A Description of Common Mental Disorders in Men Who Have Sex with Men (MSM) Referred for Assessment and Intervention at an MSM Clinic in Cape Town, South Africa.

Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa, .
AIDS and Behavior (Impact Factor: 3.49). 03/2013; DOI: 10.1007/s10461-013-0430-3
Source: PubMed

ABSTRACT Men who have sex with men (MSM) have a higher prevalence of common mental disorders (CMD), as compared with heterosexual men. HIV infection is independently associated with higher rates of CMD. Given this context, and the high background community prevalence of HIV in South Africa, MSM are at even greater risk of developing CMD. The aim of this research was to investigate neuropsychiatric symptoms and disorders in MSM who were referred for assessment and management of mental health problems, in an MSM Clinic in urban Cape Town, South Africa. Twenty-five men were screened using the MINI, AUDIT, DUDIT, and IPDE Screener. Depression, suicidality, as well as alcohol and drug use disorders were highly prevalent in this group (44, 56, 48, and 56 % respectively). The personality disorder screening was suggestive of a high prevalence of personality disorders. The high prevalence of neuropsychiatric disorders in this sample supports the idea that integrated mental health services are needed to address the complex needs of this population. Adequate input into the mental health needs of this population could reduce the potential for HIV acquisition and transmission, improve adherence to treatment and care, and ensure the provision a comprehensive health service for MSM.

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    ABSTRACT: Stigma and stress may place HIV-positive men who have sex with men (HIVϩ MSM) at risk for depression. Additionally, HIVϩ MSM might utilize multiple HIV-related services as a way to gain support for, and more effectively manage, HIV-related stressors. Although prior research has demonstrated that depression severity and utilizing support services are associated with functional or dysfunc-tional coping strategies, researchers have not investigated the impact of different coping combinations— specifically, the concurrent use of functional and dysfunctional strategies—in this population. Thus, we explored (a) how items on 1 measure of coping, the Brief COPE, capture HIV-related coping of HIVϩ MSM using Principal Components Analysis, (b) how HIVϩ MSM's coping groups into unique combinations , and (c) how these coping combinations relate to depression and the scope of HIV-related support service utilization. Our sample consisted of 170 HIVϩ MSM engaged with medical care. Results indicated the use of both functional and dysfunctional coping strategies. Unique combinations of functional and dysfunctional strategies showed differential associations with depression and the extent of HIV-related support service utilization. Specifically, individuals who engaged in low levels of both functional and dysfunctional coping, compared with individuals who more frequently engaged in functional coping strategies, were significantly less likely to use a range of critical HIV-related services. Individuals who reported frequent use of dysfunctional coping strategies, regardless of functional coping strategy use, reported higher levels of depression. Therefore, providers should continue to focus more closely on identifying functional coping strategies and reducing dysfunctional coping when working with HIVϩ MSM.


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Aug 8, 2014