Psychosocial Distress Among Young Men Who Have Sex With Men: A Scoping Review.

All eight included studies were cross-sectional, so they measured stressors and outcomes at one time and cannot show that distress caused risky behavior or poor HIV outcomes. No study explicitly measured psychosocial distress; they used different measures of psychological distress, anxiety or depression, so the findings may not capture social threat stressors. The search used terms for men who have sex with men and may have missed studies using other sexuality language. Only studies from the United States published in the past 10 years, in English, and with men who self-identified as homosexual or bisexual were included, so transgender people, other sexual minority groups and other countries are not represented. Most samples were predominantly Black or African American men, and six of the eight studies had sample sizes small enough to limit generalizability. Age was handled inconsistently across studies, with only half focusing on younger men and some analyses not stratifying by age.

Do not read this as proof that distress causes poor HIV outcomes or that a distress screen will improve viral suppression. All included studies were cross-sectional, and no included study measured psychosocial distress directly, so the review can identify associations but cannot establish cause and effect.