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Multiple Discrimination, Substance-Related Coping, and Depression Among Sexual Minority Men with HIV.
Christopher Chiu1,2,3, Hyo Jin Shin3, Hunter T Baldwin4
1Department of Psychiatry, Boston Medical Center, Boston, MA, USA.
Journal of Homosexuality
|July 14, 2025
Summary
Multiple forms of discrimination are linked to higher depression rates in HIV-positive sexual minority men who use drugs. Substance-related coping partially explains this association, highlighting the need for interventions addressing multiple stigmas.
Area of Science:
- Public Health
- Mental Health
- HIV/AIDS Research
Background:
- Sexual minority men (SMM) with HIV who use substances face significant stigma and disproportionately high rates of depression.
- Understanding the interplay between multiple forms of discrimination, substance use, and mental health is crucial for this population.
Purpose of the Study:
- To examine the relationship between multiple forms of discrimination (including substance-related discrimination) and depressive symptoms among SMM with HIV who use drugs.
- To investigate the mediating role of substance-related coping in the association between multiple discrimination and depression.
Main Methods:
- Self-report data were collected from 195 SMM with HIV who use drugs between 2017-2018.
- Measures included experienced discrimination across various categories (HIV, sexual orientation, race/ethnicity, substance use), substance-related coping strategies, and depressive symptoms.
- Statistical analyses, including ANCOVA, were used to assess differences in depressive symptoms and indirect associations.
Main Results:
- Higher numbers of discrimination categories endorsed were significantly associated with increased depressive symptoms.
- Discrimination related to substance use was a significant predictor of depressive symptoms.
- Substance-related coping partially mediated the relationship between multiple discrimination and depressive symptoms.
Conclusions:
- A cumulative association exists between experiencing multiple forms of discrimination and depressive symptoms in this population.
- Substance-related discrimination and coping strategies are key factors influencing depression.
- Interventions targeting multiple forms of discrimination are needed to reduce depression rates among SMM with HIV who use drugs.
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