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Contrary to popular belief, what puts you at risk for HIV is not always easy to pinpoint. The more researchers look into HIV risk, the more we see that it's a complicated machine with many moving parts. However, a study out of the UK has gotten a clearer sense of one of the machine's biggest gears -- depression. 

A study of British gay men found that HIV-negative gay men who reported several symptoms of depression were also more likely to report having sex without barrier protection. The study was presented at the British Association for Sexual Health and HIV conference in Glasgow, [reports aidsmap.com](http://www.aidsmap.com/page/2973369/).

An astounding 12.5% of men in the study showed symptoms of depression, compared [to about 7% in the British general population](https://www.rcpsych.ac.uk/pdf/Position%20Statement%204%20website.pdf). About [5.4% of Americans age 12 or older exhibit symptoms of depression](http://www.cdc.gov/mentalhealth/data_stats/depression.htm). However, those numbers are overshadowed by the rate of depression among British HIV-positive people of all genders and sexualities, [26% of whom exhibit symptoms of depression](http://www.aidsmap.com/Depression-associated-with-socioeconomic-difficulties-and-poor-virological-outcomes-in-UK-HIV-patients/page/2321657/), according to a recent study.

All 1,173 of the HIV-negative gay men -- mostly white and college-educated -- in the cohort had attended a sexual health clinic and reported having sex in the past three months. 

Several factors affected who was most likely to exhibit signs of depression. Men who were younger, low-income or non-college graduates had higher rates. Depression was also more common among single men (about half of those in the study had partners), regular smokers, heavy drinkers and men who [used multiple recreational drugs](http://www.thebody.com/content/75757/meth-crack-coke-and-ecstasy-effects-on-hiv-disease.html). By showing that HIV risk is exacerbated by depression and that depression is heavily influenced by social and socioeconomic factors, the study reinforces data that show that [poverty and HIV are also closely linked](http://www.thebody.com/content/73909/no-link-between-hiv-and-poverty-data-shows-otherwi.html).

The study also illuminates a cluster of factors that may put people at risk for HIV, and what puts people in situations that carry risk of HIV acquisition. Men with depressive symptoms were more likely to report sex without a condom in the past three months, whether that sex was with one person, two or more partners or any number of partners of an unknown HIV status. The study did not include whether respondents were aware of whether their HIV-positive sexual partners had an undetectable viral load, which [virtually eliminates risk of transmission](http://www.thebodypro.com/content/73978/zero-hiv-infections-seen-through-condomless-sex-wh.html).

The researchers used a common [tool for diagnosing anxiety and depression](http://phqscreeners.com/pdfs/02_PHQ-9/English.pdf). It asks how often in the last two weeks people have experienced symptoms, including "feeling tired or having very little energy," "feeling down, depressed or hopeless" and "feeling bad about yourself -- or that you are a failure or have let yourself or your family down."

Since the study looked at each participant at just one point in time, the researchers say that their study does not prove that depression is the cause of higher rates of barrier-free sex, but it does show that depression and this type of sexual risk are "strongly associated," according to aidsmap.com.

Researcher Ada Miltz of University College London said the study reinforces the importance of identifying and providing care for men who have sex with men who are depressed. Public Health England, the UK equivalent of the U.S. Centers for Disease Control and Prevention, [recently released a plan to deal with poor sexual and mental health among UK gay men](http://www.aidsmap.com/Men-who-have-sex-with-men-have-other-health-inequalities-as-well-as-poor-sexual-health-say-Public-Health-England/page/2942994/), which puts the management of mental health wellness at the center of its plan.

A study of British gay men found that HIV-negative gay men who reported several symptoms of depression were also more likely to report having sex without barrier protection.

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Depression and Risky Sex May Go Hand in Hand

Depression and Risky Sex May Go Hand in Hand, Says UK Study

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