Loneliness and depressive symptoms and the influence of social support and self-esteem among men who have sex with men in China: a cross-sectional study

Abstract

Abstract Background While psychosocial problems and their related factors in men who have sex with men (MSM) have been well documented in developed countries, there are still not many studies addressing this issue in China and the results are inconsistent. To describe loneliness and depression among Chinese MSM populations and explore their associated factors, a cross-sectional study was conducted among 655 MSM in Taizhou of Zhejiang Province between April and November, 2021. Methods Sociodemographic and psychosocial data were collected, as well as information on risky sexual behaviors. Bivariate logistic regression analyses were used to examine the associations between independent variables and outcomes of loneliness and depression. To assess moderating effects of the factors in the multivariable models for loneliness, interactions between independent variables and depressive symptoms were tested. Results Of the MSM sample, 13.28% and 7.48% perceived loneliness and reported moderate-to-severe depressive symptoms. We found that participants who perceived loneliness were more likely to have younger age (OR 0.44, 95% CI 0.21, 0.93, 15–32 years as reference group), low social support (OR 3.60, 95% CI 2.14, 6.04), low self-esteem (OR 3.03, 95% CI 1.45, 6.32) and depressive symptoms (OR 5.45, 95% CI 2.66, 11.15). The participants with moderate-to-severe depressive symptoms were more likely to have low self-esteem (OR 6.78, 95% CI 3.08, 14.95) and feelings of loneliness (OR 5.51, 95% CI 2.66, 11.40). The MSM who were young, not married, and had low self-esteem were especially vulnerable to the impact of depressive symptoms on loneliness. Conclusions In China, it is significant to implement intervention programs addressing loneliness and negative emotions for MSM, increase community social support, and destigmatize homosexuality.