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

Abstract

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.

Keywords

Men who have sex with men Condomless anal intercourse Depression Methamphetamine DSM-5 

Notes

Acknowledgements

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.

References

  1. 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. 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. 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
  4. 4.
    Wolitski R, Fenton K. Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States. AIDS Behav. 2011;15:9–17.CrossRefGoogle Scholar
  5. 5.
    CDC. HIV among gay and bisexual men. Atlanta: Centers for Disease Control and Prevention; 2016.Google Scholar
  6. 6.
    CDC. Syphilis & men who have sex with men. Atlanta: Centers for Disease Control and Prevention; 2016.Google Scholar
  7. 7.
    Patel P, Borkowf CB, Brooks JT, Lasry A, Lansky A, Mermin J. Estimating per-act HIV transmission risk: a systematic review. AIDS. 2014;28(10):1509–19.CrossRefPubMedGoogle Scholar
  8. 8.
    Smith DK, Herbst JH, Zhang X, Rose CE. Condom effectiveness for HIV prevention by consistency of use among men who have sex with men in the United States. JAIDS J Acquir Immune Defic Syndr. 2015;68(3):337–44.CrossRefPubMedGoogle Scholar
  9. 9.
    Kerridge BT, Pickering RP, Saha TD, Ruan WJ, Chou SP, Zhang H, et al. Prevalence, sociodemographic correlates and DSM-5 substance use disorders and other psychiatric disorders among sexual minorities in the United States. Drug Alcohol Depend. 2017;170:82–92.CrossRefPubMedGoogle Scholar
  10. 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
  11. 11.
    Peck JA, Reback CJ, Yang X, Rotheram-Fuller E, Shoptaw S. Sustained reductions in drug use and depression symptoms from treatment for drug abuse in methamphetamine-dependent gay and bisexual men. J Urban Health. 2005;82(1 Suppl 1):i100–8.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Lopez-Patton M, Kumar M, Jones D, Fonseca M, Kumar AM, Nemeroff CB. Childhood trauma and METH abuse among men who have sex with men: implications for intervention. J Psychiatr Res. 2016;72:1–5.CrossRefPubMedGoogle Scholar
  13. 13.
    Koblin B, Husnik MJ, Colfax GN, Huang Y, Madison M, Mayer KH, et al. Risk factors for HIV infection among men who have sex with men. AIDS. 2006;20(6):731–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Reisner SL, Mimiaga MJ, Skeer M, Bright D, Cranston K, Isenberg D, et al. Clinically significant depressive symptoms as a risk factor for HIV infection among black MSM in Massachusetts. AIDS Behav. 2009;13(4):798–810.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Alvy L, McKirnan D, Mansergh G, Koblin B, Colfax G, Flores S, et al. Depression is associated with sexual risk among men who have sex with men, but is mediated by cognitive escape and self-efficacy. AIDS Behav. 2011;15(6):1171–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Fletcher JB, Reback CJ. Depression mediates and moderates effects of methamphetamine use on sexual risk taking among treatment-seeking gay and bisexual men. Health Psychol. 2015;34(8):865.CrossRefPubMedGoogle Scholar
  17. 17.
    Sullivan PS, Salazar L, Buchbinder S, Sanchez TH. Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS. 2009;23(9):1153–62.  https://doi.org/10.1097/QAD.0b013e32832baa34.CrossRefPubMedGoogle Scholar
  18. 18.
    Van Kesteren NM, Hospers HJ, Kok G. Sexual risk behavior among HIV-positive men who have sex with men: a literature review. Patient Educ Couns. 2007;65(1):5–20.CrossRefPubMedGoogle Scholar
  19. 19.
    Bauermeister JA, Leslie-Santana M, Johns MM, Pingel E, Eisenberg A. Mr. Right and Mr. Right Now: romantic and casual partner-seeking online among young men who have sex with men. AIDS Behav. 2011;15(2):261–72.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Oldenburg CE, Perez-Brumer AG, Reisner SL, Mimiaga MJ. Transactional sex and the HIV epidemic among men who have sex with men (MSM): results from a systematic review and meta-analysis. AIDS Behav. 2015;19(12):2177–83.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 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
  22. 22.
    Chesney MA, Barrett DC, Stall R. Histories of substance use and risk behavior: precursors to HIV seroconversion in homosexual men. Am J Public Health. 1998;88(1):113–6.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Twitchell G, Huber A, Reback CJ, Shoptaw S. Comparison of general and detailed HIV risk assessments among methamphetamine abusers. AIDS Behav. 2002;6(2):153–62.CrossRefGoogle Scholar
  24. 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. 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
  26. 26.
    Mills TC, Paul J, Stall R, Pollack L, Canchola J, Chang YJ, et al. Distress and depression in men who have sex with men: the Urban Men’s Health Study. Am J Psychiat. 2004;171(2):278–85.CrossRefGoogle Scholar
  27. 27.
    Fendrich M, Avci O, Johnson TP, Mackesy-Amiti ME. Depression, substance use and HIV risk in a probability sample of men who have sex with men. Addict Behav. 2013;38(3):1715–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Hoenigl M, Chaillon A, Moore DJ, Morris SR, Smith DM, Little SJ. Clear links between starting methamphetamine and increasing sexual risk behavior: a cohort study among men who have sex with men. J Acquir Immune Defic Syndr. 2015;71:551–7.CrossRefGoogle Scholar
  29. 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
  30. 30.
    Reback CJ, Fletcher JB, Shoptaw S, Grella CE. Methamphetamine and other substance use trends among street-recruited men who have sex with men, from 2008 to 2011. Drug Alcohol Depend. 2013;133:262–5.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Blashill AJ, Mayer KH, Crane HM, Baker JS, Willig JH, Willig AL, et al. Body mass index, depression, and condom use among HIV-infected men who have sex with men: a longitudinal moderation analysis. Arch Sex Behav. 2014;43(4):729–34.CrossRefPubMedGoogle Scholar
  32. 32.
    Shiu CS, Chen YC, Tseng PC, Chung AC, Wu MT, Hsu ST, et al. Curvilinear relationship between depression and unprotected sexual behaviors among men who have sex with men. J Sex Med. 2014;11(10):2466–73.CrossRefPubMedGoogle Scholar

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

Personalised recommendations