Depression and HIV Risk Taking among Men Who Have Sex with Other Men (MSM) and Who Use the Internet to Find Partners for Unprotected Sex

PURPOSE: This study examines the prevalence of depression in a sample of men who are at high risk for the transmission of HIV. It also looks at the relationship between depressive symptomatology and involvement in HIV risk behaviors, and at the factors associated with greater/lesser depressive symptomatology. METHODS: The data come from a national sample of men, randomly chosen, who used any of 16 websites specifically to identify other men with whom they could engage in unprotected sex. Data were collected between January 2008 and May 2009 from 332 men, via telephone interviews. Multivariate analyses and structural equation modeling were used to test a conceptual model based on Syndemics Theory. RESULTS: Depression was much more prevalent in this population (26.7%) than among men in the general U.S. population. Depression was not found to be related directly to any of the HIV risk behaviors in question. It was, however, related to men's attitudes toward condom use, which was the single strongest predictor of their involvement in HIV-related risky behaviors. Multivariate analysis revealed five factors that were associated with greater levels of depression: lower educational attainment, greater discrimination based on sexual orientation, greater levels of eroticizing ejaculatory fluids, recently experiencing more substance abuse problems, and greater amounts of childhood maltreatment. CONCLUSIONS: Depression is a consequential problem in this population. Although depression does not appear to be related directly to HIV risk practices in this population, its influence cannot be discounted because of its effects on other key predictors of risk involvement.