An Exploration of Racial Differences of Psychosocial Stressors and Their Association With Mental Health Between Asian and White Sexual Minority Men: The P18 Cohort Study

There is growing concern that Asian sexual minority men (SMM), including gay, bisexual, and other men who have sex with men, may be at elevated risk of psychological distress and suicidal ideation, yet limited attention has focused on how psychosocial stressors may affect them. This study seeks to (a) explore differences in psychosocial stressors, anxiety, depression, and suicidal ideation between Asian and White SMM and (b) evaluate the potential moderation of associations between psychosocial stressors and mental health by race. Data were obtained from the P18 Cohort Study. We restricted the sample to only those who identified as non-Hispanic Asian or White and used regression analysis to assess the associations of psychosocial stressors and mental health outcomes in the overall sample by race. Of the 217 participants in our analytic sample, 23% self-identified as Asian. Compared with White SMM, Asian SMM had a higher prevalence of loneliness, internalized homophobia, and public gay-related stigma. In regression analyses, most psychosocial stressors were significantly associated with anxiety, depression, and suicidal ideation in the overall sample. Associations between each stressor and mental health outcome primarily did not differ between Asian and White SMM. However, White SMM experiencing higher levels of public gay-related stigma had greater odds of suicidal ideation, although this was not observed for Asian SMM. Overall, Asian SMM may be experiencing similar effects of psychosocial stressors on mental health to White SMM. Health professionals may want to consider how these stressors impact the mental health and well-being of their Asian SMM clients. What is the public significance of this article? Asian SMM may have an elevated prevalence of psychosocial stressors compared with White SMM. Furthermore, various psychosocial stressors were associated with several mental health outcomes among both Asian and White SMM.