Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada.
Mailman School of Public Health, Columbia University, New York City, New York, USA.
J Epidemiol Community Health. 2020 Jun;74(7):553-559. doi: 10.1136/jech-2019-213566. Epub 2020 Apr 8.
Due to stigma and discrimination, gay, bisexual and other men who have sex with men (gbMSM) potentially carry a heightened burden of loneliness. This analysis investigates loneliness among gbMSM and its relationship with self-rated physical health, along with the mediating effect of depression.
Participants were recruited using respondent-driven sampling into the Momentum Health Study (February 2012-February 2015) with follow-up visits occurring every 6 months till February 2018. Using computer-assisted self-interviews, measures of loneliness were assessed using a 6-item Loneliness Scale for Emotional and Social Loneliness (lonely vs not lonely). Current physical health was self-assessed (poor, fair, good, very good or excellent). A multivariable generalised linear-mixed model with a logit link function was used to examine the relationship between loneliness and self-rated physical health. We further investigated the mediating effect of depressive symptomatology on this relationship via the Hospital Anxiety and Depression Scale.
Of the 770 participants included, we found that 61% (n=471) experienced loneliness at baseline. Of the 674 (88%) who reported physical health, 59% (n=391) reported loneliness, compared with 87% (n=80) of those in poor/fair self-rated physical health who reported feeling lonely. After adjustment for confounding, loneliness was associated with poor self-rated physical health (adjusted OR 1.71; 95% CI 1.13 to 2.60). Depressive symptomatology was found to partially mediate this relationship.
There may be a need for the integration of social, mental and physical health programming, targeted towards gbMSM, to alleviate the degree of loneliness experienced and its co-occurrence with poor self-rated physical health.
由于耻辱感和歧视,男同性恋、双性恋和其他与男性发生性关系的男性(gbMSM)可能会承受更高的孤独感负担。本分析调查了 gbMSM 的孤独感及其与自我评估的身体健康之间的关系,以及抑郁的中介作用。
使用受访者驱动抽样(2012 年 2 月至 2015 年 2 月)招募参与者参加动力健康研究(Momentum Health Study),并在 2018 年 2 月之前每 6 个月进行一次随访。使用计算机辅助自我访谈,使用 6 项孤独量表评估孤独感,包括情感和社会孤独感的孤独量表(孤独与不孤独)。当前的身体健康状况是自我评估的(差、一般、好、很好或优秀)。使用具有对数链接函数的多变量广义线性混合模型来检查孤独感与自我评估身体健康之间的关系。我们进一步通过医院焦虑和抑郁量表调查了抑郁症状在此关系中的中介作用。
在 770 名参与者中,我们发现 61%(n=471)在基线时感到孤独。在报告身体健康的 674 名(88%)参与者中,有 59%(n=391)感到孤独,而自我评估身体健康较差/一般的参与者中,有 87%(n=80)感到孤独。在调整混杂因素后,孤独感与自我评估身体健康状况较差相关(调整后的 OR 1.71;95% CI 1.13 至 2.60)。抑郁症状被发现部分中介了这种关系。
可能需要整合针对 gbMSM 的社会、心理和身体健康计划,以减轻他们所经历的孤独感程度及其与自我评估身体健康状况较差的共同发生。