Depression and anxiety among HIV-positive men who have sex with men and men who have sex with women in China

Abstract

China is experiencing an emerging HIV epidemic among men who have sex with men (MSM). Minority stress theory posits that marginalized populations experience additional stress, which influences experiences of psychological distress and health outcomes. This study aimed to understand psychological distress of MSM relative to men who have sex with women (MSW) in an urban Chinese setting. Cross-sectional survey data were collected from 162 HIV-positive Chinese men receiving HIV treatment at Beijing's Ditan Hospital. Multiple linear regression with imputation was used to identify correlates of psychological distress. Relative to MSW, MSM were younger, more educated, and less likely to be in a relationship or have children. While both groups reported clinically elevated levels of depression and anxiety, sexual behavior was not associated with either outcome. Higher endorsement of depression symptomology was associated with worse reported physical health (β = −1.37, p < .05) and greater endorsement of maladaptive coping (β = 2.39, p < .05), whereas higher endorsement of anxiety symptomology was associated with greater endorsement of adaptive coping (β = 0.78, p < .05), diminished physical health (β = −0.86, p < .05), and a high school or greater level of education (β = 4.13, p < .05). These findings suggest that interventions targeting coping strategies may address psychological distress among HIV-positive Chinese men.

Integrating HIV and mental health interventions to address a global syndemic among men who have sex with men

“…35 Several studies have found links between exposure to minority stress and HIV risk or treatment outcomes among MSM. [36][37][38] A life-course epidemiology approach has been used to explain current mental health and HIV status, including HIV-related behaviours, as a function of the accumulation of risks and protective factors throughout a person's previous life stages. 39 This approach uses a temporal and social perspective to understand current health patterns, recognising the effect of earlier life events (eg, childhood abuse, peer bullying, and early life trauma) on HIV and mental health outcomes later in life.…”

HIV-Related Stigma, Sexual Identity, and Depressive Symptoms Among MSM Living With HIV in China: A Moderated Mediation Modeling Analysis

“…HIV-related stigma might aggravate depressive symptoms among MSM living with HIV ( Wohl et al, 2013 ; Yan et al, 2019 ; X. Yang et al, 2020 ). Although MSM living with HIV perceive and experience various types of stigma, the influence of HIV stigma has been revealed to overshadow the degree to which sexual identity–related stigma influences psychological distress for this population ( Aunon et al, 2020 ). HIV-related stigma is pervasive ( Li et al, 2016 ; Rao et al, 2008 ) and compromises people living with HIV’s (PLWH) mental health through social isolation ( Courtenay–Quirk et al, 2006 ), lack of social support ( Dowshen et al, 2009 ), self-blame, and impaired self-esteem ( Dowshen et al, 2009 ; Kalichman et al, 2009 ).…”

The relationship between acceptance of illness and quality of life among men who have sex with men living with human immunodeficiency virus: A cross-sectional study

“…Chinese MSM living with HIV not only face physical, psychological and social problems, but also suffer from the stress of HIV infection and the stigma and discrimination associated with HIV and sexual minorities [ 6 , 7 ]. The above multiple stressors have been shown to increase the risk for increased viral load, non-adherence to medication, and decreased QOL [ 8 , 9 ]. Given that QOL is an important indicator of HIV treatment and management and that the QOL of MSM living with HIV is of great concern, it is urgent to explore the factors associated with QOL of MSM living with HIV.…”