Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Medical Science (MMSc)

First Advisor

John E. Pachankis, PhD


Young rural gay and bisexual men suffer a disproportionate burden of psychiatric disorders compared to their urban and heterosexual counterparts because of the increased stigma-related stressors they face. Co-occurring mental and behavioral health problems often affect them, including depression and substance use disorders. In two randomized controlled trials, a gay-affirmative cognitive behavioral therapy called Effective Skills to Empower Effective Men significantly decreased alcohol use, and improved mental health outcomes among urban gay and bisexual men by targeting stigma-related stress responses. However, the intervention’s efficacy has not been studied among rural populations. In a randomized controlled trial, we propose to deliver this intervention via telehealth to young gay and bisexual men with co-occurring mental and behavioral health problems in rural areas of the South. A successful ESTEEM trial among rural southern gay and bisexual men could address unmet mental health needs in other rural regions.

Open Access

This Article is Open Access