Regional Differences in Social Support Among Partnered Sexual Minority Latino Men: Implications for Mental Health Outcomes

Background: Latino sexual minority men (LSMM) are at elevated risk for poor mental health. While social support is a well-established protective factor against negative mental health outcomes, LSMM may experience challenges to obtaining social support from particular sources (i.e. significant other, friends, family). Region of residence may play a role in shaping social support given cultural, political, socioeconomic, and demographic differences by geographic region in the U.S. There is limited understanding, however, about how regional differences influence social support and mental health outcomes among LSMM men in the U.S. We sought to address this gap and highlight the importance of context to inform social work strategies for improving mental health outcomes among this vulnerable and growing population.

Methods: Online surveys were administered in Spanish and English from a nationwide sample of LSMM in the U.S. Participants were recruited via location-based social media applications. Mental health outcomes were assessed with the Center for Epidemiologic Studies Depression Scale—Revised and Generalized Anxiety Disorder Assessment. The Multidimensional Scale of Perceived Social Support measured social support from significant others, friends, and family. Surveys also assessed participants’ demographic characteristics and geographic location of residence. Analyses followed two steps: First, bivariate analyses were conducted to examine relationships between sources of social support and mental health outcomes. Second, two multivariable linear regression models were used to identify predictors of anxiety and depression.

Results: The sample included 530 LSMM with a mean age of 31.2 years (SD = 6.9). Regarding residency, 26.2% lived in the Northeast, 10.8% in the Midwest, 23.8% in the South, 37.4% in the West, and 1.5% in Puerto Rico. Bivariate analyses indicated that reduced levels of social support were independently associated with increased levels of anxiety and depression. LSMM in the West reported lower levels of social support relative to LSMM living in all other U.S. geographic regions (South, Northeast, Midwest, Puerto Rico). The multivariate anxiety model revealed regional differences in anxiety with men in the South (B = 2.78, p <0.001), West (B = 2.16, p <0.001), and Puerto Rico (B = 4.77, p= 0.011) reporting greater anxiety symptoms relative to men in the Northeast. Results from adjusted linear regression models showed that increases in familial social support predicted reductions in depression (B = -1.82, p = 0.003).

Conclusions and Implications: Despite the importance of social support in protecting against negative mental health outcomes, study findings suggest that other factors across U.S. geographic regions may be predictive of anxiety and depression symptoms among LSMM. Lower levels of anxiety among LSMM in the Northeast than those in other geographic regions despite similar levels of support may be attributable to greater access to communities with high concentrations of LGBT individuals and/or Latinos, or the liberal socio-political ideology that has tended to characterize the Northeast region. Results highlight that social work interventions that seek to address LSMM’s mental health needs must take into account their regional and contextual diversity. Future social work research may identify the salient contextual factors that shape mental health among this population.