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Tackle depression and reduce risky sexual activity

June 5th, 2008

Dr Petra

A new study published in the Archives of Sexual Behaviour suggests men who have multiple sexual partners without practising safer sex are often likely to have a past history of sexual abuse and report symptoms of depression. Perhaps surprisingly it seems many HIV interventions and sex education programmes fail to account for, or address this issue.

The research by staff at UCLA’s Center for Culture, Trauma and Mental Health Disparities included a three year study on 137 gay or bisexual African American and Hispanic men who were HIV positive and had been sexually abused as a child.

Results suggested the men were often single, on a low income, lacked a formal education and did not have much family support. They were placed in one of two study groups – one focused on reducing risk taking behaviours, the other provided standard care with advice on diet, exercise and following treatment programmes.

Men met in small groups on a weekly basis for a two hour session over six weeks. They were followed up immediately after the sessions and again three and six months later.

Both groups reported a reduction in risky behaviours and depressive symptoms, although those in the risk reduction group indicated a significant reduction in risk taking activity from the start of the study to the close of their support group sessions.

Researchers indicated that group therapy that specifically addresses risk taking, depression and tackles past abuse could greatly help men currently engaged in risky sexual activity. They recommend tackling depression and past abuse be factored into existing treatment/education programmes.

The study is summarised in Science Daily.

Research like this is always helpful as it can help us pinpoint any issues that may be driving behaviour that could put people at risk. As well as helping men who are currently positive reduce any risk taking activities, such research can also help with health promotion for men and women who are not positive but who may be engaging in activities that could put them at risk from sexually transmitted infections.

Of course there’s always the worry with any study like this that there’s an underlying message of if you sleep around you must be depressed or have a past experience of abuse. Certainly this view has previously been endorsed by many religious groups, some sex educators and medics.

The crucial issue to remember here is lots of sexual activity alone is not the problem. A person who engages with multiple partners but who does so safely – using condoms and negotiating what they want while checking on the wellbeing of their partner – is not putting themselves or others at risk in the same way as someone who sleeps around but avoids condom use.

It would make sense that someone who has previously been abused and who is also currently depressed would find it difficult to negotiate condom use or other safe and consensual sexual activities. Feeling depressed and lonely could also lead someone to engage with partners they perhaps would avoid if they were feeling stronger and more confident.

Clearly we have to be careful not to go beyond this data and make out anyone who’s having lots of sex is a victim, but it would definitely be helpful to ensure those who are at risk of contracting HIV due to risky activities could be offered support that didn’t just tell them how to manage their physical health, but that also tackled their past problems and any current psychological difficulties.

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