title: Sexual Stigma, Coping Styles, and Psychological Distress: A Longitudinal Study of Men Who Have Sex With Men in Beijing, China.
abstract: The direct link between stigma against sexual minorities and psychological distress is well established. However, few studies have examined the potential mediating roles of avoidant and social support coping in the relationships between internalized and anticipated stigma associated with homosexuality and depressive symptoms and anxiety among Chinese men who have sex with men (MSM). We recruited a longitudinal sample of 493 MSM in Beijing, China from 2011 to 2012. Participants completed computer-based questionnaires at baseline, 6, and 12 months. We found significant indirect effects of anticipated MSM stigma on symptoms of both depression and anxiety via avoidant coping: anticipated MSM stigma at baseline was significantly associated with avoidant coping (B = 0.523, p < 0.001) at 6 months and, conditional on anticipated MSM stigma, avoidant coping had a significant positive effect on depressive symptoms and anxiety at 12 months (B = 0.069, p = 0.001 and B = 0.071, p = 0.014). In contrast, no significant indirect effects of anticipated MSM stigma on either psychological distress outcome via social support coping were found. No significant indirect effects of internalized MSM stigma via either avoidant or social support coping were found. These results underscore the need for interventions that address anticipations of stigma and the use of avoidant coping techniques to manage such anticipations.
authors.affiliation: Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, 550 16th Street, Floor 3, Box 0886, San Francisco, CA, 94143, USA. kyung-hee.choi@ucsf.edu.
authors.forename: Kyung-Hee
authors.initials: KH
authors.lastname: Choi
authors.affiliation: Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, 550 16th Street, Floor 3, Box 0886, San Francisco, CA, 94143, USA.
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Steward
authors.affiliation: Institute of Social Development and Public Policy, Beijing Normal University, Beijing, People's Republic of China.
authors.forename: Pierre
authors.initials: P
authors.lastname: Miège
authors.affiliation: Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, 550 16th Street, Floor 3, Box 0886, San Francisco, CA, 94143, USA.
authors.forename: Esther
authors.initials: E
authors.lastname: Hudes
authors.affiliation: Center for AIDS Prevention Studies, Department of Medicine, University of California San Francisco, 550 16th Street, Floor 3, Box 0886, San Francisco, CA, 94143, USA.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Gregorich
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000068476:Beijing / Q000453:epidemiology; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D057545:Social Stigma; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult
keywords: China; Coping; Men who have sex with men; Mental health; Sexual orientation; Stigma