Abstract #2721  -  Internalized and anticipated stigma, coping styles, disclosure of sexual orientation, and psychological distress among Chinese men who have sex with men (MSM) at high risk for HIV
Authors:   Presenting Author:   Prof Kyung-Hee Choi - University of California, San Francisco
Additional Authors:  Prof Kyung-Hee Choi, Prof Wayne Steward, Dr Estie Hudes, Prof Pierre Miège,
Aim: The link between stigma against sexual minorities and poor health outcomes including HIV risk is well established. More recent evidence indicates that the effect of stigma on psychological distress differs by different coping responses and the varying level of identity disclosure. However, few studies have examined the potential moderating roles of coping styles and disclosure of sexual orientation in the relationship between sexual stigma and psychological distress among Chinese men who have sex with men (MSM) who are at high risk for HIV.
Method / Issue: We recruited a snowball sample of 481 MSM (aged 18+) in Beijing, China from June 2011 to September 2012. Participants completed a computer-based survey that asked about demographic characteristics, internalized MSM stigma (person?s own stigmatizing views), anticipated MSM stigma (expectations of discriminatory behaviors from others), avoidance coping (withdrawing from stigmatizing situations) and social support coping (turning to others for help), disclosure of sexual orientation, and past-week depressive and anxious symptoms. We conducted hierarchical linear regression analyses to examine the potential moderating roles of MSM disclosure and avoidance and social support coping in the link of internalized stigma with depression and anxiety as well as in the link of anticipated stigma with depression and anxiety, after controlling for age, Beijing residence card, education, marital status, and sexual orientation.
Results / Comments: The main effects of internalized stigma (b=0.08 p < 0.05), avoidance coping (b=0.04 p < 0.05), social support coping (b=-0.05 p < 0.01), and MSM disclosure (b=0.34 p < 0.01) were statistically significant for depressive symptoms, whereas the main effects of avoidance coping (b=0.07 p < 0.01), social support coping (b=-0.06 p < 0.05), and MSM disclosure (b=0.47 p < 0.01) were statistically significant for anxious symptoms. None of the two- and three-way interactions between the four predictors were statistically significant (p > 0.05). The main effects of anticipated stigma (b=0.09 p < 0.001), social support coping (b=-0.06 p < 0.05), and MSM disclosure (b=0.33 p < 0.01) were statistically significant for depressive symptoms the main effects of anticipated stigma (b=0.15 p < 0.001), social support coping (b=-0.07 p < 0.01), and MSM disclosure (b=0.47 p < 0.01) were also statistically significant for anxious symptoms. None of the two- and three-way interactions between the four predictors were statistically significant (p > 0.05).
Discussion: Higher levels of internalized and anticipated stigma both were associated with poor mental health outcomes among Chinese MSM. However, we found little evidence that coping responses to stigma and MSM disclosure moderated the effect of internalized and anticipated stigma on psychological distress. Instead, avoidance coping appears to be directly related to higher levels of psychological distress, whereas social support coping appears to be directly linked to lower levels of psychological distress. MSM disclosure also appears to be directly related to higher levels of psychological distress. These results underscore the need for interventions which address internalized and anticipated stigma as well as related coping responses and MSM disclosure in order to improve psychological well-being of MSM in China.
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