Biopsychosocial approach to understanding determinants of depression among men who have sex with men living with HIV: A systematic review

Abstract

Introduction Men who have sex with men (MSM) living with HIV are more likely to be depressed than MSM without HIV. The AIDS epidemic will not end if the needs of people living with HIV and the determinants of health are not being addressed. Compared to HIV individuals without depression, depressed HIV individuals have worse clinical outcomes and higher mortality risk. Depression is caused by a complex combination of social, psychological, and biological variables. This systematic review, thereby motivated by the need to address this gap in the literature, aims to articulate determinants of depression among MSM living with HIV according to the biopsychosocial approach. Methodology We systematically searched four databases from 2011 to 2021. We searched for observational studies on determinants of depression among MSM living with HIV. The outcome is depression based on the categorical or numerical outcome. Two reviewers independently extracted data and assessed study risks of bias. Any disagreements are consulted with the third reviewer. Results We identified 533 articles, of which only eight studies are included. A total of 3,172 MSMs are included in the studies. We found the determinants of depression and categorized them according to biological, psychological, and social approaches. Conclusion The determinants of depression with the strongest evidence across studies were enacted HIV-related stigma, unemployment, sleep disturbance, current smoker, black ethnicity, born overseas, ART initiation, and access to mental health care. Despite weaker evidence, the other relevant determinants to be included were older age, internalized stigma, self-efficacy, and social support. Efforts to improve or prevent depression among MSM living with HIV could benefit from addressing the determinants of depression based on the biopsychosocial approach immediately after HIV diagnosis. Integrating mental health screening and care into HIV treatment settings would strengthen HIV prevention and care outcomes and improve access to mental healthcare.

The Relationship Between Forgiveness and Health Outcomes Among People Living with HIV: A Cross-Sectional Study in France

“…According to previous research, the experience of HIV infection is a highly stressful event for individuals and is associated with co-occurring mental disorders [ 8 , 11 ]. The purpose of the present study was to assess the dimensions of forgiveness as predictors of quality of life in PLWH.…”

“…Prevalence of psychiatric disorders in the seropositive population calls for research on psychosocial resources that may improve functioning in the face of experiencing a health crisis. HIV infection is a biopsychosocial phenomenon that affects not only physical health but also other aspects of PLWH’s lives, including occupational and social functioning, marriage and intimate relationships, and parenting [ 11 ]. Numerous conceptualizations suggest that biological, psychological, and behavioral factors interact in complex ways and influence the clinical progression of HIV-related diseases [ 12 , 13 ].…”

Patient-reported outcomes and experiences of migrants enrolled in a multidisciplinary HIV clinic with rapid, free, and onsite treatment dispensation: the ‘ASAP’ study

“…While engaged in this cohort study, psychosocial vulnerabilities were not found to decrease significantly over time. This may be linked to the idea that the first year of moving to a new country, learning about one’s HIV diagnosis, and engaging in care and treatment, can be a very challenging time across the emotional, mental, and social levels for individuals [ 15 , 57 , 58 ]. Additionally, perhaps more time (e.g., over 1–2 years) is needed to see a change in these aspects of participants’ lives.…”

What is the global prevalence of depression among men who have sex with men? A systematic review and meta-analysis

“…According to previous studies, the determinants of depression in MSM communities include HIV-related stigma, unemployment, sleep disorders, smoking, racism against blacks, birth abroad, initiation of ART, and lack of access to mental health care. Aging, internalized stigma, and lack of self-efficacy, and social support are also important in this complication [ 55 , 90 , 91 ]. However, the prevalence of depression in MSM and other key populations can be influenced by the factors mentioned in the study of Mohamad Faisal et al [ 90 ].…”

“…Aging, internalized stigma, and lack of self-efficacy, and social support are also important in this complication [ 55 , 90 , 91 ]. However, the prevalence of depression in MSM and other key populations can be influenced by the factors mentioned in the study of Mohamad Faisal et al [ 90 ]. In this study, various factors were mentioned to be effective in increasing the incidence or prevalence of depression in the MSM community, the most important of which was their infection with infectious diseases, especially HIV/AIDS.…”