Table 1 Unadjusted and adjusted associations of sociodemographic and lifestyle factors with current depressive symptoms (PHQ-9 score ≥10) among 1340 MSM who reported anal or vaginal sex in the past 3 months
N=1340 MSM reporting sex in the past 3 monthsPHQ-9 ≥10 (n=166; 12.4%)
N (%)%PbUnadjusted PR(95% CI)Overall P valuenAdjusted models PR (95% CI)Overall P valuen
Age (years)<25235 (17.8)19.60.0012.04 (1.23, 3.41)0.0011.79 (1.06, 3.01)0.032
25–29344 (26.0)14.2<0.001c1.49 (0.89, 2.48)0.001c1.57 (0.93, 2.63)0.006c
30–34255 (19.3)7.80.82 (0.45, 1.51)0.91 (0.50, 1.67)
35–39175 (13.2)9.10.95 (0.50, 1.81)1.02 (0.54, 1.95)
40–44125 (9.5)8.80.92 (0.45, 1.88)1.02 (0.50, 2.07)
45+188 (14.2)9.611
Born in the UK and white ethnicityYes, white676 (51.2)12.40.34610.33610.989
Yes, non-white86 (6.5)17.41.40 (0.85, 2.32)1.03 (0.60, 1.74)
No, white408 (30.9)10.50.85 (0.60, 1.20)0.98 (0.69, 1.39)
No, non-white151 (11.4)11.90.96 (0.59, 1.55)1.08 (0.65, 1.77)
Study regionLondon1017 (75.9)11.40.03810.03210.401
South241 (18.0)13.71.20 (0.84, 1.72)1.16 (0.80, 1.67)
Otheri82 (6.1)20.71.82 (1.15, 2.87)1.37 (0.84, 2.25)
University educationYes891 (66.5)9.3<0.0011<0.0011<0.001
No/missinga449 (33.5)18.51.98 (1.50, 2.63)1.86 (1.37, 2.51)
Employment statusEmployed1069 (79.8)10.1<0.0011<0.00110.020
Not employed/missinga271 (20.2)21.42.12 (1.59, 2.83)1.49 (1.06, 2.09)
Money to cover basic needs (financial hardship)Always958 (71.7)7.2<0.0011<0.0011<0.001
Mostly281 (21.0)16.7<0.001c2.32 (1.64, 3.28)<0.001c1.95 (1.36, 2.80)<0.001c
At times/no97 (7.3)49.56.87 (5.07, 9.31)5.16 (3.64, 7.30)
Housing statushHome owner369 (27.9)3.8<0.0011<0.0011<0.001
Renting764 (57.8)13.9<0.001c3.66 (2.12, 6.30)<0.001c3.66 (2.07, 6.48)<0.001c
Unstable/other188 (14.2)21.35.61 (3.13, 10.04)4.48 (2.40, 8.36)
Self-reported sexual identitygGay1190 (89.1)11.40.004d10.00310.011
Bisexuale127 (9.5)22.11.74 (1.21, 2.50)g1.61 (1.11, 2.31)g
Straightf19 (1.4)5.3
Proportion of ‘workmates’ who know you are gay/bisexual/attracted to men (disclosure of sexual orientation)All/almost all794 (60.8)11.70.00110.00110.012
Somej277 (21.2)7.60.044c0.65 (0.41, 1.02)0.055c0.68 (0.43, 1.09)0.192c
Few/none236 (18.1)18.61.59 (1.15, 2.21)1.47 (0.99, 2.17)
Ongoing relationship with a partnerYes579 (43.2)10.50.07310.07510.118
No/missinga761 (56.8)13.81.31 (0.97, 1.76)1.27 (0.94, 1.72)
Supportive networkk1: High levels400 (30.1)4.3<0.0011<0.0011<0.001
2464 (34.9)6.7<0.001c1.57 (0.88, 2.80)<0.001c1.40 (0.78, 2.51)<0.001c
3284 (21.3)17.34.06 (2.39, 6.90)3.84 (2.24, 6.59)
4130 (9.8)33.17.78 (4.60, 13.17)6.83 (3.96, 11.77)
5: Low levels53 (4.0)49.111.54 (6.72, 19.81)10.19 (5.82, 17.83)
Current smokerlYes334 (24.9)17.70.0011.66 (1.24, 2.23)0.0011.33 (0.98, 1.81)0.071
No/missinga1006 (75.1)10.611
Higher risk alcohol consumptionmYes259 (19.3)17.80.0031.60 (1.17, 2.19)0.0031.53 (1.11, 2.12)0.009
No/missinga1081 (80.7)11.111
Number of recreational drug used (past 3 months)0/missinga579 (43.2)8.8<0.0011<0.0011<0.001
1269 (20.1)13.8<0.001c1.56 (1.05, 2.32)<0.001c1.52 (1.02, 2.28)<0.001c
2–4302 (22.5)12.91.47 (0.99, 2.17)1.53 (1.02, 2.29)
5+190 (14.2)20.52.33 (1.59, 3.42)2.41 (1.63, 3.57)
  • Note: Adjusted models – each factor included in a separate model and adjusted for the following: age (included as four categories: <25, 25–29, 30–39 and ≥40 years), UK born (yes or no/missing), sexual identity (gay or bisexual/straight), university education (yes or no/missing), ongoing relationship status (yes or no/missing) and study region (London, South or other).

  • MSM, men who have sex with men; PHQ, Patient Health Questionnaire; PR, prevalence ratio.

  • a University education: 0.3% (n=4) missing; employed: 1.4% (n=19) missing; ongoing relationship: 0.2% (n=3) missing; smoke regularly: 0.4% (n=5) missing; higher-risk alcohol consumption: 1.2% (n=16) missing; recreational drug use: 0.8% (n=11) missing.

  • b Pearson’s χ2 test.

  • c Test for trend.

  • d Fisher’s exact test.

  • e Includes 117 men who identified as bisexual and 10 men who reported other plurisexual identity labels including queer, pansexual, omnisexual, open and bi-curious.

  • f Men who identified as straight or heterosexual: eight men reported sex with a man in the past 3 months and the remaining 11 reported having disclosed to family, friends and/or workmates that they were gay, bisexual and/or attracted to men.

  • g A Fisher’s exact test P-value is presented for univariable comparison of the three groups presented; however, in unadjusted and adjusted Poisson analyses, self-reported sexual identity is categorised into two groups: gay or bisexual/straight.

  • h Renting includes from a private landlord or council or housing association. Unstable includes temporary accommodation (hostel, shelter, bed and breakfast, squat), staying with partner or friend(s) or family or homeless.

  • i Midlands or Yorkshire and the Humber.

  • j Includes disclosure to less than half, half or more than half of work colleagues.

  • k Having a supportive network of individuals in one’s life was assessed by a modified version of the Duke-UNC Functional Social Support Questionnaire using five questions that asked about the amount of support31 (with the following response options: (1) much less than I would like; (2) less than I would like; (3) some, would like more; (4) almost as much as I would like; (5) as much as I would like). The total score across the five questions for each participant was generated and categorised as follows: 5–10 (lower levels of a supportive network), 11–24 (medium levels of a supportive network; further categorised into scores of 11–15, labeled 4, 16–20, labeled 3, and 21–24, labeled 2) and 25 (higher levels of a supportive network).

  • l Men were asked whether they ‘smoke cigarettes regularly (at least one per day)’.

  • m Higher-risk drinking is based on the first two questions of the WHO AUDIT-C questionnaire. Higher risk drinking is indicated by a score of ≥6 and lower risk drinking or no alcohol consumption by a score of <6.32

  • n Wald test using modified Poisson regression.