Prevalence and correlates of depressive symptoms among young men who have sex with men: The role of family functioning and loneliness

BACKGROUND: The overlapping vulnerabilities associated with sexual minority status and developmental transitions call for focusing on depressive symptoms among young men who have sex with men (MSM). Drawing on minority stress and family systems perspectives, this study aims to investigate the prevalence and correlates of depressive symptoms and to evaluate the mediating role of loneliness in the association between family functioning and depressive symptoms. METHODS: In this multicenter cross-sectional study, young MSM aged 16-24 years were recruited between April and October 2024 through online and offline strategies across eight sites in Foshan and Shenzhen, Guangdong Province, China. Socio-demographic, mental health, and sexual health characteristics were collected. Logistic regression was used to assess correlates of depressive symptoms, and a regression-based mediation framework was employed to examine the possible mediating role of loneliness. RESULTS: A total of 777 young MSM were recruited. Most were current students (574, 74.0%), non-heterosexual (520, 66.9%), and living in urban areas (51.6%). Overall, 37.2% of them had depressive symptoms. Non-heterosexual orientation (aOR 0.61, 95% CI 0.38-0.98), severe family dysfunction (1.86, 1.13-3.06), and loneliness (5.54, 3.75-8.18) were associated with depressive symptoms. Loneliness explained 57.5% of the association between family functioning and depressive symptoms, suggesting a substantial partial mediation. CONCLUSIONS: A substantial proportion of young MSM reported depressive symptoms. Family dysfunction was associated with depressive symptoms, with loneliness mediating the association. Interventions that address loneliness, while also fostering supportive family and community environments, could offer practical strategies for addressing mental health challenges in this population.