A mixed-methods evaluation of a health intervention for British black and ethnic minority gay men

Abstract

Background: Gay and bisexual men from British BME communities are at elevated risk of psychological distress and sexual transmitted infections including HIV. This study reports on the results of a series of extended workshop based intervention programmes, ‘The Quest’, designed to improve health and well-being outcomes for men from these communities. Using coaching principles, the workshops focused on a range of concepts including shame, resilience and authenticity. Methods: The evaluation incorporated both qualitative and quantitative methods including validated questionnaires which assessed several constructs and behaviours relating to intended and actual sexual risk, drugs and alcohol use, as well as various aspects of psychological well-being. Pre and post programme quantitative data were collected from 26 men who completed the intervention. Fourteen men participated in focus groups. Findings: Statistically significant improvements were found on measures of internalised homophobia, self-esteem and self-efficacy. Few changes were found in reported or intended health behaviours relating to safer sex or substance use, although intention to engage in ‘chemsex’ and reported use of alcohol was significantly reduced post-programme. The qualitative data revealed a number of specific challenges for men from these communities including widepread persecution and abuse within their families and ethnocultural communities; racism, exclusion, and fetishisation on the gay scene, and associated challenges in maintaining positive and coherent self-identities. Qualitative participant feedback was generally positive. Discussion: Theoretically-informed, culturally competent interventions appear to show significant potential in enhancing the well-being of BME gay and bisexual men but fuller follow-up data are needed to show longer-term benefits