An Australian study in the September edition of the journal HIV Medicine shows that gay men experiencing chronic, low-grade depression are significantly more likely to have unprotected sex with a casual or anonymous partner. Major depression, however, was linked with a reduction in unprotected sex due to decreased libido, say researchers from the South Australian Care and Prevention Programme. Chronic, low-grade depression was categorized as having a "low mood" or "the blues" for a majority of the time over a two-year period. Major depression was characterized by more serious symptoms persisting longer than two weeks.
More than 450 gay men participated in the study, conducted from 1998 to 2001. All of the study participants completed a self-administered questionnaire about depression symptoms. Additional interviews focused on sexual behavior, demographic details, medical history, and HIV status. About 28% of the men were diagnosed with major depression, and 26% with chronic, low-grade depression. The researchers found that gay men with current low-grade depression were significantly more likely to report unprotected sex with a casual partner than other study subjects, with HIV-positive men suffering from low-grade depression the most likely to engage in unsafe sex.
"It is not difficult to understand that gay men who have been stigmatized for much of their lives and who have lived through the devastation of their community by HIV may sometimes find themselves in a psychological state where they 'just don't care' about protecting themselves or others," wrote the researchers. They added that screening and treating gay men for low-grade depression should be included as part of HIV prevention efforts aimed at men who have sex with men.