The Influence of Cultural and Mental Health Factors on the Prevalence of HIV/AIDS Among Older Men Who Have Sex with Men: A Systematic Review and Meta-analysis

This systematic review and meta-analysis examines mental health disparities among older men who have sex with men (MSM) in China, highlighting significant psychological issues and a higher HIV/AIDS burden. A total of 12 studies involving 1,200 older MSM participants were included in the meta-analysis. The studies varied in design, with 7 cross-sectional studies and 5 cohort studies. Our review revealed a significant increase in anxiety, depression, and other psychological disorders among MSM, with the odds ratio (OR) for anxiety was 1.56 (95% CI, 1.30–1.88, p < 0.00001), indicating a substantial prevalence compared to controls. The heterogeneity for this finding was high (Tau² = 1.99; Chi² = 170.00, df = 9; I² = 95%). Additionally, older MSM faced a greater risk of HIV/AIDS, with a relative risk (RR) of 1.63 (95% CI; P < 0.00001) compared to younger MSM, also showing significant heterogeneity (Tau² = 0.22; Chi² = 43.03, df = 9; I² = 79%). These results highlight the significant role of cultural factors in shaping the mental health and HIV risks faced by older MSM in China. The analysis suggests that lower levels of social pressure may serve as a protective factor for mental health within this population. Given these findings, it is crucial to develop targeted mental health interventions and HIV prevention strategies tailored specifically to the needs of older MSM in China. Future research should include longitudinal studies and qualitative investigations to explore the underlying mechanisms driving these disparities.