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Loneliness and self-rated physical health among gay, bisexual and other men who have sex with men in Vancouver, Canada
  1. Megan E Marziali1,2,
  2. Heather L Armstrong1,3,
  3. Kalysha Closson1,4,
  4. Taylor McLinden1,
  5. Lu Wang1,
  6. Justin Barath1,
  7. Marianne Harris5,6,
  8. Eric A Roth7,
  9. David M Moore1,4,
  10. Nathan J Lachowsky7,8,
  11. Robert S Hogg1,9,
  12. Jordan M Sang1,
  13. Kiffer G Card8,9
  1. 1Epidemiology and Population Health Program, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
  2. 2Mailman School of Public Health, Columbia University, New York City, New York, USA
  3. 3Department of Psychology, University of Southampton, Southampton, UK
  4. 4School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
  5. 5AIDS Research Program, BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
  6. 6Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
  7. 7Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
  8. 8School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria, Victoria, Canada
  9. 9Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
  1. Correspondence to Dr Kiffer G Card, School of Public Health and Social Policy, Faculty of Human and Social Development, University of Victoria, Victoria, BC V6Z 2C7, Canada; kiffercard{at}gmail.com

Abstract

Background Due to stigma and discrimination, gay, bisexual and other men who have sex with men (gbMSM) potentially carry a heightened burden of loneliness. This analysis investigates loneliness among gbMSM and its relationship with self-rated physical health, along with the mediating effect of depression.

Methods Participants were recruited using respondent-driven sampling into the Momentum Health Study (February 2012–February 2015) with follow-up visits occurring every 6 months till February 2018. Using computer-assisted self-interviews, measures of loneliness were assessed using a 6-item Loneliness Scale for Emotional and Social Loneliness (lonely vs not lonely). Current physical health was self-assessed (poor, fair, good, very good or excellent). A multivariable generalised linear-mixed model with a logit link function was used to examine the relationship between loneliness and self-rated physical health. We further investigated the mediating effect of depressive symptomatology on this relationship via the Hospital Anxiety and Depression Scale.

Results Of the 770 participants included, we found that 61% (n=471) experienced loneliness at baseline. Of the 674 (88%) who reported good/very good/excellent physical health, 59% (n=391) reported loneliness, compared with 87% (n=80) of those in poor/fair self-rated physical health who reported feeling lonely. After adjustment for confounding, loneliness was associated with poor self-rated physical health (adjusted OR 1.71; 95% CI 1.13 to 2.60). Depressive symptomatology was found to partially mediate this relationship.

CONCLUSION There may be a need for the integration of social, mental and physical health programming, targeted towards gbMSM, to alleviate the degree of loneliness experienced and its co-occurrence with poor self-rated physical health.

  • mental health
  • psychosocial factors
  • self-rated health

https://doi.org/10.1136/jech-2019-213566

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    Footnotes

    • Contributors MEM design, interpretation, draft, final approval, HA design, draft, final approval. KC design, interpretation, final approval. TL design, interpretation, final approval. LW analysis, draft, final approval. JB analysis, draft, final approval. MH design, draft, final approval. EAR design, draft, final approval. DMM design, draft, final approval. NL design, draft, final approval. RSH design, draft, final approval. JMS design, revise, final approval. KGC design, interpretation, draft, final approval. All have agreed to be accountable for all parts of this work.

    • Funding This work was supported by the National Institute on Drug Abuse (R01DA031055-01A1) and the Canadian Institutes of Health Research (MOP-107544, 143342, PJT-153139). NJL was supported by a CANFAR/CTN Postdoctoral Fellowship Award. HLA was supported by a Postdoctoral Fellowship award from the Canadian Institutes of Health Research (Grant #MFE-152443). DMM and NJL are supported by Michael Smith Foundation for Health Research Scholar Awards (#5209, #16863). KGC is supported by a Canadian Institutes of Health Research Health Systems Impact Fellowship award, a Michael Smith Foundation for Health Research Trainee award and a Canadian HIV Trials Network/Canadian Foundation for AIDS Research Postdoctoral Fellowship award.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are publicly available.