Sexual Risk-Taking in HIV-Negative Gay and Bisexual Men Increases with Depression: Results from a U.S. National Study

Millar, Brett M.; Starks, Tyrel J.; Grov, Christian; Parsons, Jeffrey T.

doi:10.1007/s10461-016-1507-6

Cited by 41 publications

(37 citation statements)

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“…Compared to traditional regression analysis, SEM allows investigation of (complex) mediation chains and examination of the validity of the entire hypothesized conceptual model. This paper extends previous findings of a direct link between clinically significant depressive symptoms and CLS among GBMSM in the AURAH study [21], as well as in a number of other studies [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

Section: Discussionsupporting

confidence: 88%

“…There is substantial evidence for an association between symptoms of depression and increased engagement in condomless sex (CLS), including CLS with multiple partners and partners of an unknown/sero-different HIV status [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21], and HIV acquisition [22] in studies of GBMSM. Most of these studies have been conducted in the U.S. To date, two UK cross-sectional studies have investigated the relationship between symptoms of depression and CLS.…”

Section: Introductionmentioning

confidence: 99%

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Investigating Conceptual Models for the Relationship Between Depression and Condomless Sex Among Gay, Bisexual, and Other Men Who have Sex with Men: Using Structural Equation Modelling to Assess Mediation

et al. 2019

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The aim of this study is to investigate five hypothesized mechanisms of causation between depression and condomless sex with ≥ 2 partners (CLS2+) among gay, bisexual, and other men who have sex with men (GBMSM), involving alternative roles of self-efficacy for sexual safety and recreational drug use. Data were from the AURAH cross-sectional study of 1340 GBMSM attending genitourinary medicine clinics in England (2013-2014). Structural equation modelling (SEM) was used to investigate which conceptual model was more consistent with the data. Twelve percent of men reported depression (PHQ-9 ≥ 10) and 32% reported CLS2+ in the past 3 months. AURAH data were more consistent with the model in which depression was considered to lead to CLS2+ indirectly via low self-efficacy for sexual safety (indirect Beta = 0.158; p < 0.001) as well as indirectly via higher levels of recreational drug use (indirect Beta = 0.158; p < 0.001). SEM assists in understanding the relationship between depression and CLS among GBMSM.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Investigating Conceptual Models for the Relationship Between Depression and Condomless Sex Among Gay, Bisexual, and Other Men Who have Sex with Men: Using Structural Equation Modelling to Assess Mediation

et al. 2019

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“…Our study shows a strong association between depression and the use of all analysed substances. It is well known that depression can lead to a greater tendency to take more sexual risks [21]. However, our study did not address the complexity of the interaction between depression and other sexual risks, as many important questions, such as internalized homophobia or alcohol misuse, were not included in our analysis.…”

Section: Discussionmentioning

confidence: 99%

Chemsex drugs on the rise: a longitudinal analysis of the Swiss HIV Cohort Study from 2007 to 2017

et al. 2019

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Objectives Chemsex refers to the use of sex‐enhancing drugs among men who have sex with men (MSM) in combination with specific sexual and social behaviours. Longitudinal data on this development and the associated health risks are scarce. Methods Data on all recreational drugs reported in the Swiss HIV Cohort Study (SHCS) from 2007 to 2017 were collected. Drug use was analysed longitudinally for all drug classes. In addition, potential associations between patient characteristics and the consumption of methamphetamine, γ‐hydroxybutric acid/γ‐butyrolactone (GHB/GBL), 3,4‐methylenedioxymethamphetamine (MDMA/XTC), cocaine and amphetamine were analysed. Results We analysed 166 167 follow‐up entries for 12 527 SHCS participants, including 7101 free text field entries containing information about recreational drugs other than cannabis, cocaine and heroin. Overall, we observed a stable percentage (9.0%) of recreational drug use (excluding cannabis, amyl nitrite and prescription drugs). For MSM, however, there was an increase in overall drug use from 8.8% in 2007 to 13.8% in 2017, with particularly large increases for methamphetamine (from 0.2 to 2.4%; P < 0.001) and GHB/GBL (from 1.0 to 3.4%; P < 0.001). The use of each of the potentially sex‐enhancing drugs methamphetamine, GHB/GBL, cocaine, XTC/MDMA and amphetamine was significantly associated with condomless sex with nonsteady partners, and higher prevalences of depression, syphilis and hepatitis C. Conclusions The significant increase in the use of chemsex drugs among MSM in the SHCS and the strong association with coinfections and depression highlights the need for harm reduction programmes tailored to MSM. According to our results, improving knowledge about recreational drugs is important for all health care professionals working with people living with HIV.

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“…Two studies – utilizing the same sample – have previously reported on the prevalence of depression among MSM in the US. While Millar, Starks, Grov and Parsons (2017) found no differences in depression rates by geographic region, Cain et al (2017) observed higher rates of depression among those MSM living outside of urban areas. Neither of these studies examined relationship status or sexual agreements.…”

Section: Introductionmentioning

confidence: 78%

The Prevalence and Correlates of Sexual Arrangements in a National Cohort of HIV-Negative Gay and Bisexual Men in the United States

Starks

Robles²,

Bosco

et al. 2018

Arch Sex Behav

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Sexual agreements have received considerable attention as an aspect of dyadic functioning associated with HIV risk. To date, this research has primarily utilized convenience samples which over-represented men from large urban areas and with higher HIV risk. The current study utilized a national cohort of 1,061 HIV-negative gay and bisexual men recruited to be geographically diverse within the U.S. The sample included 531 (50.0%) men who identified as single. Of the 530 partnered men, 240 (45.3%) were monogamous; 238 (44.9%) were in open relationships (where sex with outside partners was permitted); and 52 (9.8%) were in monogamish relationships (where sex with outside partners was limited to instances where both primary partners were present). Regardless of urban (versus non-urban) residence, men in monogamous relationships engaged in less anal sex generally and CAS specifically with casual partners. Single men reported significantly more frequent anal sex with casual partners compared to open and monogamish men; however, there were no differences among these three groups with respect to CAS with casual partners. In multivariable models, monogamish men reported significantly more frequent marijuana use and alcohol consumption compared to all other groups. Urban (versus non-urban) residence moderated associations between sexual arrangements and depression as well as the use of illicit drugs other than marijuana. These findings point to the need to better examine the potentially unique mechanisms which confer risk and resilience for gay male couples in urban versus non-urban settings. The observed association between sexual arrangements and substance use suggest interventions which facilitate the negotiation of sexual agreements may present an opportunity to engage in dyadic substance use intervention.

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Sexual Risk-Taking in HIV-Negative Gay and Bisexual Men Increases with Depression: Results from a U.S. National Study

Cited by 41 publications

References 50 publications

Investigating Conceptual Models for the Relationship Between Depression and Condomless Sex Among Gay, Bisexual, and Other Men Who have Sex with Men: Using Structural Equation Modelling to Assess Mediation

Investigating Conceptual Models for the Relationship Between Depression and Condomless Sex Among Gay, Bisexual, and Other Men Who have Sex with Men: Using Structural Equation Modelling to Assess Mediation

Chemsex drugs on the rise: a longitudinal analysis of the Swiss HIV Cohort Study from 2007 to 2017

The Prevalence and Correlates of Sexual Arrangements in a National Cohort of HIV-Negative Gay and Bisexual Men in the United States

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