Abstract Background Although, a substantial amount of research has shown that compared with heterosexual counterparts, sexual minority populations are at increased risk of mental health symptoms, there are less public health researches on lesbian and bisexual women, making it hard to draw conclusions about the way to improve health. Methods This study examined the association of distal stressors, proximal stressors with depressive symptom. The study sample included 301 sexual minority women in Beijing, with 81.4% identifying as lesbian and 18.6% identifying as bisexual. They responded to self-report measures of sexual minority stress and depressive symptoms. Data were collected from August 2018 to October 2018. The association of minority stressors and depressive symptoms was estimated using the parallel mediation models. Results Depressive symptoms were prevalent among sexual minority women (56.1%). The correlations between distal stressors, proximal stressors and depressive symptoms were significant. The parallel mediation model showed that, expectation of rejection rather than sexual orientation concealment and internalized homophobia emerges as a significant mediator between sexual orientation-related stigma and depressive symptoms. Conclusions Early intervention addressing sexual orientation-related stigma combined with eliminating expectation of rejection would help prevent depressive symptoms in sexual minority women.

Background: Suicidal behaviors have been a crucial public health issue among young men who have sex with men (YMSM). Adverse childhood experiences (ACEs) and depression are important predictors of suicidal behaviors. Few studies have examined the underlying mechanisms. This study aims to examine the mediation mechanism from ACEs to depression and further to suicidal ideation based on a prospective cohort study of YMSM.Method: Study data were derived from 499 YMSM recruited from three cities (Wuhan, Changsha and Nanchang) of China from September in 2017 to January in 2018. ACEs (abuse, neglect and household challenges), depressive symptoms and suicidal behaviors (suicidal ideation, suicidal plan and suicidal attempt) were measured at the baseline, the first wave and second wave follow-up survey, respectively. Mediation modeling analysis was used for data analysis only for suicidal ideation due to the low frequency of suicidal plan and attempt.Results: An estimated 17.86% of YMSM reported suicidal ideation, 2.27% ever made a suicidal plan and 0.65% of YMSM had a suicidal attempt in the past six months. The effect of ACEs on suicidal ideation was fully mediated through depressive symptoms (indirect effect [95%CI] = 0.011 [0.004,0.022]). Among the three subconstructs of ACEs, childhood abuse and neglect could increase the risk of suicidal ideation in adulthood by increasing depressive symptoms (indirect effect = 0.020 [0.007,0.042] for childhood abuse, and 0.043 [0.018,0.083] for neglect), but not for household challenges (indirect effect = 0.003 [-0.011,0.018]).Conclusions: ACEs could affect suicidal ideation through depression, particularly for childhood abuse and neglect. Preventive strategies may focus on the treatment of depression and psychological counseling, especially for YMSM who ever experienced negative experiences in childhood.

Objective To investigate the willingness and influencing factors of pre-exposure prophylaxis（PrEP） in young men who have sex with men（YMSM）. Methods From September 2017 to January 2018, baseline surveys were carried out in Wuhan, Changsha, and Nanchang, among research subjects who were recruited by combining opportunity sampling and peer-driven sampling. The follow-up surveys were completed from July to September 2018, June to July 2019, October to December 2020, and July to December 2021. Univariate analysis was performed using χ2 test and t-test,and generalized estimation equations were used to analyze the influencing factors of PrEP use intention among YMSM.Results Among the 449 YMSM in the survey, 366（81.51%） reported their sexual orientation as homosexual, and 55（12.25%） did not disclose their same-sex sexual orientation before the follow-up. The baseline PrEP intention rate was the lowest（38.98%） and it reached the highest at the first follow-up（61.92%） with the PrEP willingness rates being 53.13%,51.09%, and 52.20%, respectively in the subsequent three follow-ups. The broad estimation equation showed that YMSM with open sexual orientation were more willing to use PrEP（OR=1.80, 95%CI: 1.14-2.86）, and YMSMs with higher HIV infection risk scores were more willing to use PrEP（OR=1.06, 95%CI: 1.02-1.10）. Conclusions YMSM who disclose their sexual orientation to their families, friends, colleagues, etc., and have high HIV infection risk scores are more willing to use PrEP drugs to prevent HIV infection. We should pay attention to the stress situation of sexual minorities faced by YMSM, to improve social support and adopt health interventions to reduce high-risk behaviors of HIV infection.