Chen Yea-Hung, Raymond Henry Fisher
a Department of Public Health , Center for Public Health Research , San Francisco , USA.
b Department of Epidemiology and Biostatistics , University of California , San Francisco , USA.
AIDS Care. 2017 Dec;29(12):1538-1542. doi: 10.1080/09540121.2017.1307925. Epub 2017 Apr 1.
HIV prevention plans for men who have sex with men (MSM) are often multifaceted. They involve reduction of sexual risk behaviors, such as condomless intercourse, but also often include pharmaceutical approaches, such as early treatment of HIV-infected individuals with antiretroviral therapy (ART). Effectiveness is possibly threatened by individual-level factors, such as depression. In this study of 322 San Francisco MSM (240 HIV-uninfected individuals and 82 HIV-infected individuals, according to self-report), we examine associations between depressive syndromes and HIV risk behaviors (sexual risk behaviors and ART non-adherence). Our study failed to find evidence that depressive syndromes lead to increases in ART non-adherence (risk difference, RD: 27.9; 95% confidence interval, CI: -3.5, 59.3). However, the study does suggest an association between depressive syndromes and concurrence of non-adherence and potentially HIV-discordant condomless receptive anal intercourse (RD: 36.0; 95% CI: 5.2, 66.8). Among HIV-uninfected MSM, our study suggests negative associations between depressive syndromes and sexual risk behaviors. We recommend screening and treatment of depression among HIV-infected MSM.
针对男男性行为者（MSM）的艾滋病毒预防计划通常是多方面的。这些计划包括减少性风险行为，如无保护性行为，但也常常包括药物治疗方法，比如对艾滋病毒感染者尽早采用抗逆转录病毒疗法（ART）进行治疗。有效性可能会受到个体层面因素的威胁，比如抑郁症。在这项针对322名旧金山男男性行为者的研究中（根据自我报告，其中240名未感染艾滋病毒，82名感染了艾滋病毒），我们研究了抑郁综合征与艾滋病毒风险行为（性风险行为和抗逆转录病毒疗法不依从）之间的关联。我们的研究未能找到证据表明抑郁综合征会导致抗逆转录病毒疗法不依从性增加（风险差异，RD：27.9；95%置信区间，CI：-3.5，59.3）。然而，该研究确实表明抑郁综合征与不依从以及潜在的艾滋病毒不一致的无保护被动肛交行为同时发生之间存在关联（RD：36.0；95%CI：5.2，66.8）。在未感染艾滋病毒的男男性行为者中，我们的研究表明抑郁综合征与性风险行为之间存在负相关。我们建议对感染艾滋病毒的男男性行为者进行抑郁症筛查和治疗。
