title: Sexual Identity, Stigma, and Depression: the Role of the "Anti-gay Propaganda Law" in Mental Health among Men Who Have Sex with Men in Moscow, Russia.
abstract: Depression is a major public health problem in the Russian Federation and is particularly of concern for men who have sex with men (MSM). MSM living in Moscow City were recruited via respondent-driven sampling and participated in a cross-sectional survey from October 2010 to April 2013. Multiple logistic regression models compared the relationship between sexual identity, recent stigma, and probable depression, defined as a score of ≥23 on the Center for Epidemiological Studies Depression scale. We investigated the interactive effect of stigma and participation in the study after the passage of multiple "anti-gay propaganda laws" in Russian provinces, municipalities, and in neighboring Ukraine on depression among MSM. Among 1367 MSM, 36.7% (n = 505) qualified as probably depressed. Fifty-five percent identified as homosexual (n = 741) and 42.9% identified as bisexual (n = 578). Bisexual identity had a protective association against probable depression (reference: homosexual identity AOR 0.71; 95%CI 0.52-0.97; p < 0.01). Those who experienced recent stigma (last 12 months) were more likely to report probable depression (reference: no stigma; AOR 1.75; 95%CI 1.20-2.56; p < 0.01). The interaction between stigma and the propaganda laws was significant. Among participants with stigma, probable depression increased 1.67-fold after the passage of the anti-gay laws AOR 1.67; 95%CI 1.04-2.68; p < 0.01). Depressive symptoms are common among MSM in Russia and exacerbated by stigma and laws that deny homosexual identities. Repeal of Russia's federal anti-gay propaganda law is urgent but other social interventions may address depression and stigma in the current context.
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Room E7141, Baltimore, MD, 21205, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Hylton
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Room E7141, Baltimore, MD, 21205, USA. awirtz1@jhu.edu.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Wirtz
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Room E7141, Baltimore, MD, 21205, USA.
authors.forename: Carla E
authors.initials: CE
authors.lastname: Zelaya
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Carl
authors.initials: C
authors.lastname: Latkin
authors.affiliation: AIDS Infoshare, Moscow, Russian Federation.
authors.forename: Alena
authors.initials: A
authors.lastname: Peryshkina
authors.affiliation: AIDS Infoshare, Moscow, Russian Federation.
authors.forename: Vladmir
authors.initials: V
authors.lastname: Mogilnyi
authors.affiliation: AIDS Infoshare, Moscow, Russian Federation.
authors.forename: Petr
authors.initials: P
authors.lastname: Dzhigun
authors.affiliation: AIDS Infoshare, Moscow, Russian Federation.
authors.forename: Irina
authors.initials: I
authors.lastname: Kostetskaya
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Room E7141, Baltimore, MD, 21205, USA.|Department of Statistics, The University of Haifa, Mt Carmel, Israel.
authors.forename: Noya
authors.initials: N
authors.lastname: Galai
authors.affiliation: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Room E7141, Baltimore, MD, 21205, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Beyrer
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000523:psychology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology; D015658:HIV Infections / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009031:Moscow; D011406:Propaganda; D012309:Risk-Taking; D012426:Russia; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data*; D000072339:Sexual and Gender Minorities / Q000331:legislation & jurisprudence*; D057545:Social Stigma; D014455:Ukraine; D055815:Young Adult
keywords: Bisexuality; Criminal law; Depression; Homosexuality; Men who have sex with men; Russian Federation; Stigma