Sexual minority status modifies the association between HIV risk behavior and prevalent mood or anxiety disorders in British Columbia,Canada

Purpose

This study aimed at determining to what extent sexual minority status modifies the association between HIV risk behavior and prevalent mood or anxiety disorder diagnosis in British Columbia (BC), Canada, using a population-based survey.

Methods

This analysis was based on the cross-sectional 2013–2014 Canadian Community Health Survey. The sample was restricted to respondents in BC with valid responses to the survey items considered. A multivariable logistic model, where the behavioral HIV risk score exposure was nested into the sexual minority status modifier, estimated the odds of having a prevalent mood or an anxiety disorder. The behavioral HIV risk score (0, 1, 2,?≥?3) included the following five measures: (1) age at first intercourse?<?14 years, (2) condom use during last intercourse, (3) history of sexually transmitted infections, (5) number of sexual partners in the past 12 months (<?4,?≥?4), and substance use in the past 12 months.

Results

Of the weighted sample (2,521,252), 97% (95% confidence interval (CI) 97–98) were heterosexual, while 3% (95% CI 2–3) were lesbian, gay, and bisexual (LGB). The prevalence of a mood or anxiety disorder diagnosis was 12% (95% CI 11–13). For every 1-level increment in the behavioral HIV risk score, the adjusted odds ratio of having a prevalent mood or anxiety disorder diagnosis was 1.29 (95% CI 1.03–1.54) for heterosexual respondents and 2.37 (95% CI 1.84–2.90) for LGB respondents.

Conclusion

Sexual minority status modified the relationship between HIV risk behavior and prevalent mood or anxiety disorders, with a stronger association among LGB respondents. Healthcare providers should prioritize integrated care that addresses the intersectionality between sexual risk, substance use, and mood or anxiety disorders.