Predictors of Past-Year Formal and Informal Mental Health Services Utilization Among Young Black Sexually Minoritized Men Living with HIV in Atlanta, GA.

Young Black sexually minoritized men living with HIV (SMM-LWH) face interlocking systems of oppression, including racism, homophobia, and HIV-related stigma, that negatively affect mental health. While mental health services can alleviate some of these inequities, many young Black SMM do not access them. This study aimed to examine factors associated with formal (e.g., psychologists) and informal (e.g., peer support groups) mental health service use among young Black SMM-LWH in Atlanta, GA. Between April 2021 and November 2022, we surveyed 200 young Black SMM aged 18-29 years (mean: 25). Guided by Andersen's Behavioral Model of Health Service Utilization, we used hierarchical logistical regression to examine how predisposing (e.g., education attainment), enabling (e.g., insurance coverage), and need-based (e.g., psychological symptoms) factors were associated with past-year formal and informal mental health use, using hierarchical logistic regression. Participants with higher educational attainment (adjusted odds ratio [aOR] = 1.38; 95% confidence interval [CI]: 1.07-1.77), more adverse childhood experiences (ACEs, aOR = 1.16; 95% CI: 1.06-1.26), and greater trauma symptoms (aOR = 1.03; 95% CI: 1.00-1.06) had greater odds of informal mental health service use. Higher trauma symptoms were the only factor associated with formal service use (aOR = 1.04; 95% CI: 1.01-1.07). Findings suggest that trauma symptoms are key drivers of both formal and informal mental health use, while educational attainment and ACES may facilitate informal help-seeking. Interventions that address trauma and social-structural disadvantage such as limited educational access and early-life adversity may enhance mental health service utilization among this underserved population.