The COVID-19 pandemic magnified the mental health disparities between sexual minorities and the Filipino population. This study explored the mental health disparities experienced by sexual minorities, which remains unexplored. The study utilized self-administered survey forms to explore the extent and social determinants of an alcohol use disorder, depression, and anxiety among Filipino sexual minority males during the pandemic. A total of 220 participants were recruited in October 2020. They were composed of adult Filipino cisgender males with non-heterosexual orientation from Metro Manila. The results showed significant rates of risk for alcohol use disorder, depression, and anxiety at 36.4%, 9.5%, and 26.4%, respectively. Age (OR=0.886, p=.025), homosexual orientation (OR=0.035, p=.033), bisexual orientation (OR= 0.009, p=.011), and living with relatives (OR=0.162, p=.006) were also significantly associated with depression. Age (OR=0.866, p=<.001) was significantly associated with anxiety. Moreover, compared with the general population during the pandemic, Filipino sexual minorities’ risk for alcohol use disorder was higher than depression and anxiety. These disparities were significantly associated with age, sexual orientation, and living arrangements. The findings suggest comorbidities of an alcohol use disorder, depression, and anxiety among Filipino sexual minorities that can be addressed through cost-effective online treatment modalities, information-education campaigns, integration of mental health into educational curriculums, the institution of policies that bar discrimination against sexual minorities, and initiatives to strengthen family support groups.

• Ahmed, F., Ahmed, N. E., Pissarides, C., & Stiglitz, J. (2020). Why inequality could spread COVID-19. The Lancet Public Health, 5(5), e240. https://doi.org/10.1016/S2468-2667(20)30085-2

• Alibudbud, R. (2021a). Academic experiences as determinants of anxiety and depression of Filipino college students in Metro Manila. Youth Voice Journal, 11, 1-21.

• Alibudbud, R. (2021b). On online learning and mental health during the COVID-19 pandemic: Perspectives from the Philippines. Asian Journal of Psychiatry, 66, Article 102867. https://doi.org/10.1016/j.ajp.2021.102867

• Alibudbud, R. C. (2021c). “Does sexual orientation matter?”: A comparative analysis of the prevalence and determinants of depression and anxiety among heterosexual and non-heterosexual college students in a university in Metro Manila. Journal of Homosexuality. Advance online publication. https://doi.org/10.1080/00918369.2021.2015953

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorder (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

• American Psychiatric Association. (2018). Mental Health Facts for Gay Populations. https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-Health-Facts-for-Gay-Populations.pdf

• Babor, T. F., Higgins-Biddle, J. C., Saunders, J. B., & Monteiro, M. G. (2001). The alcohol use disorders identification test: Guidelines for use in primary health care (2nd ed.). https://www.who.int/publications/i/item/WHO-MSD-MSB-01.6a

• Bjelland, I., Dahl, A. A., Haug, T. T., & Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: An updated literature review. Journal of Psychosomatic Research, 52(2), 69-77. https://doi.org/10.1016/S0022-3999(01)00296-3

• Bonita, R., Beaglehole, R., & Kjellström, T. (2006). Basic epidemiology. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/43541/9241547073_jpn.pdf

• Cleofas, J. V. (2021). Understanding COVID-19 pandemic through Science, Technology and Society (STS) Education: a textual analysis of student reflection papers. Pertanika Journal of Social Sciences & Humanities, 29(3), 1997-2012. https://doi.org/10.47836/pjssh.29.3.27

• Cleofas, J. V., & Rocha, I. (2021). Demographic, gadget and internet profiles as determinants of disease and consequence related COVID-19 anxiety among Filipino college students. Education and Information Technologies, 26(6), 6771-6786. https://doi.org/10.1007/s10639-021-10529-9

• Cockerham, W. C. (Ed.). (2017). Medical sociology (14th ed.). Routledge

• D’Augelli, A. R. (2006). Developmental and contextual factors and mental health among lesbian, gay, and bisexual youths. In A. M. Omoto & H. S. Kurtzman (Eds.), Contemporary perspectives on lesbian, gay, and bisexual psychology. Sexual orientation and mental health: Examining identity and development in lesbian, gay, and bisexual people (pp. 37-53). American Psychological Association. https://doi.org/10.1037/11261-002

• de Guzman, M. L. R. E. (2013). A validation of the hospital anxiety and depression scale (HADS) in the medically-ill. Acta Medica Philippina, 47(3). https://doi.org/10.47895/amp.v47i3.1318

• Drabble, L. A., & Eliason, M. J. (2021). Introduction to special issue: Impacts of the COVID-19 pandemic on LGBTQ+ health and well-being. Journal of Homosexuality, 68(4), 545-559. https://doi.org/10.1080/00918369.2020.1868182

• Egcas, R. A., Oducado, R. M. F., Visperas, J., Cleofas, J. S. R., & Lausa, S. M. (2021). After over a year of pandemic: Mental well-being and life satisfaction of Filipino college students. Pertanika Journal of Social Sciences & Humanities, 29(4). https://doi.org/10.47836/pjssh.29.4.17

• Estacio, L., Estacio, J. Z., & Alibudbud, R. (2021). Relationship of psychosocial factors, HIV, and sex work among Filipino drug users. Sexual Research and Social Policy, 18(4), 933-940. https://doi.org/10.1007/s13178-021-00563-0

• Gauiran, D. T. V., Samala, K. G., Lim, J. A., & De Guzman, M. L. R. E. (2018). Measurement of anxiety and depression among HIV Patients seen in the Philippine General Hospital using the Hospital Anxiety and depression Scale–Pilipino Version (HAdS-P). Acta Medica Philippina, 52(1). https://doi.org/10.47895/amp.v52i1.466

• Goldbach, C., Knutson, D., & Milton, D. C. (2021). LGBTQ+ people and COVID-19: The importance of resilience during a pandemic. Psychology of Sexual Orientation and Gender Diversity, 8(2), 123-132. https://doi.org/10.1037/sgd0000463

• Hao, F., Wang, B., Tan, W., Husain, S. F., McIntyre, R. S., Tang, X., Zhang, L., Han, X., Jiang, L., Chew, N., Tan, B. Y., Tran, B., Zhang, Z., Vu, G. L., Vu, G. T., Ho, R., Ho, C. S., & Sharma, V. K. (2021). Attitudes toward COVID-19 vaccination and willingness to pay: Comparison of people with and without mental disorders in China. BJPsych Open, 7(5), e146. https://doi.org/10.1192/bjo.2021.979

• Ho, C. S., Chee, C. Y., & Ho, R. C. (2020). Mental health strategies to combat the psychological impact of coronavirus disease 2019 (COVID-19) beyond paranoia and panic. Annals of the Academy of Medicine, Singapore, 49(3), 155-160.

• Human Rights Watch. (2017, June 21). “Just let us be” Discrimination against LGBT students in the Philippines. https://www.hrw.org/report/2017/06/21/just-let-us-be/discrimination-against-lgbt-students-philippines

• Lally, J., Samaniego, R. M., & Tully, J. (2019). Mental health legislation in the Philippines: Philippine Mental Health Act. BJPsych International, 16(3), 65-67. https://doi.org/10.1192/bji.2018.33

• Lehmiller, J. J., Garcia, J. R., Gesselman, A. N., & Mark, K. P. (2021). Less sex, but more sexual diversity: Changes in sexual behavior during the COVID-19 coronavirus pandemic. Leisure Sciences, 43(1-2), 295-304. https://doi.org/10.1080/01490400.2020.1774016

• Manalastas, E. J. (2013). Sexual orientation and suicide risk in the Philippines: Evidence from a nationally representative sample of young Filipino men. Philippine Journal of Psychology, 46(1), 1-13.

• Manalastas, E. J., Torre, B. A., Manalastas, E. J., & Torre, B. A. (2016). LGBT psychology in the Philippines. Psychology of Sexuality Review, 7(1), 60-72.

• Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of Health And Social Behavior, 36(1), 38-56. https://doi.org/10.2307/2137286

• Meyer, I. H., & Frost, D. M. (2013). Minority stress and the health of sexual minorities. In C. J. Patterson & A. R. D’Augelli (Eds.), Handbook of psychology and sexual orientation (p. 252-266). Oxford University Press. https://psycnet.apa.org/record/2012-32754-018

• Meyer, I. H., & Wilson, P. A. (2009). Sampling lesbian, gay, and bisexual populations. Journal of Counseling Psychology, 56(1), 23. http://doi.org/10.1037/a0014587

• Ogundimu, E. O., Altman, D. G., & Collins, G. S. (2016). Adequate sample size for developing prediction models is not simply related to events per variable. Journal of Clinical Epidemiology, 76, 175-182. https://doi.org/10.1016/j.jclinepi.2016.02.031

• Pan AmC., Chudzicka-Czupała, A., Grabowski, D., Pan, R., Adamus, K., Wan, X., Hetnał, M., Tan, Y., Olszewska-Guizzo, A., Xu, L., McIntyre, R. S., Quek, J., Ho, R., & Ho, C. (2020). The association between physical and mental health and face mask use during the COVID-19 pandemic: A comparison of two countries with different views and practices. Frontiers in Psychiatry, 11, Article 569981. https://doi.org/10.3389/fpsyt.2020.569981

• World Health Organization. (2016). Philippines. https://www.who.int/substance_abuse/publications/global_alcohol_report/profiles/phl.pdf?ua=1

• Yanita, S. R., & Suhardijanto, T. (2020). Corpus-based analysis of lesbian, gay, bisexual, and transgender representations in Republika. Pertanika Journal of Social Sciences & Humanities, 28(1), 143-160.

• Yusoff, M. S. B. (2019). ABC of content validation and content validity index calculation. Resource, 11(2), 49-54. https://doi.org/10.21315/eimj2019.11.2.6

• Zhang, M. W., & Ho, R. C. (2017). Moodle: The cost effective solution for internet cognitive behavioral therapy (I-CBT) interventions. Technology and Health Care, 25(1), 163-165. https://doi.org/10.3233/THC-161261

• Zigmond,erican Health Organization & World Health Organization. (2013). Addressing The Causes of Disparities in Health Service Access and Utilization for Lesbian, Gay, Bisexual And Trans (LGBT) Persons. 52nd Directing Council 65th Session of The Regional Committee. Pan American Health Organization. https://iris.paho.org/bitstream/handle/10665.2/4411/CD52_18eng.pdf?sequence=1&isAllowed=y

• Peduzzi, P., Concato, J., Kemper, E., Holford, T. R., & Feinstein, A. R. (1996). A simulation study of the number of events per variable in logistic regression analysis. Journal of Clinical Epidemiology, 49(12), 1373-1379. https://doi.org/10.1016/s0895-4356(96)00236-3

• Philippine Daily Inquirer. (2020, September 30). In the know: Facebook in PH. Inquirer.net. https://newsinfo.inquirer.net/1341781/in-the-know-facebook-in-ph

• Philippine Statistics Authority. (2013, January 10). The Educational Attainment of the Household Population (Results from the 2010 Census). https://psa.gov.ph/content/educational-attainment-household-population-results-2010-census

• Rehm, J., & Patra, J. (2010). Atlas on substance use. World Health Organization. https://www.who.int/substance_abuse/activities/msbatlaschone.pdf

• Russell, S. T., & Fish, J. N. (2016). Mental health in lesbian, gay, bisexual, and transgender (LGBT) youth. Annual Review of Clinical Psychology, 12, 465-487. https://doi.org/10.1146/annurev-clinpsy-021815-093153

• Sadock, B., Sadock, V., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

• Salerno, J. P., Devadas, J., Pease, M., Nketia, B., & Fish, J. N. (2020). Sexual and gender minority stress amid the COVID-19 pandemic: Implications for LGBTQ young persons’ mental health and well-being. Public Health Reports, 135(6), 721-727. https://doi.org/10.1177/0033354920954511

• See, A. B. (2021, March 15). Rodrigo Duterte is using one of the world’s longest COVID-19 lockdowns to strengthen his grip on the Philippines. https://time.com/5945616/covid-philippines-pandemic-lockdown/

• Snaith, R. P. (2003). The hospital anxiety and depression scale. Health and Quality of Life Outcomes, 1(1), 1-4. https://doi.org/10.1186/1477-7525-1-29

• Soh, H. L., Ho, R. C., Ho, C. S., & Tam, W. W. (2020). Efficacy of digital cognitive behavioural therapy for insomnia: A meta-analysis of randomised controlled trials. Sleep Medicine, 75, 315-325. https://doi.org/10.1016/j.sleep.2020.08.020

• Tajudin, P. N. M., Rahim, N. A. A., Idris, K., & Arshad, M. M. (2021). Weathering the economic impact of COVID-19: Challenges faced by microentrepreneurs and their coping strategies during Movement Control Order (MCO) in Malaysia. Pertanika Journal of Social Sciences & Humanities, 29(S1), 271-290. https://doi.org/10.47836/pjssh.29.S1.15

• Tan, K. K. H., Lee, K. W., & Cheong, Z. W. (2021). Current research involving LGBTQ people in Malaysia: A scoping review informed by a health equity lens. Journal of Population and Social Studies, 29, 622-643. http://doi.org/10.25133/JPSSv292021.038

• Tee, M. L., Tee, C. A., Anlacan, J. P., Aligam, K. J. G., Reyes, P. W. C., Kuruchittham, V., & Ho, R. C. (2020). Psychological impact of COVID-19 pandemic in the Philippines. Journal of Affective Disorders, 277, 379-391. https://doi.org/10.1016/j.jad.2020.08.043

• Tuliao, A. P., Landoyb, B. V., & McCharguea, D. E. (2016). Factor structure and invariance test of the alcohol use disorder identification test (AUDIT): Comparison and further validation in a U.S. and Philippines college student sample. Journal of Ethnicity in Substance Abuse, 15(2), 127-143. https://doi.org/10.1080/15332640.2015.1011731

• United Nations Development Programme & United States Agency for International Development. (2014). Being LGBT in Asia: The Philippines Country Report. United Nations Development Programme. https://www.undp.org/content/undp/en/home/librarypage/hiv-aids/being-lgbt-in-asia--the-philippine-country-report.html

• Wang, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x