Longitudinal associations of relationship support and strain and internalized homophobia with mental health among middle-aged and older gay and bisexual men

Nicholas Perry, Department of Psychology, University of Denver, Denver, CO, USA.
Tamar Goldenberg, Department of Public Health Education, School of Health and Human Sciences, UNC Greensboro, Greensboro, NC, USA.
David Huebner, Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, USA.
Andre L. Brown, Cuyahoga County Board of Health, Parma, OH, USA.
Deanna Ware, Department of Medicine, Georgetown University Medical Center, Washington, D.C., USA.
Steven Meanley, Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
Sabina Haberlen, Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Mark Brennan-Ing, Brookdale Center for Healthy Aging, Hunter College, New York, NY, USA.
James E. Egan, Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Linda Teplin, Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Ken Ho, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Roger Detels, Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
M Reuel Friedman, Department of Urban-Global Public Health, School of Public Health, Rutgers University, Piscataway, NJ, USA.
Michael Plankey, Department of Medicine, Georgetown University Medical Center, Washington, D.C., USA.

Document Type

Journal Article

Publication Date

11-22-2022

Journal

Aging & mental health

DOI

10.1080/13607863.2022.2146656

Keywords

Gay and bisexual men; close relationships; depression; homophobia; stigma

Abstract

Mental health concerns (e.g. depression, anxiety) that negatively impact gay, bisexual, and other men who have sex with men (GBMSM) persist over the life course and into old age, but less is known about potential contributors to GBMSM's mental health. Close relationships can be a source of risk or resilience from stress, exerting direct relationships on mental health, and may mediate well-established associations between minority stress and mental health. This study examined whether primary partner relationship support and strain were uniquely associated with, and mediated the association between internalized homophobia, and mental health among older GBMSM. GBMSM ( = 517, age = 60) from the Multicenter AIDS Cohort Study, who were in primary relationships with men, provided self-report data at four timepoints. We used multilevel modeling to examine longitudinal associations among relationship support and strain and internalized homophobia with depression and anxiety. Relationship strain, but not support, was positively associated with mental health concerns longitudinally. There was a significant, positive indirect effect of internalized homophobia on depression and anxiety through strain, but no support. Internalized homophobia was positively associated with relationship strain, which was positively associated with mental health symptoms longitudinally. Relationship strain was associated with depression and anxiety longitudinally among middle-aged and older GBMSM and mediated associations of internalized homophobia with mental health. The role of partner support warrants further investigation. Mental health interventions are critically needed for older GBMSM and, for partnered GBMSM, should include strategies for reducing relationship strain to foster well-being.

Department

Prevention and Community Health

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