A comparative analysis of rural and urban MSM depressive symptomology: the mediating effects of loneliness

ABSTRACT

Given the dearth of research exploring mental health differences between rural and urban men who have sex with men (MSM), we sought to examine differences in depressive symptomology and loneliness. Concurrently we examined the mediating effects of loneliness on the link between geographic locale and depressive symptoms via a mediation model. Data were collected from 156 MSM in Oklahoma. Results show urban MSM have significantly higher levels of both depressive symptomology and loneliness. Mediation analyses revealed that the link between urban/rural locale and depressive symptomology was mediated by loneliness. In other words, identifying as urban MSM may result in higher levels of depressive symptomology through feelings of loneliness. The rationale for this includes the possibility that rural MSM may have strong online social support ‘networks’ which act as a protective factor against loneliness and depressive symptomology, or that elements of urban environments increase stress in urban MSM. It is also possible that the urban landscape of Oklahoma does not provide the same level of acceptance as other urban areas in more liberal parts of the country. Interventions at the individual or community level should consider geographic location as a mesosystem factor that impacts the mental health of MSM.

KEYWORDS:

• MSM
• rural
• urban
• depression
• loneliness

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The research results discussed in this publication were made possible in total or part by funding though the award from Project number HR16-022, from the Oklahoma Center for the Advancement of Science and Technology.

Notes on contributors

Zachary Giano

Zachary Giano, Ph.D., is a post-doctoral fellow at Oklahoma State University, Center for Health Sciences. His research interests include racial/ethnic and sexual minorities, resilience, and psychosocial outcomes. His expertise includes quantitative methods.

Randolph D. Hubach

Randolph D. Hubach, PhD, MPH is the Director of the Sexual Health Research Lab at Oklahoma State University—Center for Health Sciences and Assistant Professor of Rural Health. His research interests include using community engaged principles to address sexuality-related health disparities, sexual behavior, LGBT population health, and HIV/AIDS within rural and urban communities.

Kyle Deboy

Kyle DeBoy, BA, is a DO/MPH candidate at Oklahoma State University. He works as a project coordinator at the Oklahoma State University Sexual Health Research Lab and his scientific interests include social determinants of health, health equity, rural & underserved populations, and medicine.

Hunter Meyers

Hunter Meyers, BS, is a graduate research assistant, masters of public health student, and DO candidate at Oklahoma State University. He works as an outreach special coordinator for the Sexual Health Research Lab focusing on health disparities in rural communities.

Joseph M. Currin

Joseph M. Currin, Ph.D., is an assistant professor in the Department of Psychological Sciences at Texas Tech University in Lubbock, TX. Areas of expertise include use of technology for sexual partner seeking, mental health disparities among men who have sex with men (MSM), and outcomes associated with stigma and minority stress for rural and peri-urban MSM.

Denna L. Wheeler

Denna L. Wheeler, Ph.D. is a clinical associate professor for Rural Health at Oklahoma State University Center for Health Sciences. Areas of expertise include research methodology and statistical methods, program evaluation, rural public health and rural health workforce.