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Severity of depressive symptoms may impact HIV risk among black MSM

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ATLANTA – Black men who have sex with men who have moderate depressive symptoms may be more likely to engage in high-risk sexual behaviors than those who have mild or severe depressive symptoms, according to findings presented at the 2009 National HIV Prevention Conference, held here.

Researchers from the Fenway Institute and Harvard Medical School conducted the study in collaboration with the Multicultural AIDS Coalition and Justice Resource Institute. They reviewed data from 197 black MSM who completed an interviewer-administered assessment prior to optional HIV pre- and post-test counseling and serological testing. They evaluated patients for depression using the 20-item Center for Epidemiologic Studies Depression Scale.

Matthew J. Mimiaga, ScD, MPH, from Harvard Medical School and the Fenway Institute, presented the results. “We observed a curvilinear relationship between depressive symptoms and HIV risk,” Mimiaga said. “Patients with no or mild depressive symptoms carried less risk. There was more risk among patients with moderate depressive symptoms. But patients with high levels of depression had low or no risk.”

Mimiaga said that depressive symptoms were demonstrated by 33% of the participants. Moderate depressive symptoms were observed in 19% of the participants and severe depressive symptoms were observed in 14% of participants.

Participants with moderate depressive symptoms had an adjusted odds ratio (AOR) of 9.81 (P=.01) of having serodiscordant unprotected anal sex with a casual male partner in the previous 12 months. An association between moderate depression and being diagnosed with an STD in the previous 12 months was also observed (AOR = 6.40; P=.04).

Risk factors for depression included being publicly insured with Medicaid (AOR = 4.79; P=.04) and being diagnosed with an STD in the prior 12 months (OR = 5.72; P=.04).

“Given the high prevalence of both depression and HIV risk among black MSM in the United States, and the noted association between moderate depression and sexual risk taking, incorporating screening and treatment for depression among this population may improve HIV prevention interventions efforts,” Mimiaga said.

Mimiaga MJ. A10-4. Presented at: 2009 National HIV Prevention Conference; Aug. 23-26, 2009; Atlanta.