Associations of depression and anxiety symptoms with sexual behaviour in women and heterosexual men attending sexual health clinics: a cross-sectional study

ObjectiveTo assess the association of symptoms of depression and anxiety with sexual risk behaviour and history, among women and heterosexual men attending genitourinary medicine (GUM) clinics.MethodsAttitudes to and Understanding of Risk of Acquisition of HIV (AURAH) was a cross-sectional, self-adm...

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Published in:	Sexually transmitted infections Vol. 95; no. 4; pp. 254 - 261
Main Authors:	Coyle, Rachel Margaret, Lampe, Fiona C, Miltz, Ada Rose, Sewell, Janey, Anderson, Jane, Apea, Vanessa, Collins, Simon, Dhairyawan, Rageshri, Johnson, Anne M, Lascar, Monica, Mann, Sue, O'Connell, Rebecca, Sherr, Lorraine, Speakman, Andrew, Tang, Alan, Phillips, Andrew N, Rodger, Alison, Gilson, Richard J, Asboe, David, Nwokolo, Nneka C, Clarke, Amanda, Gompels, Mark M, Allan, Sris, Scott, Christopher, Day, Sara, Fisher, Martin, Farazmand, Paymaneh, Mann, Susan, Dhar, Jyoti, Ivens, Daniel R, Sadiq, Tariq, Hart, Graham J, Miners, Alec, Elford, Jonathan, Perry, Nicky, Brady, Michael, Obeyesekera, Sharmin, Saunders, John, Taylor, Stephen, Gilleran, Gerry, Stretton, Cathy, Youssef, Elaney, Richardson, Celia, Roche, Mark, Stacey, David, Kirk, Sarah, Gompels, Mark, Jennings, Louise, Holder, Caroline, Baker, Katie-Anne, Robinson, Matthew, Street, Emma, Shomoye, Abayomi, Nwokolo, Nneka, Ogilvy, Ali, Mguni, Sfiso, Clark, Rebecca, Sajani, Cynthia, Espa, Veronica, Ladd, Sarah, Syred, Jonathan, Hamza, Lisa, Campbell, Lucy, Wandolo, Emily, Alagarajah, Janagan, Mashonganyika, Linda, Batham, Sally, Gilson, Richard, Trombin, Rita, Milinkovic, Ana, Oakland, Clare, Makoka, Nyasha, Wilson, Ruth, Green, Elizabeth, O'Connor, Sheila, Kempster, Sarah, Keating-Fedders, Katie, Ivens, Daniel, Tyrrell, Nicola, Rogers, Jemima, Belmondo, Silvia, Sohal, Manjit, Majewska, Wendy, Patterson, Anne, Okolo, Olanike, Cox, David, Tarik, Mariam, Jackson, Charlotte, Honigsbaum, Jeanette, Boggon, Clare, Ghosh, Simone, Kelly, Bernard, Aroney, Renee, Hand, James, Phiri, Elias, Partridge, Nick, Orton, Kay, Nardone, Anthony, Sullivan, Ann
Format:	Journal Article
Language:	English
Published:	England BMJ Publishing Group Ltd 01.06.2019 BMJ Publishing Group LTD BMJ Publishing Group
Series:	Original article
Subjects:	Ambulatory Care Facilities Anxiety Anxiety Disorders - psychology Behaviour clinical care Cross-Sectional Studies Depressive Disorder - psychology Female genitourinary medicine services Humans London Male Mental depression Patient Acceptance of Health Care Risk-Taking Sex Factors Sexual Behavior sexual behaviour sexual health Sexually Transmitted Diseases - prevention & control Sexually Transmitted Diseases - psychology State Medicine Surveys and Questionnaires Young Adult Young adults London United Kingdom > UK England United States > US sexual health genitourinary medicine services clinical care sexual behaviour
ISSN:	1368-4973, 1472-3263, 1472-3263
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Summary:	ObjectiveTo assess the association of symptoms of depression and anxiety with sexual risk behaviour and history, among women and heterosexual men attending genitourinary medicine (GUM) clinics.MethodsAttitudes to and Understanding of Risk of Acquisition of HIV (AURAH) was a cross-sectional, self-administered questionnaire study recruited from 20 GUM clinics in England, 2013–2014. This analysis included women and heterosexual men. The prevalence of depression and anxiety symptoms was assessed. Modified Poisson regression was used to produce adjusted prevalence ratios (aPR) for the association of t demographic, socioeconomic and lifestyle factors with depression and anxiety, adjusted for gender, age, ethnicity, education level and study region. Among individuals reporting sex in the past 3 months, associations of depression and anxiety with sexual risk behaviour and history were assessed separately by gender, adjusted for age, ethnicity, study region, education and relationship status.ResultsQuestionnaires were completed by 676 women and 470 heterosexual men. Depression symptoms were reported by 100 (14.8%) women and 33 men (7.0%). Anxiety symptoms were reported by 79 women (11.7%) and 21 men (4.5%). Among women reporting recent sex, those with depression symptoms were more likely to report condomless sex with a non-regular partner, aPR 1.38 (1.07–1.77) and recent condomless sex with two or more partners, 1.80 (1.25–2.59). Women with anxiety symptoms more likely to report recent condomless sex with two or more partners, 1.68 (1.13–2.50), low self-efficacy for condom use, 1.54 (1.02–2.31) and STI diagnosis in the last year 1.51 (1.04–2.20). Among heterosexual men reporting recent sex, depression and anxiety symptoms were associated with low self-efficacy with condom use, 2.32 (1.29–4.19) for depression and 2.23 (1.26–3.94) for anxiety, but not with measures of condomless sex.DiscussionThe associations between psychological symptoms and sexual risk behaviours highlight the importance of holistic assessment of need by both general and sexual health clinicians. We highlight the challenge in delivering holistic care associated with fragmentation of sexual health services.
Bibliography:	Original article ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	1368-4973 1472-3263 1472-3263
DOI:	10.1136/sextrans-2018-053689