Studies have shown high rates
of depression among men who have sex with men (MSM) in developed countries.
Studies have also shown association between depression and HIV risk among MSM.
However, very little research has been done on depression among African MSM.
We
assessed depression and HIV risk among a sample of MSM in Tanzania. We reviewed
data on 205 MSM who were recruited from two Tanzanian cities using the
respondent driven sampling method. Demographic and behavioral data were
collected using a structured questionnaire. HIV and sexually transmitted
infections data were determined from biological tests. Depression scores were
assessed using the Patient Health Questionnaire (PHQ-9). For the analysis,
depression scores were dichotomized as depressed (PHQ > 4) and not depressed
(PHQ ≤ 4). Bivariate and multivariable Poisson regression analyses were
conducted to assess factors associated with depression.
The prevalence of
depression in the sample was 46.3%. The mean (±SD) age of the sample was 25
(±5) years. In bivariate analysis, depression was associated with
self-identifying as gay (p = .001), being HIV positive (p < .001: <8% of
MSM knew they were HIV infected) and having a high number of sexual partners in
the last 6 months (p = .001).
Depression was also associated with sexual
(p = .007), physical (p = .003) and verbal (p < .001) abuse. In the Poisson
regression analysis, depression was associated with verbal abuse (APR = 1.91,
CI = 1.30-2.81). Depression rates were high among MSM in Tanzania. It is also
associated with abuse, HIV and HIV risk behaviors. Thus, reducing the risk of
depression may be helpful in reducing the risk of HIV among MSM in Africa.
We
recommend the colocation of mental health and HIV preventive services as a
cost-effective means of addressing both depression and HIV risk among MSM in
Africa.
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- 1 Department of Epidemiology, Human Genetics and Environmental Sciences , The University of Texas School of Public Health , Houston , TX , USA.
- 2 Department of Family Medicine and Community Health , University of Minnesota , Minneapolis , MN , USA.
- 3 Department of Sociology and Anthropology , University of Dar es Salaam , Dar es Salaam , Tanzania.
- 4 Department of Management, Policy and Community Health , The University of Texas School of Public Health , Houston , TX , USA.
- 5 Department of Psychiatry , Muhimbili University of Health Sciences , Dar es Salaam , Tanzania.
- 6 Department of Health Promotion and Behavioral Sciences , The University of Texas School of Public Health , Houston , TX , USA
- AIDS Care. 2016 Mar;28 Suppl 1:140-7. doi: 10.1080/09540121.2016.1146207.
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