title: Social factors associated with Major Depressive Disorder in homosexually active, gay men attending general practices in urban Australia.
abstract: OBJECTIVE
  Social factors associated with Major Depressive Disorder (MDD) were identified among gay men attending high HIV caseload general practices in Sydney and Adelaide.
  
  
  METHODS
  Men who visited four participating practices were invited to self-complete a survey. A self-screening tool (PHQ-9), based on the Diagnostic and Statistical Manual of Mental Disorders, version four (DSM-IV), was used to measure depressive disorders.
  
  
  RESULTS
  The rate of MDD (PHQ-9 score 10 or above) among the 195 HIV-positive gay men was significantly higher than that among the 314 non-HIV-positive gay men (31.8% vs 20.1%, p=0.002). Current MDD was independently associated with younger age, lower income, recent major adverse life events, adopting denial and isolation as coping strategies, less social support, less gay community involvement and recent sexual problems. HIV-status, however, was not independently associated with MDD.
  
  
  CONCLUSIONS
  Socio-economic hardship, interpersonal isolation and personal withdrawal were significantly and independently associated with major depression in this population of gay men.
  
  
  CONCLUSIONS
  The study provides further evidence of health inequity affecting gay men in Australia. Structural health promotion approaches focused on homophobia and discrimination, as well as community-engaged primary health care responses are called for to mitigate this inequity.
authors.affiliation: National Centre for HIV Social Research, University of New South Wales, NSW, Australia. limin.mao@unsw.edu.au
authors.forename: Limin
authors.initials: L
authors.lastname: Mao
authors.forename: Michael R
authors.initials: MR
authors.lastname: Kidd
authors.forename: Gary
authors.initials: G
authors.lastname: Rogers
authors.forename: Gavin
authors.initials: G
authors.lastname: Andrews
authors.forename: Christy E
authors.initials: CE
authors.lastname: Newman
authors.forename: Adrian
authors.initials: A
authors.lastname: Booth
authors.forename: Deborah C
authors.initials: DC
authors.lastname: Saltman
authors.forename: Susan C
authors.initials: SC
authors.lastname: Kippax
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005194:Family Practice; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D011320:Primary Health Care; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires