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Introduction <p>Men who have sex with men (MSM) living with HIV frequently experience dual internalized stigmas related to both their sexual orientation and HIV status. However, the protective roles of engaging with MSM and HIV/AIDS communities (dual community engagement) remain unclear. This study investigates how identity-specific community participation influences internalized stigma and life satisfaction, and examines whether “undetectable = untransmittable” (U = U, viral suppression below 200 copies/mL for at least 6&#xa0;months) moderates these effects.</p> Methods <p>A cross-sectional study was conducted among 1185 young Chinese MSM living with HIV (July–September 2020). Mediation analyses examined whether dual community participation indirectly enhanced life satisfaction through reduction in internalized stigma. Moderated mediation tested U = U status influenced these associations.</p> Results <p>Dual community engagement positively correlated with life satisfaction but operated through distinct pathways. HIV/AIDS community participation was associated with reduced internalized stigma related to both HIV and sexual orientation, whereas MSM community connectedness primarily correlated with lower internalized homosexual stigma. Additionally, among participants achieving U = U, the relationship between community engagement and life satisfaction was significantly stronger, suggesting that viral suppression enhances the psychosocial benefits of community involvement.</p> Conclusions <p>Active engagement in identity-specific communities substantially mitigates internalized stigma, and this effect is strengthened among those achieving U = U. Integrating community support and promoting U = U awareness within HIV care strategies can significantly enhance psychosocial outcomes for MSM living with HIV.</p> Policy Implications <p>Policies should support the development and sustainability of identity-specific community networks and integrate U = U education into public health initiatives and HIV care guidelines, thereby maximizing intervention effectiveness.</p>

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Dual Community Engagement and “Undetectable = Untransmittable”: Alleviating Internalized Stigma and Promoting Life Satisfaction Among Young Chinese Men Who Have Sex with Men Living with HIV

  • 期刊论文

  • 发表日期：

    2025年10月29日

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  • Zurong Liang,
  • Yizhen Zhang,
  • Jingtao Yu

摘要

Introduction

Men who have sex with men (MSM) living with HIV frequently experience dual internalized stigmas related to both their sexual orientation and HIV status. However, the protective roles of engaging with MSM and HIV/AIDS communities (dual community engagement) remain unclear. This study investigates how identity-specific community participation influences internalized stigma and life satisfaction, and examines whether “undetectable = untransmittable” (U = U, viral suppression below 200 copies/mL for at least 6 months) moderates these effects.

Methods

A cross-sectional study was conducted among 1185 young Chinese MSM living with HIV (July–September 2020). Mediation analyses examined whether dual community participation indirectly enhanced life satisfaction through reduction in internalized stigma. Moderated mediation tested U = U status influenced these associations.

Results

Dual community engagement positively correlated with life satisfaction but operated through distinct pathways. HIV/AIDS community participation was associated with reduced internalized stigma related to both HIV and sexual orientation, whereas MSM community connectedness primarily correlated with lower internalized homosexual stigma. Additionally, among participants achieving U = U, the relationship between community engagement and life satisfaction was significantly stronger, suggesting that viral suppression enhances the psychosocial benefits of community involvement.

Conclusions

Active engagement in identity-specific communities substantially mitigates internalized stigma, and this effect is strengthened among those achieving U = U. Integrating community support and promoting U = U awareness within HIV care strategies can significantly enhance psychosocial outcomes for MSM living with HIV.

Policy Implications

Policies should support the development and sustainability of identity-specific community networks and integrate U = U education into public health initiatives and HIV care guidelines, thereby maximizing intervention effectiveness.