Reisner Sari L, Mimiaga Matthew J, Skeer Margie, Bright Donna, Cranston Kevin, Isenberg Deborah, Bland Sean, Barker Thomas A, Mayer Kenneth H
The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA 02215, USA.
AIDS Behav. 2009 Aug;13(4):798-810. doi: 10.1007/s10461-009-9571-9. Epub 2009 May 22.
High rates of depression have been observed among men who have sex with men (MSM) relative to the general adult male population; however, a dearth of research has explored depression among Black MSM. Black MSM (n = 197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered quantitative assessment and voluntary HIV counseling and testing. Bivariate and multivariable logistic regression procedures examined the associations of demographics, behavioral HIV risk factors, and psychosocial variables with depressive symptoms by severity, using the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Adjusting for demographic and behavioral variables, significant factors associated with (1) clinically significant depressive symptoms (33%; CES-D score > or = 16): being publicly insured by Medicaid, having serodiscordant anal sex with a casual male partner, and being diagnosed with an STD in the prior 12 months; (2) moderate depressive symptoms (19%; CES-D score 16-26): having serodiscordant unprotected anal sex with a casual male partner and being diagnosed with an STD in the prior 12 months; (3) severe depressive symptoms (14%; CES-D score 27+): being publicly insured by Medicaid and reporting difficulty accessing healthcare in the past 12 months. Moderately depressed Black MSM may be more likely to engage in behaviors that place them at increased risk for HIV and other STDs. HIV prevention interventions for Black MSM may benefit from incorporating screening and/or treatment for depression, allowing MSM who are depressed to respond more effectively to behavioral change approaches.
与一般成年男性人群相比，男男性行为者（MSM）中抑郁症的发病率较高；然而，针对黑人男男性行为者抑郁症的研究却十分匮乏。通过改良的应答驱动抽样法招募的197名黑人男男性行为者于2008年1月至7月间完成了一项由访谈员实施的定量评估以及自愿的HIV咨询与检测。采用20项流行病学研究中心抑郁量表（CES-D），双变量和多变量逻辑回归程序按严重程度检验了人口统计学、行为学HIV风险因素以及心理社会变量与抑郁症状之间的关联。在对人口统计学和行为学变量进行调整后，与以下情况相关的显著因素包括：（1）具有临床意义的抑郁症状（33%；CES-D评分≥16）：通过医疗补助获得公共保险、与随意的男性伴侣进行血清学不一致的肛交以及在过去12个月内被诊断患有性传播疾病；（2）中度抑郁症状（19%；CES-D评分16 - 26）：与随意的男性伴侣进行血清学不一致的无保护肛交以及在过去12个月内被诊断患有性传播疾病；（3）重度抑郁症状（14%；CES-D评分27及以上）：通过医疗补助获得公共保险以及报告在过去12个月内难以获得医疗保健服务。中度抑郁的黑人男男性行为者可能更有可能从事使其感染HIV和其他性传播疾病风险增加的行为。针对黑人男男性行为者的HIV预防干预措施可能会受益于纳入抑郁症筛查和/或治疗，从而使抑郁的男男性行为者能够更有效地应对行为改变方法。
