Association between perceived HIV stigma, social support, resilience, self-esteem, and depressive symptoms among HIV-positive men who have sex with men (MSM) in Nanjing, China

ABSTRACT

Among Chinese HIV-positive men who have sex with men (MSM), high levels of depression are common. The association between HIV and depression is attributed to several factors, particularly HIV-related stigma. However, to date, how HIV-related stigma leads to depression among Chinese HIV-positive MSM is still unclear. As such, this study aims to examine the relationships between perceived HIV stigma, social support, resilience, self-esteem, and depressive symptoms among HIV-positive MSM in China. We conducted a cross-sectional survey study among 347 HIV-positive MSM from July to August 2016 in Nanjing, China. Measurements were sociodemographic and psychological constructs including perceived HIV stigma, social support, resilience, self-esteem, and depressive symptoms. Structural equation modeling (SEM) was used to examine the relationships among these constructs. Overall,134 (38.6%) participants had depressive symptoms. Perceived stigma was directly associated with depressive symptoms (β = .196, p < .001). Perceived stigma also indirectly affected depressive symptoms (β = .200, p < .001)through social support and self-esteem. Social support (β = −.124, p = .004) and self-esteem (β = −.536, p = .001), but not resilience, were direct predictors of depressive symptoms. Resilience was directly associated with self-esteem (β = .512, p < .001). Perceived HIV stigma could directly and indirectly impact depressive symptoms in HIV-positive MSM. Improving personal self-esteem, resilience and social support might reduce impact of perceived stigma on depressive symptoms among HIV-positive MSM in China.

KEYWORDS:

• Perceived stigma
• depressive symptoms
• HIV
• MSM
• structural equation model

Acknowledgements

We acknowledge the work and dedication of the Second Affiliated Hospital of Southeast University and all participants who generously participated in this study.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Humanities and Social Science Foundation of Ministry of Education (grant number 15YJAZH094) and the National Natural Science Foundation of China [grant number 81673196].