Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, USA.
Department of Counseling Psychology, School of Education, University of Wisconsin-Madison, USA.
Soc Sci Med. 2020 May;252:112917. doi: 10.1016/j.socscimed.2020.112917. Epub 2020 Mar 17.
Men who have sex with men (MSM) in China are disproportionately affected by HIV and mental health issues. Although predominately western-based research suggests a minority stress perspective to explain health disparities, how Chinese MSM experience stress related to being a sexual minority and how such experiences affect their health have not been carefully examined.
This study was a qualitative investigation of how stress related to sexuality (e.g., stigma, discrimination, and oppression) are experienced among MSM in China and how these experiences affect their psychological and behavioral health.
In-depth, semi-structured interviews were conducted with 24 MSM in China. Grounded theory was employed to guide data analysis.
Six categories emerged, which included: A Family-Oriented, Heteronormative Culture, Interpersonal Rejections and Marginalization, Internalization of Stigma, the Psychological Impact of Minority Stress, Impact on HIV-related Behavioral Health, and Coping. A conceptual model was developed, which illustrated relationships among categories and described sources, processes, and impact of minority stress among MSM in China. Cultural, social, and internalized sources of minority stress were shown to have detrimental effects on participants' psychological health and HIV-related behavioral health. Various coping strategies shared the purpose of navigating well-being in one's direct environment and in the larger culture.
Findings demonstrate the relevance of minority stress in behavioral health among Chinese MSM as well as the need to conceptualize minority stress within MSM's sociocultural context. HIV prevention efforts may benefit from a contextualized understanding of minority stress and addressing minority stress in a culturally congruent, community-centered fashion.
中国男男性行为者（MSM）受到艾滋病毒和心理健康问题的影响不成比例。尽管主要基于西方的研究表明少数群体压力观点可以解释健康差距，但中国 MSM 如何体验与性少数群体相关的压力，以及这些经历如何影响他们的健康，尚未得到仔细研究。
本研究是对中国 MSM 如何体验与性相关的压力（例如耻辱、歧视和压迫）以及这些经历如何影响他们的心理和行为健康进行的定性研究。
对中国的 24 名 MSM 进行了深入的半结构化访谈。采用扎根理论指导数据分析。
出现了六个类别，包括：以家庭为导向的异性恋规范文化、人际排斥和边缘化、污名内化、少数群体压力的心理影响、对 HIV 相关行为健康的影响以及应对方式。制定了一个概念模型，说明了类别之间的关系，并描述了中国 MSM 中少数群体压力的来源、过程和影响。少数群体压力的文化、社会和内化来源对参与者的心理健康和与 HIV 相关的行为健康产生了不利影响。各种应对策略都旨在在直接环境和更大的文化中应对幸福感。
研究结果表明，少数群体压力在中国 MSM 的行为健康中具有相关性，需要在 MSM 的社会文化背景下对少数群体压力进行概念化。艾滋病毒预防工作可能受益于对少数群体压力的背景化理解，并以文化上一致、以社区为中心的方式解决少数群体压力。
