Abstract
ObjectivesThe psychological health of men who have sex with men (MSM) has received increased attention in recent years. We thus investigated the psychological status and associated factors among MSM in China.MethodsA cross-sectional survey of 248 MSM was conducted from April to September 2015 using Symptom Checklist 90 (SCL-90) in Huludao and Zhengzhou, China. Statistical analyses utilized SPSS version 19.0 for Windows.ResultsAll Cronbach’s α coefficients of the SCL-90 subscales exceeded 0.7, suggesting acceptable reliability. The coefficient range of the collective validity for all the subscales was >0.4. For the divisional validity, each item correlated better with the hypothetical subscale than with other subscales. Collective validity and divisional validity were both acceptable. The four most frequent types of psychological distress among MSM were depression, obsessive-compulsive behavior, interpersonal sensitivity, and anxiety. Results of the univariate analysis revealed that the following groups had significantly higher SCL-90 scores (P < 0.05): peasantry, married MSM, respondents who reported condomless anal intercourse and a greater number of male partners, and respondents who had not undergone psychosocial counseling and whose family or friends did not know about their sexual identity. In a multivariate logistic regression model, the following parameters were independently associated with higher SCL-90 scores: being married (AOR [adjusted odds ratio] = 3.19; 95% CI [confidence interval]: 1.96 to 5.93), condomless anal intercourse (AOR = 1.16; 95% CI: 1.02 to 1.31), number of male partners (AOR = 1.66 and 1.81; 95% CI: 1.08 to 2.34 and 1.32 to 2.69), family or friends not knowing about sexual identity (AOR = 2.13; 95% CI: 1.17 to 4.92), and lack of psychosocial counseling (AOR = 2.09; 95% CI: 1.06 to 4.09).ConclusionsOur results indicate that psychological health problems among MSM in China are of concern. It is thus necessary to strengthen intervention efforts, with more emphasis on intervention programs to improve psychological health among Chinese MSM.
Highlights
Studies conducted in India and the Netherlands have revealed that men who have sex with men (MSM), in contrast with their heterosexual counterparts, have poorer mental health and experience more mental distress [1,2]
Results of the univariate analysis revealed that the following groups had significantly higher Symptom Checklist 90 (SCL-90) scores (P < 0.05): peasantry, married MSM, respondents who reported condomless anal intercourse and a greater number of male partners, and respondents who had not undergone psychosocial counseling and whose family or friends did not know about their sexual identity
In a multivariate logistic regression model, the following parameters were independently associated with higher SCL-90 scores: being married (AOR [adjusted odds ratio] = 3.19; 95% CI [confidence interval]: 1.96 to 5.93), condomless anal intercourse (AOR = 1.16; 95% CI: 1.02 to 1.31), number of male partners (AOR = 1.66 and 1.81; 95% CI: 1.08 to 2.34 and 1.32 to 2.69), family or friends not knowing about sexual identity (AOR = 2.13; 95% CI: 1.17 to 4.92), and lack of psychosocial counseling (AOR = 2.09; 95% CI: 1.06 to 4.09)
Summary
Studies conducted in India and the Netherlands have revealed that men who have sex with men (MSM), in contrast with their heterosexual counterparts, have poorer mental health and experience more mental distress [1,2]. A growing body of literature from China and France suggests that HIV risk among MSM increases when an individual reports having a relatively greater number of psychological problems [5,6,7,8]. Psychological health issues may contribute to the propensity for MSM to engage in risky sexual behavior and may affect the degree to which they might benefit from HIV prevention programs [5,6,7,8]. Another study from the United States suggests that psychological problems among MSM are highly associated with drug use and risky sexual behavior [9]. MSM with psychiatric symptoms might be at greater risk for HIV infection owing to a greater prevalence of sexual relations, multiple partners, and sexual abuse in the United States [10,11]
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