Fluctuations in depression and well-being are associated with sexual risk episodes among HIV-positive men.
OBJECTIVE
Research has suggested a weak association between depression and sexual risk behavior in men who have sex with men (MSM). The purpose of this study was to investigate the relationship between within-person fluctuations in depression and well-being and episodes of sexual risk-taking among HIV-positive MSM.


METHODS
One hundred six sexually active HIV-positive MSM living in New York City completed a structured weekly survey over 6 weeks. In Weeks 1, 3, and 5, they responded to items assessing their sexual behavior, depression, and well-being in the prior week. Multilevel logistic regression analyses were conducted to explore the relationship between changes in levels of depression and well-being, and episodes of unprotected anal intercourse (UAI).


RESULTS
Within-person deviations from participants' average levels of depression and well-being were associated with the probability of risk. The probability of a risk episode was higher in weeks when depression was higher than participants' average levels (any UAI episode: odd ratio [OR] = 1.71, 95% confidence interval [CI] [1.00, 2.90], p < .05; serodiscordant UAI episode: OR = 2.49, 95% CI [1.31, 4.73], p < .05). The probability of a risk episode was lower in weeks when well-being was higher than participants' average levels (any UAI: OR = 0.40, 95% CI [0.22, 0.74], p < .05; serodiscordant UAI: OR = 0.42, 95% CI [0.22, 0.81], p < .05). Between-person differences in depression and well-being were not associated with risk episodes (ps > .05).


CONCLUSIONS
This study is among the first to examine the association of within-person changes in depression and well-being with sexual risk behavior in a diverse sample. It contributes new evidence to literature exploring the relationship between depression and sexual risk. Future research should employ longitudinal designs to explore pathways linking within-person changes in depression with risk behavior.
Department of Sociomedical Sciences, Columbia University Mailman School of Public Health.
Patrick A
PA
Wilson
Department of Psychology, Columbia University.
Gertraud
G
Stadler
Department of Sociomedical Sciences, Columbia University Mailman School of Public Health.
Melissa R
MR
Boone
Department of Psychology, Columbia University.
Niall
N
Bolger
D000328:Adult; D003863:Depression / Q000453:epidemiology* / Q000523:psychology*; D006679:HIV Seropositivity; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D009519:New York City / Q000453:epidemiology; D010549:Personal Satisfaction; D018570:Risk Assessment; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data