title: Gradients in Depressive Symptoms by Socioeconomic Position Among Men Who Have Sex With Men in the EXPLORE Study.
abstract: This study examines gradients in depressive symptoms by socioeconomic position (SEP; i.e., income, education, employment) in a sample of men who have sex with men (MSM). Data were used from EXPLORE, a randomized, controlled behavioral HIV prevention trial for HIV-uninfected MSM in six U.S. cities (n = 4,277). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale (short form). Multiple linear regressions were fitted with interaction terms to assess additive and multiplicative relationships between SEP and depressive symptoms. Depressive symptoms were more prevalent among MSM with lower income, lower educational attainment, and those in the unemployed/other employment category. Income, education, and employment made significant contributions in additive models after adjustment. The employment-income interaction was statistically significant, indicating a multiplicative effect. This study revealed gradients in depressive symptoms across SEP of MSM, pointing to income and employment status and, to a lesser extent, education as key factors for understanding heterogeneity of depressive symptoms.
authors.affiliation: a School of Population and Public Health , University of British Columbia , Vancouver , British Columbia , Canada.
authors.forename: Basia
authors.initials: B
authors.lastname: Pakula
authors.affiliation: b Department of Epidemiology , Brown University School of Public Health , Providence , Rhode Island , USA.
authors.forename: Brandon D L
authors.initials: BD
authors.lastname: Marshall
authors.affiliation: a School of Population and Public Health , University of British Columbia , Vancouver , British Columbia , Canada.
authors.forename: Jean A
authors.initials: JA
authors.lastname: Shoveller
authors.affiliation: c Osher Center for Integrative Medicine , University of California San Francisco , San Francisco, California , USA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Chesney
authors.affiliation: d UCLA Center for World Health, Center for Health Sciences , University of California , Los Angeles , California , USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Coates
authors.affiliation: e Laboratory of Infectious Disease Prevention , New York Blood Center , New York , New York , USA.
authors.forename: Beryl
authors.initials: B
authors.lastname: Koblin
authors.affiliation: f Department of Medicine , The Fenway Institute, Harvard Medical School , Boston , Massachusetts , USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mayer
authors.affiliation: g Department of Epidemiology, Harvard School of Public Health, and Department of Psychiatry, Harvard Medical School , The Fenway Institute , Boston , Massachusetts , USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Mimiaga
authors.affiliation: h Department of Behavioral and Social Sciences , Brown University School of Public Health , Providence , Rhode Island , USA.
authors.forename: Don
authors.initials: D
authors.lastname: Operario
mesh_terms: D000293:Adolescent; D000328:Adult; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D004651:Employment; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007182:Income; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Depression; MSM; epidemiology; gradients; population health