Association between depressive symptoms, risk factors for sexually transmitted infections, and nongonococcal urethritis

BACKGROUND: Depressive symptoms and urethritis are common, and may be associated with one another. Severe depression may lead to different risk behaviors than more moderate depression. Therefore individuals with moderate depression may be at increased risk for engaging in certain risk factors and for acquiring nongonococcal urethritis (NGU) compared to individuals with severe depression. METHODS: This is a retrospective study of 521 men at high-risk for acquiring NGU. Men with and without NGU were given a depression screening instrument and asked about behavioral risk factors for acquiring sexually transmitted infections, including total partners, total new partners, condom use, and history of transactional sex. Poisson regression was used to calculate prevalence ratios for the association between depressive symptoms and behavioral risk factors. Logistic regression was used to calculate odds ratios for the association between depressive symptoms and prevalent NGU. RESULTS: Compared to men with severe or minimal depressive symptoms, men with moderate depressive symptoms were more likely to have 3 or more sexual partners in the past 60 days, to have 2 or more new sexual partners in the last 60 days, and to report a history of transactional sex. There was no association between condom use and depressive symptoms. There was no association between NGU and depressive symptoms. CONCLUSIONS: Some behavioral risk factors for acquiring sexually transmitted infections may be more common in men with moderate depressive symptoms, and men with severe depression may have similar behaviors compared to men without depression. This association between depressive symptoms and behavior may not result in increased frequency of NGU in a high-risk population.