Meanley Steven, Ware Deanna, Brennan-Ing Mark, Cook Judith A, Okafor Chukwuemeka N, Palella Frank J, Haberlen Sabina A, Shoptaw Steven, Friedman Mackey R, Plankey Michael W
Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Department of Medicine, Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC, USA.
Aging Ment Health. 2025 Jun 2:1-8. doi: 10.1080/13607863.2025.2511221.
Cisgender sexual minority men (SMM) are disproportionately affected by loneliness in transitions to older adulthood relative to their heterosexual counterparts. This study sought to evaluate whether sexual minority strengths mediated the associations between sexual minority stressors and loneliness among midlife and older adult SMM.
Data ( = 1203 SMM age 40+) came from three study visits of the Multicenter AIDS Cohort Study's (MACS) Healthy Aging Substudy (2016-2019). Evaluated sexual minority stressors included sexual orientation discrimination and internalized homophobia. Sexual minority strengths included gay community attachment and homophobia management. Time-lagged mediation analysis assessed causal relationships between sexual minority stressors, strengths, and self-reported loneliness.
Self-reported loneliness (UCLA-3) was low in our sample (median = 1, IQR [0-3], maximum = 9). Controlling for covariates, gay community attachment mediated the association between internalized homophobia and loneliness (indirect effect = 0.06, 95% CI [0.035-0.084], < 0.0001). No other statistically significant pathways to loneliness were observed.
The broader gay community reflects a source of resilience in the context of loneliness for midlife and older SMM. Community-based interventions addressing loneliness among aging SMM, particularly those with high internalized homophobia levels, should enhance opportunities for SMM who are not easily able to connect or experience the health-promotive qualities afforded by gay networks.
与异性恋男性相比，顺性别性少数男性（SMM）在步入老年的过程中受孤独感的影响更大。本研究旨在评估性少数群体的优势是否介导了中年及老年SMM中性少数群体压力源与孤独感之间的关联。
数据（n = 1203名年龄在40岁及以上的SMM）来自多中心艾滋病队列研究（MACS）健康老龄化子研究的三次研究访视（2016 - 2019年）。评估的性少数群体压力源包括性取向歧视和内化的恐同心理。性少数群体的优势包括对同性恋群体的归属感和对恐同心理的管理。时间滞后中介分析评估了性少数群体压力源、优势与自我报告的孤独感之间的因果关系。
我们样本中的自我报告孤独感（UCLA - 3）较低（中位数 = 1，四分位间距[0 - 3]，最大值 = 9）。在控制协变量后，对同性恋群体的归属感介导了内化的恐同心理与孤独感之间的关联（间接效应 = 0.06，95%置信区间[0.035 - 0.084]，p < 0.0001）。未观察到其他与孤独感有统计学显著意义的途径。
更广泛的同性恋群体反映了中年及老年SMM在孤独情境下的复原力来源。针对老年SMM孤独感的社区干预措施，尤其是针对内化恐同心理程度较高的SMM，应增加那些不易与同性恋网络建立联系或体验其健康促进特质的SMM的机会。
