Background:
Amphetamine-type stimulant (ATS) use and mental health issues are common and can occur simultaneously among men who have sex with men (MSM). This study evaluated the associations between ATS use and mental health issues.
Methods:
Thai MSM were recruited for an observational cohort at a sexual health clinic in Bangkok, Thailand, from January 2018 to May 2019. Self-reported demographic, ATS, sexual, and mental health data were collected. Mental health issues were evaluated using Hospital Anxiety and Depression Scale for depression (HADS-D) and anxiety (HADS-A) (borderline: 8-10 scores, abnormal: 11-21 scores), and Primary Care Post-Traumatic Stress Disorder Screen (PC-PTSD) for post-traumatic stress disorder (PTSD) (abnormal: 3-4 scores). Baseline data were analyzed for associations between ATS use and mental health issues using multinomial and binomial logistic regressions.
Results:
Of 1,375 MSM recruited, 146 participants (11.9%) reported ATS use within the last 6 months. Mental health issues were reported in 8.7% of participants for borderline HADS-D scores, 3.9% for abnormal HADS-D scores, 16.8% for borderline HADS-A scores, 9.1% for abnormal HADS-A scores, and 11.3% for abnormal PC-PTSD scores. ATS use was associated with borderline HADS-D scores (aOR 3.11, 95% CI 1.66–5.81) and abnormal HADS-D scores (aOR 2.82, 95% CI 1.08–7.34), after adjusting for confounders. ATS use was associated with abnormal HADS-A scores (OR 1.97, 95% CI 1.19–3.26), but the association was lost after adjusting for confounders (aOR 0.45, 95% CI 0.20–1.03). Similarly, ATS use was associated with abnormal PC-PTSD scores (OR 3.08, 95% CI 2.00–4.66), but not after adjusting for confounders (aOR 1.45, 95% CI 0.70–2.91).
Conclusion:
ATS use is directly associated with symptoms of borderline depression or worse. Associations between ATS use and anxiety and PTSD are due to confounders. Comprehensive harm reduction services for MSM reporting ATS use should include evaluation and management of mental health issues. |