Barcelona 2013
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| Abstract #397 - Well Being and Life Expectancy | ||||
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Session: 25.3: Well Being and Life Expectancy (Parallel) on Tuesday @ 11.00-13.00 in Raval Chaired by Xiaming Li, Carlos Mur Authors: Presenting Author: Prof Lorraine Sherr - UCL, United Kingdom |
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| Additional Authors: | ||||
| Aim: Psychological and physical symptoms are prevalent among MSM with diagnosed HIV, but their relationship with sexual behaviour is unclear | ||||
| Method / Issue: We assessed the associations of depression, anxiety, and physical symptom distress, with sexual behaviour among 2097 HIV-diagnosed MSM in ASTRA, a questionnaire study of UK HIV outpatients in 2011/12. Depression and anxiety were classified, respectively, by PHQ-9 and GAD-7 scores (0-4 minimal; 5-9 mild; 10-14 moderate; ≥15 severe).Physical symptom score (PSS) was the sum of distress scores from 10 common symptoms (0-1 minimal; 2-6 low; 7-9: moderate; ≥10 high). Sexual activity in the past 3 months was classified as: not sexually active; condom-protected sex or HIV-positive partner(s) only; condom-less sex with HIV-negative/status-unknown partner(s) (CLS-D). | ||||
| Results / Comments: Of 2097 MSM, 37% were not sexually active; 48% reported condom-protected sex or HIV-positive partner(s) only; 16% reported CLS-D. Prevalence of depression (PHQ-9≥10), anxiety (GAD-7≥10), and moderate/high physical symptom distress (PSS≥7) varied across sexual activity groups, being highest among MSM who were not sexually active, and lowest among MSM who reported condom-protected sex or HIV-positive partner(s) only. Among 1322 sexually active MSM, each symptom measure was associated with CLS-D. Using separate logistic models, adjusted odds ratios (95% CI) of CLS-D were: 1.3 (0.9-1.8), 1.4 (1.0-2.2) and 1.5 (1.0-2.3) for mild, moderate, severe depression versus minimal [p=0.020 trend]; 1.5 (1.1-2.1), 1.3 (0.8-2.0), 2.1 (1.3-3.4) for mild, moderate, severe anxiety versus minimal [p=0.002 trend]; 1.4 (1.0-1.9), 1.7 (1.1-2.6), 1.9 (1.3-2.9) for low, moderate, high physical symptom distress versus minimal [p<0.001 trend]. Models were adjusted for presence/HIV-status of stable partner; alcohol consumption; recent recreational drug use; ART/viral load group. | ||||
| Discussion: Among HIV-diagnosed MSM, depression, anxiety and physical symptoms have a complex association with sexual behaviour, being linked both with lack of sexual activity and, among those who are sexually active, with CLS-D. In addition to clinical importance, symptom management may be one important component of prevention strategies among HIV-diagnosed MSM. | ||||
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