Resilience among gay/bisexual young men in Western Kenya: Psychosocial and sexual health outcomes

Objective: To explore associations between intrapersonal and interpersonal factors and both sexual and psychosocial resilient outcomes among young gay, bisexual, and other men who have sex with men (GBMSM) in Western Kenya. Design: Cross-sectional observational study. Methods: Five hundred and eleven GBMSM ages 18-29 were recruited from nine communities in Western Kenya using community-based mobilization strategies. Participants completed an audio computer-assisted self-interview survey in English or Duhluo. We estimated four three-step hierarchical linear regression models to examine associations between predictors (intrapersonal and interpersonal factors) and four resilient outcomes (psychological well-being, self-esteem, condom use, HIV testing). Results: Psychosocial well-being model (modeled conversely as depression/anxiety) was significant (F(_{13, 424})=106.41, P0.001, R2=0.765) with loneliness, lesbian/gay/bisexual (LGB) difficult process, LGB identity superiority, and reactions to trauma as predictors. Self-esteem model was significant (F(12, 425)=6.40, P0.001, R2=0.153) with known HIV-seropositivity, perceived social support, internalized homonegativity, and LGB difficult process as predictors. Condom use model was significant (F(13, 379)=4.30, P0.001, R2=0.128) with perceived social support, self-esteem, and reactions to trauma as predictors. HIV testing model was significant (F(12, 377)=4.75, P0.001, R2=0.131) with loneliness, LGB identity uncertainty, LGB difficult process, and LGB identity superiority as predictors. Conclusion: This study demonstrates the variety of ways in which intrapersonal and interpersonal factors are associated with HIV-related resilient outcomes for young GBMSM in Western Kenya. HIV prevention programs for this population should be developed in collaboration with GBMSM and include intervention components that promote resilience.