Loneliness and depressive symptoms among men who have sex with men in China: A cross-sectional study

Liu, Yuhan; Yang, Yuting; Fu, Chaowei; Lin, Haijiang; Wang, Tingting; Wang, Shanling; Kuang, Jiawen; Chen, Xiaoxiao; Wang, Jingyi

doi:10.3389/fpsyt.2023.1179703

Cited by 3 publications

(1 citation statement)

References 60 publications

(71 reference statements)

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“…Previous research has shown that MSM stigma is a stronger predictor of depression than stress in general: perceived stigma and enacted stigma were highly prevalent among 736 participants, and stigma was associated with a higher prevalence of depressive symptoms [16]. The results of a cross-sectional study of Chinese MSM show that discrimination and stigma play an important role in the development of depression [17]. The results of another study in Nanjing, China, showed that perceived stigma not only directly affects depressive symptoms but also indirectly affects depression through other factors [18].…”

Section: Introductionmentioning

confidence: 91%

A Study of the Relationship between Men Who Have Sex with Men Stigma and Depression: A Moderated Mediation Model

Zhou,

Chen,

Zhong

2023

Healthcare

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(1) Background: Men who have sex with men (MSM) have a high prevalence of depression due to stigma. However, whether resilience and social support play a moderating role in the effects of stigma on depression remains to be tested. This study constructed a moderated mediation model to explore the mediating role of perceived stigma in the relationship between enacted stigma and depression and whether this relationship is moderated by social support. (2) Methods: MSM were recruited during November–December 2022 using a non-probability sampling method, and a total of 1091 participants were included. Enacted stigma, perceived stigma, resilience, social support, and depressive symptoms were measured. Mediation and moderated mediation models were used to analyze the relationships between these variables. (3) Results: Moderated mediation analyses show that enacted stigma indirectly affects depression through perceived stigma (β = 0.315, 95% confidence interval = 0.221 to 0.421). Social support had a positive moderating effect between enacted stigma and depressive symptoms (β = 0.194, p < 0.001) and a negative moderating effect between perceived stigma and depressive symptoms (β = −0.188, p < 0.001). (4) Resilience and perceived stigma mediated the relationship between enacted stigma and depression, and the relationship between enacted stigma, perceived stigma, and depression was moderated by social support. Reducing stigma while increasing social support has the potential to alleviate depressive symptoms among Chinese MSM.

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Section: Introductionmentioning

confidence: 91%

A Study of the Relationship between Men Who Have Sex with Men Stigma and Depression: A Moderated Mediation Model

Zhou,

Chen,

Zhong

2023

Healthcare

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Disrupting the Path from Depression to Loneliness: Multilevel Resilience among Older Sexual Minority Men with and without HIV

Jesus,

Ware,

Meanley

et al. 2024

AIDS Behav

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Existing studies examining resilience among sexual minority men (SMM) have been limited by only analyzing 1 level of resilience. We therefore investigated the impact of multiple levels of resilience on the bidirectional relationship between loneliness and depression symptoms among older SMM. Loneliness, depression symptoms, and multilevel resilience scores were collected across 3 time points (October 2016 to March 2017 [T1]; October 2017 to March 2018 [T2]; and October 2018 to March 2019 [T3]) among 1,264 SMM aged 40 years and older living with and without HIV. Longitudinal mediation models were used to test the mediating effect of the multilevel resilience factors at T2 on the bidirectional relationship between loneliness and depression symptoms, adjusting for sociodemographic covariates. The multilevel resilience factors were negatively associated with loneliness and depression symptoms at T1. The individual-level global resilience factor was associated with decreased odds of depression symptoms (odds ratio [OR] = 0.50; 95% CI, 0.32–0.78), while the interpersonal-level relationship confidence (OR = 0.43; 95% CI, 0.24–0.77) and reliability (OR = 0.36; 95% CI, 0.15–0.84) factors were associated with decreased odds of loneliness at T3. The total effect of loneliness at T1 on depressive symptoms at T3 was β = 0.20 (95% CI, 0.11–0.28) and was reduced to β = 0.08 (95% CI, -0.04 to 0.20) after the inclusion of the multilevel resilience factors. The total effect of depressive symptoms at T1 on loneliness at T3 was similar (β = 0.21; 95% CI, 0.13–0.28) with the direct effect of β = 0.01 (95% CI, -0.08 to 0.11) after the inclusion of the multilevel resilience factors. Regarding specific indirect effects, individual-level global resilience (depression symptoms at T3 only) as well as the interpersonal-level relationship reliability and confidence (loneliness at T3 model only) factors were statistically significant. Multilevel resilience factors mediated the bidirectional relationship between loneliness and depression symptoms. Mental health interventions should consider implementing resilience-informed strategies that mitigate depression symptoms and loneliness among older SMM.

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Improving prevalence estimates of mental health and well-being indicators among sexual minority men: a propensity-weighting approach

Dharma,

Smith,

Escobar

et al. 2024

American Journal of Epidemiology

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The prevalence and relative disparities of mental health outcomes and well-being indicators are often inconsistent across studies of Sexual Minority Men (SMM) due to selection biases in community-based surveys (non-probability sample), as well as misclassification biases in population-based surveys where some SMM often conceal their sexual orientation identities. The current paper estimated the prevalence of mental health related outcomes (depressive symptoms, mental health service use [MHSU], anxiety) and well-being indicators (loneliness and self-rated mental health) among SMM, broken down by sexual orientation using the Adjusted Logistic Propensity score (ALP) weighting. We applied the ALP to correct for selection biases in the 2019 Sex Now data (a community-based survey of SMMs in Canada) by reweighting it to the 2015-2018 Canadian Community Health Survey (a population survey from Statistics Canada). For all SMMs, the ALP-weighted prevalence of depressive symptoms is 15.96% (95% CI: 11.36%, 23.83%), while for MHSU, it is 32.13% (95% CI: 26.09, 41.20). The ALP estimates lie in between the crude estimates from the two surveys. This method was successful in providing a more accurate estimate than relying on results from one survey alone. We recommend to the use of ALP on other minority populations under certain assumptions.

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Loneliness and depressive symptoms among men who have sex with men in China: A cross-sectional study

Cited by 3 publications

References 60 publications

A Study of the Relationship between Men Who Have Sex with Men Stigma and Depression: A Moderated Mediation Model

A Study of the Relationship between Men Who Have Sex with Men Stigma and Depression: A Moderated Mediation Model

Disrupting the Path from Depression to Loneliness: Multilevel Resilience among Older Sexual Minority Men with and without HIV

Improving prevalence estimates of mental health and well-being indicators among sexual minority men: a propensity-weighting approach

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