AIDS and Behavior

, Volume 16, Issue 8, pp 2209–2215 | Cite as

Depressive Symptoms Among MSM Who Engage in Bareback Sex: Does Mood Matter?

  • E. Houston
  • T. Sandfort
  • C. Dolezal
  • A. Carballo-Diéguez
Original Paper


Much research has examined the relationship between depressive symptoms and unprotected sex among men who have sex with men (MSM), but little is known about how depression is related to the sexual behavior of men who intentionally engage in unprotected anal intercourse, or bareback sex. In this study, we explored the extent to which depressive symptoms were associated with rates of unprotected sex among barebackers, and whether this relationship was dependent upon HIV serostatus. Using a sample of 120 MSM who engage in intentional condomless sex, we found that for HIV-negative participants, depressive symptoms were associated with the overall frequency of unprotected anal intercourse as well as unprotected anal intercourse with a serodiscordant partner. For HIV-positive participants, depressive symptoms were not associated unprotected intercourse. Additional research is needed to better understand depression among men who bareback and how interventions could be designed to address depression and reduce sexual risk behaviors.


Bareback sex Men who have sex with men Anal intercourse Depression HIV/AIDS 


A pesar de la amplia investigación de la relación entre los síntomas depresivos y el sexo desprotegido entre hombres que tienen sexo con hombres (HSH), se sabe poco sobre cómo la depresión se relaciona con la conducta de los hombres que practican el sexo “bareback”, es decir, el coito anal intencionalmente desprotegido. En este estudio, exploramos si los síntomas depresivos estaban asociados a las tasas de sexo desprotegido entre un grupo de 120 hombres con episodios recientes de sexo “bareback” y si esta asociación dependía del estatus serológico por VIH. Encontramos que entre participantes VIH-negativos, los síntomas depresivos se asociaban tanto con la frecuencia global del coito anal desprotegido, como también con el coito anal desprotegido con una pareja serodiscordante. En cambio, para los participantes VIH-positivos, no hubo relación entre los síntomas depresivos y el coito anal desprotegido. Se requiere investigación adicional para comprender mejor el rol de la depresión entre hombres que practican el sexo “bareback” y para determinar cómo elaborar intervenciones que podrían enfocarse en la depresión y reducir conductas sexuales de riesgo.



Dr. Houston is supported by a training grant from the National Institute of Mental Health (T32 MH019139; Behavioral Sciences Research in HIV Infection; Principal Investigator, Theodorus Sandfort, Ph.D.). This research was supported by Grant R01 MH69333 from the NIMH to the HIV Center for Clinical and Behavioral Studies at New York State Psychiatric Institute and Columbia University (Alex Carballo-Diéguez, Ph.D., Principal Investigator). The content is solely the responsibility of the authors and does not necessarily represent the official views of NIMH or the NIH. The authors would like to thank Theresa Exner, Timothy Frasca, Rebecca Giguere, Susie Hoffman, Marina Mabragaña, John Markowitz, Tsitsi Masvaure, Judith Rabkin, and Ray Smith for their assistance and support in completing this report.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • E. Houston
    • 1
  • T. Sandfort
    • 1
  • C. Dolezal
    • 1
  • A. Carballo-Diéguez
    • 1
  1. 1.HIV Center for Clinical and Behavioral StudiesNew York State Psychiatric Institute, Columbia UniversityNew YorkUSA

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