The Effect of Sexualized Drug Use (SDU) on Sexual Risk Behavior and Mental Health Among HIV-Infected Men Who Have Sex with Men (MSM): A Longitudinal Study

Sexualized drug use (SDU) is prevalent among men who have sex with men (MSM) and has been identified as a risk factor for sexual risk behaviors (SRBs), HIV infection, and poor mental health. However, little is known about their dynamic changes and associations over time in China.

This longitudinal study is aimed at assessing the prevalence and dynamic associations between SDU, SRBs, depression, and anxiety in 384 HIV-infected MSM in Guilin, China, from 2021 to 2023.

From 2021 to 2023, no statistically significant differences were observed in the prevalence rates of SDU (from 18.5 to 14.6%), SRBs (from 51.8 to 55.7%), depression (from 35.9 to 32.3%), and anxiety (from 30.5 to 28.6%), all with P > 0.05. Our logistic regression analyses demonstrated that SDU (adjusted odds ratio (aOR) 2.86, 95% confidence interval (CI) 1.49–5.47) was a robust predictor of SRBs. Moreover, both SDU (aOR1 3.36, 95%CI 1.58–7.18) and SRBs (aOR 3.47, 95%CI 1.86–6.45) were identified as predictive factors for depression. Simultaneously, SDU (aOR 2.94, 95%CI 1.35–6.43) and SRBs (aOR 2.83, 95%CI 1.41–5.66) demonstrated predictive links to anxiety.

In summary, our study underscores the persistently high prevalence of SDU among HIV-infected MSM in Guilin, which is associated with elevated odds of engaging in SRBs, experiencing depression, and suffering from anxiety.

This study necessitates multifaceted policy interventions focusing on reducing SDU through targeted public health campaigns, integrating mental health and substance abuse treatment within HIV care, enhancing service accessibility, destigmatizing HIV and SDU, and training healthcare providers in sensitivity to MSM’s unique needs.