Perceived stigma, internalized stigma, and mental health of young Chinese men who have sex with men living with HIV/AIDS: Intersection and the importance of "undetectable = untransmittable" status.

Abstract

Stigma is closely linked to mental health issues among men who have sex with men (MSM) living with HIV/AIDS. The "Undetectable = Untransmittable" (U = U) concept has been instrumental in reducing HIV/AIDS-related stigma and improving treatment adherence among people living with HIV/AIDS. However, the effect of U = U status on internalized stigma related to both HIV/AIDS and homosexual identity remains unclear. This study explores how U = U status influences stigma internalization and mental health among young Chinese MSM living with HIV/AIDS, focusing on the intersectional stigma associated with HIV/AIDS status and sexual orientation. A purposeful sampling approach was used to recruit young Chinese MSM living with HIV/AIDS (n = 1,185). Structural equation model, stratified by U = U status, examined the relationships between perceived stigma, internalized stigma, and mental health in the two subgroups. Respondents without U = U reported higher internalized HIV/AIDS stigma and mental health issues but lower perceived homosexual stigma. For this group, perceived HIV/AIDS stigma contributed to the internalization of stigma, with only internalized HIV/AIDS stigma significantly affecting mental health. Among those with U = U, perceived homosexual stigma and internalized HIV/AIDS stigma both negatively impacted mental health. Perceived stigma related to both identities was significantly associated with internalized homosexual stigma. U = U status significantly shapes the identity experiences and mental health of young Chinese MSM with HIV/AIDS. Tailored interventions addressing both HIV/AIDS and MSM-related stigma are needed, with an intersectional approach to reduce stigma and foster supportive environments. (PsycInfo Database Record (c) 2025 APA, all rights reserved).