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Previous studies have often examined these factors separately, without considering their interconnections. Network analysis offers a way to explore these relationships, but has seldom been applied to MSM in the context of both mental health and sexual risk. This study aimed to: (1) model psychosocial symptom networks among MSM; (2) compare network structures across demographic subgroups; and (3) examine how central symptoms relate to high-risk sexual behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey was conducted among 405 MSM in Taizhou, China, using venue-based and online snowball sampling. Psychosocial problems\u2014including depression, anxiety, self-esteem, internalized homonegativity, loneliness, perceived social support, and sociosexual orientation\u2014were assessed using validated self-report scales. High-risk sexual behavior was measured based on condom use and number of sexual partners. Network analysis was used to examine symptom-level associations, and network comparison tests explored differences across demographic subgroups. Associations between central symptoms and high-risk behaviors were examined using correlation and regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 405 MSM, 12.4% reported moderate-to-severe depression and 10.1% moderate-to-severe anxiety. Strongest network connections appeared between depression and anxiety, and between loneliness and sociosexual desire. Central nodes included\n                      <jats:italic>\u2018feeling nervous\u2019<\/jats:italic>\n                      , desire for uncommitted sexual relationships,\n                      <jats:italic>\u2018feeling tired\u2019<\/jats:italic>\n                      ,\n                      <jats:italic>\u2018lacking companionship\u2019,<\/jats:italic>\n                      and\n                      <jats:italic>\u2018no good\u2019<\/jats:italic>\n                      . Significant structural differences were found between participants\u2009&lt;\u200933\u00a0years and those\u2009\u2265\u200933\u00a0years (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017), with older individuals showing generally weaker psychosocial connections. Central symptoms were significantly associated with risky sexual behaviors, especially in younger participants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Emotional distress, low self-esteem, loneliness, and sociosexual desire emerged as central psychosocial problems linked to high-risk sexual behaviors among MSM. Network structures differed by age, with younger MSM showing stronger interconnections. These findings highlight the need for age-specific, targeted interventions to reduce sexual risk and improve mental health among MSM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40359-025-03550-x","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T15:44:27Z","timestamp":1762962267000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Psychosocial symptom networks and high-risk sexual behaviors among men who have sex with men: a network analysis"],"prefix":"10.1186","volume":"13","author":[{"given":"Nan","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuting","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijiang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaowei","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanling","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"3550_CR1","unstructured":"UNAIDS. 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