Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
Psychol Health Med. 2009 Dec;14(6):705-15. doi: 10.1080/13548500903334754.
Men who have sex with men (MSM) in India are a hidden population, facing unique environmental stressors and cultural pressures that place them at risk for depression. Depression may affect HIV risk behavior in MSM, and may affect the degree to which MSM may benefit from HIV prevention interventions. Depression in MSM in India, however, has largely been understudied. Two hundred ten MSM in Chennai completed an interviewer-administered behavioral assessment battery, which included the 20-item Center for Epidemiologic Studies Depression Scale (CES-D), demographics, sexual risk and identity, and other psychosocial variables. Over half (55%) of the sample exceeded the cutoff (CES-D >or= 16) to screen in for clinically significant depressive symptoms; this was associated with having had unprotected anal sex (OR = 1.97; 95% CI: 1.01-3.87) and higher number of male partners (OR = 1.04; 95% CI: 1.01-1.07). Statistically significant bivariate predictors of meeting the screen in for depressive symptoms included sexual identity (Kothi > Panthi; OR = 4.90; 95% CI: 2.30-10.54), not being married (OR = 3.40; 95% CI: 1.72-6.81), not having a child (OR = 4.40; 95% CI: 2.07-9.39), family not knowing about one's MSM identity (OR = 2.30; 95% CI: 1.18-4.90), having been paid for sex (OR = 5.10; p 95% CI: 2.87-9.47), and perceiving that one is at risk for acquiring HIV (OR = 1.10; 95% CI: 1.02-1.17; continuous). In a multivariable logistic-regression model, unique predictors of screening in for depressive symptoms included not being married (AOR = 3.10; 95% CI: 1.23-7.65), having been paid for sex (AOR = 3.80; 95% CI: 1.87-7.99) and the perception of increased risk for HIV (AOR = 1.10; 95% CI: 1.03-1.21; continuous); unprotected anal sex in the 3 months prior to study enrollment approached statistical significance (AOR = 2.00; 95% CI: 0.91-4.48). Depression among MSM in Chennai is of concern and should be considered while developing HIV prevention interventions with this population. MSM who are not married, sex workers, and those who perceive they are at risk for acquiring HIV may be of higher risk for symptoms of depression.
男男性行为者（MSM）在印度是一个隐藏的群体，他们面临着独特的环境压力和文化压力，使他们面临抑郁的风险。抑郁可能会影响 MSM 的艾滋病毒风险行为，也可能影响 MSM 从艾滋病毒预防干预中受益的程度。然而，印度的 MSM 抑郁问题在很大程度上仍未得到研究。110 名钦奈的 MSM 完成了一项由访谈者管理的行为评估工具包，其中包括 20 项流行病学研究中心抑郁量表（CES-D）、人口统计学、性风险和身份以及其他社会心理变量。样本中有超过一半（55%）的人超过了筛选有临床显著抑郁症状的截止值（CES-D > 或 = 16）；这与无保护肛交（OR = 1.97；95%CI：1.01-3.87）和性伴侣数量较多（OR = 1.04；95%CI：1.01-1.07）有关。符合抑郁症状筛选标准的有统计学意义的双变量预测因素包括性身份（Kothi > Panthi；OR = 4.90；95%CI：2.30-10.54）、未婚（OR = 3.40；95%CI：1.72-6.81）、没有孩子（OR = 4.40；95%CI：2.07-9.39）、家人不知道自己的 MSM 身份（OR = 2.30；95%CI：1.18-4.90）、卖淫（OR = 5.10；p < 0.001；95%CI：2.87-9.47）和认为自己有感染艾滋病毒的风险（OR = 1.10；95%CI：1.02-1.17；连续）。在多变量逻辑回归模型中，筛选抑郁症状的独特预测因素包括未婚（AOR = 3.10；95%CI：1.23-7.65）、卖淫（AOR = 3.80；95%CI：1.87-7.99）和对艾滋病毒风险增加的认知（AOR = 1.10；95%CI：1.03-1.21；连续）；研究入组前 3 个月无保护肛交接近统计学意义（AOR = 2.00；95%CI：0.91-4.48）。钦奈 MSM 的抑郁问题令人关注，在为该人群制定艾滋病毒预防干预措施时应予以考虑。未婚、性工作者和认为自己有感染艾滋病毒风险的 MSM 可能有更高的抑郁症状风险。
