Social support and depressive symptoms among ‘money’ boys and general men who have sex with men in Shanghai, China
Huamei Yan A , Frank Y. Wong B C D , Tony Zheng E , Zhen Ning A F , Yingying Ding A , Eric J. Nehl B , Lavinia Lin B and Na He A B GA Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China.
B Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
C The Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
D Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
E Shanghai Piaoxue Cultural Media Limited, Shanghai 200023, China.
F Shanghai Center for Disease Control and Prevention, Shanghai 200336, China.
G Corresponding author. Email: nhe@shmu.edu.cn
Sexual Health 11(3) 285-287 https://doi.org/10.1071/SH14017
Submitted: 15 January 2014 Accepted: 27 February 2014 Published: 12 June 2014
Abstract
The primary objective was to examine prevalence and correlates of social support and depressive symptoms among male sex workers (known as ‘money boys’ (MBs)) and general men who have sex with men (MSM) in Shanghai. The Social Provision Scale (SPS), which consists of 24 items, scored out of 4 for social provision, was used to evaluate the functions of social relationships. The score for each item ranges from 1 to 4, with a higher score indicating more social provision. The overall mean SPS score was 68.1 (s.d. = 6.53) for MBs and 69.3 (s.d. = 6.99) for general MSM. Depression was measured with a 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D), where a score of 9 has been recommended as the cutoff score to indicate possible depressive symptoms. The prevalence of depressive symptoms was 57.9%, with MBs having a higher level of depressive symptoms than general MSM (70.0% v. 46.1%) (odds ratio = 1.86, 95% confidence interval = 1.07–3.24). Social support was a protective factor for depressive symptoms (odds ratio = 0.92, 95% confidence interval = 0.89–0.96). MSM in China, particularly MBs, are vulnerable to low social support and high depressive symptoms, highlighting the need for tailored psychological programs targeting this population.
Additional keywords: emotional health, gay men, male sex workers.
References
[1] Sandfort TG, Bakker F, Schellevis FG, Vanwesenbeeck I. Sexual orientation and mental and physical health status: findings from a Dutch population survey. Am J Public Health 2006; 96 1119–25.| Sexual orientation and mental and physical health status: findings from a Dutch population survey.Crossref | GoogleScholarGoogle Scholar | 16670235PubMed |
[2] Bostwick WB, Boyd CJ, Hughes TL, McCabe SE. Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. Am J Public Health 2010; 100 468–75.
| Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States.Crossref | GoogleScholarGoogle Scholar | 19696380PubMed |
[3] Meyer IH. Minority stress and mental health in gay men. J Health Soc Behav 1995; 36 38–56.
| Minority stress and mental health in gay men.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2M3ls1KjsQ%3D%3D&md5=4796b5f571e16cae5f6262b8f1fd274cCAS | 7738327PubMed |
[4] Cox N, Vanden BW, Dewaele A, Vinke J. General and minority stress in an LGB population in Flanders. J LGBT Health Res 2009; 4 181–94.
| General and minority stress in an LGB population in Flanders.Crossref | GoogleScholarGoogle Scholar |
[5] Frost DM, Lehavot K, Meyer IH. Minority stress and physical health among sexual minority individuals. J Behav Med 2013;
| Minority stress and physical health among sexual minority individuals.Crossref | GoogleScholarGoogle Scholar | 23864353PubMed |
[6] Raffaelli M, Andrade F, Wiley AR, Sanchez-Armass O, Edwards LL, Aradillas-Garcia C. Stress, social support, and depression: a test of the stress-buffering hypothesis in a Mexican sample. J Res Adolesc 2013; 23 283–9.
| Stress, social support, and depression: a test of the stress-buffering hypothesis in a Mexican sample.Crossref | GoogleScholarGoogle Scholar |
[7] Zimmerman MA, Ramirez-Valles J, Zapert KM, Maton KI. A longitudinal study of stress-buffering effects for urban African-American male adolescent problem behaviors and mental health. J Community Psychol 2000; 28 17–33.
| A longitudinal study of stress-buffering effects for urban African-American male adolescent problem behaviors and mental health.Crossref | GoogleScholarGoogle Scholar |
[8] Huang ZJ, He N, Nehl EJ, Zheng T, Smith BD, Zhang J, et al Social network and other correlates of HIV testing: findings from male sex workers and other MSM in Shanghai, China. AIDS Behav 2012; 16 858–71.
| Social network and other correlates of HIV testing: findings from male sex workers and other MSM in Shanghai, China.Crossref | GoogleScholarGoogle Scholar | 22223298PubMed |
[9] Cutrona CE, Russell DW. The provisions of social relationships and adaptation to stress. In Jones WH, Perlman D, editors. Advances in personal relationships, vol. 1. Greenwich, CT: JAI Press Inc.; 1987. pp. 37–67.
[10] Kohout FJ, Berkman LF, Evans DA, Cornoni-Huntley J. Two shorter forms of the CES-D (Center for Epidemiological Studies Depression) depression symptoms index. J Aging Health 1993; 5 179–93.
| Two shorter forms of the CES-D (Center for Epidemiological Studies Depression) depression symptoms index.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3s3kvFKjtg%3D%3D&md5=fce9d12b2d7ffe64353844ffa021c47cCAS | 10125443PubMed |
[11] Yu X, Tam WW, Wong PT, Lam TH, Stewart SM. The Patient Health Questionnaire-9 for measuring depressive symptoms among the general population in Hong Kong. Compr Psychiatry 2012; 53 95–102.
| The Patient Health Questionnaire-9 for measuring depressive symptoms among the general population in Hong Kong.Crossref | GoogleScholarGoogle Scholar | 21193179PubMed |
[12] Lu J, Ruan Y, Huang Y, Yao J, Dang W, Gao C. Major depression in Kunming: prevalence, correlates and co-morbidity in a south-western city of China. J Affect Disord 2008; 111 221–6.
| Major depression in Kunming: prevalence, correlates and co-morbidity in a south-western city of China.Crossref | GoogleScholarGoogle Scholar | 18377998PubMed |
[13] Mak AD, Wu JC, Chan Y, Chan FK, Sung JJ, Lee S. Dyspepsia is strongly associated with major depression and generalised anxiety disorder – a community study. Aliment Pharmacol Ther 2012; 36 800–10.
| Dyspepsia is strongly associated with major depression and generalised anxiety disorder – a community study.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC38bltVClsg%3D%3D&md5=45a15e1a1d1315ddac3803f684377074CAS | 22957985PubMed |
[14] Pan A, Franco OH, Wang YF, Yu ZJ, Ye XW, Lin X. Prevalence and geographic disparity of depressive symptoms among middle-aged and elderly in China. J Affect Disord 2008; 105 167–75.
| Prevalence and geographic disparity of depressive symptoms among middle-aged and elderly in China.Crossref | GoogleScholarGoogle Scholar | 17568685PubMed |
[15] Salomon EA, Mimiaga MJ, Husnik MJ, Welles SL, Manseau MW, Montenegro AB, et al Depressive symptoms, utilization of mental health care, substance use and sexual risk among young men who have sex with men in EXPLORE: implications for age-specific interventions. AIDS Behav 2009; 13 811–21.
| Depressive symptoms, utilization of mental health care, substance use and sexual risk among young men who have sex with men in EXPLORE: implications for age-specific interventions.Crossref | GoogleScholarGoogle Scholar | 18709453PubMed |
[16] Liu H, Liu H, Cai Y, Rhodes AG, Hong F. Money boys, HIV risks, and the associations between norms and safer sex: a respondent-driven sampling study in Shenzhen, China. AIDS Behav 2009; 13 652–62.
| Money boys, HIV risks, and the associations between norms and safer sex: a respondent-driven sampling study in Shenzhen, China.Crossref | GoogleScholarGoogle Scholar | 18841459PubMed |
[17] Nehl EJ, Wong FY, He N, Huang ZJ, Zheng T. Prevalence and correlates of alcohol use among a sample of general MSM and money boys in Shanghai, China. AIDS Care 2012; 24 324–30.
| Prevalence and correlates of alcohol use among a sample of general MSM and money boys in Shanghai, China.Crossref | GoogleScholarGoogle Scholar | 21902561PubMed |
[18] Zhao J, Cai WD, Gan YX, Zhang Y, Yang ZR, Cheng JQ, et al A comparison of HIV infection and related risk factors between money boys and noncommercial men who have sex with men in Shenzhen, China. Sex Transm Dis 2012; 39 942–8.
| A comparison of HIV infection and related risk factors between money boys and noncommercial men who have sex with men in Shenzhen, China.Crossref | GoogleScholarGoogle Scholar | 23191947PubMed |
[19] He N, Wong FY, Huang ZJ, Ding Y, Fu C, Smith BD, et al HIV risks among two types of male migrants in Shanghai, China: money boys vs. general male migrants. AIDS 2007; 21 S73–9.
| HIV risks among two types of male migrants in Shanghai, China: money boys vs. general male migrants.Crossref | GoogleScholarGoogle Scholar | 18172395PubMed |
[20] He N, Wong FY, Huang ZJ, Thompson EE, Fu C. Substance use and HIV risks among male heterosexual and ‘money boy’ migrants in Shanghai, China. AIDS Care 2007; 19 109–15.
| Substance use and HIV risks among male heterosexual and ‘money boy’ migrants in Shanghai, China.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28nptFSgtA%3D%3D&md5=be66e997390f3f85ff73dffa208a448aCAS | 17129865PubMed |
[21] MacIntosh RC, Strickland OJ. Differential item responses on CES-D inventory: a comparison of elderly Hispanics and non-Hispanic Whites in the United States and item usage by elderly Hispanics across time. Aging Ment Health 2010; 14 556–64.
| Differential item responses on CES-D inventory: a comparison of elderly Hispanics and non-Hispanic Whites in the United States and item usage by elderly Hispanics across time.Crossref | GoogleScholarGoogle Scholar | 20480413PubMed |
[22] Chapleski EE, Lamphere JK, Kaczynski R, Lichtenberg PA, Dwyer JW. Structure of a depression measure among American Indian elders: confirmatory factor analysis of the CES-D scale. Res Aging 1997; 19 462–85.
| Structure of a depression measure among American Indian elders: confirmatory factor analysis of the CES-D scale.Crossref | GoogleScholarGoogle Scholar |
