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

Nicholas Perry*, Tamar Goldenberg, David Huebner, Andre L. Brown, Deanna Ware, Steven Meanley, Sabina Haberlen, Mark Brennan-Ing, James E. Egan, Linda Teplin, Ken Ho, Roger Detels, M. Reuel Friedman, Michael Plankey

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives: 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. Methods: GBMSM (N = 517, M 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)1609-1618
Number of pages10
JournalAging and Mental Health
Volume27
Issue number8
DOIs
StatePublished - 2023

Keywords

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

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Gerontology
  • Phychiatric Mental Health

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