BC-CfE researchers examine mood and anxiety disorders and their links to HIV risk among sexual minorities

New research led by the BC-CfE’s Dr. Viviane Dias Lima examines how sexually risky behavior is linked to mood or anxiety disorders among lesbian, gay, and bisexual people in BC.

Dr. Lima is the BC-CfE’s Senior Methodologist as well as a scientist with the Centre and an Associate Professor in the Department of Medicine at UBC.

In the study she authored, alongside her colleagues Dr. Bob Hogg, Kalysha Closson, Martin St-Jean, Kiffer Card, Travis Salway and Thomas L. Patterson, Dr. Lima’s aim was to determine to what extent sexual minority status modifies the association between HIV risk behavior and prevalent mood or anxiety disorder diagnoses in BC. The study achieved this by using a population-based survey, the cross-sectional 2013-2014 Canadian Community Health Survey.

The researchers developed a behavioral HIV risk score using data available from the survey. The behavioral HIV risk score, categorized as 0, 1, 2, and ≥3 factors, included the following five measures: age at first intercourse, condom use during last intercourse, history of sexually transmitted infections, number of sexual partners in the past 12 months, and substance use in the past 12 months.

Mood and anxiety disorders are the most prevalent mental health disorders affecting Canadians. And, although mood and anxiety disorders are distinctly separate, they are often co-occurring. Three-quarters of mental health disorder-related healthcare services used by Canadians are for mood and anxiety disorders, amounting to more than half of the total direct costs spent on all mental health disorders. About 12% of BC’s population is afflicted by anxiety disorders in any given year, representing the most prevalent mental health disorder in the province.

The survey data showed 97% of respondents were heterosexual, while 3% were lesbian, gay, or bisexual (LGB). The prevalence of a mood or anxiety disorder diagnosis was confirmed at 12%. The authors also found that for every 1-level increase in the behavioral HIV risk score, the adjusted odds ratio of having a prevalent mood or anxiety disorder diagnosis was 1.29 for heterosexual respondents and, coming in at nearly double, 2.37 for LGB respondents.

The study’s findings show sexual minority status modified the relationship between HIV risk behavior and prevalent mood or anxiety disorders, with a stronger association among LGB respondents. In light of the findings, the authors call on policymakers and healthcare providers to prioritize integrated and holistic care that addresses the intersectionality between sexual risk, substance use, and mood and anxiety disorders, particularly among the sexual minority patient population.

Dr. Lima said, “It was troubling to see that LGB experienced a much stronger influence of our behavioral HIV risk score on the prevalence of mood or anxiety disorders than heterosexual participants. Further studies should assess the role of trauma, shame, stigma, social exclusion and other factors on these findings.”

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