Sexually transmitted diseases (STDs) and depression impact millions of individuals each year in the United States, with direct medical costs exceeding $41 billion. While the interactions of these conditions are poorly understood, they are increasingly addressed in primary care whereas historically they have been addressed separately. We analyzed data associated with the 18-25year age group from the 2014 National Survey of Drug Use and Health, a cross-sectional survey of the civilian, non-institutionalized US population aged ≥12years for factors associated with past year diagnosis of STD (STDy). Independent variables included participant demographics; lifetime diagnosis of major depressive episode (MDE); participant behaviors associated with STD risk (patient-provided); and medical record data associated with mental illness treatment (clinically-observed). Of 18,142 participants, the prevalence of MDE and STD was 15.3% and 2.4%, respectively, with significant differences by gender and race. MDE was associated with increased risk of STDy among females (odds ratio [OR]=1.61; 95% confidence interval [CI]=1.18-2.20), males (OR=2.32; CI=1.15-4.70), those of white race (OR=3.02; CI=2.02-4.53), and lower income levels and insurance status. Univariate modeling found that receiving mental health treatment, and use of marijuana, alcohol, and illegal drugs were each associated with significantly increased STDy. In a multivariate logistic regression, receiving mental health treatment became protective for STDy (AOR=0.55; CI=0.32-0.95]). Individuals with a history of depression are at increased risk of STDy, with this risk modified by factors readily ascertained within primary care. As depression treatment is increasingly incorporated into primary care there are means to more effectively target intervention resources.
Keywords: Disease screening; Major depressive disorder; Primary care; Sexually transmitted disease.
Copyright © 2016. Published by Elsevier Inc.