Storholm Erik David, Satre Derek D, Kapadia Farzana, Halkitis Perry N
Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA.
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Arch Sex Behav. 2016 Aug;45(6):1431-41. doi: 10.1007/s10508-015-0566-5. Epub 2015 Aug 27.
Young gay, bisexual, and other men who have sex with men (YMSM) are at increased likelihood of experiencing depression and engaging in condomless sexual behaviors. The goal of the current investigation was to examine the relationship between negative mood and compulsive sexual behavior (CSB) and to assess for their individual and combined influence on sexual risk-taking behavior among a diverse sample of YMSM in New York City (the P18 Cohort Study). We first analyzed sociodemographic, depressive symptoms, CSB, and sexual risk-taking from the cross-sectional data of 509, 18- or 19-year-old YMSM recruited using non-probability sampling. We found a significant positive correlation between CSB and depression and between CSB and frequency of condomless anal sex acts reported over the last 30 days. Multivariate results found that the presence of both depression and CSB contributed to elevated sexual risk-taking among these urban YMSM. Clinical implications include the importance of assessing for CSB when depression is present and vice versa in order to improve HIV prevention. Informed by minority stress theory and syndemic theory, our results suggest that interventions focused on the health of YMSM recognize that mental health and social context all interact to increase physical health vulnerability vis-a-vis sexual behaviors, depression, and CSB. Thus, HIV prevention and intervention programs need to incorporate mental health components and services that address these needs.
年轻的男同性恋者、双性恋者以及其他与男性发生性行为的男性（YMSM）出现抑郁和进行无保护性行为的可能性更高。本次调查的目的是研究负面情绪与强迫性性行为（CSB）之间的关系，并评估它们对纽约市不同YMSM样本（P18队列研究）中性冒险行为的个体影响及综合影响。我们首先分析了通过非概率抽样招募的509名18或19岁YMSM的横断面数据中的社会人口统计学、抑郁症状、CSB和性冒险情况。我们发现CSB与抑郁之间以及CSB与过去30天内报告的无保护肛交行为频率之间存在显著正相关。多变量结果发现，抑郁和CSB的同时存在导致这些城市YMSM的性冒险行为增加。临床意义包括，当存在抑郁时评估CSB的重要性，反之亦然，以改善艾滋病毒预防。基于少数群体压力理论和共病理论，我们的结果表明，针对YMSM健康的干预措施认识到心理健康和社会环境都会相互作用，增加在性行为、抑郁和CSB方面的身体健康脆弱性。因此，艾滋病毒预防和干预项目需要纳入解决这些需求的心理健康组成部分和服务。
