Sintomas depressivos em adolescentes e jovens homens que fazem sexo com homens durante a pandemia de Covid-19 no município de Vitória da Conquista, BA

Abstract

This study investigated the prevalence of depressive symptoms among adolescent and young men who have sex with men (AYMSM), the factors associated with severe depressive symptoms, and validated the construct of the Center for Epidemiologic Studies Depression Scale (CES-D) in this group during the COVID-19 pandemic in Vitória da Conquista, BA. This was a cross-sectional study with participants aged 15–24 years, recruited using Respondent Driven Sampling (RDS) between June and December 2021. Data were collected through interviews using a semi-structured questionnaire addressing sociodemographic and behavioral characteristics, alcohol and drug use, self-assessed health, healthcare access, discrimination, and violence. The CES-D scale was used to assess severe depressive symptoms (score ≥22). Associations with the outcome were examined using bivariate and multivariate Poisson regression analyses to estimate prevalence ratios (PR) and 95% confidence intervals (95% CI). All analyses were weighted using Giles’ estimator. The internal consistency of the CES-D was evaluated using Spearman’s coefficient and Cronbach’s alpha. Item analysis was conducted through item-total correlation, mean inter-item correlation, and Cronbach’s alpha coefficient. The internal consistency assessment showed that most items had significant and positive correlations, except item 4, which presented a negative direction. The overall reliability of the scale was 0.90. Item reliability analysis showed adequate consistency for most items, except item 4, and the mean inter-item correlation was greater than 0.20. Among the 111 participants, 36.9% had no or mild depressive symptoms, 19.5% had moderate symptoms, and 43.6% had severe depressive symptoms. Severe depressive symptoms were associated with consuming five or more alcoholic drinks on three or more days per week (PR=2.09; 95% CI=1.28–3.41), self-rated health as fair, poor, or very poor (PR=2.00; 95% CI=1.30–3.10), and discrimination on social media (PR=2.16; 95% CI=1.41–3.31). The internal consistency assessment of the CES-D showed high reliability. A high prevalence of severe depressive symptoms was observed among AYMSM, reflecting the intensification of pre-existing vulnerabilities and the accumulation of adverse psychosocial factors during the pandemic, which disproportionately affected their mental health. Broader public policies are needed to prevent depressive symptoms among AYMSM, ensure access to mental health services, and implement punitive measures against discriminatory practices, particularly during health crises.