Researchers from the Institute on Sexuality, Inequality and Health at San Francisco State University in San Francisco, CA collected data from a probability sample of 912 men who lived in New York, NY, Miami, FL and Los Angeles, CA. All identified as Latino and non-heterosexual, and almost 90 percent were between the ages of 20 and 40. The sample was recruited at gay social venues popular among Latinos (such as bars, clubs and weeknight events) and from a publicity campaign. Around 70 percent of participants were immigrants, over half of whom lived in the United States for 10 years or less. The study took place between October 1998 and March 1999.

Participants completed face-to-face interviews, which assessed symptoms of psychological distress, financial hardship and experiences of homophobia and racism during childhood and adulthood. The men also answered questions pertaining to loneliness, self-esteem and social support systems (i.e., family members who accept them, connection to their community).

In the six months prior to the study, 61 percent of participants reported at least one occurrence of sleep problems, 44 percent reported anxiety, 80 percent reported sad or depressed mood and 17 percent reported suicidal ideation. Significantly, over one in five reported sad or depressed mood "many times" within this time period.

The three most commonly reported experiences of homophobia all happened during childhood: hearing that gays are not normal, hearing that gays grow up to be alone and harboring a deep feeling that being gay hurts and embarrasses one’s family. Racism was reported less frequently than homophobia (perhaps because many of the men were immigrants and therefore did not grow up in a racial minority). The most commonly reported experience of racism was, in fact, in the context of intimacy: 62 percent said they felt others objectified them sexually based on their ethnicity. In terms of finances, 61 percent reported running out of money for basic necessities at some point in their lives and 54 percent reported needing to borrow money to survive. Overall, almost a third of the men were unemployed, "surprisingly high" figures considering that 65 percent of participants reported having had some college education, the study authors noted.

After careful analysis, the researchers found that homophobia, racism and financial problems combined with a lack of social support systems strongly predict social isolation and low-self esteem, which in turn lead to psychological distress. They also found that loneliness and low self-esteem in and of themselves strongly predict symptoms of psychological distress (such as depression and anxiety).

In addition, around 22 percent of participants reported being HIV-positive, 68 percent HIV-negative and 10 percent unsure of their serostatus. Though the study did not explore how HIV affects mental health, the researchers noted that participants with HIV reported higher levels of psychological distress than those not infected. A report on the relationship between HIV and the mental health of gay and bisexual Latinos is forthcoming, the researchers added.

"The negative mental health outcomes observed in this study are deeply connected to a lifelong history and current experiences of social discrimination owing to sexual orientation and racial/ethnic diversity, as well as high levels of financial hardship due to severe unemployment and poverty," the study authors wrote.

All in all, mental health programs that target gay and bisexual Latinos -- particularly immigrants -- must address the isolation and low self-esteem that can result from social discrimination and poverty, the researchers concluded. Programs should also build upon community involvement, gay-friendly family members and any other available social support systems to reduce or reverse the negative mental health effects of discrimination.