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Depressive Symptoms, Alcohol and Drug Use, and Physical and Sexual Abuse Among Men Who Have Sex with Men in Kisumu, Kenya: The Anza Mapema Study

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Abstract

Men who have sex with men (MSM) are disproportionately burdened by depressive symptoms and psychosocial conditions including alcohol and substance abuse as well as physical and sexual abuse. We examined sociodemographic and psychosocial factors associated with depressive symptoms at baseline among a cohort of MSM in Kisumu, Kenya. Depressive symptoms were assessed via the Personal Health Questionnaire 9 instrument and examined dichotomously. We performed multivariable modified Poisson regression with robust standard errors for the binary outcome. Among 711 participants: 11.4% reported severe depressive symptoms; 50.1% reported harmful alcohol abuse; 23.8% reported moderate substance abuse; 80.9% reported any childhood physical or sexual abuse; and 39.1% experienced recent trauma due to same-sex behaviors. In the final multivariable model, severe depressive symptoms were more common for men who were ≥ 30 years old, had completed ≤ 8 years of education, had experienced childhood physical or sexual abuse, and had recently experienced trauma due to same-sex behaviors. Our results demonstrate that comprehensive services capable of identifying and addressing depressive symptoms, alcohol and substance abuse, and physical and sexual abuse must be expanded within this sample of MSM.

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Acknowledgements

The authors would like to thank the men of the Anza Mapema Study. Special thanks also go to all research and staff members of the Anza Mapema Study and the Nyanza Reproductive Health Society including Leah Osula, Beatrice Achieng, George N’gety, Caroline Oketch, Violet Apondi, Evans Kottonya, Caroline Agwanda, Ted Aloo, George Oloo, Caroline Obare, Eve Obondi, and Edmon Obat, as well as Donath Emusu, Boaz Otieno Nyunya, and Gaston Djomand. We thank the Centers for Disease Control and Prevention (U01GH000762) and the Evidence for HIV Prevention in Southern Africa (MM/EHPSA/NRHS/0515008) for providing financial support for the Anza Mapema Study. Finally, we thank Dr. Ross Slotten and the Slotten Scholarship in Global Health at the University of Illinois at Chicago for supporting this work.

Funding

The Anza Mapema Study was supported through funding provided by the Centers for Disease Control and Prevention (U01GH000762) and by Evidence for HIV Prevention in Southern Africa (MM/EHPSA/NRHS/0515008).

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Authors and Affiliations

  1. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 1603 W Taylor St. (M/C 923), Room 917, Chicago, IL, 60612, USA

    Colin P. Kunzweiler, Robert C. Bailey & Supriya D. Mehta

  2. Nyanza Reproductive Health Society, Kisumu, Kenya

    Duncan O. Okall & Fredrick O. Otieno

  3. Departments of Medicine, Global Health, and Epidemiology, University of Washington, Seattle, WA, USA

    Susan M. Graham

Authors
  1. Colin P. Kunzweiler
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  2. Robert C. Bailey
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  3. Duncan O. Okall
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  4. Susan M. Graham
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  5. Supriya D. Mehta
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  6. Fredrick O. Otieno
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Corresponding author

Correspondence to Colin P. Kunzweiler.

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Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in the Anza Mapema Study involving human participants were in accordance with the ethical standards of the Maseno University Ethics Review Committee, the Institutional Review Board of the University of Illinois at Chicago, and the Human Subjects Division of the University of Washington.

Informed Consent

Trained research personnel reviewed all consent materials with the participant and answered any questions related to the Anza Mapema Study. Written informed consent was obtained from all participants enrolled in the Anza Mapema Study.

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Kunzweiler, C.P., Bailey, R.C., Okall, D.O. et al. Depressive Symptoms, Alcohol and Drug Use, and Physical and Sexual Abuse Among Men Who Have Sex with Men in Kisumu, Kenya: The Anza Mapema Study. AIDS Behav 22, 1517–1529 (2018). https://doi.org/10.1007/s10461-017-1941-0

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