title: Lifetime Doctor-Diagnosed Mental Health Conditions and Current Substance Use Among Gay and Bisexual Men Living in Vancouver, Canada.
abstract: Studies have found that gay, bisexual, and other men who have sex with men (GBM) have higher rates of mental health conditions and substance use than heterosexual men, but are limited by issues of representativeness.
  
  
  
  To determine the prevalence and correlates of mental health disorders among GBM in Metro Vancouver, Canada.
  
  
  
  From 2012 to 2014, the Momentum Health Study recruited GBM (≥16 years) via respondent-driven sampling (RDS) to estimate population parameters. Computer-assisted self-interviews (CASI) collected demographic, psychosocial, and behavioral information, while nurse-administered structured interviews asked about mental health diagnoses and treatment. Multivariate logistic regression using manual backward selection was used to identify covariates for any lifetime doctor diagnosed: (1) alcohol/substance use disorder and (2) any other mental health disorder.
  
  
  
  Of 719 participants, 17.4% reported a substance use disorder and 35.2% reported any other mental health disorder; 24.0% of all GBM were currently receiving treatment. A lifetime substance use disorder diagnosis was negatively associated with being a student (AOR = 0.52, 95% CI [confidence interval]: 0.27-0.99) and an annual income ≥$30,000 CAD (AOR = 0.38, 95% CI: 0.21-0.67) and positively associated with HIV-positive serostatus (AOR = 2.54, 95% CI: 1.63-3.96), recent crystal methamphetamine use (AOR = 2.73, 95% CI: 1.69-4.40) and recent heroin use (AOR = 5.59, 95% CI: 2.39-13.12). Any other lifetime mental health disorder diagnosis was negatively associated with self-identifying as Latin American (AOR = 0.25, 95% CI: 0.08-0.81), being a refugee or visa holder (AOR = 0.18, 95% CI: 0.05-0.65), and living outside Vancouver (AOR = 0.52, 95% CI: 0.33-0.82), and positively associated with abnormal anxiety symptomology scores (AOR = 3.05, 95% CI: 2.06-4.51).
  
  
  
  Mental health conditions and substance use, which have important implications for clinical and public health practice, were highly prevalent and co-occurring.
authors.affiliation: a School of Public Health & Social Policy , University of Victoria , Victoria , Canada.|b Centre for Addictions Research British Columbia , Victoria , Canada.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Lachowsky
authors.affiliation: c British Columbia Centre for Excellence in HIV/AIDS , Vancouver , Canada.
authors.forename: Joshun J S
authors.initials: JJ
authors.lastname: Dulai
authors.affiliation: c British Columbia Centre for Excellence in HIV/AIDS , Vancouver , Canada.
authors.forename: Zishan
authors.initials: Z
authors.lastname: Cui
authors.affiliation: c British Columbia Centre for Excellence in HIV/AIDS , Vancouver , Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Sereda
authors.affiliation: c British Columbia Centre for Excellence in HIV/AIDS , Vancouver , Canada.
authors.forename: Ashleigh
authors.initials: A
authors.lastname: Rich
authors.affiliation: d Department of Psychiatry , University of California, San Diego , La Jolla , California , USA.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Patterson
authors.affiliation: e School of Population and Public Health , University of British Columbia , Vancouver , Canada.
authors.forename: Trevor T
authors.initials: TT
authors.lastname: Corneil
authors.affiliation: c British Columbia Centre for Excellence in HIV/AIDS , Vancouver , Canada.|f Faculty of Medicine , University of British Columbia , Vancouver , Canada.
authors.forename: Julio S G
authors.initials: JS
authors.lastname: Montaner
authors.affiliation: a School of Public Health & Social Policy , University of Victoria , Victoria , Canada.|b Centre for Addictions Research British Columbia , Victoria , Canada.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Roth
authors.affiliation: c British Columbia Centre for Excellence in HIV/AIDS , Vancouver , Canada.|g Faculty of Health Sciences , Simon Fraser University , Burnaby , Canada.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Hogg
authors.affiliation: c British Columbia Centre for Excellence in HIV/AIDS , Vancouver , Canada.|f Faculty of Medicine , University of British Columbia , Vancouver , Canada.
authors.forename: David M
authors.initials: DM
authors.lastname: Moore
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000453:epidemiology; D001955:British Columbia / Q000453:epidemiology; D006679:HIV Seropositivity / Q000453:epidemiology; D006556:Heroin Dependence / Q000453:epidemiology; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012307:Risk Factors; D000072339:Sexual and Gender Minorities / Q000523:psychology / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*
keywords: Anxiety; depression; drug use; mental illness; sexual minority; syndemics