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Individual Oral Paper

LGBTQ+

LGBT: Relationships, Family, and Community Context

1 - (IOP 28) The Role of Collective and Individual Self-esteem on Depression and Sexual Risk Behavior of Indian Men Who Have Sex with Men

Sunday, November 23, 2025
10:01 AM - 10:15 AM CST
Location: Imperial 11, Level 4
Keywords: LGBTQ+, Global Mental Health, HIV / AIDS
Recommended Readings: Safren, S. A., Thomas, B., Biello, K. B., Mayer, K. H., Rawat, S., Dange, A., ... & Mimiaga, M. J. (2021). Strengthening resilience to reduce HIV risk in Indian MSM: a multicity, randomised, clinical efficacy trial. The Lancet Global Health, 9(4), e446-e455.,   ,   ,   ,  
Introduction
Collective self-esteem (CSE) is a component of an individual’s self-image whereby people evaluate themselves in relation to their social groups. This is particularly important in collectivist cultures such as India. Men who have sex with men (MSM) in India face stigma and marginalization which might impact their collective and individual self-esteem, and in turn, depression and HIV sexual risk behavior.

Methods
301 Indian MSM in the control group (total study N = 608) completed baseline and quarterly assessments over one year. Participants completed the Collective Self-Esteem Scale (CSES; Luhtanen & Crocker, 1992), the Rosenberg individual Self-Esteem scale (RSES; Rosenberg, 1965), the CES-D-10 measuring clinically significant depressive symptoms (Radloff, 1977), and an assessment of condomless anal sex. Analyses included a confirmatory factor analysis (CFA) to create latent variables for components of collective self-esteem based on prior work, and subsequent serial mediation path analyses.

Results
Three usable factors of CSE emerged from CFA: positive view of group, negative view of group, and public view of group (χ2 (39) = 69.144, p < .001, CFI = .957, TLI = .940, RMSEA = .051, 90% CI [.031, .071], and SRMR = .046).
In the final path analysis with good data fit (χ2 (6) = 11.350, p = .078, CFI = .964, TLI = .910, RMSEA = .055, 90% CI [.000, .103], and SRMR = .029), only one of the collective self-esteem factors, public view of group, emerged with significant effects.
Significant direct effects were found for public view of group predicting individual self-esteem (B = 1.739, β = .298, p = .003, BCa CI [.722, 3.143]), individual self-esteem predicting depression (B = -.388, β = -.292, p < .001, 95% BCa CI [-.604, -.206]), and depression predicting condomless anal sex acts (B = .306, β = .193, p = .088, 95% BCa CI [.088, .885]). The bootstrapped test of indirect effects was significant, showing that public view of group predicted condomless anal sex acts via the intervening effects of individual self-esteem and depression (B = -.207, β = -.017, 95% BCa CI [-1.051, -.047]). When accounting for these indirect effects, the direct effect of public view of group on condomless anal sex acts was non-significant, thus supporting full longitudinal mediation.

Conclusion
The effects of collective self-esteem on depression and sexual risk behavior in Indian MSM is nuanced. Of the three factors related to collective self-esteem, only one, public perception of how their group is viewed, showed effects. Accordingly, Indian MSM’s more positive public view of their group led to higher individual self-esteem, which led to lower depression, and, in turn, higher depression was associated with increased condomless anal sex. When developing interventions to address mental health and/or sexual risk behavior among MSM in India, accounting for how participants perceive societal attitudes towards as well as external, socially constructed views of their group may be an important factor to address.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Describe the interacting effects of collective self-esteem, individual self-esteem, and depression on Indian MSM's sexual behavior in the context of HIV prevention.