Demetria N Cain1,2, Chloe Mirzayi1,3, H Jonathon Rendina1,4,5, Ana Ventuneac1,6, Christian Grov1,3, Jeffrey T Parsons1,4,5. 1. 1 Center for HIV/AIDS Educational Studies and Training, Hunter College of the City University of New York (CUNY) , New York, New York. 2. 2 Community Health Sciences Doctoral Program, Community Health Sciences, University of Illinois at Chicago School of Public Health , Chicago, Illinois. 3. 3 Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy , New York, New York. 4. 4 Department of Psychology, Hunter College of the City University of New York (CUNY) , New York, New York. 5. 5 Health Psychology and Clinical Science Doctoral Program, The Graduate Center of the City University of New York (CUNY) , New York, New York. 6. 6 Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai , New York, New York.
Abstract
PURPOSE: Depression negatively impacts the health and well-being of gay and bisexual men (GBM). However, little is known about the contexts in which rural GBM live relative to those living in urban areas and their overall mental health. The aim of this study was to examine associations between population density and depressive symptoms and the role of internalized homonegativity and social support as potential mediators. METHODS: A nationally representative sample of 1071 GBM (mean age = 40.24) was enrolled. Participants provided their zip codes, which were categorized according to population density and rank-normalized. RESULTS: In a path analysis model adjusted for race/ethnicity, college education, age, and relationship status, higher population density was significantly associated with increased social support (B = 0.11, P = 0.002) and decreased internalized homonegativity (B = -0.06, P < 0.001). In turn, lower social support (B = -2.93, P < 0.001) and greater internalized homonegativity (B = 4.93, P < 0.001) were significantly associated with greater depressive symptoms. The indirect effects of population density on depression through social support (B = -0.33, P < 0.001) and internalized homonegativity (B = -0.31, P < 0.001) were statistically significant, suggesting evidence for mediation of the effects. CONCLUSIONS: These results indicate that living in less inhabited areas acts on depressive symptoms through mechanisms of lower social support and higher internalized homonegativity. These findings suggest that social contexts in which GBM live can affect mental health outcomes and indicate the need for further support and inclusion of GBM, especially in less inhabited areas.
PURPOSE:Depression negatively impacts the health and well-being of gay and bisexual men (GBM). However, little is known about the contexts in which rural GBM live relative to those living in urban areas and their overall mental health. The aim of this study was to examine associations between population density and depressive symptoms and the role of internalized homonegativity and social support as potential mediators. METHODS: A nationally representative sample of 1071 GBM (mean age = 40.24) was enrolled. Participants provided their zip codes, which were categorized according to population density and rank-normalized. RESULTS: In a path analysis model adjusted for race/ethnicity, college education, age, and relationship status, higher population density was significantly associated with increased social support (B = 0.11, P = 0.002) and decreased internalized homonegativity (B = -0.06, P < 0.001). In turn, lower social support (B = -2.93, P < 0.001) and greater internalized homonegativity (B = 4.93, P < 0.001) were significantly associated with greater depressive symptoms. The indirect effects of population density on depression through social support (B = -0.33, P < 0.001) and internalized homonegativity (B = -0.31, P < 0.001) were statistically significant, suggesting evidence for mediation of the effects. CONCLUSIONS: These results indicate that living in less inhabited areas acts on depressive symptoms through mechanisms of lower social support and higher internalized homonegativity. These findings suggest that social contexts in which GBM live can affect mental health outcomes and indicate the need for further support and inclusion of GBM, especially in less inhabited areas.
Entities:
Keywords:
internalized homonegativity; men who have sex with men; mental health; minority stress; population density; social support
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