Role of substance use in explaining fluctuations in mental and physical health among HIV+ MSM

Background: Depression and decreased health due to HIV are likely to be issues among HIV + men who have sex with men (MSM). These men are also more likely to engage in substance use than other populations. Observing patterns in levels of depression and HIV-related health, and corresponding substance use, is important to understanding health and well-being among men in this population. Research has suggested there is a relationship between mental and physical health and substance use among HIV+ MSM. However, the directionality of the relationship remains unclear.

Methods: An ethnically diverse sample of 100 HIV+ MSM completed depression and health measures four times over an 8-week period. Depression was assessed using the Center for Epidemiological Studies – Depression (CES-D) and the Functional Assessment of HIV Infection (FAHI). Participants also completed weekly measures that gauged substance use behaviors occurring in the prior week. Latent growth curve modeling and random effects regression analysis were used to analyze the data.

Results: Analyses revealed substantial fluctuations over time in levels of depression and HIV-related health. Substance use predicted levels of depression and physical health, suggesting a causal relationship between current substance use and future mental and physical health.

Conclusions: The interplay among substance use, mental health, and physical health among HIV+ MSM deserves further exploration. The current findings suggest that substance use is an important factor predicting poor health outcomes among these men, and that prevention and treatment interventions should incorporate substance use in promoting health among HIV+ MSM.