Abstract
BackgroundThe high heterosexual marriage rate could be a ‘double-edge’ sword for the emotional health of Chinese men who have sex with men (MSM). The aim of this study was to determine if current marriage and breakdown of marriage (divorce) have different effects on the mental health of Chinese MSM.MethodsEight hundred seven MSM were recruited using respondent-driven sampling from four cities in northeastern China. Gay-related stressful events (GRSE) were measured using the Gay Related Stressful Life Events Scale; social support was measured by the Social Support Rating Scale (SSRS); and depressive and anxiety symptoms were assessed using the Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS), respectively.ResultsOf the study participants, 13.4% were married to women and 4.5% were divorced. The rates of marriage or divorce were 35.3 and 75.8% for participants 30–39 and > 40 years of age, respectively. The current married MSM had the highest SDS (50.0 ± 10.9) and SSRS (35.8 ± 8.6) levels, but the lowest SAS (38.7 ± 12.1) levels. Divorced MSM had the highest SAS (44.4 ± 9.6) and lowest SSRS (30.8 ± 8.1) levels. Age, GESE number, and HIV infection were predictors for SDS and SAS, and current marriage was associated with significantly decreased level of SAS (β = − 0.136, P = 0.001) based on multiple linear analysis.ConclusionsCurrent marriage is associated with significantly decreased levels of anxiety symptoms among Chinese MSM. More studies are needed to understand the mechanisms underlying the effects of different marriage status on the emotional distress of Chinese MSM.
Highlights
The high heterosexual marriage rate could be a ‘double-edge’ sword for the emotional health of Chinese men who have sex with men (MSM)
A few studies have shown that keeping homosexual behaviors a secret could reduce the frequency of gay-related stressful events (GRSEs) among MSM [10, 11], but no studies have reported if such a defensive choice could reduce the levels of depression or anxiety symptoms for married MSM
The Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) means were significantly elevated among MSM with Human Immunodeficiency Virus (HIV) infection
Summary
The high heterosexual marriage rate could be a ‘double-edge’ sword for the emotional health of Chinese men who have sex with men (MSM). The marriage rate is significantly higher in Chinese MSM than MSM in Western countries (3–5%) [5, 6] Such a choice, could be a ‘double-edge’ sword. A few studies have shown that keeping homosexual behaviors a secret could reduce the frequency of gay-related stressful events (GRSEs) among MSM [10, 11], but no studies have reported if such a defensive choice could reduce the levels of depression or anxiety symptoms for married MSM. Several studies have reported depression, anxiety, sexual abuse, and other psychological syndemics among MSM in China [11, 14], only a few studies have assessed associations between high marriage rates and emotional health [15, 16]. The present study aimed to determine the following: (1) if current marriage is associated with significantly decreased levels of anxiety symptoms; (2) marriage to a woman may worsen the emotional status, depression symptoms; (3) the dissolution of a marriage will influence the emotional health and increase and/or decrease the levels of anxiety and depression symptoms
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