Adherence to antiretroviral therapy (ART) is a complex and multi-determined process that is influenced by psychosocial variables. Although international studies have pointed to the adverse impact of HIV stigma, sexual stigma, and depression on ART adherence among men who have sex with men (MSM) with HIV, less is known about this association among Brazilians. We aimed to (a) evaluate indicators of depression, stigma related to HIV and homosexuality, and adherence to ART in a sample of Brazilian MSM living with HIV; (b) assess possible correlations between the variables analyzed, and (c) assess the impact of HIV and sexual stigma and depression on ART adherence. This cross-sectional study comprised 138 Brazilian MSM living with HIV as participants. Scales used included: a sociodemographic/clinical questionnaire, the questionnaire for assessment of adherence to antiretroviral therapy (CEAT-HIV), the Beck depression inventory (BDI-II), the internalized homophobia scale, and the HIV stigmatization scale. The mean adherence score was relatively high (78.83, within a range of 17–89 points). However, we observed inadequate ART adherence (CEAT-HIV < 75) in 28 (20.2%) respondents. Participants reported high scores for internalized sexual stigma, perceived sexual stigma in the community, and HIV stigma. Symptoms of depression were identified in 48.47% of participants. We found negative correlations between depression, HIV stigma, and treatment adherence, but not between sexual stigma and ART adherence. HIV-related stigma and sexual stigma were positively correlated with depression. Our regression analysis indicated that each year of age at diagnosis of HIV increased adherence by 0.22 points, on average. Each additional BDI-II score reduced adherence to ART by 0.20 points. The high prevalence of depression, HIV stigma, and sexual stigma, and their adverse effects on ART adherence and mental health, point to the need to implement evidence-based interventions to reduce sexual and serological stigma in the general population, as well as to mitigate the negative impacts of stigma on MSM living in HIV in Brazil. They also highlight the importance of periodically screening for these variables among MSM treated in Brazilian public health services, especially among those with inadequate adherence to ART.

Despite advances in legislation and social attitudes, workplace discrimination against sexual and gender minority populations remains prevalent, posing significant psychosocial risks. This study aims to explore the occupational health challenges faced by LGBTQIA+ populations, examining factors of discrimination, support, and prevention strategies. Methods: A narrative review of articles from the Scopus, PubMed, and Web of Science databases was carried out, focusing on studies published between 2011 and 2024. Articles in English, Spanish, and Portuguese were considered. Results: 359 studies were identified, and 11 articles were selected for analysis. The findings reveal pervasive discrimination experienced by LGBTQIA+ workers in the workplace, impacting their mental health and job satisfaction. Factors influencing disclosure of sexual or gender identity at work were identified, including workplace characteristics and anti-discrimination policies. Conclusions: Promoting inclusive and supportive work environments is crucial to the well-being of LGBTQIA+ employees. Recommendations include strengthening anti-discrimination protections, improving education and training on LGBTQIA+ issues, and promoting explicit communication about support and equality. Despite progress, more research is needed to address gaps in understanding and effectively promote the occupational health of sexual and gender minority populations.

Understanding the determinants of the occupational health of specific populations and their work-related vulnerabilities is important for developing more effective psychosocial interventions. The aims of this study were (1) to explore differences in occupational health between groups of men versus women and heterosexual versus LGBTQIA+ individuals living in Portugal; (2) to assess whether belonging to LGBTQIA+ groups or being a woman predicts worse occupational health; and (3) to evaluate differences in absenteeism frequency and possible predictors based on sexual orientation and gender. This cross-sectional quantitative study involved 577 participants living and working in Portugal (mean age: 41.62 years, SD = 11.41). To assess occupational health, we used the Copenhagen Psychosocial Questionnaire (COPSOQ III—Middle Version). Women and LGBTQIA+ individuals reported poorer occupational health compared to men and heterosexual individuals, although greater discrepancies were observed in LGBTQIA+ individuals, especially in mental health indicators. Gender and sexual orientation were found to have modest but statistically significant effects on occupational health. The absenteeism frequency was higher among women. Our data suggest improvements in terms of women’s occupational health in Portugal, but not gender equality, which indicates that there are still points to be improved. These findings also suggest the persistence of stigma related to sexual diversity and its effects on the occupational health of LGBTQIA+ and underscore the need for more inclusive workplace policies in Portugal.

Introduction: Different religious narratives associate same-sex sexuality, in its various manifestations, with moral deviation or sin. Gay men who are socialized in more religious communities appear to experience and internalize greater levels of homonegativity, as well as to present greater indicators of depressive symptoms. The purpose of this study was to evaluate indicators of perceived homonegativity in the community and internalized, and signs/symptoms of depression reported by Brazilian gay men with a nominal religion and compare them to those reported by Atheists or Agnostics. Method: Our sample comprised 194 Brazilian gay men, distributed into three groups: Christians (Protestants and Catholics, n = 71; 36.6%); Spiritualists (Kardecists or religions of African origin, n = 52; 26.8%) and Atheists or Agnostics (n = 71; 36.6%). The following measurement instruments were used: sociodemographic questionnaire, Internalized Homophobia Scale and Beck Depression Scale. Results: High mean scores of depression were verified in all groups, and 60% of the sample presented some level of depression. There was a higher level of self-reported homonegativity among Christians and Spiritualists compared to that reported by Atheists or Agnostics, with the differences between the groups being significant. The regression analysis indicated a significant effect of religion on homonegativity, but not on depression. Conclusion: Our results suggest that gay men’s chronic exposure to non-affirming religious affiliation contexts may harm the construction of a positive gay identity and should be taken into consideration when addressing mental health inequalities of sexual minorities.

Homonegativity is associated with several adverse physical and mental health outcomes in gay men. However, the intersection between homonegativity and racism remains little investigated in Brazil. The aim of this study was to assess, in a sample of cisgender Brazilian gay men, associations between skin color, homonegativity, psychological distress, and socioeconomic variables. Method: A cohort of 229 Brazilian gay men, 151 (66%) white and 78 (34%) black or brown were assessed. Participants completed the Internalized Homophobia Scale, the Beck Depression Inventory-II, and the State–Trait Anxiety Inventory. Results: In the general sample, high levels of homonegativity, symptoms of depression, and trait and state anxiety were found, particularly among young and low-income individuals. Black and brown participants reported significantly higher levels of trait and state anxiety, but not depression or homonegativity. Black and brown skin color were a predictor of trait and state anxiety, but not of homonegativity or depression. Conclusions: The high levels of psychological distress and homonegativity found in the general sample indicate the importance of developing preventive interventions of racial discrimination and sexual prejudice for the general community and psychoeducational and therapeutic interventions for Brazilian gay men, regardless of skin color. They also suggest the relevance of customizing these interventions to meet the specificities of black/brown Brazilian gay men, a population doubly exposed to the burden of stigma, considering the intersection between racial and sexual stigma in the Brazilian sociocultural reality.

Background: Compulsive Sexual Behavior Disorder is highly prevalent among men who have sex with men (MSM) and is associated with adverse health outcomes, yet validated assessment tools for this population are critically lacking. This research aimed to adapt the Hypersexual Behavior Inventory (HBI) among Portuguese MSM (N = 1116 across four studies). Method and Results: Following translation and adaptation (Study 1a/1b), Exploratory Factor Analysis suggested a two-factor structure of the instrument (Study 2). Moreover, Item Response Theory showed strong item discrimination and convergent/divergent validity. Confirmatory Factor Analysis (Study 3) favored a bifactor structure—one general hypersexuality factor plus two facets (Control/Consequences and Coping). Criterion validity was evident from positive associations with depression, anxiety, and stress. Finally, ROC analyses (Study 4) demonstrated excellent discrimination and established clinical cutoffs. Conclusions: Overall, the HBI emerges as a reliable, culturally attuned tool for early risk identification in MSM and for informing tailored psychosocial interventions in health settings.