title: Depression and Social Stigma Among MSM in Lesotho: Implications for HIV and Sexually Transmitted Infection Prevention.
abstract: Social stigma is common among men who have sex with men (MSM) across Sub-Saharan Africa, and may influence risks for HIV and sexually transmitted infections (STIs) via its association with depression. We conducted a cross-sectional study of 530 MSM in Lesotho accrued via respondent-driven sampling. Using generalized structural equation models we examined associations between stigma, social capital, and depression with condom use and testing positive for HIV/STIs. Depression was positively associated with social stigma experienced or perceived as a result of being MSM. In contrast, increasing levels of social cohesion were negatively associated with depression. Social stigma was associated with testing positive for HIV; however, this association did not appear to be mediated by depression or condom use. These data suggest a need for integrated HIV and mental health care that addresses stigma and discrimination and facilitates positive social support for MSM.
authors.affiliation: Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, E7133, 615 N. Washington St., Baltimore, MD, 21205, USA, sstahlm1@jhu.edu.
authors.forename: Shauna
authors.initials: S
authors.lastname: Stahlman
authors.forename: Ashley
authors.initials: A
authors.lastname: Grosso
authors.forename: Sosthenes
authors.initials: S
authors.lastname: Ketende
authors.forename: Stephanie
authors.initials: S
authors.lastname: Sweitzer
authors.forename: Tampose
authors.initials: T
authors.lastname: Mothopeng
authors.forename: Noah
authors.initials: N
authors.lastname: Taruberekera
authors.forename: John
authors.initials: J
authors.lastname: Nkonyana
authors.forename: Stefan
authors.initials: S
authors.lastname: Baral
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology*; D015658:HIV Infections / Q000517:prevention & control*; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D007927:Lesotho / Q000453:epidemiology; D008297:Male; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012309:Risk-Taking; D012747:Sexual Partners / Q000523:psychology; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D063508:Social Discrimination; D057545:Social Stigma; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological