Objectives
This study examines gradients in depressive symptoms by socioeconomic position (SEP) (i.e., income, education, employment) in a large, multi-site sample of MSM.
Methods
Baseline data were used from EXPLORE, a randomized controlled behavioral HIV prevention trial for HIV-uninfected MSM in 6 U.S. cities (n=4,277). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale (short form). A series of multiple linear regressions were fitted with interaction terms to assess additive and multiplicative relationships between SEP and depressive symptoms.
Results
Depressive symptoms were more prevalent among MSM with lower income, lower educational attainment, and those in the unemployed/other employment category. Income, education and employment all made significant contributions in additive models after adjustment. The employment and income interaction was statistically significant, indicating a multiplicative effect.
Conclusions
This study revealed gradients in depressive symptoms across SEP of MSM, pointing to income and employment status, and to a lesser extent education, as key factors for understanding heterogeneity of depressive symptoms.