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Sexual Minority Stigma, Sexual Orientation Concealment, Social Support and Depressive Symptoms Among Men Who have Sex with Men in China: A Moderated Mediation Modeling Analysis

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Abstract

Men who have sex with men (MSM) often experience depressive symptoms. However, the potential mechanisms resulting in depressive symptoms are not fully understood. Here, we explore possible mechanisms behind the associations between sexual minority stigma (SMS), sexual orientation concealment (SOC), and social support (SS) with depressive symptoms among MSM. Data (N = 715) used in the study were from the baseline survey of a 3-year cohort study in China. Computer-assisted self-interview was used to collect data. Mediation and moderated mediation modeling analysis were employed to address the question. It was found that SOC partially mediated the association between SMS and depressive symptoms (indirect effect = 0.11, 95% CI 0.05–0.17). SS moderated the mediation model by buffering the path from SMS to SOC (β = 0.17, t = 3.18, P = 0.002). These findings suggested that SS might strengthen the association between SMS and depressive symptoms by moderating the pathway between SMS and SOC.

Resumen

Los hombres que tienen sexo con hombres (HSH) a menudo experimentan síntomas depresivos. Sin embargo, los mecanismos asociados a estos síntomas, aún no se comprenden completamente. En este estudio exploramos posibles mecanismos detrás de las asociaciones entre el estigma de las minorías sexuales (EMS), el ocultamiento de la orientación sexual (OOS) y el apoyo social (AS) con síntomas depresivos entre los HSH. Los datos (N = 715) utilizados en el estudio provienen de la encuesta de referencia de un estudio de cohorte de tres años en China. Se utilizó una entrevista personal asistida por computadora para recopilar los datos. Modelos de mediación y mediación moderada fueron empleados para el análisis de los datos. Se encontró que la OOS mediaba parcialmente la asociación entre EMS y síntomas depresivos (efecto indirecto = 0.11, IC 95% 0.05–0.17). El AS moderó el modelo de mediación al amortiguar la ruta de EMS a OOS (β = 0.17, t = 3.18, P = 0.002). Estos hallazgos sugieren que el AS podría fortalecer la asociación entre EMS y síntomas depresivos al moderar la vía entre EMS y OOS.

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Acknowledgements

We appreciate all participants in this study for sharing their life experiences and perceptions. We would like to thank authors for the contribution of this article.

Funding

This study was founded by the Humanities and Social Science Foundation of Ministry of Education (Grant No. 15YJAZH094) and the National Natural Science Foundation of China (Grant No. 81673196).

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Author notes

  1. Changmian Ding and Xiangfan Chen have contributed equally to this study.

Authors and Affiliations

  1. School of Health Sciences, Wuhan University, 115 Donghu Road, Wuhan, 430071, Hubei, China

    Changmian Ding, Xiangfan Chen, Huimin Yang, Xiaoyan Li, Shumin Deng, Hong Yan & Shiyue Li

  2. School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China

    Wei Wang

  3. Department of Epidemiology, University of Florida, Gainesville, USA

    Bin Yu

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  1. Changmian Ding
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Correspondence to Hong Yan or Shiyue Li.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Medical Ethics Committee at Wuhan University, China.

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Ding, C., Chen, X., Wang, W. et al. Sexual Minority Stigma, Sexual Orientation Concealment, Social Support and Depressive Symptoms Among Men Who have Sex with Men in China: A Moderated Mediation Modeling Analysis. AIDS Behav 24, 8–17 (2020). https://doi.org/10.1007/s10461-019-02713-3

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