PROJECT SUMMARY
Older gay and bisexual men living with HIV (OGBMLH) are twice as likely to experience depression compared
to heterosexual and HIV-negative counterparts. Depression is now a leading cause of morbidity and mortality
among OGBMLH, exceeding that caused by HIV. Consistent with national trends, major contributing factors
are elevated rates of loneliness, social isolation, and lack of social support. Innovative interventions that
connect OGBMLH to services that increase social support and resilience to reduce depression and loneliness
are needed to improve the health and quality of life of OGBMLH. While many socially isolated OGBMLH could
benefit from community-building elder services such as congregate meal programs, bereavement groups,
support groups, and social gatherings, many do not access services, in part due to fear of discrimination.
Scalable efforts are needed to help OGBMLH struggling with depression and loneliness to overcome barriers
to engagement in existing social services that could significantly reduce depression and loneliness. We aim to
develop and refine a novel evidence-informed intervention, Bridge 2 Belonging (B2B), to reduce depression
and loneliness among OGBMLH by leveraging three evidence-based intervention strategies: cognitive
behavioral therapy-based friendship enrichment program (FEP), motivational interviewing (MI) communication
styles, and peer mentorship (PM). Guided by the ADAPT-ITT model, we will systematically solicit feedback on
these interventions from OGBMLH (n=30) and subsequently community experts (n=15) to iteratively inform an
innovative peer-delivered B2B intervention to increase participation in LGBTQ+ affirmative community-building
services to reduce symptoms of depression and loneliness, and secondarily improve physical health and
quality of life. We will then conduct a small proof-of-concept pilot (n=15) to assess the feasibility and
acceptability of the B2B intervention, including the produced manual and peer training. By systematically
adapting evidence-based content informed by stakeholder feedback, this R21 will produce and pilot a critically
needed intervention to increase engagement in affirmative community-building services to decrease
depression and loneliness, as well as improve physical health and quality of life among OGBMLH.
