Anxiety and depression strongly associated with sexual risk behaviors among networks of young men in Dar es Salaam, Tanzania

Abstract

This study tested the association between mental health scores and sexual risk behaviors among male members of social groups known as “camps” in Dar es Salaam, Tanzania. Anxiety and depression were measured using the HSCL-25 and condom use and sexual partner concurrency were assessed through self-report. 1113 sexually active men with an average age of 27 years were included in the analyses. Higher anxiety and depression scores were significantly associated with both condom use (Anxiety AOR=0.58, 95% CI: 0.44, 0.77; Depression AOR=0.60, 95% CI: 0.47, 0.77) and concurrency (Anxiety AOR=2.32, 95% CI: 1.73, 3.12; Depression AOR=2.08, 95% CI: 1.60, 2.70). The results of this study provide information salient to the development of effective HIV prevention interventions targeting populations with high burdens of anxiety and depression. The feasibility and effect of integrating mental health promotion activities into HIV prevention interventions should be explored.

“As a Young Pregnant Girl… The Challenges You Face”: Exploring the Intersection Between Mental Health and Sexual and Reproductive Health Amongst Adolescent Girls and Young Women in South Africa

“…That's why people commit suicide. I used to have that… mentality… suicidal thoughts because of people" (19)(20)(21)(22)(23)(24)NW).…”

“…Even when you make a minor mis-take… he will beat you, and you end up afraid… you now live in fear… When happy, it doesn't last for long… sometimes he will take out his anger on you even when you did nothing… but you continue to love him even when friends try to talk some sense to you, but you will continue staying and loving him because you are afraid of him and not at liberty to do your own things" (19-24 years, MPU). Refusal to have sex with a partner also led to violence: "sometimes, it happens that he wants to sleep with you, and you don't want to, then he gets angry and he beats you" (19)(20)(21)(22)(23)(24)KZN). Those AGYW who had experienced intimate partner violence explained their reluctance to disclose to her family and friends: "In most times, you keep quiet and when they ask you 'what happened, why are you hurt?'…”

“…Those AGYW who had experienced intimate partner violence explained their reluctance to disclose to her family and friends: "In most times, you keep quiet and when they ask you 'what happened, why are you hurt?' you just tell them that you got hurt, you turned and bumped into a wall" (19)(20)(21)(22)(23)(24)KZN). Experiencing violence negatively impacted AGYW self-esteem and self-worth: "It has to do with how you perceive yourself, he sees me as not good enough then maybe you will find that boyfriend that hits you, he is the one that you want to stay with because you think where else will you find another boyfriend?…”

Peer Review #3 of "Depression and sexual risk behavior among long-distance truck drivers at roadside wellness clinics in Kenya (v0.1)"

“…Truck drivers are also at high-risk of HIV infection because of the high rates of sexual risk behavior, including engaging in condomless sex and having multiple partners [12][13][14][15]. A small number of studies in sub-Saharan Africa have explored the relationship between depression and sexual risk, including in a general population at risk for HIV infection in South Africa [16,17] and among social networks of young men in Tanzania [18]. Although this relationship is complex, one possible explanation may be that maladaptive thought patterns arising from depression, such as those related to impulsivity and hopelessness [19], might lead to the adoption of risky behavior and increase the propensity for self-harm.…”

HIV Co-Morbidities and Multi-Morbidities

“…Furthermore, marked negative correlations have been obtained between daily dietary intakes of of healthy ingredients, including zinc, selenium, and vitamin C with neuropsychiatric and psychological health outcomes, such as depressiveness, anxiety, mood state and stress responsiveness expressions reported in Iranian HIV-patients [26]. In this context it must be borne in mind that HIV-disease progression as well as the perceptions of deteriorations in health may induce further risk-taking behaviors and other forms of neuropsychiatric aberration, such as addictive behaviors [27][28][29][30]. Consequently, it seems no surprise that risk-analyses for suicidal behaviors are affected: with on-going real suicide risk, defined for occurence during the final month, displayed an incidence of 18% of of the patients in the HIV-positive cohort and no incidence in the HIV-negative cohort [31].…”