Abstract
BACKGROUND: Previous studies have explored the mental health of HIV-positive people. However, research specifically focusing on HIV-positive men who have sex with men (MSM) is relatively limited. From the configuration perspective, this study explored different combines influencing depression in HIV-positive MSM using fuzzy-set qualitative comparative analysis (fsQCA). METHODS: Data was collected from April to July 2023. A total of 551 HIV-positive MSM served as valid samples. Participants completed electronic questionnaires, including information such as Family APGAR Index, Sense of Coherence Scale-13, Simplified Coping style Questionnaire, Templar's Death Anxiety Scale, Patient Health Questionnaire-9. This study simultaneously used two different analysis methods - linear regression model and fsQCA. RESULTS: In the regression model, this study found that the sense of coherence has the greatest impact on depression. Through fsQCA, this study identified four configurations that may contribute to depression in HIV-positive MSM. The sense of coherence was a core condition in each configuration. In the configuration 1a most associated with depression, the sense of coherence was absent as a core condition, death anxiety and stigma were present as core conditions, and positive coping style was absent as a peripheral condition. CONCLUSIONS: A higher sense of coherence is an important protective factor in reducing the risk of depression in HIV-positive MSM. Configurations formed by different variables all have a significant impact on depression in this study. In clinical intervention for depression of HIV-positive MSM, attention should be simultaneously paid to both internal psychological characteristics and external factors such as family environment.