Resilience and depressive symptoms among young Chinese men who have sex with men living with HIV: the mediating role of perceived social support and the moderating role of HIV suppression status

Consistent evidence documents the protective role of resilience in mental health, yet less is known about whether this association operates through different domains of perceived social support or varies by HIV suppression status. This study examined the direct and indirect associations between resilience and depressive symptoms through perceived support from family, friends, and significant others among young Chinese men who have sex with men (MSM) living with HIV. It further tested whether these pathways varied by participants’ Undetectable = Untransmittable (U=U) status . Drawing on a community-based survey of 1,185 participants, moderated mediation analyses showed that resilience was negatively associated with depressive symptoms. Perceived family support significantly mediated this association, whereas support from friends and significant others did not. HIV suppression status moderated the association between resilience and perceived family support and between perceived friend support and depressive symptoms. The cross-sectional design limits causal inference, and non-probability sampling may restrict generalisability. Findings suggest that the mental health benefits of resilience and perceived social support are shaped by both relational context and treatment-related status. Interventions for young MSM living with HIV should distinguish sources of social support and tailor psychosocial support according to individuals’ HIV suppression status and related care needs.