title: Depression and sexual dysfunction among HIV-positive and HIV-negative men who have sex with men: mediation by use of antidepressants and recreational stimulants.
abstract: Erectile dysfunction and other forms of sexual dysfunction are highly prevalent among HIV+ men who have sex with men (MSM). Research has not previously identified the mechanisms by which depression may be associated with sexual dysfunction among HIV-positive and HIV-seronegative (HIV-negative) MSM. The present study examined the role of antidepressant use, stimulant use, and smoking as mediators of the relation between depression and sexual dysfunction among HIV-positive and HIV-negative MSM. Participants enrolled in the Multicenter AIDS Cohort Study, an ongoing prospective study of the natural and treated histories of HIV infection among MSM in the United States, completed a modified version of the International Index of Erectile Function for MSM. The study sample included 1,363 participants, with 619 HIV-positive men and 744 HIV-negative men. A structural equation model examined depression as a predictor of subsequent sexual dysfunction, mediated by antidepressant use, stimulant use, and smoking. Depression predicted subsequent sexual function among both HIV-negative and HIV-positive MSM. This effect appeared to be both a direct effect and an indirect effect via antidepressant use. Findings suggest that antidepressant medication use may partially explain sexual dysfunction among MSM.
authors.affiliation: Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada, trevor.hart@ryerson.ca.
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Hart
authors.forename: Brian
authors.initials: B
authors.lastname: Mustanski
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Ryan
authors.forename: Pamina M
authors.initials: PM
authors.lastname: Gorbach
authors.forename: Ron D
authors.initials: RD
authors.lastname: Stall
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Surkan
authors.forename: Michael
authors.initials: M
authors.lastname: Plankey
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003863:Depression / Q000188:drug therapy*; D007172:Erectile Dysfunction / Q000188:drug therapy*; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D017008:Negotiating; D015995:Prevalence; D011446:Prospective Studies; D012907:Smoking; D014481:United States
chemical_list: D000928:Antidepressive Agents; D013287:Illicit Drugs