Black and White Racial Disparities in Depression and Anxiety Among a Cohort of HIV+ MSM in Atlanta, GA Público

Abstract

Introduction: In the United States, MSM (men who have sex with men) have been shown to have higher rates of both HIV and depression/anxiety than the general population. Compared to white MSM in the US, black MSM are disproportionately affected by these comorbidities. Studies have linked depression and anxiety among HIV+ individuals to poorer continuity of care and suboptimal adherence to ART treatment.

Methods: To examine racial disparities in depression and anxiety among HIV+ MSM in Atlanta, GA, a prospective, longitudinal cohort study was conducted with a sample size of 400 HIV+ MSM. All measures were collected through a baseline CASI (computer-assisted self-interview) behavior survey. SAS statistical software was used to perform both univariate and bivariate analyses in order to produce a multivariable logistic regression model.

Results: After assessment of the three different depression/anxiety screening scales of PHQ-4, PHQ-8, and GAD-7 scales, there were 316 (79.00%) participants considered for presence of depression/anxiety in the combined scale.  According to the combined scale, 121 (38.29%) participants were characterized as having depression and/or anxiety while 195 (61.71%) participants did not. There were no differences in race, length of time since HIV diagnosis, or sexual orientation for those characterized as depressed/anxious versus those who were not, but there were statistically significant differences in age, education, income, and insurance status. After adjusting for these variables, the adjusted odds ratio of depression/anxiety among black HIV+ MSM compared to white HIV+ MSM was 1.11 (95% CI=0.93,1.33) and was not significant.

Discussion:  When comparing depression/anxiety levels between black and white HIV+ MSM, no association was observed.  Our study helps fill the gap in the current research area of racial disparities in depression and anxiety among HIV+ MSM in Atlanta in order to contribute knowledge to further develop appropriate interventions. Depression and anxiety’s detrimental effects on HIV care and treatment indicate the importance of uncovering the disparities and causes from this harmful comorbidity.

Table of Contents

INTRODUCTION………………………………………………………………………..1

METHODS…………………………………………………………………….……...…..4

RESULTS…………………………………………………………………….….......…..…9

DISCUSSION…………………………………………………………………….….…...12

REFERENCES…………………………………………………………………...………16

TABLES…………………………………………………………………….…..………...19

FIGURES…………………………………………………………………….………..…23

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Palavra-chave	Anxiety Race MSM HIV Racial Disparities Depression
Committee Chair / Thesis Advisor	Guest, Jodie, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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