Psychological and physical symptoms and sexual behaviour among HIV-diagnosed men who have sex with men (MSM) in the UK

F. Lampe, A. Speakman, L. Sherr, A. Phillips, S. Collins, R. Gilson, M. Johnson, M. Fisher, E. Wilkins, J. Anderson, M. Daskalopoulou, S. Edwards, J. McDonnell, N. Perry, M. Jones, R. O'Connell, M. Lascar, G. Hart, A. Johnson, A. MinersA. Geretti, W. Burman, J. Elford, A. Rodger

Research output: Contribution to journalMeeting abstractpeer-review


Background: Psychological and physical symptoms are prevalent among MSM with diagnosed HIV, but their relationship with sexual behaviour is unclear. Methods: 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: 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. Conclusions: 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.
Original languageEnglish
Article numberO5
Pages (from-to)2-2
Number of pages1
JournalHIV Medicine
Issue number2
Publication statusPublished - 3 Apr 2013


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