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 What's more, their risk of acquiring HIV increases with the number
of mental health factors they report, researchers found.
Past studies have found that mental disorders, ranging from
depression to substance abuse, are often seen among men with HIV,
but “nothing about whether these factors predict HIV risk behaviors
or becoming infected with HIV,” said study leader Matthew Mimiaga,
from Harvard Medical School and Massachusetts General Hospital in
Boston.
The Centers for Disease Control and Prevention (CDC) estimates that
some 1.1 million people in the U.S. are living with HIV. About one
case in six is undiagnosed. While the CDC says only about 4 percent
of U.S. males have sex with other men, they represent about
two-thirds of the country’s new infections.
Additionally, it’s known that the lesbian, gay, bisexual and
transgender (LGBT) community also suffers from an increased burden
of mental health problems.
When two health conditions tend to occur together in one population,
researchers call them "syndemic."
For the new study in the Journal of Acquired Immune Deficiency
Syndromes, the researchers looked at how five conditions -
depression, alcohol abuse, stimulant use, multi-drug abuse and
exposure to childhood sexual violence - affect men's risk of
acquiring HIV.
They analyzed data on 4,295 men who reported having sex with men
within the previous year. The participants were asked about
depressive symptoms, heavy alcohol and drug use and childhood sexual
abuse.
The participants did not have HIV when they entered the study
between 1999 and 2001. They then completed a behavioral survey and
HIV test every six months for four years.
Overall, 680 men completed the study. Those who reported the most
mental health issues were the most likely to become HIV positive by
the end of the study. They were also most likely to report
unprotected anal sex and unprotected anal sex with a person who has
HIV.
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For example, compared to people without any of the five syndemic
conditions, those with four or five had about a nine-fold increased
risk of being infected with HIV by the end of the study.
The people with four or five mental disorders were also about three
times more likely to have unprotected anal sex and about four times
as likely to have unprotected anal sex with a person infected with
HIV, compared to people without any mental health issues.
Mimiaga said that the next step is to look at how this information
can be used to improve HIV prevention methods.
“We need to think about the fact that men who have sex with men in
the U.S. have a high prevalence of these syndemic factors (which)
for the most part get in the way of traditional HIV messaging or
traditional HIV interventions,” he said. “These factors . . . are
driving a lot of the risk and really need to be addressed in a
comprehensive approach.”
Future research should also examine whether these mental disorders
and behavioral risk factors create barriers to men getting treatment
for HIV once they are infected, Mimiaga said.
SOURCE: http://bit.ly/1yhMU3C Journal of Acquired Immune Deficiency
Syndromes, online December 11, 2014.
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