Comparison of depression and anxiety between HIV-negative men who have sex with men and women (MSMW) and men who have sex with men only (MSMO): a cross-sectional study in Western China

Abstract

ObjectiveTo compare the prevalence of depression, anxiety and comorbidity between HIV-negative men who have sex with men and women (MSMW) and men who have sex with men only (MSMO) and examine the associated factors with depression and anxiety separately.DesignA cross-sectional study.SettingThe study was conducted in Western China.ParticipantsFrom April 2013 to October 2014, 2422 participants aged 18–65 years, who were male at birth, had engaged in sex with male partners in the past 6 months, self-reported negative or unknown HIV status, were willing to participate and provided informed consent were recruited using non-probability sampling. An anonymous self-administered questionnaire was used to collect the data. A total of 1809 HIV-negative men who have sex with men (MSM) were eligible for the final analysis.ResultsOf 1809 MSM, 16.1% were MSMW and 83.9% were MSMO. The prevalence of depression, anxiety and comorbidity was 50.86%, 36.43% and 32.65%, respectively, for MSMW; these results were higher than those for MSMO (35.18%, 23.52% and 18.91%, respectively). After adjusting for potential confounding factors, the prevalence of depression and anxiety was higher among MSMW than among MSMO. The prevalence of depression and/or anxiety was associated with young age, lower educational level, lower monthly income, lower HIV score and some risky sexual behaviour (had never engaged in HIV counselling, had obtained commercial sexual services in the past 6 months and sometimes/always looked for sexual partners through the internet). The prevalence of depression and anxiety was lower for those who drank less than once a week than for those who never drank.ConclusionOur findings suggest the need to address mental health among MSMW. Future health intervention strategies should integrate mental health services and traditional HIV prevention programmes and should consider the differences between MSMW and MSMO.Trial registration numberChiCTR-TRC-13003849; Pre-results.

The mediating role of self-stigma and self-efficacy between intimate partner violence (IPV) victimization and depression among men who have sex with men in China

“…Thus the result could be partially attributed to the cross-study variations in methodology (e.g., sample characteristics, definition and measurement of IPV). We also found a prevalence of 36.0% of depression in the MSM sample, which is comparable to the prevalence reported in previous studies among MSM in China [40,41]. Younger age and lower income level were associated with increased risk of depression, corroborating with prior studies among Chinese MSM [42,43].…”

“…A qualitative study also showed that internalized homophobia was higher when the MSM population were younger and concealment strategies are often used by young MSM instead of coming out to avoid discrimination and violence associated with stigmatized identity [45]. A study showed that Younger MSM had a higher prevalence of anxiety than older MSM [41], which was also strongly linked to depression. In addition, young MSM were more likely to have sexual risk behaviors and have lower utilization of mental health care, which may further aggravate their psychological problem [46].…”

The Prevalence of Depression Associated with the Infection Status and Sexual Behaviors among Men Who Have Sex with Men in Shenzhen, China: A Cross-Sectional Study

“…The CES-D scale [23] is usually used as a screening tool in clinical practice and has high sensitivity, which may have led to the higher depression prevalence found in our study. In studies carried in Shanghai and west China, 52.1% and 50.8% had depression symptoms [2,24], which is higher than the results in our study; despite adopting the same depression scale, these discrepancies might be due to differences in culture and HIV infection status.…”

“…The results of the multivariate analysis showed that a lack of awareness of AIDS knowledge (OR: 2.636, 95% CI: 1.384-5.020), peer education (OR: 1.752, 95% CI: 1.055-2.190) increased the odds of depression, while more peer educators with a high informational support profile was related to higher self-efficacy, social support, and behavior management [25]. In addition, those not identifying as heterosexual seemed to more readily become depressed (OR: 1.805, 95% CI: 1.080-3.018), in contrast with another finding [2]; the prevalence of depression was 35.18% among men who have sex with men only and 50.86% among men who have sex with men and women, which may be related to marital status. This result seems inconclusive with regard to the relationship between depression and the gender of one's sex partners.…”

“…A large number of studies worldwide have shown that men who have sex with men (MSM) have a poor mental health status compared to those with only heterosexual partners. MSM also face general mental health conditions, such as drug abuse, depression, anxiety, and suicidal intentions and behaviors [1][2][3][4][5][6][7]. The risk for depression and anxiety disorders has been shown to be at least 1.5 times higher among lesbian, gay, and bisexual people compared to the heterosexual population, and the lifetime prevalence of suicide attempt was 4.4 times higher among gay and bisexual men [8].…”