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Depression, Compulsive Sexual Behavior, and Sexual Risk-Taking Among Urban Young Gay and Bisexual Men: The P18 Cohort Study

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Abstract

Young gay, bisexual, and other men who have sex with men (YMSM) are at increased likelihood of experiencing depression and engaging in condomless sexual behaviors. The goal of the current investigation was to examine the relationship between negative mood and compulsive sexual behavior (CSB) and to assess for their individual and combined influence on sexual risk-taking behavior among a diverse sample of YMSM in New York City (the P18 Cohort Study). We first analyzed sociodemographic, depressive symptoms, CSB, and sexual risk-taking from the cross-sectional data of 509, 18- or 19-year-old YMSM recruited using non-probability sampling. We found a significant positive correlation between CSB and depression and between CSB and frequency of condomless anal sex acts reported over the last 30 days. Multivariate results found that the presence of both depression and CSB contributed to elevated sexual risk-taking among these urban YMSM. Clinical implications include the importance of assessing for CSB when depression is present and vice versa in order to improve HIV prevention. Informed by minority stress theory and syndemic theory, our results suggest that interventions focused on the health of YMSM recognize that mental health and social context all interact to increase physical health vulnerability vis-a-vis sexual behaviors, depression, and CSB. Thus, HIV prevention and intervention programs need to incorporate mental health components and services that address these needs.

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References

  • Adimora, A. A., & Auerbach, J. D. (2010). Structural interventions for HIV prevention in the United States. Journal of Acquired Immune Deficiency Syndromes, 55(2), 132–135.

    Article  Google Scholar 

  • Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, CA: Sage.

    Google Scholar 

  • Bancroft, J., Janssen, E., Strong, D., & Vukadinovic, Z. (2003). The relation between mood and sexuality in gay men. Archives of Sexual Behavior, 32(3), 231–242.

    Article  PubMed  Google Scholar 

  • Bancroft, J., & Vukadinovic, Z. (2004). Sexual addiction, sexual compulsivity, sexual impulsivity, or what? Toward a theoretical model. Journal of Sex Research, 41(3), 225–234.

    Article  PubMed  Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Beidas, R. S., Birkett, M., Newcomb, M. A., & Mustanski, B. (2012). Do psychiatric disorders moderate the relationship between psychological distress and sexual risk-taking behaviors in young men who have sex with men? A longitudinal perspective. AIDS Patient Care and STDs, 26(6), 366–374.

    Article  PubMed  Google Scholar 

  • Benotsch, E. G., Kalichman, S. C., & Kelly, J. A. (1999). Sexual compulsivity and substance use in HIV-seropositive men who have sex with men: Prevalence and predictors of high-risk behaviors. Addictive Behaviors, 24(6), 857–868.

    Article  PubMed  Google Scholar 

  • Botvin, G. J., Epstein, J. A., Schinke, S. P., & Diaz, T. (1994). Predictors of cigarette smoking among inner-city minority youth. Journal of Developmental and Behavioral Pediatrics, 15(2), 67–73.

    Article  PubMed  Google Scholar 

  • Coleman, E. (2003). Compulsive sexual behavior: What to call it, how to treat it? SIECUS Report, 31(5), 12–16.

    Google Scholar 

  • Coleman, E., Miner, M., Ohlerking, F., & Raymond, N. (2001). Compulsive Sexual Behavior Inventory: A preliminary study of reliability and validity. Journal of Sex and Marital Therapy, 27(4), 325–332.

    Article  PubMed  Google Scholar 

  • Cooper, A., Scherer, C. R., Boies, S., & Gordon, B. (1999). Sexuality on the internet: From sexual exploration to pathological expression. Professional Psychology: Research and Practice, 30, 154–164.

    Article  Google Scholar 

  • Crepaz, N., & Marks, G. (2001). Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review. Health Psychology, 20(4), 291–299.

    Article  PubMed  Google Scholar 

  • D’Augelli, A. R., Hershberger, S. L., & Pinkington, N. W. (2010). Lesbian, gay, and bisexual youth and their families: Disclosure of sexual orientation and its consequences. American Journal of Orthopsychiatry, 68(3), 361–371.

    Article  Google Scholar 

  • Dube, E. M., & Savin-Williams, R. C. (2001). Sexual identity development among ethnic sexual-minority male youths. Developmental Psychology, 35(6), 1389–1398.

    Article  Google Scholar 

  • Frost, D. M., Parsons, J. T., & Nanin, J. E. (2007). Stigma, concealment and symptoms of depression as explanations for sexually transmitted infections among gay men. Journal of Health Psychology, 12(4), 636–640.

    Article  PubMed  Google Scholar 

  • Halkitis, P. N. (2010). Reframing HIV prevention for gay men in the United States. American Psychologist, 65(8), 753–763.

    Article  Google Scholar 

  • Halkitis, P. N., Moeller, R. W., Siconolfi, D. E., Storholm, E. D., Solomon, T. M., Hampton, M. C., & Bub, K. (2013a). Measurement model exploring a syndemic in emergent adult gay and bisexual men. AIDS and Behavior, 17(1), 662–673.

    Article  PubMed  PubMed Central  Google Scholar 

  • Halkitis, P. N., Wolitski, R. J., & Millett, G. A. (2013b). A holistic approach to addressing HIV infection dipartites in gay, bisexual, and other MSM. American Psychologist, 68(4), 261–273.

    Article  PubMed  Google Scholar 

  • Hatzenbuehler, M. L., O’Clerigh, C., Grasso, C., Mayer, K., Safren, S., & Bradford, J. (2012). Effect of same-sex marriage laws on health care use and expenditures in sexual minority men: A quasi-natural experiment. American Journal of Public Health, 102(2), 285–291.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hatzenbuehler, M. L., Phelan, J. C., & Link, B. G. (2013). Stigma as a fundamental cause of population health inequalities. American Journal of Public Health, 103(5), 813–821.

    Article  PubMed  PubMed Central  Google Scholar 

  • Holt, M. (2011). Gay men and ambivalence about ‘gay community’: From gay community attachment to personal communities. Culture, Health and Sexuality, 13(8), 857–871.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., & Rompa, D. (1995). Sexual sensation seeking and sexual compulsivity scales: Reliability, validity, and predicting HIV risk behavior. Journal of Personality Assessment, 65(3), 586–601.

    Article  PubMed  Google Scholar 

  • Kapadia, F., Siconolfi, D. E., Barton, S., Olivieri, B., Lombardo, L., & Halkitis, P. N. (2013). Social support network characteristics and sexual risk taking among a racially/ethnically diverse sample of young, urban, men who have sex with men. AIDS and Behavior, 17(5), 1819–1828.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kosunen, E., Haltiala-Heino, R., Rimpela, M., & Laippala, P. (2003). Risk-taking sexual behaviour and self-reported depression in middle adolescence-a school based survey. Child: Care, Health and Development, 29(5), 337–344.

    Google Scholar 

  • Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36(1), 38–56.

    Article  PubMed  Google Scholar 

  • Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697.

    Article  PubMed  PubMed Central  Google Scholar 

  • Miner, M. H., Coleman, E., Center, B. A., Ross, M., & Rosser, B. R. (2007). The Compulsive Sexual Behavior Inventory: Psychometric properties. Archives of Sexual Behavior, 36(4), 579–587.

    Article  PubMed  Google Scholar 

  • Muench, F., & Parsons, J. T. (2004). Sexual compulsivity and HIV: Identification and treatment. Focus, 19(6), 1–5.

    PubMed  Google Scholar 

  • Mustanski, B., Garofalo, R., Herrick, A., & Donenberg, G. (2007). Psychosocial health problems increase risk for HIV among urban young men who have sex with men: Preliminary evidence of a syndemic in need of attention. Annals of Behavioral Medicine, 34(1), 37–45.

    Article  PubMed  PubMed Central  Google Scholar 

  • New York City Department of Health and Mental Hygiene. (2011). HIV/AIDS among men who have sex with men in New York City 2009 (HIV Epidemiology and Field Services Program). New York, NY.

  • Newcomb, M. E., & Mustanski, B. (2009). Moderators of the relationship between internalized homophobia and risky sexual behavior in men who have sex with men: A meta-analysis. Archives of Sex Behavior, 40(1), 189–199.

    Article  Google Scholar 

  • Parsons, J. T., Grov, C., & Golub, S. A. (2012). Sexual compulsivity, co-occurring psychosocial health problems, and HIV risk among gay and bisexual men: Further evidence of a syndemic. American Journal of Public Health, 102(1), 156–162.

    Article  PubMed  PubMed Central  Google Scholar 

  • Parsons, J. T., Kelly, B. C., Bimbi, D. S., DiMaria, L., Wainberg, M. L., & Morgenstern, J. (2008). Explanations for the origins of sexual compulsivity among gay and bisexual men. Archives of Sexual Behavior, 37(5), 817–826.

    Article  PubMed  Google Scholar 

  • Perdue, T., Hagan, H., Thiede, H., & Valleroy, L. (2003). Depression and HIV risk behavior among Seattle-Area injection drug users and young men who have sex with men. AIDS Education and Prevention, 15(1), 81–92.

    Article  PubMed  Google Scholar 

  • Reece, M. (2003). Sexual compulsivity and HIV serostatus disclosure among men who have sex with men. Sexual Addiction and Compulsivity, 10, 1–11.

    Article  Google Scholar 

  • Rosario, M., Schrimshaw, E. W., & Hunter, J. (2006). A model of sexual risk behaviors among young gay and bisexual men: Longitudinal associations of mental health, substance abuse, sexual abuse, and the coming-out process. AIDS Education and Prevention, 18(5), 444–460.

    Article  PubMed  PubMed Central  Google Scholar 

  • Salomon, E. A., Mimiaga, M. J., Husnik, M. J., Welles, S. L., Manseau, M. W., Montenegro, A. B., et al. (2009). Depressive symptoms, utilization of mental health care, substance use and sexual risk among young men who have sex with men in EXPLORE: Implications for age-specific interventions. AIDS and Behavior, 13, 811–821.

    Article  PubMed  Google Scholar 

  • Savin-Williams, R. C. (2001). A critique of research on sexual minority-youths. Journal of Adolescents, 24(1), 5–13.

    Article  Google Scholar 

  • Semple, S. J., Zians, J., Grant, I., & Patterson, T. L. (2006). Sexual compulsivity in a sample of HIV-positive methamphetamine-using gay and bisexual men. AIDS and Behavior, 10(5), 587–598.

    Article  PubMed  Google Scholar 

  • Shrier, L. A., Harris, S. K., Sternberg, M., & Beardslee, W. R. (2001). Association of depression, self-esteem, and substance use with sexual risk among adolescents. Preventive Medicine, 33, 179–189.

    Article  PubMed  Google Scholar 

  • Siconolfi, D. E., Halkitis, P. N., Allomong, T. A., & Burton, C. L. (2009). Body dissatisfaction & eating disorders in a sample of gay and bisexual men. International Journal of Men’s Health, 8(3), 254–264.

    Article  Google Scholar 

  • Singer, M. (1994). AIDS and the health crisis of the U.S. urban poor: The perspective of critical medical anthropology. Social Science and Medicine, 39(7), 931–948.

    Article  PubMed  Google Scholar 

  • Singer, M. (1996). A dose of drugs, a touch of violence, a case of AIDS: Conceptualizing the SAVA syndemic. Free Inquiry in Creative Sociology, 24, 99–110.

    Google Scholar 

  • Sobell, L. C., & Sobell, M. B. (1996). Timeline Followback user’s guide: A calendar method for assessing alcohol and drug use. Toronto: Addiction Research Foundation.

    Google Scholar 

  • Stall, R., Friedman, M. S., & Cantania, J. A. (2008). Interacting epidemics and gay men’s health: A theory of syndemic production among urban gay men. In R. J. Wolitski, R. Stall, & R. O. Valdiserri (Eds.), Unequal opportunity: Health disparities affecting gay and bisexual men in the United States (pp. 251–274). New York: Oxford Univerisity Press.

    Google Scholar 

  • Stall, R., Mills, T. C., Williamson, J., Hart, T., Greenwood, G., Paul, J., et al. (2003). Association of co-occuring psychosocial health problems and increased vulnerability to HIV/AIDS among urban men who have sex with men. American Journal of Public Health, 93(6), 939–942.

    Article  PubMed  PubMed Central  Google Scholar 

  • Steer, R. A., & Clark, D. A. (1997). Psychometric characteristics of the Beck Depression Inventory-II with college students. Measurement and Evaluation in Counseling and Development, 30, 128–136.

    Google Scholar 

  • Storholm, E. D., Fisher, D. G., Napper, L. E., Reynolds, G. L., & Halkitis, P. N. (2011a). Proposing a tentative cut point for the compulsive sexual behavior inventory. Archives of Sexual Behavior, 40(6), 1301–1308.

    Article  PubMed  PubMed Central  Google Scholar 

  • Storholm, E. D., Fisher, D. G., Napper, L. E., Reynolds, G. L., & Halkitis, P. N. (2011b). A psychometric analysis of the compulsive sexual behavior inventory. Sexual Addiction & Compulsivity, 18(2), 86–103.

    Article  Google Scholar 

  • Strathdee, S. A., Hogg, R. S., Martindale, S. L., Cornelisse, P. G. A., Craib, K. J. P., Montaner, J. S. G., et al. (1998). Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. Journal of Acquired Immune Deficiency Syndromes, 19(1), 61–66.

    Article  Google Scholar 

  • Sullivan, P. S., Salazar, L., Buchbinder, S., & Sanchez, T. H. (2009). Estimating the proportion of HIV transmissions from main sex partners among men who have sex with men in five US cities. AIDS, 23, 1153–1162.

    Article  PubMed  Google Scholar 

  • Watters, J. K., & Biernacki, P. (1989). Targeted sampling: Options for the study of hidden populations. Social Problems, 36(4), 416–430.

    Article  Google Scholar 

  • Whisman, M. A., Perez, J. E., & Ramel, W. (2000). Factor structure of the Beck Depression Inventory-Second Edition (BDI-II) in a student sample. Journal of Clinical Psychology, 56, 545–551.

    Article  PubMed  Google Scholar 

  • Wilson, P. A., Stadler, G., Boone, M. R., & Bolger, N. (2014). Fluctuations in depression and well-being are associated with sexual risk episodes among HIV-positive men. Health Psychology, 33(7), 681–685.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wong, W., Chaw, J. K., Kent, C. K., & Klausner, J. D. (2005). Risk factors for early syphilis among gay and bisexual men seen in an STD clinic: San Francisco, 2002-2003. Sexually Transmitted Diseases, 32(7), 458–463.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study is funded by a grant from the National Institute of Drug Abuse (R01DA025537) with additional funding for Dr. Storholm provided by the National Institute of Drug Abuse Training Grant (T32DA007250).

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Correspondence to Perry N. Halkitis.

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Storholm, E.D., Satre, D.D., Kapadia, F. et al. Depression, Compulsive Sexual Behavior, and Sexual Risk-Taking Among Urban Young Gay and Bisexual Men: The P18 Cohort Study. Arch Sex Behav 45, 1431–1441 (2016). https://doi.org/10.1007/s10508-015-0566-5

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  • DOI: https://doi.org/10.1007/s10508-015-0566-5

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