Impact of acculturation and psychological adjustment on mental health among migrant adolescents in Guangzhou, China: a cross-sectional questionnaire study.

OBJECTIVES: The aim of this study was to examine the pathway and associations among acculturation (ie, language, social interaction and lifestyle), psychological adjustment and mental health of internal migrant adolescents in China. DESIGN: Cross-sectional questionnaire study. SETTING: Six private migrant junior high schools located in Tianhe and Baiyun districts in Guangzhou were chosen as the study sites. PARTICIPANTS: A total of 1122 migrant adolescents aged 11-17 years old completed the study. MAIN OUTCOME MEASURES: Mental health was measured by using the Social Anxiety Scale for Children (SASC) and major depression disorder (MDD) in a Brief Child and Family Phone Interview. Acculturation and psychological adjustment were measured by a self-designed and verified questionnaire. Multiple regression models and structural equation models were performed to analyse the association among acculturation, psychological adjustment and mental health while controlling for participant demographic characteristics. RESULTS: The average MDD score for boys was 8.78 (SD=2.17) and for girls was 8.56 (SD=2.22), while the average SASC score for boys was 14.67 (SD=3.72) and for girls was 13.41 (SD=4.01). Psychological adjustment had a direct positive effect on MDD (p<0.001, ß=0.30) and SASC (p<0.001, ß=0.28), and it was the key variable fully mediating the impact of acculturation components on MDD and partly mediating the impact of acculturation on SASC, whereas lifestyle showed a direct negative effect (p=0.003, ß=-0.17) on SASC. Of the three acculturation components, lifestyle had the strongest influence on psychological adjustment (p<0.001, ß=0.37 and 0.51), followed by social interaction (p<0.001, ß=0.24 and 0.13) and language (p<0.001, ß=0.17 and 0.11). CONCLUSIONS: The association between acculturation and the mental health of internal migrant adolescents was complex and could be mediated by psychological adjustment. Interventions such as promoting local language and social interaction are needed to enhance psychological adjustment and further improve the mental health of migrant adolescents.

Alcohol use, stigmatizing/discriminatory attitudes, and HIV high-risk sexual behaviors among men who have sex with men in China.

OBJECTIVE: This research was conducted to assess the correlates of alcohol consumption and HIV/AIDS-related stigmatizing and discriminatory attitudes among men who have sex with men (MSM) in Shandong province, China. METHODS: A cross-sectional survey provided demographics, sexual behaviors, illicit drug use, alcohol consumptions, and service utilization. RESULTS: Of 1,230 participants, 82.8% were single, 85.7% aged <35 years, 47.2% had college or higher education, and 11.7% drank alcohol >3 times per week in the past six months. The average total score of stigmatizing and discriminatory attitude was 37.4 ± 4.4. More frequent episodes of alcohol use were independently associated with higher levels of HIV/AIDS-related stigma and discrimination, unprotected anal sex, bisexual identity, multiple male sex partners, drug use, and lower levels of education. Expressing higher levels of HIV/AIDS-related stigmatizing and discriminatory attitudes was independently associated with alcohol use, unprotected male anal sex, bisexuals, more male sex partners, commercial sex with men, and non-receipt of peer education in the past year. CONCLUSION: HIV/AIDS-related stigmatizing and discriminatory attitudes are common and associated with alcohol use and unprotected sex among MSM. The finding highlights the needs to develop programs that would reduce HIV/AIDS-related stigmatizing and discriminatory attitudes and strengthen alcohol use prevention and risk reduction initiatives among MSM.