AIDS and Behavior

, Volume 22, Issue 5, pp 1461–1466 | Cite as

Associations Between Major Depressive Episode, Methamphetamine Use Disorder Severity, and Engagement in Sexual Risk-Taking Among Methamphetamine-Using Men Who Have Sex with Men

  • Jesse B. Fletcher
  • Dallas Swendeman
  • Cathy J. Reback
Original Paper


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.


Men 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.

Ethical Approval

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

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Jesse B. Fletcher
    • 1
  • Dallas Swendeman
    • 2
    • 3
  • Cathy J. Reback
    • 1
    • 3
  1. 1.Friends Research Institute, Inc.Los AngelesUSA
  2. 2.Center for HIV Identification, Prevention and Treatment ServicesUniversity of California, Los AngelesLos AngelesUSA
  3. 3.David Geffen School of Medicine, Semel Institute for Neuroscience and Human BehaviorUniversity of California, Los AngelesLos AngelesUSA

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