Background/introduction In the UK, HIV transmission remains ongoing among men who have sex with men (MSM). Data on mental health and sexual behaviour is limited among MSM whose HIV-status is negative/unknown.
Aim(s)/objectives To describe the association of depressive symptoms with measures of condomless sex (CLS).
Methods AURAH (Attitudes to, and Understanding of, Risk of Acquisition of HIV) is a cross-sectional questionnaire study in 20 UK STI clinics. We included MSM recruited from May 2013–January 2014 who reported anal sex in the past three months. Depressive symptoms were defined as a PHQ-9 score ≥10. We examined the association of depressive symptoms with: CLS in the past three months with (i) ≥2 partners (ii) discordant status partner(s) (unknown/HIV-positive) and self-reported STI diagnosis in the past year, using logistic regression.
Results Of 457 MSM included (20% non-white, mean[IQR] age 33), 130 (29%), 167 (37%) and 184 (40%) reported ≥2 CLS partners, discordant CLS and diagnosed STI respectively. Fifty-nine men (13%) had depressive symptoms; 78% of whom were not receiving treatment for depression. Adjusting for age, non-white ethnicity, university education, having a stable partner and recruitment region, depressive symptoms were associated with ≥2 CLS partners [adjusted OR (95% CI): 1.83 (1.01, 3.31), p = 0.048], discordant CLS [2.67 (1.49, 4.77), p = 0.001] and diagnosed STI [2.03 (1.13, 3.63), p = 0.017].
Discussion/conclusion Depressive symptoms are associated with CLS and recent STI among MSM. Management of mental health may play a role in HIV/STI prevention, although causality cannot be inferred and other factors may influence both sexual behaviour and depression.
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