living in the continental U.S","volume":"30","author":"Zamudio-Haas","year":"2019","journal-title":"Journal of Health Care for the Poor and Underserved"}],"container-title":["Health Promotion International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/38\/4\/daab188\/51824847\/daab188.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/heapro\/article-pdf\/38\/4\/daab188\/51824847\/daab188.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T14:39:49Z","timestamp":1696257589000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/heapro\/article\/doi\/10.1093\/heapro\/daab188\/6445199"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,28]]},"references-count":42,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/heapro\/daab188","relation":{},"ISSN":["0957-4824","1460-2245"],"issn-type":[{"value":"0957-4824","type":"print"},{"value":"1460-2245","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8,1]]},"published":{"date-parts":[[2021,11,28]]},"article-number":"daab188"}}