Family and its Role in HIV, Mental Health, Violence, and Stigma Among Indigenous Gay and Bisexual Men in Guatemala: A Qualitative Study

Abstract

Guatemala is a highly religious and conservative country with one of the largest Indigenous populations in the world. Due to centuries of oppression since Spanish colonization, Indigenous people have faced discrimination leading to a number of health and economic disparities. In addition, there are no protections against discrimination for sexual minorities in Guatemala. Therefore, Indigenous sexual minorities are at increased risk of experiencing negative health outcomes, violence, and intersectional stigma. Studies have shown the protective effect of familial social support for sexual minorities and in Guatemala, family plays a major role in economic and social support throughout an individual's life span. This study aims to examine the experiences of Indigenous gay and bisexual men (GBM) in Guatemala and the role that family plays in HIV, mental health, violence, and stigma using qualitative methods. In this study, 22 semi-structured, in-depth interviews were conducted with Indigenous GBM from Guatemala. These interviews were then coded and analyzed to identify themes related to the study aims. The results show that familial relationships are central to the lives of Indigenous GBM, but many felt that they had to choose between family and their personal freedom. Maternal relationships were highly valued among GBM, while paternal relationships were more absent, and at times hostile and violent. Family often served as a source of negative mental health, as well as a resource in accessing mental health services. Violence was common among family members, especially from fathers and brothers. Religion was a central reason that Indigenous GBM feared rejection from their parents and where many homophobic attitudes were learned and perpetuated. Indigenous GBM recommended that there be services that address family relationships and help GBM navigate coming out and repairing relationships with their parents and siblings. This study provides necessary context in order to create culturally relevant interventions to address the health disparities experienced by Indigenous GBM in Guatemala.