@article{ref1,
title="Opposing associations of depression with sexual behaviour: implications for epidemiological investigation among gay, bisexual and other men who have sex with  men",
journal="Sexually Transmitted Infections",
year="2021",
author="Lampe, Fiona C. and Burman, William J. and Johnson, Anne M. and Edwards, Simon and Sewell, Janey and Phillips, Andrew N. and Rodger, Alison J. and Miltz, Ada R. and Sherr, Lorraine and Allan, Sris",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: The aim of this report is to investigate the nature of the relationship between depression and condomless sex (CLS) among gay, bisexual and other men who  have sex with men (GBMSM). <br><br>METHODS: Data are from the Antiretrovirals, Sexual  Transmission Risk and Attitude (ASTRA) study of people living with HIV and attending  one of eight HIV outpatient clinics in England (2011-2012) and the Attitudes to and  Understanding of Risk of Acquisition of HIV (AURAH) study of HIV-negative/unknown  status individuals attending one of 20 genitourinary medicine clinics in England  (2013-2014). This analysis included GBMSM only. For each study, the prevalence of  depressive symptoms (Patient Health Questionnaire-9 score ≥10) was presented  according to three categories of sex in the past 3 months (considering anal/vaginal  sex with men/women and anal sex with men in separate definitions): (1) no sex, (2)  condom-protected sex only and (3) CLS. Multinomial logistic regression with  'condom-protected sex only' as the reference group was used to adjust for age and  (for ASTRA participants) time since HIV diagnosis. <br><br>RESULTS: There were opposing  associations of depression with recent sexual behaviour: the prevalence of  depression was higher among those who reported no sex and those who reported CLS,  compared with those who reported condom-protected sex only. Among the 2170  HIV-positive GBMSM in ASTRA, considering anal/vaginal sex with men/women, the  prevalence of depressive symptoms was 32%, 20% and 28%, respectively, among men  reporting no sex (n=783), condom-protected sex only (n=551) and CLS (n=836) (global  p<0.001). Among the 1477 HIV-negative GBMSM in AURAH, the prevalence of depressive  symptoms was 12%, 8% and 13%, respectively, for no sex (n=137), condom-protected sex  only (n=487) and CLS (n=853) (global p=0.017). Patterns were similar after  adjustment and when only considering anal sex between men. <br><br>CONCLUSIONS: Depression  may be linked both to lack of sexual activity and to sexual risk taking. When  investigating associations between depression and CLS, it is important to separate  out individuals reporting condom-protected sex only from those reporting no sex.<p /> <p>Language: en</p>",
language="en",
issn="1368-4973",
doi="10.1136/sextrans-2020-054634",
url="http://dx.doi.org/10.1136/sextrans-2020-054634"
}