Psychological Symptoms Are Associated with Both Abstinence and Risky Sex Among Men with HIV

Abstract

Sexual abstinence is often deemed the “safest behavior” in HIV prevention, but is sometimes associated with psychological symptoms (e.g., depression) just as sexually risky behavior is. This study explored whether sexual abstinence and risky sexual behavior among men with HIV are associated with similar constellations of psychological symptoms. Prior research has not addressed this issue because abstinent people often are not included in the sample, or when data are analyzed, researchers combine abstinent people with sexually active people who practice safer sex. Past research also neglects the co-morbidity of psychological symptoms. A latent class analysis of the psychological symptoms (assessed with the Symptom Check List 90-R; Derogatis, 1994) of 140 men with HIV, mostly from rural New England, revealed three latent classes; men who were asymptomatic on all symptom domains (28.8%), men who were symptomatic on all domains (34.1%), and men who were symptomatic on internalizing domains (37.1%), but were asymptomatic on the externalizing symptoms of hostility and paranoid ideation. Logistic regression showed that sexual behavior during the past 90 days of men in the all symptom class and the internalizing symptoms class was similar, with abstinence and risky sex predominating, and safer sex being relatively uncommon for both classes. The sexual behavior of men in the asymptomatic class differed, with safer sex being relatively more likely to occur compared to the symptomatic classes. These findings suggest that the psychological symptom profile of sexually abstinent people places them at risk for inconsistent condom use should they engage in sexual behavior.

The psychological health and associated factors of men who have sex with men in China: A cross-sectional survey

“…The initial sample size (N = 203) was calculated according to the formula n = 100 × (1 − p ) / p . It has been reported that 33.0–46.1% of MSM experience symptoms of depression or anxiety disorders in China [ 6 , 8 , 31 ]. To ensure an adequate sample size, the lowest prevalence rate (33%) was used as the p value.…”

“…The Symptom Checklist 90 (SCL-90) has been one of the most reliable psychopathological testing tools for clinical populations worldwide and is becoming one of the most popular measures with which to assess psychiatric distress in diverse cultures worldwide. SCL-90 is a self-reporting tool that has proven reliable and valid for psychological evaluation [ 29 , 30 ], including its use in HIV/AIDS studies [ 31 – 33 ]. The Chinese version of the SCL-90 has also proven reliable and valid in studies of the general population in China [ 33 , 34 ].…”

Sexuality, sexual well being, and intimacy during COVID-19 pandemic: An advocacy perspective

“…In another study, sexually abstinent men were compared with those with high-risk sexual behavior having HIV, and the authors reported that the two groups had similar prevalence of depression, burnout, anxiety, and insomnia. [ 39 ] HIV, however, having entirely different social dynamics and established routes of sexual transmission will be different from other infectious diseases. Psychological distress and sexual abstinence have been shown to share a bi-directional relationship, as increased stress can also induce people to avoid sexual activities altogether.…”

Influences of Economic, Social and Cultural Marginalization on the Association Between Alcohol Use and Sexual Risk Among Formerly Incarcerated Latino Men

“…al., (2015) concluded in their recent review, anxiety and depressive symptoms instigate cognitive and motivational processes that may alter risk perception, can lead to cognitive distortions which can deter rational decision-making, or can lead to self-gratifying behaviors that distract from negative feelings associated with psychological symptoms. 107 High levels of stress, anxiety, and depression have been associated with both high sexual desire leading to risk (high number of sexual partners, alcohol use prior to sex, and inconsistent condom use) 108,109 and to low sexual activity that is highly risky, i.e., hypoactive sexual desire (low libido) and erectile dysfunction in combination with no condom use (to reduce likelihood of losing erections). 110–113 High stress, depression, and anxiety have also been linked to high levels of acquiring sexually transmitted infections.…”