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Unsafe sex among gay men linked to depression

Wednesday, 11 October 2000

Homosexual men with long-term, low-grade depression are almost twice as likely to have had unsafe casual sex in the last six months, according to the findings of researchers at Adelaide University.

A research team led by Dr Gary Rogers from Adelaide University's Department of General Practice surveyed more than 400 gay and other homosexually active men who enrolled into an integrated health care program in Adelaide since 1998.

The Care & Prevention Program, as it is known, is funded by the South Australian Department of Human Services. The men underwent comprehensive health evaluations, which included questionnaires about their recent sexual behaviour and a diagnostic interview to identify depression and other psychological problems.

Men who were severely depressed reported less sex overall because serious depression is associated with a lower sex drive. When these men were excluded, however, a clear relationship emerged between unprotected sex and long-term lower grade depression, known as dysthymia.

"Forty percent of the men with dysthymia reported having had unprotected sex in the six months before they joined the Program, compared with 22% of the men who weren't dysthymic," Dr Rogers says. "This is a statistically significant difference."

But why? "It may be that the low self-esteem that is part of long-term depression leads to men not caring enough about themselves to stay safe," Dr Rogers says.

The team will announce their findings at the Australasian Society for HIV Medicine conference at the Sofitel Hotel in Melbourne this week. They will also report on outcomes in the more than 270 men who have so far participated in the Care & Prevention Program for more than a year.

"Gay men appear to suffer serious health disadvantage, and at the time they enrolled, 27% of the men met the criteria for dysthymia. This had fallen to 16% of the same men at follow-up, and we also saw significant improvement in a range of other health measures," Dr Rogers says.

"It's our hope that by promoting the mental health of gay men we may be able to improve their ability to sustain safer sexual practices. It is pleasing that we have seen a very dramatic fall in the prevalence of depressive problems in the men who have taken part in the Program."

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