Depression, substance abuse and stigma among men who have sex with men in coastal Kenya

Abstract

Objectives Mental health conditions can erode quality of life and interfere with health-related behaviours such as medication adherence. We aimed to determine the prevalence and correlates of depression and other psychosocial factors among self-identified men who have sex with men (MSM) in coastal Kenya. Design A cross-sectional survey. Methods Psychosocial and mental health characteristics were assessed in an audio computer-assisted self-interview (ACASI) survey among 112 MSM participating in two ongoing HIV-positive and HIV-negative cohorts in Mtwapa, Kenya. Results One-third of participants met criteria for major depressive disorder [16.1%, 95% confidence interval (95% CI) 9.8–24.2] or other depressive disorder (15.2%, 95% CI 9.1–23.2). Alcohol abuse was reported by 45% of respondents (95% CI 35.2–54.3) and other substance abuse by 59.8% (95% CI 50.1–69.0). Sexual and HIV stigma were moderate, with median scores of 11 [interquartile range (IQR) 6–17, potential range 0–33] and 25 (IQR 23–29, potential range 11–44), respectively. There were significant bivariate correlations between alcohol abuse, other substance abuse, sexual stigma and childhood and recent abuse. In a multivariable linear regression model, sexual stigma (beta = 0.17, 95% CI 0.03–0.32) and marriage to a woman (beta = −2.41 95% CI −4.74 to −0.09) were each associated with depression score. Conclusion We found moderate to high levels of depression and substance abuse, and moderate levels of sexual stigma. These variables were highly inter-correlated and associated with an experience of trauma or abuse. Comprehensive mental health services are needed in this population to address these issues.

Experienced HIV-Related Stigma and Psychological Distress in Peruvian Sexual and Gender Minorities: A Longitudinal Study to Explore Mediating Roles of Internalized HIV-Related Stigma and Coping Styles

“…Consequently, experienced HIV-related stigma or the societal, cultural, and interpersonal rejection of people living with this attribute (HIV seropositive status) is justified. A substantial body of literature has examined how living in societal contexts with negative attitudes toward PLWH, the ‘experienced’ facet of HIV-related stigma (25), is associated with mental health (12,15–17, 18, 20–23, 26–30). A significant proportion of this literature has focused on the different contexts that subpopulations (e.g., racial/ethnic minorities, sexual and gender minorities, women) face within the United States (12, 15, 16, 21, 26–28).…”

“…A significant proportion of this literature has focused on the different contexts that subpopulations (e.g., racial/ethnic minorities, sexual and gender minorities, women) face within the United States (12, 15, 16, 21, 26–28). There is also a growing body of literature examining how HIV-related stigma affects mental health across different populations in other countries and contexts (17, 18, 20, 22, 23, 29, 30). Longitudinal data regarding this relationship would be particularly helpful for establishing causal relationships.…”

The Prevalence and Correlates of HIV and Undiagnosed Infection among Men Who Have Sex with Men in Hanoi, Vietnam: Findings from a Cross-sectional, Biobehavioral Study

“…Previous international research underscores that homosexuality-related stigma and discrimination are associated with a higher risk of depression (16, 17). Depression has been found to be highly prevalent among MSM, particularly HIV-positive men (18, 19), and is considered a major health issue among MSM (20).…”

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

“…We found high prevalence of probable MDD (24%) in this sample of truck drivers. When comparing across studies that also used the PHQ-9 from non-community-based samples, this estimate was higher than a sample of HIV-positive adult men attending clinics in Uganda (12%) [21], but lower than in a study among adult men who have sex with men (MSM) in coastal Kenya enrolled in an HIV research study (42%) [37]. Manuscript to be reviewed Survey in Kenya, 5.5% of men reported having been diagnosed with depression in the past months [38].…”