Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, 167 Point St, Providence, RI, 02906, USA.
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA.
Curr HIV/AIDS Rep. 2020 Feb;17(1):35-62. doi: 10.1007/s11904-019-00479-w.
PURPOSE OF REVIEW: Men who have sex with men (MSM) in China experience elevated risks of mental health issues in comparison to the general population in China, which contribute to vulnerability to HIV/STI risks and can comprise the effectiveness of HIV prevention efforts. A conceptual framework for understanding this mental health disparity is minority stress theory, which posits that experiences of external prejudice events (i.e., distal stressors) and internal stress processes such as internalized homophobia and concealment (i.e., proximal stressors) contribute to sexual minorities' elevated risk of psychological distress. To deepen the understanding of mental health among Chinese MSM and explore the potential utility of minority stress theory in this population, this paper synthesizes research evidence regarding prevalent mental health issues as well as how minority stress may be linked to psychological health in Chinese MSM. RECENT FINDINGS: Results indicate that Chinese MSM experience a high prevalence of several mental health issues including depression, anxiety, suicidal behaviors, and alcohol dependence. This review further reveals minority stress to be an important determinant of psychological distress among Chinese MSM, though evidence is mixed regarding the relationship between proximal minority stress and psychological health. Nonetheless, there is a lack of mental health services and interventions focusing on MSM in China. Culturally relevant, competent, and LGBT-affirmative mental health interventions are needed for Chinese MSM. To guide future intervention research, we provide considerations for reducing minority stress and promoting psychological health among Chinese MSM.
目的综述:与中国一般人群相比,男男性行为者(MSM)经历着更高的心理健康问题风险,这导致他们更容易面临 HIV/性传播感染(STI)风险,也会影响到 HIV 预防措施的有效性。理解这一心理健康差异的一个概念框架是少数群体应激理论,该理论认为,外部偏见事件(即远距离应激源)和内部应激过程(如内化的恐同和隐瞒)的经历导致了性少数群体心理困扰的风险增加。为了更深入地了解中国 MSM 的心理健康,并探讨少数群体应激理论在该人群中的潜在效用,本文综合了有关中国 MSM 普遍存在的心理健康问题以及少数群体应激如何与心理健康相关的研究证据。
最新发现:结果表明,中国 MSM 经历了多种心理健康问题,包括抑郁、焦虑、自杀行为和酒精依赖。本综述进一步表明,少数群体应激是中国 MSM 心理困扰的一个重要决定因素,但少数群体近端应激与心理健康之间的关系证据不一。尽管如此,中国缺乏针对 MSM 的心理健康服务和干预措施。需要针对中国 MSM 提供文化相关、有能力且支持 LGBT 的心理健康干预措施。为了指导未来的干预研究,我们提供了一些考虑因素,以减少中国 MSM 的少数群体应激并促进他们的心理健康。
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