title: Suicidal Ideation, Resilience, and Healthcare Implications for Newly Diagnosed HIV-Positive Men Who Have Sex with Men in China: A Qualitative Study.
abstract: Globally, suicidal ideation and behavior have been widely reported among people living with human immunodeficiency virus (HIV). Knowledge gaps exist regarding the longer life and resilience-related experiences of people living with HIV (PLWH). Specifically, there is a dearth of data about the interaction of perceived risk and resilient factors resulting in a wide spectrum of intentional suicidal ideation outcomes in a Chinese cultural context. This qualitative research drew from a larger ethnographic study of newly diagnosed HIV-positive men who have sex with men (MSM) in Mainland China. Interviews were conducted with 31 MSM within 6 months of diagnosis of HIV infection. Initial suicidal ideation was commonly reported with participants subsequently feeling more resilient to these thoughts through gaining a greater understanding of their prognosis and treatment. Post-HIV diagnosis, some participants reported forming new relationships and receiving increased support from their partners, friends, peers, families, and community-based organizations. At follow-up, these participants generally reported suicidal ideation had declined. However, participants who continued to express suicidal ideation perceived extended pressure from their families' expectations for them to engage in heterosexual marriages and parenthood. Furthermore, these men reported ongoing hardships in their daily life, unemployment, lack of social support, and isolation. Among this Mainland Chinese cohort of HIV-positive MSM, suicidal ideation may be a transient phenomenon experienced initially following HIV diagnosis that resolves with increased and specific familial, social, and service-based support. It is crucial to identify the causes of stress and social suffering associated with HIV diagnosis in order to reduce suicidal ideation. In China, action is needed to develop routine mental health screening and to increase services that support PLWH. Important services mechanism to accomplish this are promoting resilience through intentional activities as well as continued public health campaigns to reduce stigma toward HIV-positive MSM.
authors.affiliation: School of Public Health, Shandong University, No. 44 Wen Hua Xi Road, Jinan, 250012, China. haochuli@med.unc.edu.|UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. haochuli@med.unc.edu.
authors.forename: Haochu
authors.initials: H
authors.lastname: Li
authors.affiliation: UNC Project-China, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Tucker
authors.affiliation: School of Clinical Sciences, Auckland University of Technology, Northcote, Auckland, New Zealand.|School of Global and Population Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Holroyd
authors.affiliation: School of Public Health, Shandong University, No. 44 Wen Hua Xi Road, Jinan, 250012, China.|Department of Sociology, State University of New York College at Buffalo, Buffalo, NY, USA.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: School of Public Health, Shandong University, No. 44 Wen Hua Xi Road, Jinan, 250012, China.
authors.forename: Baofa
authors.initials: B
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D036301:Qualitative Research; D059020:Suicidal Ideation; D055815:Young Adult
keywords: China; HIV; Men who have sex with men; Resilience; Sexual orientation; Suicidal ideation