A systematic review assessed mental health care among LGBT+ older adults and older people living with human immunodeficiency virus (HIV), given that these populations experience a disproportionate burden of behavioral health conditions compared to their heterosexual, cisgender, and HIV-negative peers. The results appeared in Aging & Mental Health.
Investigators searched three databases using Boolean search strings, and inclusion/exclusion criteria were developed and applied to the search outcomes to appropriately narrow results. Article quality and evidence of bias were evaluated using the National Heart, Lung, and Blood Institute quality-assessment tool, and the Critical Appraisal Skills Program assessment tool. In total, 2,031 articles were screened, and 28 of those articles met inclusion criteria for analysis.
The study found several key themes, including a lack of provider competency in caring for LGBT+ patients, lower rates of insurance coverage, greater mental health burden, social and structural determinants of health, policy solutions, and technology and health literacy.
“There were several domains identified in the literature as barriers to accessing mental health care, as well as opportunities to better attend to the mental health needs of these populations,” the researchers concluded. “Provider training, implementing health technology solutions, and enacting public policy changes could improve mental health outcomes.”
Keywords: HIV, LGBT aging, LGBT older adults, MSM, health disparities, mental health, older PLWH