Zhang Ran, Qiao Shan, Aggarwal Abhishek, Yuan Guangzhe, Muttau Nobutu, Sharma Anjali, Lwatula Clementina, Ngosa Levy, Kabwe McLean, Manasyan Albert, Menon Anitha, Ostermann Jan, Weissman Sharon, Li Xiaoming, Harper Gary W
University of South Carolina, Columbia, South Carolina, USA.
University of South Carolina, Columbia, South Carolina, USA.
Arch Psychiatr Nurs. 2024 Feb;48:51-58. doi: 10.1016/j.apnu.2024.01.004. Epub 2024 Jan 9.
Sexual minority men (SMM) in Zambia face significant challenges including stigma, discrimination, and mental health issues, which further impact their HIV-related risk behaviors. This study aimed to investigate the associations between enacted stigma, substance abuse, HIV-related behaviors, and mental health (i.e., depression, anxiety, and post-traumatic stress disorder [PTSD] symptoms) among SMM in Zambia. SMM aged 18-35 years who reported having multiple and/or concurrent sexual partners or low and/or inconsistent condom use in the past three months were recruited from four districts in Zambia between February and November 2021. Participants completed an anonymous interviewer-administered survey. Key variables of interest were compared between participants with higher vs. lower levels of enacted stigma. Independent samples t-tests were used for continuous variables, and chi-squared tests were used for categorical variables. A total of 197 eligible SMM participated in the study (mean age = 24.41 years). Participants with a higher level of enacted stigma showed a higher level of anxiety symptoms (χ = 12.91, p ≤ .001), PTSD symptoms (χ = 7.13, p < .01), tobacco use (χ = 10.47, p < .01), cannabis use (χ = 5.90, p < .05), and a higher number of sexual partners (t = 1.99, p < .05) in the past three months. Stigma reduction interventions may help mitigate substance abuse, HIV-related behaviors, and adverse mental health outcomes among SMM in Zambia. Health care providers, especially psychiatric-mental health nurses, can incorporate strategies for recognizing and addressing stigma into their practice through training and integrate multiple resources to create an inclusive and non-judgmental environment for SMM to improve their well-being.
赞比亚的性少数男性面临着诸多重大挑战，包括耻辱感、歧视和心理健康问题，这些问题进一步影响了他们与艾滋病毒相关的风险行为。本研究旨在调查赞比亚性少数男性中遭受的耻辱感、药物滥用、与艾滋病毒相关的行为以及心理健康（即抑郁、焦虑和创伤后应激障碍 [PTSD] 症状）之间的关联。2021年2月至11月期间，从赞比亚四个地区招募了年龄在18至35岁之间、报告在过去三个月中有多个和/或同时性伴侣或避孕套使用频率低和/或不一致的性少数男性。参与者完成了一项由访谈员进行的匿名调查。比较了遭受耻辱感程度较高和较低的参与者之间的关键感兴趣变量。连续变量使用独立样本t检验，分类变量使用卡方检验。共有197名符合条件的性少数男性参与了该研究（平均年龄 = 24.41岁）。遭受耻辱感程度较高的参与者在过去三个月中表现出更高水平的焦虑症状（χ = 12.91，p≤.001）、创伤后应激障碍症状（χ = 7.13，p <.01）、烟草使用（χ = 10.47，p <.01）、大麻使用（χ = 5.90，p <.05）以及更多的性伴侣（t = 1.99，p <.05）。减少耻辱感的干预措施可能有助于减轻赞比亚性少数男性中的药物滥用、与艾滋病毒相关的行为以及不良心理健康结果。医疗保健提供者，尤其是精神心理科护士，可以通过培训将识别和解决耻辱感的策略纳入他们的实践中，并整合多种资源，为性少数男性创造一个包容和无歧视的环境，以改善他们的福祉。
