title: "It's for us -newcomers, LGBTQ persons, and HIV-positive persons. You feel free to be": a qualitative study exploring social support group participation among African and Caribbean lesbian, gay, bisexual and transgender newcomers and refugees in Toronto, Canada.
abstract: Stigma and discrimination harm the wellbeing of lesbian, gay, bisexual and transgender (LGBT) people and contribute to migration from contexts of sexual persecution and criminalization. Yet LGBT newcomers and refugees often face marginalization and struggles meeting the social determinants of health (SDOH) following immigration to countries such as Canada. Social isolation is a key social determinant of health that may play a significant role in shaping health disparities among LGBT newcomers and refugees. Social support may moderate the effect of stressors on mental health, reduce social isolation, and build social networks. Scant research, however, has examined social support groups targeting LGBT newcomers and refugees. The purpose of this qualitative study was to explore experiences of social support group participation among LGBT African and Caribbean newcomers and refugees in an urban Canadian city.
  
  
  
  We conducted 3 focus groups with a venue-based sample of LGBT African and Caribbean newcomers and refugees (n = 29) who attended social support groups at an ethno-specific AIDS Service Organization. Focus groups followed a semi-structured interview guide and were analyzed using narrative thematic techniques.
  
  
  
  Participant narratives highlighted immigration stressors, social isolation, mental health issues, and challenges meeting the SDOH. Findings reveal multi-level benefits of social support group participation at intrapersonal (self-acceptance, improved mental health), interpersonal (reduced isolation, friendships), community (reciprocity, reduced stigma and discrimination), and structural (housing, employment, immigration, health care) levels.
  
  
  
  Findings suggest that social support groups tailored for LGBT African and Caribbean newcomers and refugees can address social isolation, community resilience, and enhance resource access. Health care providers can provide support groups, culturally and LGBT competent health services, and resource access to promote LGBT newcomers and refugees' health and wellbeing.
authors.affiliation: Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, M5S 1V4, ON, Canada. carmen.logie@utoronto.ca.|Women's College Research Institute, Women's College Hospital, 790 Bay Street, 7th Floor, Toronto, M5G 1N8, ON, Canada. carmen.logie@utoronto.ca.
authors.forename: Carmen H
authors.initials: CH
authors.lastname: Logie
authors.affiliation: Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, M5S 1V4, ON, Canada.
authors.forename: Ashley
authors.initials: A
authors.lastname: Lacombe-Duncan
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, M5T 3M7, ON, Canada.
authors.forename: Nakia
authors.initials: N
authors.lastname: Lee-Foon
authors.affiliation: Black Coalition for AIDS Prevention, 20 Victoria Street, 4th Floor, Toronto, M5C 2N8, ON, Canada.
authors.forename: Shannon
authors.initials: S
authors.lastname: Ryan
authors.affiliation: Black Coalition for AIDS Prevention, 20 Victoria Street, 4th Floor, Toronto, M5C 2N8, ON, Canada.
authors.forename: Hope
authors.initials: H
authors.lastname: Ramsay
mesh_terms: D000328:Adult; D000349:Africa; D002170:Canada; D017691:Caribbean Region; D054242:Emigrants and Immigrants; D005006:Ethnicity; D005260:Female; D015658:HIV Infections; D006296:Health Services; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008603:Mental Health; D036301:Qualitative Research; D012036:Refugees; D000072339:Sexual and Gender Minorities; D066270:Social Capital; D064890:Social Determinants of Health; D063508:Social Discrimination; D012934:Social Isolation; D057545:Social Stigma; D012944:Social Support; D055815:Young Adult
keywords: LGBT; Mental health; Newcomer; Refugee; SDOH; Sexual and gender minorities; Social determinants of health; Social support