The Impact of Perceived and Internalized Stigma on the Mental Health of Young Chinese MSM with HIV/AIDS: The Role of Undetectable=Untransmittable (U=U) Status

Background and Purpose: The correlation between stigma and mental health issues in men who have sex with men (MSM) is well-documented. The paradigm of undetectable equals untransmittable (U=U) has emerged as a pivotal concept in mitigating stigma and promoting adherence to treatment among individuals living with HIV/AIDS. Despite its significance, the role of U=U status in modulating self-stigma among MSM with HIV/AIDS remains underexplored. This research aims to delve into how young Chinese MSM living with HIV/AIDS perceive their identities in light of their U=U status and the impact of intersectional stigma on their mental health.

Methods: Utilizing a community-based survey, this study engaged a sample of 1185 young Chinese MSM diagnosed with HIV/AIDS. Structural equation modeling, categorized by U=U status, was applied to assess the dynamics between perceived stigma, internalized stigma, and mental health outcomes within these groups. The methodological approach was designed to uncover nuanced insights into the stigma experienced by these individuals and its psychological ramifications.

Results: The analysis revealed that respondents without U=U status exhibited elevated levels of internalized HIV/AIDS-related stigma and mental health challenges, coupled with a diminished perception of stigma related to their homosexual identity. Notably, for this subgroup, only the stigma linked to their HIV/AIDS status significantly deteriorated their mental health. Conversely, for individuals with U=U status, stigma pertaining to both their HIV/AIDS and homosexual identities adversely influenced their mental health. The study highlighted the presence of a pathway from stigma perception to its internalization across both groups, emphasizing the pervasive nature of stigma in their lives.

Conclusions and Implications: The study’s findings illuminate the complex interplay between U=U status, identity perception, and mental health among young Chinese MSM living with HIV/AIDS. It underscores the transformative potential of U=U status in reshaping identities and ameliorating stigma’s impact on mental health. The research advocates for targeted interventions that address stigma internalization and its psychological effects on individuals living with HIV/AIDS, taking into account the nuanced differences conferred by U=U status. By focusing on the intersectionality of stigmas related to HIV/AIDS and homosexuality, the study calls for a holistic approach to support and intervention strategies that are sensitive to the multifaceted identities of MSM living with HIV/AIDS. This research contributes to a broader understanding of the stigma-mitigating effects of U=U status and its importance in the mental health and well-being of PLWHA, paving the way for more inclusive and effective social work practices and research in the domain of HIV/AIDS.