Depression and Sexual Dysfunction Among HIV-Positive and HIV-Negative Men Who Have Sex With Men: Mediation by Use of Antidepressants and Recreational Stimulants

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• 作者：Trevor A. Hart (1) (2)
  Brian Mustanski (3)
  Daniel T. Ryan (3)
  Pamina M. Gorbach (4)
  Ron D. Stall (5)
  Pamela J. Surkan (6)
  Michael Plankey (7)
  
  1. Department of Psychology ; Ryerson University ; 350 Victoria St. ; Toronto ; ON ; M5B 2K3 ; Canada
  2. Dalla Lana School of Public Health ; University of Toronto ; Toronto ; ON ; Canada
  3. Department of Medical Social Sciences ; Northwestern University ; Chicago ; IL ; USA
  4. Department of Epidemiology ; University of California ; Los Angeles ; Los Angeles ; CA ; USA
  5. Department of Infectious Diseases and Microbiology ; University of Pittsburgh ; Pittsburgh ; PA ; USA
  6. School of Public Health ; Johns Hopkins University ; Baltimore ; MD ; USA
  7. School of Medicine Division of Infectious Diseases ; Georgetown University ; Washington ; DC ; USA
  
• 关键词：Depression ; Sexual dysfunction ; SSRIs ; Men who have sex with men ; Erectile dysfunction ; Sexual orientation
• 刊名：Archives of Sexual Behavior
• 出版年：2015
• 出版时间：February 2015
• 年：2015
• 卷：44
• 期：2
• 页码：399-409
• 全文大小：434 KB
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• 刊物类别：Behavioral Science
• 刊物主题：Psychology
  Sexual Behavior
  Social Sciences
  
• 出版者：Springer Netherlands
• ISSN：1573-2800

文摘

Erectile dysfunction and other forms of sexual dysfunction are highly prevalent among HIV+ men who have sex with men (MSM). Research has not previously identified the mechanisms by which depression may be associated with sexual dysfunction among HIV-positive and HIV-seronegative (HIV-negative) MSM. The present study examined the role of antidepressant use, stimulant use, and smoking as mediators of the relation between depression and sexual dysfunction among HIV-positive and HIV-negative MSM. Participants enrolled in the Multicenter AIDS Cohort Study, an ongoing prospective study of the natural and treated histories of HIV infection among MSM in the United States, completed a modified version of the International Index of Erectile Function for MSM. The study sample included 1,363 participants, with 619 HIV-positive men and 744 HIV-negative men. A structural equation model examined depression as a predictor of subsequent sexual dysfunction, mediated by antidepressant use, stimulant use, and smoking. Depression predicted subsequent sexual function among both HIV-negative and HIV-positive MSM. This effect appeared to be both a direct effect and an indirect effect via antidepressant use. Findings suggest that antidepressant medication use may partially explain sexual dysfunction among MSM.