Gay Men Research Articles

Exploring Resilience Among Midlife and Older Sexual Minority and Heterosexual Adults: A Multidimensional Analysis.

Research on resilience in sexual minority midlife and older adults is limited. Using a multidimensional approach, this study examined trait resilience (optimism), resilience as a dynamic process (perceived control), and relational resilience (social support), analyzing their roles in physical and mental health among sexual minority adults. Analyzing data from MIDUS 2 and MIDUS Refresher, we examined a sample of 492 participants, comprising 164 sexual minority and 328 propensity-matched heterosexual individuals. Among sexual minority participants, perceived control was associated with fewer chronic conditions and optimism with lower depressed affect. Among heterosexual participants, perceived control was associated with both outcomes. Subgroup analyses found variations, particularly among lesbian and bisexual women. Resilience measures were not associated with the health outcomes for gay or bisexual men. This study highlighted the complex roles of trait resilience and dynamic resilience processes in association with health outcomes among sexual minority midlife and older adults across diverse subgroups.

Informed, but uncertain: managing transmission risk and isolation in the 2022 mpox outbreak among gay and bisexual men in Australia.

In 2022, a global outbreak of mpox (formerly 'monkeypox') emerged in non-endemic countries, including Australia, predominantly affecting gay, bisexual and other men who have sex with men. Public health advice on transmission and isolation emerged rapidly from different sources, sometimes conflicting and producing uncertainty. Using the concept of 'counterpublic health', which acknowledges the incorporation of official science and experiences of affected communities into embodied practice, this paper investigates how people affected by mpox in Australia managed risk of transmission and navigated self-isolation. In-depth interviews were conducted with 16 people: 13 people diagnosed with mpox and three close contacts. All participants were cisgender gay and bisexual men living in Australia. Participants thought critically about public health advice, often finding it restrictive and unresponsive to the needs of people with mpox. Participants' decisions about reducing mpox risk and isolating often drew on experiences with other infections (i.e. HIV; COVID-19) and were made collaboratively with the people closest to them (e.g. partners, friends, family) to sustain relationships. Future public health responses to infectious disease outbreaks would benefit from identifying more opportunities to formalise and embed mechanisms to obtain feedback from affected communities so as to inform responses.

Feasibility, acceptability, and perceived usefulness of a community-evidence-based harm reduction intervention for sexualized stimulant use among Mexican gay, bisexual, and other men who have sex with men.

The use of stimulants and other substances with the purpose of enhancing, maintaining, and prolonging sexual activity is known as sexualized substance use. Also known as chemsex, this pattern of use has been mainly explored in high-income countries. The aim of this article was to assess the feasibility, acceptability, and usefulness of a community- evidence-based harm reduction intervention among Mexican gay, bisexual, and other men who have sex with men (gbMSM) adults who reported sexualized stimulant use in the past 6 months and who were not enrolled in any psychosocial treatment. The in-person intervention was designed in partnership with gbMSM who used substances. It consisted of 39 harm reduction strategies before, during, and after episodes of use. The components of the intervention were health and self-care, safety, and psychopharmacology. The intervention was delivered at a university campus, a public recreational space, and an HIV public clinic. Feasibility to deliver the intervention was assessed based on enrolment and completion rates; acceptability through a 28-item, 5-point Likert scale (140 max.) constructed and validated for the Mexican population with good reliability coefficients; usefulness through a 5-point Likert scale ("not useful"-"very useful") for each of the 39 strategies; and potential behavioral change by subtracting the likelihood of implementing each strategy minus the frequency of use of the technique before the intervention. Participants (n = 19; recruitment rate = 35.2%; completion rate = 84.2%) rated the intervention as acceptable with a mean score of 121.6 (SD = 7.5). The highest potential for behavioral change was regarding the use of information about the half-life of stimulants, polysubstance use, and overdose prevention. This intervention is feasible when provided within public health services where potential participants are already in contact. Harm reduction strategies need to surpass sexually transmitted infections prevention and HIV care and focus on substance use and mental health strategies.

Occupational involvement of older gay men

Occupational involvement of older gay men

Mpox (Monkeypox) Virus and Its Co-Infection with HIV, Sexually Transmitted Infections, or Bacterial Superinfections: Double Whammy or a New Prime Culprit?

Epidemiologic studies have established that mpox (formerly known as monkeypox) outbreaks worldwide in 2022–2023, due to Clade IIb mpox virus (MPXV), disproportionately affected gay, bisexual, and other men who have sex with men. More than 35% and 40% of the mpox cases suffer from co-infection with HIV and sexually transmitted infections (STIs) (e.g., Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, and herpes simplex virus), respectively. Bacterial superinfection can also occur. Co-infection of MPXV and other infectious agents may enhance disease severity, deteriorate outcomes, elongate the recovery process, and potentially contribute to the morbidity and mortality of the ensuing diseases. However, the interplays between MPXV and HIV, bacteria, other STI pathogens and host cells are poorly studied. There are many open questions regarding the impact of co-infections with HIV, STIs, or bacterial superinfections on the diagnosis and treatment of MPXV infections, including clinical and laboratory-confirmed mpox diagnosis, suboptimal treatment effectiveness, and induction of antiviral drug resistance. In this review article, we will discuss the progress and knowledge gaps in MPXV biology, antiviral therapy, pathogenesis of human MPXV and its co-infection with HIV, STIs, or bacterial superinfections, and the impact of the co-infections on the diagnosis and treatment of mpox disease. This review not only sheds light on the MPXV infection and co-infection of other etiologies but also calls for more research on MPXV life cycles and the molecular mechanisms of pathogenesis of co-infection of MPXV and other infectious agents, as well as research and development of a novel multiplex molecular testing panel for the detection of MPXV and other STI co-infections.

Following western conceptions of masculinity: homohysteria and transgressive bodies in a masculine Turkish environment

ABSTRACT This article uses qualitative interview data derived from 18 Turkish gay males who exist within in a traditionally masculine space in order to examine for a social movement pattern based in relation to the Western context. In examining the entanglement of homophobia with cisgender masculine social hierarchies it suggests similarity between current Turkish culture and historical American culture: that the antecedent of homophobia facilitates an approximate social process of hierarchy-making that privileges heterosexuality and cisgender bodies while stigmatising femininity and queer bodies. Results also show limited signs of resistance, with a differing embodiment of hypertrophic bodies, and cautious optimism with aspirations of liberation through adopted western identity politics.

Unveiling Masculinity: A Critical Analysis of Gender Representation in Men's Fragrance Advertisements

The aim of this study is to examine how male sexuality is visually portrayed in advertisements for men's perfume and to investigate the notions of masculinity, gender, and sexuality depicted therein. Through a visual text analysis approach rooted in social semiotic theory with literature study, the study examines 27 advertisements predominantly from Western countries (Specifically France and Italy), analyzing elements such as visual composition, gendered representations, and societal implications. The analysis of the sampled images reveals stereotypical representations of male and female sexuality, conveyed through the use of sexuality and gender concepts. For male consumers, exposure to these representations may lead to the internalization of these ideals, influencing their self-image and behavior. These representations not only maintain existing power differentials but also hinder progress towards gender equality and challenging societal norms.

Sexual orientation concealment, hope, and depressive symptoms among gay and bisexual men: a moderated-moderation model

ABSTRACT The prevalence of depressive symptoms among gay and bisexual men is cause for concern. This study aimed to investigate whether hope and its two components (agency and pathways) moderated the relationship between sexual orientation concealment and depressive symptoms in gay and bisexual men and whether the moderating effects were conditional on sexual orientation. Participants were 197 gay men aged 18 to 71 years (M = 35.13 years, SD = 12.18 years) and 212 bisexual men aged 18 to 66 years (M = 29.24 years, SD = 10.46 years) who completed The Centre for Epidemiologic Studies Depression Scale, The Sexual Orientation Concealment Scale, and The Adult Hope Scale. Results did not support the moderating role of hope, agency, or pathways. The interaction between sexual orientation and pathways was significantly associated with depressive symptoms. Higher levels of pathways were associated with lower levels of depressive symptoms for both groups of men, however, the association was stronger for gay men compared with bisexual men. Higher levels of hope, agency, and pathways were associated with lower levels of depressive symptoms. Interventions aimed at increasing hope may be beneficial for reducing depressive symptoms among gay and bisexual men.

Sexual identity, poverty, and utilization of government services

Previous literature has established that lesbian, gay, and bisexual (LGB) people are at least as likely to be poor as heterosexual people, standing in contrast to myths of “gay affluence.” These findings have used datasets limited by either sample size or using partnership status to infer sexual orientation. Using U.S. data from the Household Pulse Survey, which allows us to identify large samples of individuals who self-identify as lesbian, gay, or bisexual, we find that bisexuals have lower incomes and are more likely to experience poverty, and bisexual individuals, gay men, and lesbian women are more likely to report financial hardship. Additionally, we find that LGB people utilize government assistance at higher rates than heterosexual people, even when allowing for selection into poverty status. We propose several explanations for these differentials, drawing on the program non-participation literature, and suggest that social network effects, lessened stigma, and increased reliance on public programs may explain these differences. Finally, we examine receipt of the enhanced child tax credit and find evidence that gay men and lesbian women with children were less likely to receive it than heterosexual men and women with children.

A Study on Perceptions of Undetectable = Untransmittable Among Gay Men with Human Immunodeficiency Virus in the HIV Community on Twitter in Japan: An Exploratory Qualitative Study Using a Modified Grounded Theory Approach.

This study explores the perceptions of the Undetectable = Untransmittable (U = U) campaign among gay men with HIV in Japan who are part of the HIV community on Twitter. We conducted detailed semistructured interviews with 12 participants using a modified grounded theory approach. The analysis resulted in 31 concepts, 5 subcategories, 9 categories, and 2 core categories. The relationship between categories and core categories was examined in conjunction with the transcriptions, yielding a comprehensive category map depicting the process of understanding U = U. The three main processes emerged: participants expressed "expectations for improvement," underwent stages of "understanding U = U," and encountered "dilemmas" in forming their opinions. There are two routes to "understanding U = U": Route 1 involved a frictionless understanding of U = U, and Route 2 involved difficulty in understanding the slogan. In both routes, participants experienced the dilemma of "but I still have HIV" and regarding its ease of use. These dilemmas and difficulties in understanding U = U affected their "expectations for improvement." Efforts to promote U = U in Japan must address challenges in public understanding and related dilemmas. This entails reformulating the U = U message in simpler terms, leveraging professional explanations, disseminating it to a broader audience, and incorporating ideas from individuals living with HIV to enhance the message.

Picturing the dance: intersections of gender, sexuality, and age in older women queer square dancers

A dearth of research has focused on the diverse experiences of aging sexual minority populations and, in particular, older sexual minority women. Studies that have disaggregated the population of lesbian, gay, bisexual, transgender, questioning, queer, intersex and two-spirit (LGBTQIS+) older adults reveal that due to minority stress and a lifetime of disadvantage. Lesbians experience higher rates of chronic health conditions and mental health problems (including loneliness) than heterosexual women and greater financial inequalities compared to gay men or heterosexual women. Despite this, limited inquiry has explored the everyday lives of older queer women and fewer still draws upon women’s commentary on their own lived experiences or centers older women as authoritative agents and experts on their own lives. In response to this knowledge deficit, this research traverses the aging experiences of female-identified members of a gay square dance (GSD) club in Toronto, Canada. We apply queer theory to explicate the unique ways in which a GSD club queers the aging process for 14 older women dancers. Findings of the inquiry highlight the ways in which these dancers confront and reject heteronormativity, while illuminating pathways to successful aging for older sexual diverse women. The older women dancers in this study perform gender in ways that challenged heteronormativity and gender binaries, enhanced belongingness and acceptance, embodied joy, and fostered wellness. These concepts have been identified as critical factors in successful aging and highlight what queering aging might look like for this resilient population who have overcome a lifetime of disadvantage.

Navigating patterns of oral PrEP use: A qualitative longitudinal study of gay, bisexual, and queer men's dynamic practices of pausing, on-demand, and stopping PrEP in Canada

The Canadian HIV pre-exposure prophylaxis (PrEP) guidelines recommend both daily and on-demand dosing for gay, bisexual, and queer men (GBQM), meeting additional risk criteria. However, limited research explored how GBQM implement pausing, on-demand, discontinuation, and resumption of PrEP, including the contextual factors affecting decision-making. Using a relationally situated implementation science framework, we examined how GBQM tailor PrEP use to changing social and sexual circumstances. We conducted 109 longitudinal interviews with current and former PrEP users from Ontario (n = 18) and British Columbia (n = 20), Canada, at three time points between 2020 and 2022. We identified three dynamic PrEP use trajectories: pausing, on-demand, and stopping. Pausing involved brief breaks followed by a return to daily use during heightened sexual activity. Others followed the 2-1-1 on-demand schedule, while some stopped PrEP with plans to resume if social and sexual circumstances change. During the COVID-19 pandemic, participants paused PrEP when sexual activities decreased, restarting daily use when sexual engagements resumed. Others paused due to relationship changes or sexual inactivity, resuming PrEP in anticipation of sex. On-demand PrEP was adopted to manage side effects or save costs. Some stopped PrEP for sustained periods due to monogamy, private insurance loss, side effects, or low perceived HIV risk. Participants expressed concerns regarding lack of information on these strategies, relying on online sources or peers for guidance. Most participants obtained enough PrEP knowledge to adapt use appropriately. Comprehensive education campaigns on adaptable PrEP use effectiveness and strategies to discontinue and resume PrEP for clinicians and GBQM should be implemented.

Developing an mHealth program to improve HIV care continuum outcomes among young Black gay and bisexual men

BackgroundYoung Black gay and bisexual men (YBGBM) in the United States face significant disparities in HIV care outcomes. Mobile health (mHealth) interventions have shown promise with improving outcomes for YBGBM across the HIV care continuum.MethodsWe developed an mHealth application using human-centered design (HCD) from 2019–2021 in collaboration with YBGBM living with HIV and with HIV service providers. Our HCD process began with six focus groups with 50 YBGBM and interviews with 12 providers. These insights were used to inform rapid prototyping, which involved iterative testing and refining of program features and content, with 31 YBGBM and 12 providers. We then collected user feedback via an online survey with 200 YBGBM nationwide and usability testing of a functional prototype with 21 YBGBM.ResultsFocus groups and interviews illuminated challenges faced by YBGBM living with HIV, including coping with an HIV diagnosis, stigma, need for social support, and a dearth of suitable information sources. YBGBM desired a holistic approach that could meet the needs of those newly diagnosed as well as those who have been living with HIV for many years. Program preferences included video-based content where users could learn from peers and experts, a range of topics, a community of people living with HIV, and tools to support their health and well-being. Providers expressed enthusiasm for an mHealth program to improve HIV care outcomes and help them serve clients. Rapid prototyping resulted in a list of content topics, resources, video characteristics, community features, and mHealth tools to support adherence, retention, goal setting, and laboratory results tracking, as well as tools to help organization staff to support clients. Online survey and usability testing confirmed the feasibility, acceptability, and usability of the content, tools, and features.ConclusionsThis study demonstrates the potential of a video-based mHealth program to address the unique needs of YBGBM living with HIV, offering support and comprehensive information through a user-friendly interface and videos of peers living with HIV and of experts. The HCD approach allowed for continuous improvements to the concept to maximize cultural appropriateness, utility, and potential effectiveness for both YBGBM and HIV service organizations.

An mHealth Intervention for Gay and Bisexual Men's Mental, Behavioral, and Sexual Health in a High-Stigma, Low-Resource Context (Project Comunică): Protocol for a Randomized Controlled Trial.

The World Health Organization reported that 80% of new HIV diagnoses in Europe in 2014 occurred in Central and Eastern Europe. Romania has a particularly high HIV incidence, AIDS prevalence, and number of related deaths. HIV incidence in Romania is largely attributed to sexual contact among gay and bisexual men. However, homophobic stigma in Romania serves as a risk factor for HIV infection for gay and bisexual men. The Comunică intervention aims to provide a much-needed HIV risk reduction strategy, and it entails the delivery of motivational interviewing and cognitive behavioral therapy skills across 8 live text-based counseling sessions on a mobile platform to gay and bisexual men at risk of HIV. The intervention is based on the information-motivation-behavior and minority stress models. There is preliminary evidence suggesting that Comunică holds promise for reducing gay and bisexual men's co-occurring sexual (eg, HIV transmission risk behavior), behavioral (eg, heavy alcohol use), and mental (eg, depression) health risks in Romania. This paper describes the protocol for a randomized controlled trial designed to test the efficacy of Comunică in a national trial. To test Comunică's efficacy, 305 gay and bisexual men were randomized to receive Comunică or a content-matched education attention control condition. The control condition consisted of 8 time-matched educational modules that present information regarding gay and bisexual men's identity development, information about HIV transmission and prevention, the importance of HIV and sexually transmitted infection testing and treatment, heavy alcohol use and its associations with HIV transmission risk behavior, sexual health communication, finding social support, and creating sexual health goals. Participants undergo rapid HIV and syphilis testing and 3-site chlamydia and gonorrhea testing at baseline and the 12-month follow-up. Outcomes are measured before the intervention (baseline) and at the 4-, 8-, and 12-month follow-ups. The study was funded in September 2018, and data collection began in May 2019. The last participant follow-up was in January 2024. Currently, the data analyst is cleaning data sets in preparation for data analyses, which are scheduled to begin in April 2024. Data analysis meetings are scheduled regularly to establish timelines and examine the results as analyses are gradually being conducted. Upon completion, a list of manuscripts will be reviewed and prioritized, and the team will begin preparing them for publication. This study is the first to test the efficacy of an intervention with the potential to simultaneously support the sexual, behavioral, and mental health of gay and bisexual men in Central and Eastern Europe using motivational interviewing support and sensitivity to the high-stigma context of the region. If efficacious, Comunică presents a scalable platform to provide support to gay and bisexual men living in Romania and similar high-stigma, low-resource countries. ClinicalTrials.gov NCT03912753; https://clinicaltrials.gov/study/NCT03912753. DERR1-10.2196/52853.

Factors Associated With Recent Decline in Anal Health Among Older Gay and Bisexual Men: A Cross-sectional Analysis.

We investigated factors associated with "worse than usual" anal health among gay and bisexual men aged ≥35 years recruited to a longitudinal study of anal human papillomavirus infection/lesions from September 2010 to August 2015.Among 616 participants (median age 49 years; 36% HIV-positive), 42 (6.8%) reported worse than usual anal health in the last 4 weeks. Associated factors included spending less time with gay friends (odds ratio [OR] = 2.25, 95% CI = 1.06-4.77), most time "feeling down"(OR = 9.17, 95% CI = 2.94-28.59), reduced libido (OR = 2.90, 95% CI = 1.52-5.52), current anal symptoms (OR = 6.55, 95% CI = 2.54-16.90), recent anal wart diagnosis (OR = 4.33, 95% CI = 1.98-9.49), and fear of developing anal cancer (OR = 9.34, 95% CI = 4.52-19.28).Concerns regarding anal health should be routinely discussed by clinicians, and potentially associated psychosocial, physical, and sexual issues further explored.

Homosexual identity and network overlap predictors of HIV infection among older men from rural China: a case–control study

BackgroundThe number of newly reported older (≥50 years old) people living with HIV/AIDS in China has been steadily increasing, and heterosexual transmission has been identified as the major route.MethodsIn this...

Exploring debates over “boys love” media in the Philippines: from misogynistic backlash to queer emancipation

ABSTRACT As a genre originally emerging from Japanese women’s popular culture and developing into a transnational phenomenon, debates over “Boys Love” (BL) media have increased in recent years. Within this article, we explore debates over BL through a case study of its reception in the Philippines, situating our analysis within the broader context of the Philippines’ heteropatriarchal culture. Drawing upon critical discourse analysis of traditional and new media discussions responding to the rise of BL fandom in the Philippines and qualitative interviews with 31 LGBTQ+ fans of BL, we reveal tensions between those who view BL positively and negatively. Through a feminist and reparative queer reading of our data, we contrast cisgender gay men’s dismissal of the genre as always already problematic due to its emergence from women’s culture with LGBTQ+ Philippine fans’ positioning of BL as an emancipatory media genre that combats homophobia. Ultimately, we argue that attempts by certain critics in the Philippines to downplay the queer emancipatory potentials of BL emerges from a misogynistic rejection of the contributions of women to Philippine queer culture. We conclude by calling for a more nuanced appreciation of BL’s queer interventions which recognises the genre’s deconstructive force.

Beyond barks and bodies: Pup play and body image in gay, bi, trans, and queer men through a Deleuzian lens

Body image is a complex issue that affects individuals from all genders and sexual orientations. Within the queer community pup play is a BDSM-related activity where participants take on the role of a pup/dog, complete with barking, crawling, and other canine behaviors. In this research, we explored how identifying as a pup shapes the body image of gay, bisexual, queer, and trans (GBQT) men using a Deleuzian approach. The process of cellphilming included attendance of three online workshops and the creation of a short cellphilm about their body image. Seventeen participants across five groups completed the workshops and submitted a cellphilm. Data was analyzed through discourse analysis, and while our analysis includes workshop quotes and film excerpts, the true depth of the films, capturing elements like lighting and sound, goes beyond the transcribed words. Three overarching discursive considerations are reported: (i) reinforcing body standards for GBTQ men, (ii) capacity for changing feelings about bodies, and (iii) becoming a pup. Participants suggested that although the pup community is more accepting of diverse bodies, hegemonic body standards for GBTQ men still apply. However, participants also described how identifying as a pup and connecting with others in the pup community was a way to navigate body image tensions.

Morphosyntactic stereotypes of speakers with different genders and sexual orientations: an experimental investigation

Abstract Previous research has identified differences in language use between speakers representing different genders and sexual orientations, as well as stereotypical beliefs about the existence of such differences. The present paper investigates such stereotypical beliefs among speakers of two varieties of Spanish and explores whether linguistic stereotypes of gender and sexual orientation are stronger in a society with more conservative gender roles. We conducted an experiment where 252 speakers of European and Mexican Spanish were shown pairs of texts and sentences depicting the same event but differing in the use of morphosyntactic resources, creating stereotypically “masculine” and “feminine” variants of the same text or sentence. The informants were asked which of the variants was more likely uttered by a woman (rather than a man), a lesbian woman (rather than a straight woman), or a gay man (rather than a straight man). Some of the morphosyntactic features were strongly associated with speaker gender (e.g., use of first- and second-person singular) and others with lesbian (e.g., use of impersonal structures) or gay speakers (e.g., direct reported speech). Contrary to expectations, the responses did not differ according to informants’ age, gender, or nationality. While the present study did not reveal any differences between the two societies, more cross-linguistic and cultural research is needed to elucidate the effect of society on morphosyntactic variation and stereotypes thereof.

Effectiveness of an eHealth intervention for reducing psychological distress and increasing COVID-19 knowledge and protective behaviors among racialized sexual and gender minority adults: A quasi-experimental study (#SafeHandsSafeHearts).

Sexual and gender minority and racialized populations experienced heightened vulnerability during the Covid-19 pandemic. Marginalization due to structural homophobia, transphobia and racism, and resulting adverse social determinants of health that contribute to health disparities among these populations, were exacerbated by the Covid-19 pandemic and public health measures to control it. We developed and tested a tailored online intervention (#SafeHandsSafeHearts) to support racialized lesbian, gay, bisexual, transgender, queer, and other persons outside of heteronormative and cisgender identities (LGBTQ+) in Toronto, Canada during the pandemic. We used a quasi-experimental pre-test post-test design to evaluate the effectiveness of a 3-session, peer-delivered eHealth intervention in reducing psychological distress and increasing Covid-19 knowledge and protective behaviors. Individuals ≥18-years-old, resident in Toronto, and self-identified as sexual or gender minority were recruited online. Depressive and anxiety symptoms, and Covid-19 knowledge and protective behaviors were assessed at baseline, 2-weeks postintervention, and 2-months follow-up. We used generalized estimating equations and zero-truncated Poisson models to evaluate the effectiveness of the intervention on the four primary outcomes. From March to November 2021, 202 participants (median age, 27 years [Interquartile range: 23-32]) were enrolled in #SafeHandsSafeHearts. Over half (54.5%, n = 110) identified as cisgender lesbian or bisexual women or women who have sex with women, 26.2% (n = 53) cisgender gay or bisexual men or men who have sex with men, and 19.3% (n = 39) transgender or nonbinary individuals. The majority (75.7%, n = 143) were Black and other racialized individuals. The intervention led to statistically significant reductions in the prevalence of clinically significant depressive (25.4% reduction, p < .01) and anxiety symptoms (16.6% reduction, p < .05), and increases in Covid-19 protective behaviors (4.9% increase, p < .05), from baseline to postintervention. We demonstrated the effectiveness of a brief, peer-delivered eHealth intervention for racialized LGBTQ+ communities in reducing psychological distress and increasing protective behaviors amid the Covid-19 pandemic. Implementation through community-based organizations by trained peer counselors supports feasibility, acceptability, and the importance of engaging racialized LGBTQ+ communities in pandemic response preparedness. This trial is registered with ClinicalTrials.gov, number NCT04870723.