"Our lives matter": a qualitative examination of the impact of COVID-19 shelter-in-place orders on resource security and mental and physical health of Black and Latino sexual minority men in California and New York

Abstract

The COVID-19 and HIV pandemics have disproportionately affected Black and Latino sexual minority men (BLSMM) in the United States, with them having the highest burden of disease. Despite this disparity, few studies have examined the intersection of COVID-19 mitigation measures, access to healthcare, and other social determinants during the COVID-19 pandemic among BLSMM. To fill this gap in the literature, the purpose of this study is to explore the impact of the pandemic on mental and physical health, access to healthcare, and resource security among BLSMM. Using an interpretive phenomenological approach, we conducted individual interviews with 41 participants between August 2021 and December 2022. Interviews were recorded, transcribed, and analyzed using thematic content analysis. Participants ranged in age from 19-65 years. The majority described their gender as male (93%). Black participants comprised the majority of the sample (73%), with 25% identified as Latino. Participants' narratives indicated a sense of hopelessness, despair, anxiety, and depression-all amplified by social isolation experienced from COVID-19 shelter-in-place (SIP) orders. Fear of contracting COVID-19 disrupted engagement in healthcare. Resource security was exacerbated by unemployment, resulting in food and housing insecurity and reliance on government assistance programs. These findings highlight the pandemic's impact on participants' mental and physical health, access to healthcare, and resource security. Our findings suggest a more nuanced and culturally tailored public health response approach, expanding telemedicine to increase access to healthcare, and other governmental policy changes to increase access to affordable housing and food, regardless of immigration status.

Keywords: COVID-19; mental health; resource insecurity; sexual minority men; shelter-in-Place.

Figure 1.

Intersectional thematic analysis process for understanding the impact of COVID-19 shelter-in-place orders and resource insecurity on BLSMM health and well-being.