Clinically Significant Depressive Symptoms as a Risk Factor for HIV Infection Among Black MSM in Massachusetts |
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Authors: | Sari L Reisner Matthew J Mimiaga Margie Skeer Donna Bright Kevin Cranston Deborah Isenberg Sean Bland Thomas A Barker Kenneth H Mayer |
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Institution: | (1) The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215, USA;(2) Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA;(3) School of Public Health, Harvard University, Boston, MA, USA;(4) Justice Resource Institute, Boston, MA, USA;(5) Massachusetts Department of Public Health, Boston, MA, USA;(6) Brown Medical School/Miriam Hospital, Providence, RI, USA |
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Abstract: | High rates of depression have been observed among men who have sex with men (MSM) relative to the general adult male population;
however, a dearth of research has explored depression among Black MSM. Black MSM (n = 197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered
quantitative assessment and voluntary HIV counseling and testing. Bivariate and multivariable logistic regression procedures
examined the associations of demographics, behavioral HIV risk factors, and psychosocial variables with depressive symptoms
by severity, using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Adjusting for demographic and behavioral
variables, significant factors associated with (1) clinically significant depressive symptoms (33%; CES-D score ≥ 16): being
publicly insured by Medicaid, having serodiscordant anal sex with a casual male partner, and being diagnosed with an STD in
the prior 12 months; (2) moderate depressive symptoms (19%; CES-D score 16–26): having serodiscordant unprotected anal sex
with a casual male partner and being diagnosed with an STD in the prior 12 months; (3) severe depressive symptoms (14%; CES-D
score 27+): being publicly insured by Medicaid and reporting difficulty accessing healthcare in the past 12 months. Moderately
depressed Black MSM may be more likely to engage in behaviors that place them at increased risk for HIV and other STDs. HIV
prevention interventions for Black MSM may benefit from incorporating screening and/or treatment for depression, allowing
MSM who are depressed to respond more effectively to behavioral change approaches. |
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Keywords: | MSM Depression African American HIV STD |
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