Adverse childhood experiences, sexual minority stigma, social support and depressive symptoms among Chinese men who have sex with men: A moderated mediation modelling analysis

Men who have sex with men (MSM) are at high risk of depression. This study explores the mediation mechanism between ACEs, sexual minority stigma and depression, as well as the moderation effect of social support in the mediation model. Study data were derived from 693 MSM in China. The ACEs, sexual minority stigma, social support and depression were measured using reliable instruments. Mediation and moderated mediation model were used for analysis. 49.95% of the study sample reported having depressive symptoms in the past week. The association between ACEs and depressive symptoms was partially mediated by sexual minority stigma, overall (indirect effect = 0.32, 95% CI [ 0.18, 0.53]) and by different subscales (0.51 [0.29, 0.83] for abuse, 0.76 [0.40, 1.32] for neglect, and 0.64 [0.26, 1.12] for household dysfunction). Social support moderated the mediation model and varied in different pathways with social support negatively moderated the paths of ACEs-sexual minority stigma and ACEs-depression and positively moderated the path of sexual minority stigma-depression. Study findings suggest a mediation mechanism between ACEs, sexual minority stigma and depressive symptoms. Social support serves as a moderator in the mediation model, providing data for future effective interventions.