Department of Epidemiology and Health Statistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China.
J Adolesc. 2024 Aug;96(6):1293-1303. doi: 10.1002/jad.12338. Epub 2024 May 20.
Young men who have sex with men (YMSM) may experience high levels of sexual minority stigma (SMS) and depressive symptoms (DS) over the world and in China. However, there is a lack of studies investigating the longitudinal effects of SMS on DS of YMSM, especially focusing on YMSM and separating the between-person and within-person effects. This study aimed to fill the said gaps.
Study data were derived from a prospective cohort of 349 YMSM from central China (Wuhan, Changsha, Nanchang), the baseline survey was started in 2017 with one follow-up visit every year. SMS and DS were measured three times using valid and reliable instruments. The cross-lagged panel model (CLPM) and the random intercept CLPM (RI-CLPM) were used to examine the between-person and within-person concurrent and lagged effects, respectively.
Findings of CLPM revealed bidirectional associations between SMS and DS over time. RI-CLPM suggested that at the between-person level, SMS was significantly associated with DS, echoing the results of CLPM. However, this reciprocal relationship has not been found at the within-person level.
The associations between SMS and DS among YMSM at the population level is more significant than that at the individual level. We suggest that interventions should be against the adverse effects of cultural marginalization and systemic change the social concepts to reduce the amount of SMS in society.
在全球范围内以及中国,男男性行为者(MSM)可能会经历高度的性少数群体耻辱感(SMS)和抑郁症状(DS)。然而,缺乏研究调查 SMS 对 YMSM 的 DS 的纵向影响,特别是关注 YMSM 并区分个体间和个体内效应。本研究旨在填补这一空白。
研究数据来自中国中部(武汉、长沙、南昌)的 349 名男男性行为者的前瞻性队列研究,基线调查于 2017 年开始,每年进行一次随访。使用有效和可靠的工具对 SMS 和 DS 进行了三次测量。使用交叉滞后面板模型(CLPM)和随机截距交叉滞后面板模型(RI-CLPM)分别检验个体间和个体内的同期和滞后效应。
CLPM 的结果显示,SMS 和 DS 之间存在双向关联。RI-CLPM 表明,在个体间水平上,SMS 与 DS 显著相关,与 CLPM 的结果一致。然而,在个体内水平上没有发现这种相互关系。
在人群水平上,MSM 之间的 SMS 和 DS 之间的关联比个体水平上更为显著。我们建议干预措施应针对文化边缘化和系统性变革的社会观念的不利影响,以减少社会中 SMS 的数量。