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Article

Family Support and Sociocultural Factors on Depression among Black and Latinx Sexual Minority Men

by
Donte T. Boyd
1,2,*,
S. Raquel Ramos
3,
Camille R. Quinn
1,
Kristian V. Jones
4,
Leo Wilton
5,6 and
LaRon E. Nelson
2,7,8
1
College of Social Work, Ohio State University, Columbus, OH 43210, USA
2
Center for Interdisciplinary Research on AIDS, New Haven, CT 06510, USA
3
Department, Rory Meyers College of Nursing, New York University, New York, NY 10010, USA
4
School of Social Work, University of Texas at Austin, Austin, TX 78712, USA
5
Department of Human Development, State University of New York at Binghamton, Binghamton, NY 13902, USA
6
Faculty of Humanities, University of Johannesburg, Johannesburg 2006, South Africa
7
School of Nursing, Yale University, New Haven, CT 06477, USA
8
St. Michael’s Hospital, Li Ka Shing Knowledge Institute, MAP Centre for Urban Health Solutions, Toronto, ON M5B 1W8, Canada
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2021, 18(13), 6759; https://doi.org/10.3390/ijerph18136759
Submission received: 11 May 2021 / Revised: 9 June 2021 / Accepted: 14 June 2021 / Published: 23 June 2021
(This article belongs to the Special Issue Mental Health Opportunities and Challenges across LGBTQ+ Communities)
Versions Notes

Abstract

:
Family-based approaches are critical for improving health outcomes in sexual minority men (SMM) of color. Yet, it is unclear how family context, internalized homophobia, and stress influence mental health outcomes among sexual minority men of color. From a cross-sectional sample of 448 participants, aged 16–24 years, survey data were analyzed to examine rates of family social support, the perception of sexuality by family, the stressfulness of life events, internalized homophobia, and other contextual variables on depression using linear regression. Our results indicated that an 86% increase in family social support was related to a −0.14 decrease in depression (ß = −0.14, p = 0.004). In addition, SMM who were separated by family and friends because of their sexuality were statistically significant and positively associated with depression (ß = 0.09, p < 0.001). Findings from our study suggest that the influence from the microsystem is salient in modifying mental health outcomes for SMM of color.

1. Introduction

Approximately 3.9 million persons in the United States identify as sexual minority men [1] (SMM). The term sexual minority refers to a person whose sexual identity is not exclusively heterosexual [2]. Due to the many identities SMM may hold, their lived experiences cannot be viewed in isolation. The intersectionality framework acknowledges the many facets of an individual’s identity and how these identities contribute to interlocking systems of power or inequality [3,4,5]. For example, SMM may have male gender privilege; however, when gender is intersected with race, ethnicity, and sexual identity, the context of one’s power status may shift depending on the context of their environment. Recent literature indicates that SMM are three times as likely to experience depression [6,7] and twice as likely to experience certain mental health disorders when compared to heterosexual men and women in the United States [7,8], thus highlighting how their sexual minority identity can impact their mental health and well-being.
According to previous research, major depression is common in SMM [9] and associated with a high disease burden [10]. Depression can be devastating to an individual’s quality of life and can decrease their productivity, physical health [11,12], and potentially increase their HIV risk [13]. In addition, depression has been associated with chronic comorbid conditions, such as cardiovascular disease [14], and an increase in alcohol use, substance misuse, and family disruption/rejection [12,15]. In sexual minority communities, family factors around sexual identity have a salient role. We define family factors broadly as family support, family values, and familial embarrassment that are portrayed by parents, caregivers, and/or sibling(s) from one’s biological or chosen family [16,17].

1.1. Family Factors

One family factor or dynamic that has been shown to have a deleterious effect on the mental health of SMM is rejection based on sexual identity [18,19]. Family disruption due to rejection has severe consequences for the physical and mental health of young adult SMM [18,19,20]. SMM young adults who have experienced family disruption because of rejection were found more likely to be suicidal and to have high levels of depression [20]. Conversely, we also know that the presence of parental support and positive communication has decreased HIV risk in Black sexual minority young people and adults [16,17]. Family factors are an exponentially significant factor in mitigating HIV risk and familial stigma and depression about sexual identity.

1.2. Family Social Support

Family social support has been associated as a protective factor among SMM [12]. Family social support includes both emotional as well as tangible support, specifically financial assistance and other resources [12]. The extant literature on family support has shown family members’ acceptance or rejection of one’s choice in sexual partners is associated with depression among SMM [12,21,22,23]. There is empirical evidence that highlights the nuance within family support; for instance, qualitative research highlighted that those who were rejected by some family members often found support from their mothers [24].

1.3. Internalized Homophobia

SMM of color can experience a lack of family support due to rejection, which may result in both depression and internalized homophobia [25]. Internalized homophobia is an individual’s internal conflict with their sexual identity and creates negative perceptions that are directed internally [25]. This can have deleterious effects on overall mental health and well-being [26,27,28,29] resulting from the interconnectedness of sexual identity, family factors, and internalized homophobia on depression. In addition, some research has found that racism compounded with internalized homophobia has been associated with maladaptive outcomes on sexual minorities [30,31]. Several researchers have framed internalized homophobia as an aspect of the coming-out process that is marked by low self-esteem and heightened levels of depression and anxiety [26,32,33]. Longitudinal research has highlighted that the lessening of internalized homophobia over time is associated with positive health outcomes among SMM [33].

1.4. Stressful Life Events

Another factor to consider related to depression in SMM is stressful life events. SMM commonly experience stigma and discrimination during their lifetime [34]. These experiences are ongoing and experienced across multiple everyday domains of livelihood, such as education, employment, housing, recreation, and through religious worship [35]. Verbal, physical, and sexual violence are also commonly experienced [34,35]. Moreover, prior research has indicated that SMM experience multiple layers of stigmas daily such as racism, racial and social discrimination, and internalized heterosexism, which negatively impacts their mental health [31]. In addition, SMM are also more likely to avoid accessing healthcare treatment if they believe the healthcare clinicians will discriminate against them in case they are diagnosed with HIV or other sexually transmitted infections [36]. The interconnectedness of compounding effects from multiple forms of stigma and discrimination is overly burdensome and can lead to depression in this population [37].

1.5. The Present Study

Building on prior research, the authors contend that family-based approaches that acknowledge the intersections of sexual identity, race, family factors, stressful life events, and occurrences of internalized homophobia are critical for improving SMM’s mental health and related outcomes [38,39]. This has been recommended for use in quantitative analyses to explain variance and further understand the multi-contextual, holistic, social identities of individuals in health outcomes research [5,38,39]. The purpose of this study was to use an intersectional methodological approach to examine the relationship of family factors, internalized homophobia, and stressful life events on depression among SMM of color. We hypothesize that a lack of family support, internalized homophobia, and stressful life events are positively correlated with depression among SMM men of color.

2. Methods

2.1. Procedures

The Healthy Young Men’s (HYM) Cohort Study is a longitudinal study (baseline, 6-month follow-up assessments) conducted with 448 Black, Latino, or multi-racial/ethnic (i.e., they identify in part as Black and/or Latino) YMSM. The study design described elsewhere [40,41,42,43], involved the recruitment of YMSM in Los Angeles, CA, USA, using both venue-based and social media recruitment strategies from May 2016 through September 2017. The HYM cohort study aims were to prevent and reduce HIV incidence among young SMM of color by examining the barriers and protective factors that contribute to their engagement in care. Young SMM who were HIV seronegative (N = 448) and those who were seropositive (N = 50) were eligible to participate in the study. General eligibility criteria were: (1) 16 to 24 years of age; (2) male assignment at birth; (3) self-identify as gay, bisexual, or uncertain about their sexual orientation; (4) report having a sexual experience with a man within the last 12 months; (5) self-identify as African American/Black, Hispanic/Latino, or multiracial ethnic; and (6) reside in Los Angeles or a surrounding county with no plans on moving outside of the area for at least six months. The current study uses data from wave 5 of Latino and Black SMM (N = 372).
The HYM primary study is described thoroughly elsewhere [40,41,42,43]. Institutional Review Board approval was obtained from Children’s Hospital Los Angeles.

2.2. Measures

The outcome variable for this study is depression. Depression was measured using the Brief Symptom Inventory (BSI-18) [44], which assessed current symptoms of somatization, depression, and anxiety (i.e., within the past seven days). The BSI has been used with this particular population. To identify participants whose symptoms reached a clinical level of concern, BSI subscale scores were converted to T scores. Scores greater than or equal to 63 indicate clinical concern. To compare participants above and below the threshold for clinical concern, scores for somatization, depression, and anxiety were dichotomized (<63, no clinical concern = 0, ≥63, clinical concern = 1) [45]. The alpha for the depression subscale was 0.84.
Several contextual variables were collected. Age was treated as a continuous variable. Employment status was measured (1 = full time, 2 = not working at this time and not looking for employment, 3 = not working at this time and looking for employment). Sexual identity options were (1 = gay, 2 = heterosexual, 3 = bisexual, 4 = other same sex, 5 = pansexual, 6 = unsure/question, 7 = other).
Several criteria were used to measure family context. Family social support [46] was measured using a four-item scale (ranging from 1 = very strongly disagree to 4 = agree) asking the respondents to agree or disagree with the following: (1) “My family tries to help”; (2) “I can talk about my problems with my family”; (3) “My family is willing to help me make decisions”; and (4) “I get the emotional help and support I need from family”. FSS scores were created by averages across item responses (α = 0.91) and standardized before analysis. Separation from family and friends because of sexuality (SFFS) was measured using a single item—“As an adult, how often have you had to move away from friends or family because of your sexuality?”—from a subscale of homophobic experiences, with scores ranging from a single instance (1) to many times (4). Perceived embarrassment and hurt due to sexuality by family (PEHS) was measured using a single item—“Today, how often do you feel that your sexuality hurts and embarrasses your family?”—from a subscale of homophobic experiences, with scores ranging from never (1) to many times (4) [46].
The variable stressful life events was measured by participants indicating whether they had experienced each of the 32 stressful life events during the last six months (0 = no, 1 = yes). The list of stressful life events included a subset of 27 items from Nott and Vedhara’s [47] scale for stressful events among men who have sex with men living with HIV (e.g., “You had problems/difficulties with a close friend”) and a further five items representing additional stressful events identified as salient to homosexual young men in prior research conducted by this team (“You came out to your family”) [47]. A score representing the total number of stressful life events was created by summing the number of events endorsed. In addition, for each stressful life event endorsed, participants rated the severity of that stressor over the last 6 months (1 = low, 10 = high) [41,43].
Internalized homophobia was measured using the Revised Internalized Homophobia Scale (IHP-R); [40,41] it included four items measured on a scale ranging from strongly disagree (0) to strongly agree (3). IHP scores were created by averaging across item responses (α = 0.89).

2.3. Data Analysis

All analyses were conducted on observations that included non-missing data for the outcome, depression. Statistical tests of association were conducted between the measures described in the methods and the continuous outcome, depression. Table 1 provides descriptive statistics for the study sample. Table 2 provides bivariate correlations, mean, and standard deviations among independent variables: family social support, stressful life events, internalized homophobia, SFFS, and PEHS; the control variables are: age, sexual identity, and employment status on the outcome depression. Next, a multiple regression was conducted on the independent variables and the dependent variables (Table 3) (N = 372). Post-estimation tests were performed after the analysis to check for multicollinearity between variables. Survey data were analyzed using listwise deletion. For survey scales, a mean score of the scale items was generated for participants with non-missing data. All analyses were conducted in STATA 16.

3. Results

3.1. Descriptive Statistics

Table 1 provides descriptive information on mean scores for major study variables from wave 5. The analytic sample consisted of 372 participants between the ages of 18 and 29; the mean age was 24; range = 18–29. Fifty-eight percent self-identified as Latinx (N = 244), 23% as African American (N = 87) and 22% as mixed race (N = 83). The majority of the sample (78%) self-identified as homosexual, 11% being bisexual, 4% MSM, 3% pansexual, 2% heterosexual, and approximately 2% unsure or questioning. In addition, most of the sample reported working full-time (48%); 32% self-reported working part-time. Fifteen percent of the sample reported not working but looking for work, and 5% reported not working and not looking for work.
Overall, participants did not experience clinical levels of depression (M = 49, SD = 9.61). Generally, 13% had experienced some form of a stressful life event and 38% of the sample struggled with internalized homophobia. Moreover, 39% of the sample reported they were separated from their family and friends because of their sexuality, and 30% reported feeling embarrassed and hurt due to sexuality by family. Lastly, 71% reported they had received some social support from their family.

3.2. Bivariate Correlation Analysis

Table 2 provides bivariate correlations between the primary study variables and the outcome variable of depression symptoms. The results of the Pearson correlation indicated that there was a significant positive association between stressful life events and depression symptoms (r = 0.30, p < 0.001). There were positive relationships between internalized homophobia and depression (r = 0.29, p < 0.001) and stressful life events (r = 0.14, p < 0.05). A negative correlation existed between family social support and depression (r = −0.25, p < 0.001) serving as a buffer, stressful life events (r = −0.15, p < 0.05), and internalized homophobia (r = 0.10, p < 0.05). The results also indicated a positive correlation between SFFS and depression symptoms (r = 0.28, p < 0.001), stressful life events (r = 0.30, p < 0.01), internalized homophobia (r = 0.24, p < 0.001), and family support (r = −0.19, p = 0.002). PEHS was positively associated with depression (r = 0.19, p < 0.001), as well as stressful life events (r = 0.24, p < 0.001), family social support (r = 0.15, p < 0.001), and age (r = 0.35, p < 0.001), and there was a negative relationship between depression and SFFS (r = −0.20, p < 0.001). Employment was positively correlated with depression (r = 0.15, p < 0.05), stress (r = 0.10, p < 0.05), internalized homophobia (r = 0.08, p < 0.05), and social discrimination (family values) (r = 0.12, p < 0.05), and negatively associated with family support (r = −0.13, p < 0.010).

3.3. Multiple Regression

The overall model (Table 3) was statistically significant, and the variables accounted for 24% of the amount of variance in depression, R2 = 0.24, F (16, 355) = 6.96, p < 0.001. Stressful life events were found to be statistically significant and positively associated with depression (ß = 0.18, p = 0.026). Findings indicated that an 86% increase in family social support was associated with a −0.14 decrease in depression (ß = −0.14, p = 0.004), while holding all other variables constant. For every one-unit increase in internalized homophobia, there was a 0.21 increase in depression (ß = 0.21, p < 0.001). PEHS was statistically significant and positively associated with depression (ß = 0.09, p < 0.001). Employment (not working and looking for work) was positively associated with depression among SMM (ß = 0.13, p = 0.12). Lastly, identifying as pansexual was positively associated with depression for SMM (ß =2.61, p = 0.05).

4. Discussion

The purpose of this secondary analysis was to examine how the presence or lack of family support as well as internalized homophobia influenced depression rates among SMM. This study utilized intersectionality theories, which included both risk and protective processes, and an analytical model to investigate depression among SMM. The significant association between family social support and SMM who reported stressful life events, depression, and internalized homophobia is consistent with research that indicated internalized homophobia may cause stigma anticipation and perceptions of negative treatment by their parents based on their identities [27,48]. Participants in this study did not report moderate or high rates of depression. This may be due to SMM being less likely than other groups to report depression [49].
Our study findings indicated that an increase in family social support was associated with less depression, which is consistent with previous studies that family support serves as a protective mechanism against negative health outcomes [16,17,50]. Black and Latinx SMM in this study may have supportive networks of family members who support them during stressful and joyful times. In addition, they may also have positive relationships within these networks including their parents. These relationships between SMM of color and their families may have a positive influence on their overall mental health.
In addition, we found significant negative associations between stressful life events, internalized homophobia, perceived embarrassment and hurt due to sexuality by family, and depression. The primary implication of this finding is that more effort is needed to develop networks of support in Black and Latinx communities centered on parents and families, including fictive kin—individuals who may not be blood relatives—to reduce depression and promote mental health and well-being in this population. This highlights the importance of the family and members of the social network who are considered family because of their unconditional support and friendship.
This study contributes to the literature as our findings support the belief that the influence from the microsystem is salient to modifying mental health outcomes [49]. The indirect influence from mesosystems and categories of identity on depression in Black and Latinx SMM suggests a positive relationship between family values and depression as well as between family embarrassment and depression. Previous studies indicated that discriminatory behavior and/or treatment by parents could increase feelings of stigma along with internalized homophobia, which could further marginalize SMM in terms of their feelings of oppression and the toll this may take on them [49,50]. Further, homophobia and discrimination in African American communities tend to create environments that are less friendly to sexual minorities. This delays sexual orientation disclosure and increases the risk of contracting HIV [51,52,53,54].

5. Limitations

The results of our study should be interpreted considering several limitations. First, this was a cross-sectional sub-study, and our analysis only captures one point in time (wave 5) and does not account for longitudinal or temporal changes. Due to this, the role of the ecodevelopmental or intersectional processes associated with depressive symptoms was not assessed over time. In addition, our findings may not be generalizable to all youth and young adults of color in the United States. Further, our findings are limited to a sample of young SMM from Los Angeles, there is a lack of a random sample, and the parent study includes the mental element of the ecodevelopmental theory, so no causal or directional inferences were drawn, though there could be unknown threats to internal validity, including maturation and history. Moreover, maturation noted the possibility that mental or physical changes happening to the participant beyond the researcher’s control might have affected the participants’ responses.

6. Implications and Conclusions

Our findings suggest the necessity of using an intersectional lens to examine the relationship between SMMs’ mental health and parent/family social support. This is particularly important considering the lack of research on the intersecting identities of SMM. More research examining the intersections of family and culture is needed due to the high prevalence of depression among this population compared to their peers. The results from our study prompt the need for research and health practitioners to better navigate uncharted territory in relationships between family and young SMM to promote the use of specific interventions to improve health outcomes in this group.

Author Contributions

D.T.B., S.R.R., C.R.Q., K.V.J., L.W., L.E.N. contributed to the study conceptualization and writing of the manuscript (Introduction, Literature Review, Discussion, and Conclusion). D.T.B., S.R.R., L.W. contributed to the study conceptualization, data analyses and writing of the manuscript (Materials and Methods, and Results). All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable (This is a secondary data analysis study).

Informed Consent Statement

Not applicable.

Data Availability Statement

The data is not available to the public without the consent of the PI.

Conflicts of Interest

The authors declare that they have no conflict of interest.

References

  1. Newport, F. In, U.S., Estimate of LGBT Population Rises to 4.5%. Gallup, 22 May 2018. Available online: https://news.gallup.com/poll/234863/estimate-lgbt-population-rises.aspx (accessed on 25 April 2021).
  2. Suen, L.W.; Lunn, M.R.; Katuzny, K.; Finn, S.; Duncan, L.; Sevelius, J.; Flentje, A.; Capriotti, M.R.; Lubensky, M.E.; Hunt, C.; et al. What Sexual and Gender Minority People Want Researchers to Know About Sexual Orientation and Gender Identity Questions: A Qualitative Study. Arch. Sex. Behav. 2020, 49, 2301–2318. [Google Scholar] [CrossRef]
  3. Crenshaw, K. Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color. Stanf. Law Rev. 1991, 43, 1241. [Google Scholar] [CrossRef]
  4. Crenshaw, K.; Gotanda, N.; Peller, G.; Thomas, K. Critical Race Theory: The Key Writings That Formed the Movement; New Press: New York, NY, USA, 1995; pp. 276–291. [Google Scholar]
  5. Bowleg, L. The Problem with the Phrase Women and Minorities: Intersectionality—an Important Theoretical Framework for Public Health. Am. J. Public Health 2012, 102, 1267–1273. [Google Scholar] [CrossRef] [PubMed]
  6. Lee, C.; Oliffe, J.L.; Kelly, M.T.; Ferlatte, O. Depression and Suicidality in Gay Men: Implications for Health Care Providers. Am. J. Men’s Health 2017, 11, 910–919. [Google Scholar] [CrossRef]
  7. King, M.; Semlyen, J.; Tai, S.S.; Killaspy, H.; Osborn, D.; Popelyuk, D.; Nazareth, I. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry 2008, 8, 70. [Google Scholar] [CrossRef] [Green Version]
  8. Plöderl, M.; Tremblay, P. Mental health of sexual minorities. A systematic review. Int. Rev. Psychiatry 2015, 27, 367–385. [Google Scholar] [CrossRef]
  9. Pachankis, J.E.; Cochran, S.D.; Mays, V.M. The mental health of sexual minority adults in and out of the closet: A population-based study. J. Consult. Clin. Psychol. 2015, 83, 890–901. [Google Scholar] [CrossRef]
  10. Whiteford, H.A.; Ferrari, A.; Degenhardt, L.; Feigin, V.; Vos, T. The Global Burden of Mental, Neurological and Substance Use Disorders: An Analysis from the Global Burden of Disease Study 2010. PLoS ONE 2015, 10, e0116820. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  11. Greden, J.F. The burden of recurrent depression: Causes, consequences, and future prospects. J. Clin. Psychiatry 2001, 62, 5–9. [Google Scholar] [PubMed]
  12. Latkin, C.A.; Van Tieu, H.; Fields, S.; Hanscom, B.S.; Connor, M.; Hanscom, B.; Hussen, S.A.; Scott, H.M.; Mimiaga, M.J.; Wilton, L.; et al. Social Network Factors as Correlates and Predictors of High Depressive Symptoms among Black Men Who Have Sex with Men in HPTN 061. AIDS Behav. 2016, 21, 1163–1170. [Google Scholar] [CrossRef] [Green Version]
  13. Ahaneku, H.; Ross, M.W.; Nyoni, J.E.; Selwyn, B.; Troisi, C.; Mbwambo, J.; Adeboye, A.; McCurdy, S. Depression and HIV risk among men who have sex with men in Tanzania. AIDS Care 2016, 28, 140–147. [Google Scholar] [CrossRef] [Green Version]
  14. Egede, L.E.; Ellis, C. Diabetes and depression: Global perspectives. Diabetes Res. Clin. Pract. 2010, 87, 302–312. [Google Scholar] [CrossRef]
  15. Yoshikawa, H.; Wilson, P.A.-D.; Chae, D.H.; Cheng, J.-F. Do Family and Friendship Networks Protect against the Influence of Discrimination on Mental Health and HIV Risk among Asian and Pacific Islander Gay Men? AIDS Educ. Prev. 2004, 16, 84–100. [Google Scholar] [CrossRef]
  16. Boyd, D.T.; Quinn, C.R.; Aquino, G.A. The Inescapable Effects of Parent Support on Black Males and HIV Testing. J. Racial Ethn. Health Disparities 2020, 7, 563–570. [Google Scholar] [CrossRef]
  17. Boyd, D.T.; Threats, M.; Winifred, O.; Nelson, L.E. The Association between African American Father–Child Relationships and HIV Testing. Am. J. Men’s Health 2020, 14, 1557988320982702. [Google Scholar] [CrossRef] [PubMed]
  18. Katz-Wise, S.L.; Rosario, M.; Tsappis, M. LGBT youth and family acceptance. Pediatr. Clin. N. Am. 2016, 63, 1011. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  19. Ryan, C.; Huebner, D.; Diaz, R.M.; Sanchez, J. Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults. Pediatrics 2009, 123, 346–352. [Google Scholar] [CrossRef]
  20. Ryan, C.; Russell, S.T.; Huebner, D.; Diaz, R.; Sanchez, J. Family Acceptance in Adolescence and the Health of LGBT Young Adults. J. Child Adolesc. Psychiatr. Nurs. 2010, 23, 205–213. [Google Scholar] [CrossRef]
  21. Beam, C.R.; Collins, E.M. Trajectories of Depressive Symptomatology and Loneliness in Older Adult Sexual Minorities and Heterosexual Groups. Clin. Gerontol. 2018, 42, 172–184. [Google Scholar] [CrossRef] [PubMed]
  22. Tomori, C.; Srikrishnan, A.K.; Ridgeway, K.; Solomon, S.S.; Mehta, S.H.; Solomon, S.; Celentano, D.D. Perspectives on Sexual Identity Formation, Identity Practices, and Identity Transitions among Men Who Have Sex with Men in India. Arch. Sex. Behav. 2016, 47, 235–244. [Google Scholar] [CrossRef]
  23. Yang, C.; Latkin, C.; Tobin, K.; Patterson, J.; Spikes, P. Informal Social Support and Depression among African American Men Who Have Sex with Men. J. Community Psychol. 2013, 41, 435–445. [Google Scholar] [CrossRef] [Green Version]
  24. Coleman, C.L. Qualitative perspectives about living with HIV from seropositive African American MSM aged 50 years and older. Issues Mental Health Nurs. 2017, 38, 486–492. [Google Scholar] [CrossRef]
  25. Frost, D.M.; Meyer, I.H. Internalized homophobia and relationship quality among lesbians, gay men, and bisexuals. J. Couns. Psychol. 2009, 56, 97–109. [Google Scholar] [CrossRef] [Green Version]
  26. Newcomb, M.E.; Mustanski, B. Moderators of the Relationship Between Internalized Homophobia and Risky Sexual Behavior in Men Who Have Sex with Men: A Meta-Analysis. Arch. Sex. Behav. 2009, 40, 189–199. [Google Scholar] [CrossRef] [PubMed]
  27. Meyer, I.H.; Dean, L. Internalized Homophobia, Intimacy, and Sexual Behavior among Gay and Bisexual Men. In Stigma and Sexual Orientation: Understanding Prejudice against Lesbians, Gay Men, and Bisexuals; Herek, G.M., Ed.; Sage Publications, Inc.: London, UK, 1998; pp. 160–186. [Google Scholar]
  28. Shidlo, A. Internalized homophobia: Conceptual and empirical issues in measurement. In Lesbian and Gay Psychology: Theory, Research, and Clinical Applications; Greene, B., Herek, G.M., Eds.; Sage Publications, Inc.: London, UK, 1994. [Google Scholar]
  29. Rosario, M.; Schrimshaw, E.W.; Hunter, J.; Braun, L. Sexual identity development among lesbian, gay, and bisexual youths: Consistency and change over time. J. Sex Res. 2006, 43, 46–58. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  30. Velez, B.L.; Polihronakis, C.J.; Watson, L.B.; Cox, R., Jr. Heterosexism, racism, and the mental health of sexual minority people of color. Couns. Psychol. 2019, 47, 129–159. [Google Scholar] [CrossRef]
  31. Thoma, B.C.; Huebner, D.M. Health consequences of racist and antigay discrimination for multiple minority adolescents. Cult. Divers. Ethn. Minor. Psychol. 2013, 19, 404–413. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  32. Bos, H.M.W.; Sandfort, T.G.M.; De Bruyn, E.H.; Hakvoort, E.M. Same-sex attraction, social relationships, psychosocial functioning, and school performance in early adolescence. Dev. Psychol. 2008, 44, 59–68. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  33. Igartua, K.J.; Gill, K.; Montoro, R. Internalized Homophobia: A Factor in Depression, Anxiety, and Suicide in the Gay and Lesbian Population. Can. J. Community Ment. Health 2003, 22, 15–30. [Google Scholar] [CrossRef]
  34. Herrick, A.L.; Stall, R.; Chmiel, J.S.; Guadamuz, T.E.; Penniman, T.; Shoptaw, S.; Ostrow, D.; Plankey, M.W. It Gets Better: Resolution of Internalized Homophobia Over Time and Associations with Positive Health Outcomes among MSM. AIDS Behav. 2013, 17, 1423–1430. [Google Scholar] [CrossRef] [Green Version]
  35. Gyamerah, A.O.; Taylor, K.D.; Atuahene, K.; Anarfi, J.K.; Fletcher, M.; Raymond, H.F.; McFarland, W.; Dodoo, F.N.-A. Stigma, discrimination, violence, and HIV testing among men who have sex with men in four major cities in Ghana. AIDS Care 2020, 32, 1036–1044. [Google Scholar] [CrossRef]
  36. Semple, S.J.; Stockman, J.K.; Goodman-Meza, D.; Pitpitan, E.V.; Strathdee, S.A.; Chavarin, C.V.; Rangel, G.; Torres, K.; Patterson, T.L. Correlates of Sexual Violence among Men Who Have Sex with Men in Tijuana, Mexico. Arch. Sex. Behav. 2016, 46, 1011–1023. [Google Scholar] [CrossRef] [Green Version]
  37. Eaton, L.A.; Earnshaw, V.A.; Maksut, J.L.; Thorson, K.R.; Watson, R.J.; Bauermeister, J. Experiences of stigma and health care engagement among Black MSM newly diagnosed with HIV/STI. J. Behav. Med. 2018, 41, 458–466. [Google Scholar] [CrossRef] [PubMed]
  38. Hylton, E.; Wirtz, A.L.; Zelaya, C.E.; Latkin, C.; Peryshkina, A.; Mogilnyi, V.; Dzhigun, P.; Kostetskaya, I.; Galai, N.; Beyrer, C. Sexual Identity, Stigma, and Depression: The Role of the “Anti-gay Propaganda Law” in Mental Health among Men Who Have Sex with Men in Moscow, Russia. J. Hered. 2017, 94, 319–329. [Google Scholar] [CrossRef]
  39. Crenshaw, K. Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. Univ. Chic. Leg. Forum 1989, 1989, 139–167. [Google Scholar]
  40. Seng, J.S.; Lopez, W.D.; Sperlich, M.; Hamama, L.; Meldrum, C.D.R. Marginalized identities, discrimination burden, and mental health: Empirical exploration of an interpersonal-level approach to modeling intersectionality. Soc. Sci. Med. 2012, 75, 2437–2445. [Google Scholar] [CrossRef] [Green Version]
  41. Hidalgo, M.A.; Layland, E.; Kubicek, K.; Kipke, M. Sexual Racism, Psychological Symptoms, and Mindfulness among Ethnically/Racially Diverse Young Men Who Have Sex with Men: A Moderation Analysis. Mindfulness 2020, 11, 452–461. [Google Scholar] [CrossRef]
  42. Herek, G.M.; Cogan, J.C.; Gillis, J.R.; Glunt, E.K. Correlates of internalized homophobia in a community sample of lesbians and gay men. J. Gay Lesbian Med. Assoc. 1998, 2, 17–26. [Google Scholar]
  43. Kipke, M.D.; Kubicek, K.; Wong, C.F.; Robinson, Y.A.; Akinyemi, I.C.; Beyer, W.J.; Hawkins, W.; E Rice, C.; Layland, E.; Bray, B.C.; et al. A Focus on the HIV Care Continuum Through the Healthy Young Men’s Cohort Study: Protocol for a Mixed-Methods Study. JMIR Res. Protoc. 2019, 8, e10738. [Google Scholar] [CrossRef]
  44. Asner-Self, K.K.; Schreiber, J.B.; Marotta, S.A. A cross-cultural analysis of the Brief Symptom Inventory-18. Cult. Divers. Ethn. Minor. Psychol. 2006, 12, 367–375. [Google Scholar] [CrossRef] [PubMed]
  45. Derogatis, L.R.; Melisaratos, N. The Brief Symptom Inventory: An introductory report. Psychol. Med. 1983, 13, 595–605. [Google Scholar] [CrossRef] [PubMed] [Green Version]
  46. Díaz, R.M.; Ayala, G.; Bein, E.; Henne, J.; Marin, B.V. The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: Findings from 3 US cities. Am. J. Public Health 2001, 91, 927–932. [Google Scholar] [CrossRef] [Green Version]
  47. Wong, C.F.; Kipke, M.D.; Weiss, G.; McDavitt, B. The impact of recent stressful experiences on HIV-risk related behaviors. J. Adolesc. 2010, 33, 463–475. [Google Scholar] [CrossRef] [Green Version]
  48. Legate, N.; Weinstein, N.; Ryan, W.S.; DeHaan, C.R.; Ryan, R.M. Parental autonomy support predicts lower internalized homophobia and better psychological health indirectly through lower shame in lesbian, gay and bisexual adults. Stigma Health 2019, 4, 367–376. [Google Scholar] [CrossRef]
  49. Lu, W.; Lindsey, M.A.; Irsheid, S.; Nebbitt, V.E. Psychometric Properties of the CES-D among Black Adolescents in Public Housing. J. Soc. Soc. Work Res. 2017, 8, 595–619. [Google Scholar] [CrossRef]
  50. Bruce, D.; Harper, G.W.; Bauermeister, J.A. Minority stress, positive identity development, and depressive symptoms: Implications for resilience among sexual minority male youth. Psychol. Sex. Orientat. Gend. Divers. 2015, 2, 287–296. [Google Scholar] [CrossRef]
  51. Fields, E.L.; Bogart, L.M.; Galvan, F.H.; Wagner, G.J.; Klein, D.J.; Schuster, M.A. Association of Discrimination-Related Trauma with Sexual Risk among HIV-Positive African American Men Who Have Sex with Men. Am. J. Public Health 2013, 103, 875–880. [Google Scholar] [CrossRef]
  52. Hightow-Weidman, L.B.; Ii, G.P.; Jones, K.C.; Outlaw, A.Y.; Fields, S.D.; Smith, J.C.; The YMSM of Color SPNS Initiative Study Group. Racial and Sexual Identity-Related Maltreatment among Minority YMSM: Prevalence, Perceptions, and the Association with Emotional Distress. AIDS Patient Care STDs 2011, 25, S39–S45. [Google Scholar] [CrossRef]
  53. Juster, R.-P.; Smith, N.G.; Ouellet, É.; Sindi, S.; Lupien, S.J. Sexual Orientation and Disclosure in Relation to Psychiatric Symptoms, Diurnal Cortisol, and Allostatic Load. Psychosom. Med. 2013, 75, 103–116. [Google Scholar] [CrossRef] [Green Version]
  54. Poteat, V.P.; Mereish, E.H.; DiGiovanni, C.D.; Koenig, B.W. The effects of general and homophobic victimization on adolescents’ psychosocial and educational concerns: The importance of intersecting identities and parent support. J. Couns. Psychol. 2011, 58, 597–609. [Google Scholar] [CrossRef] [Green Version]
Table
Table 1. Demographics (N = 414).
Table 1. Demographics (N = 414).
VariableMeanSDRange
Depression49.069.6141–93
Stressful Life Events5.114.470–38
Internalized Homophobia6.252.884–16
SFFS1.220.591–4
PEHS2.000.931–4
Family Social Support5.001.491–7
Age24.001.00(SE)18–29
SFFS, separation by family and friends because of sexuality; PEHS, perceived embarrassment and hurt due to sexuality by family.
Table
Table 2. Correlations on independent variables on depression.
Table 2. Correlations on independent variables on depression.
Depression1234567
Stressful Life Events0.31 ***1
Internalized Homophobia0.29 ***0.14 *1
Family Support−0.25 ***−0.15 *−0.010 *1
SFFS0.28 ***0.30 ***0.24 ***−0.19 ***1
PEHS0.19 ***0.24 ***0.15 *−0.20 ***0.35 ***1
Age−0.060.010.010.010.01−0.031
Employment0.15 *0.10 *0.08 *−0.13 **0.12 *−0.02640.04271
* p < 0.05, ** p < 0.01, *** p < 0.001; SFFS, separation by family and friends because of sexuality; PEHS, perceived embarrassment and hurt due to sexuality by family.
Table
Table 3. Multiple regression on depression (N = 372).
Table 3. Multiple regression on depression (N = 372).
VariableBSEß
Depression
Stressful Life Events0.16 ***0.050.18
Internalized Homophobia1.23 ***0.300.21
Family Social Support−0.41 **0.14−0.14
SFFS0.55 *0.240.09
PEHS0.290.370.04
Age−0.120.10−0.06
Sexual Identity
Heterosexual (straight)−2.021.97−0.05
Bisexual−0.440.64−0.03
Other same sex (e.g., Man who has s..)0.950.990.05
Pansexual2.61 *1.280.10
Unsure/questioning−0.642.23−0.01
Other—Please specify:−2.032.22−0.04
Employment
Yes, working full-time−0.610.45−0.07
Not working at this time and NOT looking−0.880.99−0.04
Not working at this time and looking1.52 *0.640.13
* p < 0.05, ** p < 0.01, *** p < 0.001; SFFS, separation by family and friends because of sexuality; PEHS, perceived embarrassment and hurt due to sexuality by family.
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Boyd, D.T.; Ramos, S.R.; Quinn, C.R.; Jones, K.V.; Wilton, L.; Nelson, L.E. Family Support and Sociocultural Factors on Depression among Black and Latinx Sexual Minority Men. Int. J. Environ. Res. Public Health 2021, 18, 6759. https://doi.org/10.3390/ijerph18136759

AMA Style

Boyd DT, Ramos SR, Quinn CR, Jones KV, Wilton L, Nelson LE. Family Support and Sociocultural Factors on Depression among Black and Latinx Sexual Minority Men. International Journal of Environmental Research and Public Health. 2021; 18(13):6759. https://doi.org/10.3390/ijerph18136759

Chicago/Turabian Style

Boyd, Donte T., S. Raquel Ramos, Camille R. Quinn, Kristian V. Jones, Leo Wilton, and LaRon E. Nelson. 2021. "Family Support and Sociocultural Factors on Depression among Black and Latinx Sexual Minority Men" International Journal of Environmental Research and Public Health 18, no. 13: 6759. https://doi.org/10.3390/ijerph18136759

APA Style

Boyd, D. T., Ramos, S. R., Quinn, C. R., Jones, K. V., Wilton, L., & Nelson, L. E. (2021). Family Support and Sociocultural Factors on Depression among Black and Latinx Sexual Minority Men. International Journal of Environmental Research and Public Health, 18(13), 6759. https://doi.org/10.3390/ijerph18136759

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