title: Clinically significant depressive symptoms as a risk factor for HIV infection among black MSM in Massachusetts.
abstract: High rates of depression have been observed among men who have sex with men (MSM) relative to the general adult male population; however, a dearth of research has explored depression among Black MSM. Black MSM (n = 197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered quantitative assessment and voluntary HIV counseling and testing. Bivariate and multivariable logistic regression procedures examined the associations of demographics, behavioral HIV risk factors, and psychosocial variables with depressive symptoms by severity, using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Adjusting for demographic and behavioral variables, significant factors associated with (1) clinically significant depressive symptoms (33%; CES-D score > or = 16): being publicly insured by Medicaid, having serodiscordant anal sex with a casual male partner, and being diagnosed with an STD in the prior 12 months; (2) moderate depressive symptoms (19%; CES-D score 16-26): having serodiscordant unprotected anal sex with a casual male partner and being diagnosed with an STD in the prior 12 months; (3) severe depressive symptoms (14%; CES-D score 27+): being publicly insured by Medicaid and reporting difficulty accessing healthcare in the past 12 months. Moderately depressed Black MSM may be more likely to engage in behaviors that place them at increased risk for HIV and other STDs. HIV prevention interventions for Black MSM may benefit from incorporating screening and/or treatment for depression, allowing MSM who are depressed to respond more effectively to behavioral change approaches.
authors.affiliation: The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215, USA. sreisner@fenwayhealth.org
authors.forename: Sari L
authors.initials: SL
authors.lastname: Reisner
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Mimiaga
authors.forename: Margie
authors.initials: M
authors.lastname: Skeer
authors.forename: Donna
authors.initials: D
authors.lastname: Bright
authors.forename: Kevin
authors.initials: K
authors.lastname: Cranston
authors.forename: Deborah
authors.initials: D
authors.lastname: Isenberg
authors.forename: Sean
authors.initials: S
authors.lastname: Bland
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Barker
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
mesh_terms: D000328:Adult; D044383:Black People; D003863:Depression / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology*; D006678:HIV; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D012725:Sexual Behavior / Q000208:ethnology / Q000523:psychology*; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000208:ethnology; D012959:Socioeconomic Factors; D055815:Young Adult; D001741:Black or African American