Sexual Identity, Stigma, and Depression: the Role of the “Anti-gay Propaganda Law” in Mental Health among Men Who Have Sex with Men in Moscow, Russia
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Depression is a major public health problem in the Russian Federation and is particularly of concern for men who have sex with men (MSM). MSM living in Moscow City were recruited via respondent-driven sampling and participated in a cross-sectional survey from October 2010 to April 2013. Multiple logistic regression models compared the relationship between sexual identity, recent stigma, and probable depression, defined as a score of ≥23 on the Center for Epidemiological Studies Depression scale. We investigated the interactive effect of stigma and participation in the study after the passage of multiple “anti-gay propaganda laws” in Russian provinces, municipalities, and in neighboring Ukraine on depression among MSM. Among 1367 MSM, 36.7% (n = 505) qualified as probably depressed. Fifty-five percent identified as homosexual (n = 741) and 42.9% identified as bisexual (n = 578). Bisexual identity had a protective association against probable depression (reference: homosexual identity AOR 0.71; 95%CI 0.52–0.97; p < 0.01). Those who experienced recent stigma (last 12 months) were more likely to report probable depression (reference: no stigma; AOR 1.75; 95%CI 1.20–2.56; p < 0.01). The interaction between stigma and the propaganda laws was significant. Among participants with stigma, probable depression increased 1.67-fold after the passage of the anti-gay laws AOR 1.67; 95%CI 1.04–2.68; p < 0.01). Depressive symptoms are common among MSM in Russia and exacerbated by stigma and laws that deny homosexual identities. Repeal of Russia’s federal anti-gay propaganda law is urgent but other social interventions may address depression and stigma in the current context.
KeywordsMen who have sex with men Homosexuality Bisexuality Depression Stigma Criminal law Russian Federation
We wish to thank SANAM clinic and Tatiana Bondarenko for insight, support, and use of the SANAM clinic for conduct of qualitative research and the Be Safe study. We appreciate the efforts put forth by Irina Deobald and Konstantin Dyakonov in the formative phases of this project. We are deeply thankful to the participants who contributed their time and personal experiences to this study.
CB, ALW, CEZ, NG, VM, AP, and CL collaborated in the design and oversight of the overall study. PD and KI collected data. EH conducted data analysis. ALW reviewed and provided input to the statistical analysis. EH and ALW wrote the initial drafts of this manuscript. All authors had full access to the data, reviewed and edited the manuscript, and all take responsibility for its integrity as well as the accuracy of the analysis.
Compliance with Ethical Standards
The study was approved by both the Ethics Committee of the State Medical University, IP Pavlov, St. Petersburg, Russia, and the Johns Hopkins Bloomberg School of Public Health Institutional Review Board, Baltimore, Maryland.
Funding for this study came from the National Institute of Mental Health (NIMH R01 MH085574-01A2) “High Risk Men: Identity, Health Risks, HIV and Stigma” funded from 2009 to 2014. Drs. Wirtz, Latkin, Galai, and Beyrer are also supported by the Johns Hopkins University Center for AIDS Research (P30AI094189).
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