Stahlman Shauna, Grosso Ashley, Ketende Sosthenes, Sweitzer Stephanie, Mothopeng Tampose, Taruberekera Noah, Nkonyana John, Baral Stefan
Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, E7133, 615 N. Washington St., Baltimore, MD, 21205, USA,
AIDS Behav. 2015 Aug;19(8):1460-9. doi: 10.1007/s10461-015-1094-y.
Social stigma is common among men who have sex with men (MSM) across Sub-Saharan Africa, and may influence risks for HIV and sexually transmitted infections (STIs) via its association with depression. We conducted a cross-sectional study of 530 MSM in Lesotho accrued via respondent-driven sampling. Using generalized structural equation models we examined associations between stigma, social capital, and depression with condom use and testing positive for HIV/STIs. Depression was positively associated with social stigma experienced or perceived as a result of being MSM. In contrast, increasing levels of social cohesion were negatively associated with depression. Social stigma was associated with testing positive for HIV; however, this association did not appear to be mediated by depression or condom use. These data suggest a need for integrated HIV and mental health care that addresses stigma and discrimination and facilitates positive social support for MSM.
在撒哈拉以南非洲地区，男男性行为者（MSM）中普遍存在社会耻辱感，并且这种耻辱感可能通过与抑郁症的关联影响感染艾滋病毒和性传播感染（STIs）的风险。我们通过应答驱动抽样对莱索托的530名男男性行为者进行了一项横断面研究。使用广义结构方程模型，我们研究了耻辱感、社会资本和抑郁症与使用避孕套以及艾滋病毒/性传播感染检测呈阳性之间的关联。抑郁症与因身为男男性行为者而经历或感知到的社会耻辱感呈正相关。相比之下，社会凝聚力水平的提高与抑郁症呈负相关。社会耻辱感与艾滋病毒检测呈阳性有关；然而，这种关联似乎并非由抑郁症或使用避孕套介导。这些数据表明，需要提供综合的艾滋病毒和心理健康护理，以解决耻辱感和歧视问题，并为男男性行为者提供积极的社会支持。
