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感染艾滋病毒的男男性行为者中交叉污名与心理健康之间的关联

Association Between Intersectional Stigma and Psychological Well-Being Among Men Who Have Sex with Men Living with HIV.

作者信息

Mi Tianyue, Yang Xueying, Lan Guanghua, Qiao Shan, Shen Zhiyong, Zhou Yuejiao, Li Xiaoming

机构信息

Department of Health Promotion, Education, and Behavior & South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina, 915 Greene St, Columbia, SC, 29208, USA.

Guangxi Center for Disease Control and Prevention, Nanning, China.

出版信息

AIDS Behav. 2025 Jun 27. doi: 10.1007/s10461-025-04795-8.

Abstract

Men who have sex with men (MSM) living with HIV face considerable psychosocial challenges, including stigma and discrimination, which may affect their mental health. Instead of considering each stigmatized identity in isolation, this study investigated the association between intersected HIV- and MSM-related stigma and psychological well-being of MSM living with HIV. Data of 402 MSM living with HIV were collected through a cross-sectional study in Guangxi, China, focusing on the association between HIV-/MSM-related stigma and HIV-related health outcomes among MSM living with HIV. Latent Moderated Structural Equations Approach was employed to examine the moderation effect of MSM-related stigma on the relationship between HIV-related stigma and mental health outcomes. The findings revealed that with a lower level of MSM-related stigma, the associations between HIV-related stigma and depression (β = 0.99, 95%CI [-0.63, 2.61], p = 0.23) or anxiety (β = 1.61, 95%CI [-0.44, 3.65], p = 0.12) were not significant; with a higher level of MSM-related stigma, the association between HIV-related stigma and depression (β = 3.32, 95%CI [1.67, 4.96], p < 0.001) or anxiety (β = 4.95, 95%CI [2.68, 7.22], p < 0.001) showed significant positive associations. The study demonstrates that higher levels of MSM-related stigma can intensify the relationship between HIV-related stigma and depression/anxiety among MSM. By emphasizing the role of intersectional stigma in adverse mental health outcomes, these findings will inform the development of effective and sustainable health strategies, policies, and services, including tailored mental health services and community-led stigma reduction programs aimed at the enhancement of well-being among MSM living with HIV.

摘要

感染艾滋病毒的男男性行为者面临着诸多心理社会挑战,包括耻辱感和歧视,这可能会影响他们的心理健康。本研究并非孤立地考虑每种受污名化的身份,而是调查了与艾滋病毒和男男性行为相关的交叉耻辱感与感染艾滋病毒的男男性行为者心理健康之间的关联。通过在中国广西进行的一项横断面研究,收集了402名感染艾滋病毒的男男性行为者的数据,重点关注与艾滋病毒/男男性行为相关的耻辱感与感染艾滋病毒的男男性行为者中与艾滋病毒相关的健康结果之间的关联。采用潜在调节结构方程方法来检验男男性行为相关耻辱感对艾滋病毒相关耻辱感与心理健康结果之间关系的调节作用。研究结果显示,在男男性行为相关耻辱感水平较低时,艾滋病毒相关耻辱感与抑郁(β = 0.99,95%置信区间[-0.63, 2.61],p = 0.23)或焦虑(β = 1.61,95%置信区间[-0.44, 3.65],p = 0.12)之间的关联不显著;在男男性行为相关耻辱感水平较高时,艾滋病毒相关耻辱感与抑郁(β = 3.32,95%置信区间[1.67, 4.96],p < 0.001)或焦虑(β = 4.95,95%置信区间[2.68, 7.22],p < 0.001)之间呈现出显著的正相关。该研究表明,较高水平的男男性行为相关耻辱感会加剧感染艾滋病毒的男男性行为者中艾滋病毒相关耻辱感与抑郁/焦虑之间的关系。通过强调交叉耻辱感在不良心理健康结果中的作用,这些发现将为制定有效且可持续的健康战略、政策和服务提供信息,包括量身定制的心理健康服务以及旨在提高感染艾滋病毒的男男性行为者幸福感的社区主导的耻辱感减少项目。

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