Date of Award

January 2021

Document Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Mayur M. Desai

Abstract

Objectives: The analytical goal of this project is to better understand the association of sexual orientation disclosure among different social networks of Thailand men who have sex with men (MSM) and depression. Along with this, we aim to extensively explore the intersectional influence of social support and intimate partner violence (IPV) experiences with each other, with disclosure, and ultimately depression outcomes.

Methods: The secondary dataset for this project was comprised of results from a cross-sectional study. This study utilized a web-based epidemiological and behavioral survey, distributed among young MSM ages 15-24. Self-reported data was provided through collaboration with Mahidol University and was stripped of any identifying variables related to participants. While data was collected in various countries making up the Greater Mekong Sub-Region, this study was specific to 1468 respondents from the country of Thailand.

Results: Over 50% of the 1468 respondents in this sample were categorized with depression. Sexual orientation disclosure was investigated among four social groups: (1) “Other people in the same school/university/workplace”, (2) “Friends outside school/university/workplace”, (3) “Teachers in your school/university/boss in your workplace”, and (4) “Family members”. Across each group, those who disclosed to everyone consistently were found to have a lower prevalence of depression. This association was statistically significant for all groups (p<0.050) except for “Family members” (p=0.052). Full disclosure to social groups was found to have a statistically significant association with increased social support. Most respondents (43.9%) were categorized with low social support, and this group had the highest level of depression compared to those with more social support. An increase in levels of social support correlated with a statistically significant association for lowered depression outcomes. Experiences of IPV within the last six months had a statistically significant relationship with depression (p=0.002). An association between being a victim of IPV, alone and in conjunction with being a perpetrator, was associated with increased odds of depression, however IPV experiences did not meaningful differ based on disclosure.

Conclusions: Thai MSM show higher rates of depression among social groups that they do not disclose their sexual orientation to compared to groups that they do. An increase in social support correlates with full disclosure among social networks, and appears as a prominent, partial mediator to depression outcomes. While the IPV experience of being a victim is shown to be associated with the highest reported levels of depression, followed by the experience of being both a victim and perpetrator, IPV experiences generally remain unaltered based on disclosure status. No statistically significant association is seen between social support and IPV types, however they individually have a clear association with depression.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 06/01/2022

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