Objectives Connections to the gay community may elicit negative self-appraisals among men who have sex with men (MSM), which may be exacerbated for people with HIV (PWH). Fitness engagement may mediate self-appraisals by maintaining or improving appearance and health. We hypothesized that gay community connections would be positively related to negative self-appraisal and explored whether this association would be mediated by fitness engagement and moderated by HIV status. Method Data were obtained from the Multicenter AIDS Cohort Healthy Aging study (N = 1,026; PWH n = 525; people without HIV [PWOH] n = 501). Structural equation modeling (SEM) examined associations between gay community connections, negative self-appraisal (body image dissatisfaction, self-perception of aging), and fitness engagement (physical activity, motivation to be fit). Multiple-group SEM tested the moderating effects of HIV serostatus. Results The SEM fit the data well (root mean square error of approximation = 0.056; 90% CI: 0.046, 0.066). Connection to the gay community was inversely related to negative self-appraisals and positively related to fitness engagement. Fitness engagement mediated the association between community connections and negative self-appraisal and was inversely related to negative self-appraisals. Among PWH, the association between community connections and self-appraisal was weaker and the effect of fitness engagement on negative self-appraisal was stronger compared to PWOH. Discussion Connection to the gay community may be a source of resilience for aging MSM by lessening negative self-appraisals and promoting strategies that address body image dissatisfaction and self-perceptions of aging. Interventions facilitating connections to the gay community may support healthy aging in this population.

中文翻译：

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与男性发生性关系的中老年男性与同性恋社区的心理联系和消极自我评价：健身参与的中介效应

目标 与同性恋社区的联系可能会引起男男性行为者 (MSM) 的负面自我评价，这可能会加剧艾滋病病毒感染者 (PWH) 的情况。健身参与可以通过保持或改善外表和健康来调节自我评价。我们假设同性恋社区关系与消极的自我评价呈正相关，并探讨了这种关联是否会受到健身参与的调节和 HIV 状况的调节。方法 数据来自多中心艾滋病队列健康老龄化研究（N = 1,026；PWH n = 525；未感染 HIV 的人 [PWOH] n = 501）。结构方程模型 (SEM) 检查了同性恋社区联系、负面自我评价（身体形象不满、对衰老的自我认知）和健身参与（身体活动、健身动机）之间的关联。多组 SEM 测试了 HIV 血清状况的调节作用。结果 SEM 很好地拟合了数据（近似的均方根误差 = 0.056；90% CI：0.046，0.066）。与同性恋社区的联系与消极的自我评价呈负相关，与健身参与度呈正相关。健身参与调节了社区联系与负面自我评价之间的关联，并且与负面自我评价呈负相关。在 PWH 中，社区联系与自我评价之间的关联较弱，与 PWOH 相比，健身参与对负面自我评价的影响更强。讨论 通过减少消极的自我评价和促进解决身体形象不满和衰老自我认知的策略，与同性恋社区的联系可能是老年 MSM 恢复力的来源。促进与同性恋社区联系的干预措施可能支持这一人群的健康老龄化。