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The additive effects of depressive symptoms and polysubstance use on HIV risk among gay, bisexual, and other men who have sex with men

The additive effects of depressive symptoms and polysubstance use on HIV risk among gay, bisexual, and other men who have sex with men
The additive effects of depressive symptoms and polysubstance use on HIV risk among gay, bisexual, and other men who have sex with men
Introduction
Among gay, bisexual, and other men who have sex with men (GBM), collinearity between polysubstance use and mental health concerns has obscured their combined effects on HIV risk with multivariable results often highlighting only one or the other.

Methods
We used mediation and moderation analyses to examine the effects of polysubstance use and depressive symptoms on high-risk sex (i.e., condomless anal sex with serodiscordant/unknown status partner) in a sample of sexually-active GBM, aged ≥16 years, recruited in Metro Vancouver using respondent driven sampling. Hospital Anxiety and Depression Scale scores assessed mental health. Alcohol Use Disorder Identification Test scores assessed alcohol disorders. Poly-use of multiple drug types (e.g., stimulants, sedatives, opiates, hallucinogens) was assessed over the previous six months.

Results
Among 719 predominantly white (68.0%), gay-identified (80.7%) GBM, alcohol use was not associated with increased prevalence of high-risk sex. Controlling for demographic factors and partner number, an interaction between polysubstance use and depressive symptoms revealed that the combined effects were additively associated with increased odds for high-risk sex. Mediation models showed that polysubstance use partially mediated the relationship between depressive symptoms and high-risk sex.

Conclusion
An interaction effect between polysubstance use (defined by using 3 or more substances in the past six months) and depressive symptoms (defined by HADS scores) revealed that the combination of these factors was associated with increased risk for high-risk sex – supporting a syndemic understanding of the production of HIV risk.
0306-4603
158-165
Card, Kiffer G.
4bece098-5a9b-46cf-a64e-615f14acce73
Lachowsky, Nathan J.
87634bac-759c-4e7b-9f16-22fb37e87cf6
Armstrong, Heather L.
3dc9c223-1a61-47ad-ab0b-50d06cddf4f2
Cui, Zishan
298721d1-0246-4602-9120-c626eec8b142
Wang, Lu
ba6444ab-4021-438b-b126-2cab56dcfb0d
Sereda, Paul
7b1e0f3a-2477-4bc7-9f65-910dee84a320
Jollimore, Jody
61140450-bdfb-421f-96f5-5a62f7833332
Patterson, Thomas L.
4c6e5206-8275-4e30-8749-e1e045c8d483
Corneil, Trevor
e36b4b42-79b2-403c-89ea-48898d300886
Hogg, Robert S.
3f71ad69-9c8a-4732-bb86-4aa0652e1f3f
Roth, Eric A.
4900d79c-ac00-475b-8bb9-e96243905ca7
Moore, David M.
b3bb7f8f-4409-412e-959b-bcda959a8d2d
Card, Kiffer G.
4bece098-5a9b-46cf-a64e-615f14acce73
Lachowsky, Nathan J.
87634bac-759c-4e7b-9f16-22fb37e87cf6
Armstrong, Heather L.
3dc9c223-1a61-47ad-ab0b-50d06cddf4f2
Cui, Zishan
298721d1-0246-4602-9120-c626eec8b142
Wang, Lu
ba6444ab-4021-438b-b126-2cab56dcfb0d
Sereda, Paul
7b1e0f3a-2477-4bc7-9f65-910dee84a320
Jollimore, Jody
61140450-bdfb-421f-96f5-5a62f7833332
Patterson, Thomas L.
4c6e5206-8275-4e30-8749-e1e045c8d483
Corneil, Trevor
e36b4b42-79b2-403c-89ea-48898d300886
Hogg, Robert S.
3f71ad69-9c8a-4732-bb86-4aa0652e1f3f
Roth, Eric A.
4900d79c-ac00-475b-8bb9-e96243905ca7
Moore, David M.
b3bb7f8f-4409-412e-959b-bcda959a8d2d

Card, Kiffer G., Lachowsky, Nathan J., Armstrong, Heather L., Cui, Zishan, Wang, Lu, Sereda, Paul, Jollimore, Jody, Patterson, Thomas L., Corneil, Trevor, Hogg, Robert S., Roth, Eric A. and Moore, David M. (2018) The additive effects of depressive symptoms and polysubstance use on HIV risk among gay, bisexual, and other men who have sex with men. Addictive Behaviors, 82, 158-165. (doi:10.1016/j.addbeh.2018.03.005).

Record type: Article

Abstract

Introduction
Among gay, bisexual, and other men who have sex with men (GBM), collinearity between polysubstance use and mental health concerns has obscured their combined effects on HIV risk with multivariable results often highlighting only one or the other.

Methods
We used mediation and moderation analyses to examine the effects of polysubstance use and depressive symptoms on high-risk sex (i.e., condomless anal sex with serodiscordant/unknown status partner) in a sample of sexually-active GBM, aged ≥16 years, recruited in Metro Vancouver using respondent driven sampling. Hospital Anxiety and Depression Scale scores assessed mental health. Alcohol Use Disorder Identification Test scores assessed alcohol disorders. Poly-use of multiple drug types (e.g., stimulants, sedatives, opiates, hallucinogens) was assessed over the previous six months.

Results
Among 719 predominantly white (68.0%), gay-identified (80.7%) GBM, alcohol use was not associated with increased prevalence of high-risk sex. Controlling for demographic factors and partner number, an interaction between polysubstance use and depressive symptoms revealed that the combined effects were additively associated with increased odds for high-risk sex. Mediation models showed that polysubstance use partially mediated the relationship between depressive symptoms and high-risk sex.

Conclusion
An interaction effect between polysubstance use (defined by using 3 or more substances in the past six months) and depressive symptoms (defined by HADS scores) revealed that the combination of these factors was associated with increased risk for high-risk sex – supporting a syndemic understanding of the production of HIV risk.

Full text not available from this repository.

More information

Accepted/In Press date: 4 March 2018
e-pub ahead of print date: 6 March 2018
Published date: 1 July 2018

Identifiers

Local EPrints ID: 430033
URI: http://eprints.soton.ac.uk/id/eprint/430033
ISSN: 0306-4603
PURE UUID: e7fa9f90-cdeb-431f-9e54-3f2dd8993528
ORCID for Heather L. Armstrong: ORCID iD orcid.org/0000-0002-1071-8644

Catalogue record

Date deposited: 10 Apr 2019 16:30
Last modified: 17 Dec 2019 01:22

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Contributors

Author: Kiffer G. Card
Author: Nathan J. Lachowsky
Author: Zishan Cui
Author: Lu Wang
Author: Paul Sereda
Author: Jody Jollimore
Author: Thomas L. Patterson
Author: Trevor Corneil
Author: Robert S. Hogg
Author: Eric A. Roth
Author: David M. Moore

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