The Additive Effects of Depressive Symptoms and Polysubstance Use on HIV Risk Among Gay, Bisexual, and Other Men Who Have Sex with Men

dc.contributor.authorCard, Kiffer G.
dc.contributor.authorLachowsky, Nathan J.
dc.contributor.authorArmstrong, Heather L.
dc.contributor.authorCui, Zishan
dc.contributor.authorWang, Lu
dc.contributor.authorSereda, Paul
dc.contributor.authorJollimore, Jody
dc.contributor.authorPatterson, Thomas L.
dc.contributor.authorCorneil, Trevor
dc.contributor.authorHogg, Robert S.
dc.contributor.authorRoth, Eric A.
dc.contributor.authorMoore, David M.
dc.date.accessioned2022-06-16T23:01:23Z
dc.date.available2022-06-16T23:01:23Z
dc.date.copyright2018en_US
dc.date.issued2018
dc.descriptionThe authors would like to thank the Momentum Study participants, office staff and community advisory board, as well as our community partner agencies, Health Initiative for Men, YouthCO HIV and Hep C Society, and Positive Living Society of BC.en_US
dc.description.abstractIntroduction—Among gay, bisexual, and other men who have sex with men (GBM), collinearity between polysubstance use and mental health concerns has obscured their combined effects on HIV risk with multivariable results often highlighting only one or the other. Methods—We used mediation and moderation analyses to examine the effects of polysubstance use and depressive symptoms on high-risk sex (i.e., condomless anal sex with serodiscordant/unknown status partner) in a sample of sexually-active GBM, aged >16 years, recruited in Metro Vancouver using respondent driven sampling. Hospital Anxiety and Depression Scale scores assessed mental health. Alcohol Use Disorder Identification Test scores assessed alcohol disorders. Poly-use of multiple drug types (e.g., stimulants, sedatives, opiates, hallucinogens) was assessed over the previous six months. Results—Among 719 predominantly white (68.0%), gay-identified (80.7%) GBM, alcohol use was not associated with increased prevalence of high-risk sex. Controlling for demographic factors and partner number, an interaction between polysubstance use and depressive symptoms revealed that the combined effects were additively associated with increased odds for high-risk sex. Mediation models showed that polysubstance use partially mediated the relationship between depressive symptoms and high-risk sex. Conclusion—An interaction effect between polysubstance use (defined by using 3 or more substances in the past six months) and depressive symptoms (defined by HADS scores) revealed that the combination of these factors was associated with increased risk for high-risk sex – supporting a syndemic understanding of the production of HIV risk.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipThis study is funded by National Institute on Drug Abuse (R01DA031055-01A1) and the Canadian Institutes for Health Research, including through a Foundation Grant awarded to RSH (MOP-107544, 143342, PJT-153139). NJL was supported by a CANFAR/CTN Postdoctoral Fellowship Award. DMM and NJL are supported by Scholar Awards from the Michael Smith Foundation for Health Research (#5209, #16863). HLA is supported by a Postdoctoral Fellowship Award from the Canadian Institutes of Health Research (Grant # MFE-152443). KGC is funded by a UWW-Engage Fellowship.en_US
dc.identifier.citationCard, K. G., Lachowsky, N. J., Armstrong, H. L., Cui, Z., Wang, L., Sereda, P., Jollimore, J., Patterson, T. L., Corneil, T., Hogg, R. S., Roth, E. A., & Moore, D. M. (2018). “The Additive Effects of Depressive Symptoms and Polysubstance Use on HIV Risk Among Gay, Bisexual, and Other Men Who Have Sex With Men.” Addictive Behaviors, 82, 158–165. https://doi.org/10.1016/j.addbeh.2018.03.005en_US
dc.identifier.urihttps://doi.org/10.1016/j.addbeh.2018.03.005
dc.identifier.urihttp://hdl.handle.net/1828/13980
dc.language.isoenen_US
dc.publisherAddictive Behaviorsen_US
dc.subjectGay and bisexual menen_US
dc.subjectPolysubstance useen_US
dc.subjectAlcohol useen_US
dc.subjectHIV risken_US
dc.subjectDepressive Symptomsen_US
dc.titleThe Additive Effects of Depressive Symptoms and Polysubstance Use on HIV Risk Among Gay, Bisexual, and Other Men Who Have Sex with Menen_US
dc.typePostprinten_US

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