The Intersection of Mental Health and Sexual and Gender Minority Identities for Older Adults Living with Human Immunodeficiency Virus A Narrative Review

Overwhelming evidence suggests a critical need to address mental health disparities that disproportionately affect SGM OALWH in the United States. Yet, there remains a dearth of mental health -focused interventions tailored to SGM OALWH. The development and evaluation of randomized trials containing large and diverse sample sizes of SGM OALWHs are urgently needed. In Box 1 , we outline recent statistics highlighting the intersections of HIV, mental health, aging SGM status, and race/ethnicity. Ultimately, providers must practice cultural humility and sensitivity to SGM OALWH. Given the high rates of trauma exposure in this population, trauma -informed care must be the SOC and address co-occurring mental health conditions that limit engagement in HIV medical care. Clinicians having a repertoire of affirming local, regional, and national SGM OALWH resources to refer patients to is an invaluable resource that can improve health outcomes for this priority population. National -level resources may provide a launching point for identifying locally tailored services (Table 2). Furthermore, knowing that many SGM older adults will never disclose their SGM identity, therefore, creating an affirming clinical environment for all patients without making heterosexual assumptions is critical for improving health outcomes. Clinicians can boost the resilience of this population with culturally congruent and traumainformed care. Finally, policymakers urgently need to prioritize funding interventions that address the salient social determinants that hinder HIV and mental health-care engagement among SGM OALWH.