Associations Between Major Depressive Episode, Methamphetamine Use Disorder Severity, and Engagement in Sexual Risk-Taking Among Methamphetamine-Using Men Who Have Sex with Men
Depression and methamphetamine use have been associated with increased sexual risk-taking among men who have sex with men (MSM). This study estimated associations between current major depressive episode and/or methamphetamine use disorder and engagement in condomless anal intercourse (CAI). From March 2014 thru January 2016, 286 methamphetamine-using MSM were enrolled into a RCT to reduce methamphetamine use and sexual risk-taking. Analyses revealed that current major depressive episode was associated with a 92% increase in the rate of engagement in CAI with casual male partners (IRR 1.92; 95% CI 1.12–3.31) and a 76% increase in the rate of engagement in CAI with anonymous male partners (IRR 1.76; 95% CI 1.00–3.09). Additionally, for each unit increase in diagnostic methamphetamine use disorder severity, rates of engagement in CAI with anonymous male partners increased by 44% (IRR 1.44; 95% CI 1.11–1.87) and rates of engagement in CAI with exchange male partners increased by 140% (IRR 2.40; 95% CI 1.39–4.13). Neither diagnosis was associated with CAI with main male partners. Depression and methamphetamine use influence sexual risk-taking in unique ways, and interventions working with MSM should assess participants for both depression and methamphetamine use, and may tailor intervention content based on diagnostic outcomes.
KeywordsMen who have sex with men Condomless anal intercourse Depression Methamphetamine DSM-5
Funding for this study was provided by the National Institute on Drug Abuse, Grant #R01DA035092. Drs. Reback and Swendeman acknowledge additional support from the National Institute of Mental Health (P30 MH58107).
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Centers for Disease Control and Prevention. STDs in men who have sex with men. Washington, DC: Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; 2016.Google Scholar
- 2.Centers for Disease Control and Prevention. Reported STDs in the United States, 2016: high burden of STDs threaten millions of Americans. Washington, DC: National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; 2017.Google Scholar
- 3.Wolitski R, Stall R, Valdiserri R, editors. Unequal opportunity: health disparities affecting gay and bisexual men in the United States. New York: Oxford University Press; 2008.Google Scholar
- 5.CDC. HIV among gay and bisexual men. Atlanta: Centers for Disease Control and Prevention; 2016.Google Scholar
- 6.CDC. Syphilis & men who have sex with men. Atlanta: Centers for Disease Control and Prevention; 2016.Google Scholar
- 10.SAMHSA. A provider’s introduction to substance abuse treatment for lesbian, gay, bisexual, and transgender individuals. Contract no.: (SMA) 12-4104. Washington, DC: U.S. Department of Health and Human Services; 2012.Google Scholar
- 21.Gorbach PM, Weiss RE, Jeffries R, Javanbakht M, Drumright LN, Daar ES, et al. Behaviors of recently HIV-infected men who have sex with men in the year postdiagnosis: effects of drug use and partner types. JAIDS J Acquir Immune Defic Syndr. 2011;56(2):176–82. https://doi.org/10.1097/QAI.0b013e3181ff9750.CrossRefPubMedGoogle Scholar
- 24.First MB, Williams JB, Karg RS, Spitzer RL. SCID-5-CV: structured clinical interview for DSM-5 disorders. Washington, DC: American Psychiatric Association; 2016.Google Scholar
- 25.Center for Behavioral Health Statistics and Quality. 2015 National Survey on Drug Use and Health: detailed tables. Rockville: Substance Abuse and Mental Health Services Administration; 2016.Google Scholar
- 29.Finlayson TJ, Le B, Smith A, Bowles K, Cribbin M, Miles I, et al. HIV risk, prevention, and testing behaviors among men who have sex with men. National HIV Behavioral Surveillance System, 21 US cities, United States, 2008: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2011.Google Scholar