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Body Mass Index, Depression and Sexual Transmission Risk Behaviors Among HIV-Positive MSM

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Abstract

Depression has been shown to be a risk factor for serodiscordant unprotected anal intercourse (SDUAI) in some studies, but not others. Body mass index (BMI) has recently been associated with SDUAI; however, to date, no published study has investigated the interactive effect of depression and BMI on SDUAI. The current study assessed the association between depression, BMI, and SDUAI among HIV-positive MSM. Participants were 430 HIV-positive MSM recruited in a Boston community health center where they received primary care. Participants completed audio computer-assisted self interview (ACASI) measures. Objective height and weight and other clinical variables were accessed through participants’ electronic medical records. Depression was positively associated with SDUAI. This association was significantly moderated by BMI. Elevated levels of depression were only associated with SDUAI for underweight participants. These findings suggest that underweight, depressed HIV-positive MSM may be particularly likely to engage in SDUAI.

Resumen

La depresión ha sido reconocida como un riesgo para las personas serodiscordantes que participan en relaciones sexuales anales sin protección (SRSASP) en algunos estudios, pero no otros. El índice de masa corporal (IMC) ha sido asociado recientemente con personas SRSASP; sin embargo, hasta este momento, ningún estudio publicado ha investigado el efecto de la interacción de la depresión y IMC en personas SRSASP. Los participantes fueron 430 hombres que tienen sexo con hombres (HSH) seropositivos que se reclutaron en un centro médico comunitario en Boston donde recibían cuidado médico primario. Los participantes completaron una audio entrevista asistida por la computadora. La altura, el peso objetivo y otras medidas clínicas se obtuvieron a través de los historiales médicos electrónicos de los participantes. La depresión fue asociada directamente con SRSASP. Esta asociación fue moderada apreciablemente por el IMC. Los niveles elevados de depresión fueron asociados solamente con SRSASP para los participantes con bajo peso corporal. Estos resultados sugieren que los HSH seropositivos, deprimidos y con bajo peso corporal pueden estar en riesgo particular de entrar en SRSASP.

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Acknowledgments

This study was supported by HRSA grant H97HA01293 and NIMH grant 5R01MH068746-05 awarded to Drs. Kenneth H. Mayer and Steven A. Safren. The authors would like to thank the following individuals for their hard work that made the study possible: Daniel Aguilar, Jeremy Hobsen, Robert Knauz, Rodney VanDerwarker, Benjamin Capistrant, Jessica Ripton, Danielle Dang, Liz Salomon, Bonnie Kissler, Alex Weissman, Adam Sussman, Dhana Perry, Christopher Sterling, William O’Brien, the medical providers at Fenway Health, the Fenway Community Advisory Board, the staff for the HRSA-funded EPPIC site at UCSF including Carol Dawson-Rose and Stephen Morin. We also thank Drs. Margaret Chesney and Ronald Stall for their consultation about the project. Finally, and most importantly, we thank the study participants.

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Authors and Affiliations

  1. Massachusettes General Hospital, Harvard Medical School, 1 Bowdoin Sq, 7th Floor, Boston, MA, 02114, USA

    Aaron J. Blashill, Conall O’Cleirigh & Steven A. Safren

  2. The Fenway Institute, Fenway Health, Boston, USA

    Aaron J. Blashill, Conall O’Cleirigh, Kenneth H. Mayer, Brett M. Goshe & Steven A. Safren

  3. Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA

    Kenneth H. Mayer

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  1. Aaron J. Blashill
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  2. Conall O’Cleirigh
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  3. Kenneth H. Mayer
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  5. Steven A. Safren
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Correspondence to Aaron J. Blashill.

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Blashill, A.J., O’Cleirigh, C., Mayer, K.H. et al. Body Mass Index, Depression and Sexual Transmission Risk Behaviors Among HIV-Positive MSM. AIDS Behav 16, 2251–2256 (2012). https://doi.org/10.1007/s10461-011-0056-2

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  • DOI: https://doi.org/10.1007/s10461-011-0056-2

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