Has Depression Surpassed HIV As a Burden to Gay and Bisexual Men's Health in the United States?

Abstract

Background: At the same time that advances in HIV prevention and treatment have changed the epidemic for gay and bisexual men, another epidemic faces this population. Gay and bisexual men represent one of the highest risk groups for depression, which potentially poses quality-of-life and public health challenges comparable to those of HIV. The present study seeks to inform comprehensive care for sexual minority men by estimating and comparing the morbidity of HIV and depression for US gay and bisexual men. Methods: Weighted counts of gay and bisexual men living with HIV and depression were derived from the CDC's Medical Monitoring Project and the National Survey on Drug Use and Health, respectively. Years lived with disability for HIV and depression come were calculated using the Global Burden of Disease Study's disability weights. Findings: Among gay and bisexual adult men in the US, the prevalence of past-year major depressive episodes is 14.17%, while the prevalence of HIV is 11.52%. We estimate that in calendar year 2015, major depressive episodes imposed 85,361 (95% CI: 58,293-112,212) years lived with disability among US adult gay and bisexual men, whereas HIV posed 42,981 (95% CI: 36,221-49,722) years lived with disability. Interpretation: This present analysis shows that depression morbidity currently exceeds that for HIV among US adult gay and bisexual men. While gay and bisexual men are frequently understood to be a high-risk population for HIV, including in guidelines for HIV prevention and treatment, the present analysis suggests that this population should also be considered at high-risk for depression. Healthcare providers should increasingly attend to the mental health needs of their gay and bisexual patients both within and outside of the context of HIV prevention and treatment. Funding Statement: The National Institute of Mental Health provided funding for this study (T32MH20031, Bromberg; R01MH109413, Pachankis, Paltiel). Declaration of Interests: The authors declare that they have no competing interests. Ethical Approval Statement: The authors state ethics approval not applicable.