Harper Gary W, Hong Chenglin, Jauregui Juan C, Odhiambo Elijah Ochieng, Jadwin-Cakmak Laura, Olango Kennedy, Rivet Amico K, Tucker Heather M, Lyons Myla, Odero Wilson, Graham Susan M
Department of Health Behavior and Health Equity, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.
School of Social Work, University of Connecticut, Hartford, Connecticut, USA.
Am J Community Psychol. 2024 Dec;74(3-4):249-261. doi: 10.1002/ajcp.12767. Epub 2024 Nov 4.
Young gay and bisexual men and other men who have sex with men (GBMSM) in Kenya experience pervasive intersectional stigma and discrimination, contributing to elevated levels of negative mental health symptoms. Grounded in the Minority Stress Model, this paper explores associations of proximal and distal minority stressors with three types of negative mental health outcomes among young HIV-negative GBMSM (n = 63) between the ages of 19-34 who participated in a pilot trial of a sexual health intervention. Using the PHQ-9, GAD-7, and PC-PTSD-5 screening measures, levels of clinically significant symptoms were reported as follows: 15.8% depressive symptoms, 12.7% anxiety symptoms, 31.7% posttraumatic stress symptoms. Results from stepwise linear regression analyses suggest that GBMSM-related stigma (distal stressor) was the strongest correlate for all three mental health outcomes, and concealment motivation (proximal stressor) was an additional significant correlate only in the depressive symptoms model. These findings should be viewed with caution and seen as initial observations given the small sample which limits our interpretations of the findings. Structural-level interventions are needed to decrease GBMSM's exposure to intersectional stigma and discrimination, such as decriminalization of same-sex sexual activity, as well as individual and group-level interventions that assist GBMSM with improving their adaptive coping strategies.
肯尼亚的年轻男同性恋者、双性恋男性以及其他与男性发生性行为的男性（GBMSM）普遍遭受交叉污名化和歧视，导致负面心理健康症状水平升高。基于少数群体压力模型，本文探讨了近端和远端少数群体压力源与19至34岁参与性健康干预试点试验的HIV阴性年轻GBMSM（n = 63）中三种负面心理健康结果之间的关联。使用PHQ - 9、GAD - 7和PC - PTSD - 5筛查量表，报告的具有临床意义的症状水平如下：15.8%有抑郁症状，12.7%有焦虑症状，31.7%有创伤后应激症状。逐步线性回归分析结果表明，与GBMSM相关的污名（远端压力源）是所有三种心理健康结果的最强相关因素，而隐瞒动机（近端压力源）仅在抑郁症状模型中是另一个显著相关因素。鉴于样本量较小限制了我们对研究结果的解释，这些发现应谨慎看待并视为初步观察结果。需要进行结构性层面的干预，以减少GBMSM遭受交叉污名化和歧视的情况，如同性性活动非刑罪化，以及进行个体和团体层面的干预，帮助GBMSM改善其适应性应对策略。
