title: Depression and HIV risk among men who have sex with men in Tanzania.
abstract: Studies have shown high rates of depression among men who have sex with men (MSM) in developed countries. Studies have also shown association between depression and HIV risk among MSM. However, very little research has been done on depression among African MSM. We assessed depression and HIV risk among a sample of MSM in Tanzania. We reviewed data on 205 MSM who were recruited from two Tanzanian cities using the respondent driven sampling method. Demographic and behavioral data were collected using a structured questionnaire. HIV and sexually transmitted infections data were determined from biological tests. Depression scores were assessed using the Patient Health Questionnaire (PHQ-9). For the analysis, depression scores were dichotomized as depressed (PHQ > 4) and not depressed (PHQ ≤ 4). Bivariate and multivariable Poisson regression analyses were conducted to assess factors associated with depression. The prevalence of depression in the sample was 46.3%. The mean (±SD) age of the sample was 25 (±5) years. In bivariate analysis, depression was associated with self-identifying as gay (p = .001), being HIV positive (p < .001: <8% of MSM knew they were HIV infected) and having a high number of sexual partners in the last 6 months (p = .001). Depression was also associated with sexual (p = .007), physical (p = .003) and verbal (p < .001) abuse. In the Poisson regression analysis, depression was associated with verbal abuse (APR = 1.91, CI = 1.30-2.81). Depression rates were high among MSM in Tanzania. It is also associated with abuse, HIV and HIV risk behaviors. Thus, reducing the risk of depression may be helpful in reducing the risk of HIV among MSM in Africa. We recommend the colocation of mental health and HIV preventive services as a cost-effective means of addressing both depression and HIV risk among MSM in Africa.
authors.affiliation: a Department of Epidemiology, Human Genetics and Environmental Sciences , The University of Texas School of Public Health , Houston , TX , USA.
authors.forename: Hycienth
authors.initials: H
authors.lastname: Ahaneku
authors.affiliation: b Department of Family Medicine and Community Health , University of Minnesota , Minneapolis , MN , USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Ross
authors.affiliation: c Department of Sociology and Anthropology , University of Dar es Salaam , Dar es Salaam , Tanzania.
authors.forename: Joyce E
authors.initials: JE
authors.lastname: Nyoni
authors.affiliation: a Department of Epidemiology, Human Genetics and Environmental Sciences , The University of Texas School of Public Health , Houston , TX , USA.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Selwyn
authors.affiliation: d Department of Management, Policy and Community Health , The University of Texas School of Public Health , Houston , TX , USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Troisi
authors.affiliation: e Department of Psychiatry , Muhimbili University of Health Sciences , Dar es Salaam , Tanzania.
authors.forename: Jessie
authors.initials: J
authors.lastname: Mbwambo
authors.affiliation: f Department of Health Promotion and Behavioral Sciences , The University of Texas School of Public Health , Houston , TX , USA.
authors.forename: Adeniyi
authors.initials: A
authors.lastname: Adeboye
authors.affiliation: f Department of Health Promotion and Behavioral Sciences , The University of Texas School of Public Health , Houston , TX , USA.
authors.forename: Sheryl
authors.initials: S
authors.lastname: McCurdy
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012309:Risk-Taking; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D013636:Tanzania / Q000453:epidemiology
keywords: Africa; HIV; Men who have sex with men; Tanzania; depression