Depression and HIV risk among men who have sex with men in Tanzania

Abstract

Studies have shown high rates of depression among men who have sex with men (MSM) in developed countries. Studies have also shown association between depression and HIV risk among MSM. However, very little research has been done on depression among African MSM. We assessed depression and HIV risk among a sample of MSM in Tanzania. We reviewed data on 205 MSM who were recruited from two Tanzanian cities using the respondent driven sampling method. Demographic and behavioral data were collected using a structured questionnaire. HIV and sexually transmitted infections data were determined from biological tests. Depression scores were assessed using the Patient Health Questionnaire (PHQ-9). For the analysis, depression scores were dichotomized as depressed (PHQ > 4) and not depressed (PHQ ≤ 4). Bivariate and multivariable Poisson regression analyses were conducted to assess factors associated with depression. The prevalence of depression in the sample was 46.3%. The mean (±SD) age of the sample was 25 (±5) years. In bivariate analysis, depression was associated with self-identifying as gay (p = .001), being HIV positive (p < .001: <8% of MSM knew they were HIV infected) and having a high number of sexual partners in the last 6 months (p = .001). Depression was also associated with sexual (p = .007), physical (p = .003) and verbal (p < .001) abuse. In the Poisson regression analysis, depression was associated with verbal abuse (APR = 1.91, CI = 1.30–2.81). Depression rates were high among MSM in Tanzania. It is also associated with abuse, HIV and HIV risk behaviors. Thus, reducing the risk of depression may be helpful in reducing the risk of HIV among MSM in Africa. We recommend the colocation of mental health and HIV preventive services as a cost-effective means of addressing both depression and HIV risk among MSM in Africa.

Acting within an increasingly confined space: A qualitative study of sexual behaviours and healthcare needs among men who have sex with men in a provincial Tanzanian city

“…These findings are similar to other studies from the metropolitan city of Dar es Salaam, Tanzania, where MSM reported high levels of alcohol abuse, commercial sex work, and stigma in healthcare [ 1 , 5 , 6 ]. In our study, men expected partners to be involved in multiple concurrent partnerships, and also they themselves engaged in simultaneous sexual relations.…”

“…Furthermore, qualitative studies have revealed that MSM face stigma based on sexual orientation/behaviour when seeking healthcare services, which has created barriers to timely diagnosis and treatment [ 3 , 4 ]. At the same time, research has shown that sexual risk perceptions and preventive measures might be low among MSM, and high levels of commercial sex work, condomless sex, substance abuse, and depression have been reported [ 5 – 8 ].…”

Beyond biomedical and comorbidity approaches: Exploring associations between affinity group membership, health and health seeking behaviour among MSM/MSW in Nairobi, Kenya

“…Further, associations between sexual stigma and depression have also been well documented in extant literature (Choi et al, 2016;Logie et al, 2012;Wohl et al, 2013). In addition, associations between depression and substance use, as well as sexual risk-taking practices have been documented (Ahaneku et al, 2016;Fletcher & Reback, 2015;Reisner et al, 2009).…”

Factors associated with psychological distress among young women in Kisumu, Kenya

“…The co-occurrence of psychological and physical illness has been found globally in rich, middle-income, and low-income countries, such as Kenya 8. Given the high prevalence of HIV in sub-Saharan Africa,9 it is especially important to assess psychological disorders, for instance depression,10 and even difficulty with coping skills in response to negative daily life events,11 as these can affect behaviors that place people at higher risk for HIV and other sexually transmitted infections (STIs). Moreover, persons infected with HIV who also have depression or other psychological disorders have difficulty with self-care, which includes medication adherence12 and successful participation in a linkage to care intervention 13…”