The relationship between social support and depression among HIV-positive men who have sex with men in China: the chain mediating role of psychological flexibility and hope

Run Wang; Fang Zheng; Guiying Cao; Lloyd A Goldsamt; Yan Shen; Ci Zhang; Mengyao Yi; Wenwen Peng; Xianhong Li

doi:10.3389/fpubh.2023.1271915

The relationship between social support and depression among HIV-positive men who have sex with men in China: the chain mediating role of psychological flexibility and hope

Front Public Health. 2023 Nov 8:11:1271915. doi: 10.3389/fpubh.2023.1271915. eCollection 2023.

Authors

Run Wang¹, Fang Zheng², Guiying Cao², Lloyd A Goldsamt³, Yan Shen¹, Ci Zhang¹, Mengyao Yi¹, Wenwen Peng¹, Xianhong Li¹

Affiliations

¹ Xiangya School of Nursing, Central South University, Changsha, Hunan, China.
² Department of AIDS, The First Hospital of Changsha, Changsha, Hunan, China.
³ Rory Meyers College of Nursing, New York University, New York, NY, United States.

Abstract

Introduction: HIV and mental health problems are a global syndemic. One key issue is that the significant mental health problems among people vulnerable to acquiring or living with HIV have not been fully addressed. Access to social support has been one of the biggest challenges for HIV-positive men who have sex with men (HIV+ MSM). Lower social support has been linked to more severe depression symptoms. However, the mechanisms underlying the association between social support and depression in HIV+ MSM are unclear. Two possible mediators include hope and psychological flexibility. This study aimed to examine the relationship between social support and depression in HIV+ MSM and to explore the single mediating effects of hope and psychological flexibility and the chain mediating effect of these two variables on this relationship.

Methods: A convenience sample was used to recruit participants from the designated HIV/AIDS hospital in Changsha city, Hunan Province of China. A total of 290 HIV+ MSM completed questionnaires.

Results: Our findings showed that hope mediated the relationship between social support and depression in HIV+ MSM. Furthermore, the chain mediation model confirmed a direct negative association between social support and depression, but this relationship was largely mediated by the chain effects of hope and psychological flexibility.

Conclusions: Integrating hope and psychological flexibility into interventions may provide better mental health support for HIV+ MSM and improve their wellbeing and quality of life.

Keywords: HIV; depression; hope; men who have sex with men; psychological flexibility; social support.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China / epidemiology
Depression / epidemiology
HIV Infections* / epidemiology
HIV Infections* / psychology
Homosexuality, Male / psychology
Humans
Male
Quality of Life
Sexual and Gender Minorities*
Social Support

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was funded by the National Natural Science Foundation of China, the funder was XL and the funding number was 72074226; and by the China Medical Board Open Competition Project, the funder was XL and the funding number was 22–465.