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Has depression surpassed HIV as a burden to gay and bisexual men’s health in the United States? A comparative modeling study

Abstract

Background

While advances in HIV prevention and treatment have changed the epidemic for gay and bisexual men, another epidemic faces this population. Gay and bisexual men represent one of the highest risk groups for depression, which potentially poses quality-of-life and public health challenges comparable to those of HIV. The present study seeks to inform comprehensive care for sexual minority men by estimating and comparing the morbidity of HIV and depression for US gay and bisexual men.

Methods

In 2018, weighted counts of gay and bisexual men living with HIV and depression were derived from the CDC’s Medical Monitoring Project and the National Survey on Drug Use and Health, respectively. Years lived with disability for HIV and depression were calculated using the Global Burden of Disease Study’s disability weights.

Findings

Among gay and bisexual adult men in the US, the prevalence of past-year major depressive episodes is 14.17%, while the prevalence of HIV is 11.52%. We estimate that in calendar year 2015, major depressive episodes imposed 85,361 (95% CI 58,293–112,212) years lived with disability among US adult gay and bisexual men, whereas HIV posed 42,981 (95% CI 36,221–49,722) years lived with disability.

Interpretation

This analysis shows that depression morbidity currently exceeds that for HIV among US adult gay and bisexual men. While gay and bisexual men are frequently understood to be a high-risk population for HIV, including in guidelines for HIV prevention and treatment, the present analysis suggests that this population should also be considered high-risk for depression.

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Data availability

The data that support the findings of this study are publicly available from the Centers for Disease Control and Prevention, the Global Burden of Disease Study, and the Substance Abuse and Mental Health Services Administration.

Abbreviations

ART:

Antiretroviral therapy

CDC:

Centers for Disease Control and Prevention

NSDUH:

National Survey on Drug Use and Health

USPSTF:

United States Preventive Services Task Force

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Acknowledgements

The authors would like to acknowledge the StatLab at Yale University Library for their consultation on this paper.

Funding

Daniel Bromberg was supported by funding from the National Institute of Mental Health (T32 MH20031). John Pachankis and David Paltiel were supported by funding from the National Institute of Mental Health (R01 MH109413). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.

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Authors and Affiliations

Authors

Contributions

All authors conceptualized and designed the protocol for this study. DJB conducted the analyses and wrote the manuscript for this study, with input from JEP, ADP, and SHB. All authors reviewed the manuscript and approved the final document for publication.

Corresponding author

Correspondence to John E. Pachankis.

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Conflict of interest

The authors declare that they have no competing interests. John E. Pachankis receives royalties from Oxford University Press for books related to LGBTQ-affirmative mental health treatments.

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Bromberg, D.J., Paltiel, A.D., Busch, S.H. et al. Has depression surpassed HIV as a burden to gay and bisexual men’s health in the United States? A comparative modeling study. Soc Psychiatry Psychiatr Epidemiol 56, 273–282 (2021). https://doi.org/10.1007/s00127-020-01938-1

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  • DOI: https://doi.org/10.1007/s00127-020-01938-1

Keywords

  • Depression
  • HIV/AIDS
  • Morbidity
  • Prevalence
  • Sexual and gender minorities