Participant characteristics (N = 186).

In Ghana, as in many countries globally, sexually diverse, gay and bisexual men who have sex with men (MSM) face a syndemic of HIV and mental illness. This global syndemic of HIV and poor mental health among MSM is driven by social and structural processes, including stigma, human rights abuses, and interpersonal violence that exacerbate marginalization, poverty, and illness and hamper access to health services. Many countries like Ghana lack prevalence data documenting the burden of mental health challenges among MSM. This cross-sectional study followed a waitlist-controlled randomized control trial (RCT) of a multilevel intersectional (HIV, sexual, and gender nonconformity) stigma-reduction intervention for healthcare facility staff and MSM to improve HIV testing in Accra and Kumasi, Ghana. Participants were screened for depression, anxiety and PTSD with the Patient Health Questionaire-9, General Anxiety Disorder-7, and Primary Care Post Traumatic Stress Disorder Screen for DSM-5 (PC-PTSD-5). Univariate analyses were conducted to assess the prevalence of symptoms of depression, suicidality, anxiety, and PTSD by HIV status. 186 participants completed the mental health survey. Among the sample, high prevalence of mental health concerns was reported: 52.1% mild to severe depression; 35.0% suicidality; 50.5% mild to severe anxiety; and 29.8% PTSD. The prevalence was higher among those who were living with HIV compared to HIV negative: moderate to severe depression 25.7 vs. 20.5%; suicidality 45.7% vs. 36.1%; moderate to severe anxiety 9.5% vs. 14.3%; and PTSD 50.0% vs. 30.8%. Investigation of risk and protective factors and investment in mental healthcare for MSM is needed.