David A Wiss1, Marjan Javanbakht2, Michael J Li3, Michael Prelip1, Robert Bolan4,5, Steve Shoptaw3, Pamina M Gorbach2. 1. Department of Community Health Sciences, Fielding School of Public Health, University of California, 650 Young Drive South, Los Angeles, CA90095, USA. 2. Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA. 3. Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA. 4. Los Angeles LGBT Center, Los Angeles, CA, USA. 5. Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Abstract
OBJECTIVE: To understand the relationship between drug use, food insecurity (FI) and mental health among men who have sex with men (MSM). DESIGN: Cohort study (2014-2019) with at least one follow-up. SETTING: Visits at 6-month intervals included self-assessment for FI and depressive symptoms. Urine testing results confirmed drug use. Factors associated with FI were assessed using multiple logistic regression with random effects for repeated measures. General structural equation modelling tested whether FI mediates the relationship between drug use and depressive symptoms. PARTICIPANTS: Data were from HIV-positive and high-risk HIV-negative MSM in Los Angeles, CA (n 431; 1192 visits). RESULTS: At baseline, FI was reported by 50·8 % of participants, depressive symptoms in 36·7 % and 52·7 % of urine screening tests were positive for drugs (i.e. marijuana, opioids, methamphetamine, cocaine and ecstasy). A positive drug test was associated with a 96 % increase in the odds of being food insecure (95 % CI 1·26, 3·07). Compared to those with high food security, individuals with very low food security have a nearly sevenfold increase in the odds of reporting depressive symptoms (95 % CI 3·71, 11·92). Findings showed 14·9 % of the association between drug use (exposure) and depressive symptoms (outcome) can be explained by FI (mediator). CONCLUSION: The prevalence of FI among this cohort of HIV-positive and high-risk HIV-negative MSM was high; the association between drug use and depressive symptoms was partially mediated by FI. Findings suggest that enhancing access to food and nutrition may improve mood in the context of drug use, especially among MSM at risk for HIV transmission.
OBJECTIVE: To understand the relationship between drug use, food insecurity (FI) and mental health among men who have sex with men (MSM). DESIGN: Cohort study (2014-2019) with at least one follow-up. SETTING: Visits at 6-month intervals included self-assessment for FI and depressive symptoms. Urine testing results confirmed drug use. Factors associated with FI were assessed using multiple logistic regression with random effects for repeated measures. General structural equation modelling tested whether FI mediates the relationship between drug use and depressive symptoms. PARTICIPANTS: Data were from HIV-positive and high-risk HIV-negative MSM in Los Angeles, CA (n 431; 1192 visits). RESULTS: At baseline, FI was reported by 50·8 % of participants, depressive symptoms in 36·7 % and 52·7 % of urine screening tests were positive for drugs (i.e. marijuana, opioids, methamphetamine, cocaine and ecstasy). A positive drug test was associated with a 96 % increase in the odds of being food insecure (95 % CI 1·26, 3·07). Compared to those with high food security, individuals with very low food security have a nearly sevenfold increase in the odds of reporting depressive symptoms (95 % CI 3·71, 11·92). Findings showed 14·9 % of the association between drug use (exposure) and depressive symptoms (outcome) can be explained by FI (mediator). CONCLUSION: The prevalence of FI among this cohort of HIV-positive and high-risk HIV-negative MSM was high; the association between drug use and depressive symptoms was partially mediated by FI. Findings suggest that enhancing access to food and nutrition may improve mood in the context of drug use, especially among MSM at risk for HIV transmission.
Entities:
Keywords:
Depressive symptoms; Drug use; Food insecurity; HIV/AIDS; Men who have sex with men
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