title: Prevalence and associated factors of depressive and anxiety symptoms among HIV-infected men who have sex with men in China.
abstract: HIV-positive men who have sex with men (HIVMSM) face severe stigma and high levels of stressors, and have high prevalence of mental health problems (e.g., depression and anxiety). Very few studies explored the role of positive psychological factors on mental health problems among HIVMSM. The present study investigated the prevalence of two mental health problems (anxiety and depression), and their associated protective (gratitude) and risk (enacted HIV-related stigma, and perceived stress) factors among HIVMSM in China. A cross-sectional survey was conducted among 321 HIVMSM in Chengdu, China, by using a structured questionnaire. Over half (55.8%) of the participants showed probable mild to severe depression (as assessed by the Center of Epidemiologic Studies Depression scale); 53.3% showed probable anxiety (as assessed by the General Anxiety Disorder scale). Adjusted logistic regression models revealed that gratitude (adjusted odds ratio (ORa = 0.90, 95% confidence intervals (95% CI) = 0.86-0.94) was found to be protective, whilst perceived stress (ORa = 1.17, 95% CI = 1.12-1.22) and enacted stigma (ORa = 7.72, 95% CI = 2.27-26.25) were risk factors of depression. Gratitude (ORa = 0.95, 95% CI = 0.91-0.99) was also found to be protective whilst perceived stress (ORa = 1.19, 95% CI = 1.14-1.24) was a risk factor of anxiety. Gratitude did not moderate the associations found between related factors and poor mental health. It is warranted to promote mental health among HIVMSM, as depression/anxiety was highly prevalent. Such interventions should consider enhancement of gratitude, reduction of stress, and removal of enacted stigma as potential strategies, as such factors were significantly associated with depression/anxiety among HIVMSM.
authors.affiliation: a Division of Behavioral Health and Health Promotion, The School of Public Health and Primary Care, Faculty of Medicine , The Chinese University of Hong Kong , Shatin , Hong Kong.
authors.forename: Jinghua
authors.initials: J
authors.lastname: Li
authors.affiliation: a Division of Behavioral Health and Health Promotion, The School of Public Health and Primary Care, Faculty of Medicine , The Chinese University of Hong Kong , Shatin , Hong Kong.|b The Chinese University of Hong Kong Shenzhen Research Institute , Shenzhen , People's republic of China.
authors.forename: Phoenix K H
authors.initials: PK
authors.lastname: Mo
authors.affiliation: c Department of Behavioral and Social Sciences , Brown University School of Public Health , Providence , RI , USA.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Kahler
authors.affiliation: a Division of Behavioral Health and Health Promotion, The School of Public Health and Primary Care, Faculty of Medicine , The Chinese University of Hong Kong , Shatin , Hong Kong.|b The Chinese University of Hong Kong Shenzhen Research Institute , Shenzhen , People's republic of China.|d Centre for Medical Anthropology and Behavioral Health , Sun Yat-sen University , Guangzhou , People's republic of China.
authors.forename: Joseph T F
authors.initials: JT
authors.lastname: Lau
authors.affiliation: e West China School of Public Health, Sichuan University , People's republic of China.
authors.forename: Mengran
authors.initials: M
authors.lastname: Du
authors.affiliation: f Chengdu Center for Disease Control and Prevention , Sichuan , People's republic of China.
authors.forename: Yingxue
authors.initials: Y
authors.lastname: Dai
authors.affiliation: g School of Public Health , Drexel University , Philadelphia , USA.
authors.forename: Hanyang
authors.initials: H
authors.lastname: Shen
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology / Q000821:virology; D044466:Asian People / Q000523:psychology / Q000706:statistics & numerical data; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D057545:Social Stigma; D012944:Social Support; D013240:Stereotyping; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Depression; gratitude; men who have sex with men; perceived stress; stigma