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- Title
Testing the Synergistic Effects of Depression, Anxiety, and Substance Use in Unsafe Sex: a Cross-sectional Study.
- Authors
Villalobos-Gallegos, Luis; Medina-Mora, María Elena; Marín-Navarrete, Rodrigo; Magis-Rodriguez, Carlos; Ruiz-Velasco Acosta, Silvia
- Abstract
Condom use is the most affordable method to prevent sexually transmitted infections (STIs). Anxiety, depression, and substance use have been used as covariates of condom use, but little is known about the possibility of synergistic effects. The objective of this study was to determine the synergist effect of depression, anxiety, and substance use in unsafe sex. Individuals receiving residential treatment for substance use were recruited in 21 centers in Mexico City. Data on substance use, depression (PHQ-9), anxiety (GAD-7), and condom use (number of unsafe sex occasions) was collected. Four Poisson regression models were adjusted to compare the additive or interactive effect of these variables. We found that model 2 (anxiety and depression interactive model) showed a better fit when compared with its additive-only counterpart (model 1), χ2[1] = 29.538, p <.001; model 4 (anxiety, depression, and substance use interactive model) had a better fit that model 3 (anxiety, depression, and substance use additive model), χ2[1] = 23.479, p <.001. Models with interactive terms produced better predictions of condom use. Only depression symptoms displayed a synergistic effect with substance use. These findings may be the result of unique components of the symptoms, and they stress the importance of including interactive terms when testing the associations or the effects of mental health variables in health outcomes, particularly in condom use.
- Subjects
MEXICO City (Mexico); SUBSTANCE abuse; MENTAL depression; UNSAFE sex; SEXUALLY transmitted diseases; ANXIETY; CONDOM use
- Publication
International Journal of Mental Health & Addiction, 2021, Vol 19, Issue 6, p1951
- ISSN
1557-1874
- Publication type
Article
- DOI
10.1007/s11469-020-00291-3