Supplemental Table 1: Unweighted characteristics by depression status among 11,992 men
who have sex with men in 12 Indian cities
Characteristica
Site, n (row %)
Bengaluru
Belgaum
Bhopal
Chennai
Coimbature
New Delhi
Hyderabad
Lucknow
Madurai
Mangalore
Vijayawada
Visakhapatnam
Region/State, n (row %)
Andhra Pradesh
Karnataka
Tamil Nadu
Central/North
Median age (IQR)
Marital Status, n (%)
Never married
Currently married/living with partner
Widowed/divorced/other
Sexual identity, n (%)
Panthi
Kothi
Double Deckers (DD)
Gay
MSM
Bisexual
Education, n (%)
Primary school or less
Secondary school
High school and above
Employment, n (%)
Monthly/weekly wages
Daily/seasonal wages
Unemployed
Other (student or retired)
Median monthly income (IQR) (rupees)
Disclosure of being MSM, n (%)
No
Disclosure to spouse/family
Disclosure to others but not to spouse/family
HIV positive awareness and disclosure, n (%)
Negative
Known positive, undisclosed status
Known positive, disclosed status
Unknown positive
No/mild
depressionb
(N=10388)
Depressionb
(N=1604)
931 (93.1)
884 (88.4)
874 (87.6)
934 (93.4)
673 (67.3)
806 (80.8)
935 (93.7)
931 (93.1)
688 (68.7)
939 (93.9)
956 (95.6)
837 (83.7)
69 (6.9)
114 (11.6)
124 (12.4)
66 (6.6)
327 (32.7)
191 (19.2)
63 (6.3)
69 (6.9)
313 (31.3)
61 (6.1)
44 (4.4)
163 (16.3)
2728 (91.0)
2754 (91.9)
2295 (76.5)
2611 (87.2)
26 (21-33)
270 (9.0)
244 (8.1)
706 (23.5)
384 (12.8)
28 (22-36)
6078 (58.5)
3931 (37.8)
379 (3.7)
758 (47.4)
706 (44.1)
137 (8.6)
3470 (33.4)
2252 (21.7)
2401 (23.1)
179 (1.7)
698 (6.7)
1388 (13.4)
461 (28.8)
562 (35.1)
396 (24.7)
17 (1.1)
30 (1.9)
135 (8.4)
2285 (22.0)
4478 (43.1)
3625 (34.9)
376 (23.5)
726 (45.4)
499 (31.2)
5102 (49.1)
3640 (35.0)
396 (3.8)
1250 (12.0)
6000 (40008000)
792 (49.5)
605 (37.8)
67 (4.2)
137 (8.6)
6000 (35008000)
4192 (40.4)
804 (7.7)
5392 (51.9)
457 (28.5)
264 (16.5)
880 (55.0)
9540 (91.8)
63 (0.6)
259 (2.5)
526 (5.1)
1307 (81.5)
25 (1.6)
155 (9.7)
117 (7.3)
p-valuec
<0.001
<0.001
<0.001
<0.001
<0.001
0.014
<0.001
0.024
<0.001
<0.001
Total
(N=11992)
1000
998
998
1000
1000
997
998
1000
1001
1000
1000
1000
2998
2998
3001
2995
26 (22-34)
6836 (57.0)
4637 (38.7)
516 (4.3)
3931 (32.8)
2814 (23.5)
2797 (23.3)
196 (1.6)
728 (6.1)
1523 (12.7)
2661 (22.2)
5204 (43.4)
4124 (34.4)
5894 (49.2)
4245 (35.4)
463 (3.9)
1387 (11.6)
6000 (40008000)
4649 (38.8)
1068 (8.9)
6272 (52.3)
10847 (90.5)
88 (0.7)
414 (3.5)
643 (5.4)
Characteristica
Sex work in prior 6 months, n (%)
No
Yes
Unprotected anal sex in prior 6 months, n (%)
No
Yes
No anal sex in prior 6 months
Median number of male partners in prior 6 months
(IQR)
Injection drug use in prior 6 months, n (%)
No
Yes
Any drug use in prior 6 months, n (%)
No
Yes
Alcohol use and dependence, n (%)
None/mild
Harmful/hazardous
Alcohol dependent
Alcohol use before sex in prior 6 months, n (%)
No
Yes
No sex in prior 6 months
Median social support scored (IQR)
Median composite stigma scoree (IQR)
Ever forced sex, n (%)
No
Yes
Adult intimate partner violence, n (%)
No
Yes
aPercentages
No/mild
depressionb
(N=10388)
Depressionb
(N=1604)
p-valuec
Total
(N=11992)
7896 (76.2)
2468 (23.8)
955 (60.1)
633 (39.9)
<0.001
8851 (74.1)
3101 (25.9)
4154 (40.0)
5667 (54.6)
567 (5.5)
498 (31.1)
980 (61.2)
123 (7.7)
1 (1-2)
1 (1-3)
10279 (99.0)
101 (1.0)
1557 (97.4)
41 (2.6)
<0.001
11836 (98.8)
142 (1.2)
7942 (76.5)
2441 (23.5)
1284 (80.2)
317 (19.8)
0.001
9226 (77.0)
2758 (23.0)
6393 (61.5)
2211 (21.3)
1784 (17.2)
783 (48.9)
259 (16.2)
559 (34.9)
4406 (42.4)
4413 (42.5)
1565 (15.1)
6 (2-11)
5 (2-7)
532 (33.4)
778 (48.8)
284 (17.8)
8 (5-12)
9 (6-13)
7821 (75.7)
2509 (24.3)
856 (53.8)
735 (46.2)
<0.001
8677 (72.8)
3244 (27.2)
8960 (86.5)
1402 (13.5)
1060 (66.5)
535 (33.5)
<0.001
10020 (83.8)
1937 (16.2)
4652 (38.8)
6647 (55.4)
690 (5.8)
<0.001
0.006
1 (1-2)
7176 (59.9)
2470 (20.6)
2343 (19.5)
<0.001
4938 (41.2)
5191 (43.3)
1849 (15.4)
3 (7-11)
5 (2-8)
<0.001
<0.001
<0.001
are column percentages, unless otherwise noted.
or mild depression defined by a score of 9 or less on the PHQ-9 depression scale, depression defined as a score of 10 or more.
cP-value from Person chi-square test for categorical characteristics and Wilcoxon rank sum for continuous characteristics.
dSocial support score ranged from 0 to 20 with higher scores reflecting more social support.
eComposite stigma score was estimated by averaging stigma scores from 4 scales: vicarious stigma, enacted stigma, felt normative
stigma, and internalized stigma; score ranged from 0 to 20 with higher scores reflecting more stigma.
bNo
Supplementary Table 2: Correlates of depressiona among 11,997 men who have sex with men
in 12 Indian cities
Age (per 10 years)
Marital Status
Never married
Currently married/living with partner
Widowed/divorced/other
Sexual identity
Panthi
Kothi
Double Deckers (DD)
Gay
MSM
Bisexual
Disclosure of being MSM, n (%)
No
Disclosure to spouse/family
Disclosure to others but not to spouse/family
HIV positive awareness and disclosure
Negative
Known positive, undisclosed status
Known positive, disclosed status
Unknown positive
Sex work in prior 6 months
Number of male sex partners in prior 6 months
(per 5 partner increase)
Unprotected anal sex in prior 6 months
No
Yes
No anal sex in prior 6 months
Alcohol use and dependence (AUDIT)
None/mild
Harmful/hazardous
Alcohol dependence
Alcohol use before sex in prior 6 months
Injection drug use in prior 6 months
Social support (per 1 point increase)
Composite stigma (per 1 point increase)
Ever forced sex
Adult intimate partner violence
aDepression
defined as a score of 10 or more on the PHQ-9.
Unadjusted
Odds Ratio
95%
Confidence
Interval
1.23
1.16, 1.31
Adjusted
Odds Ratio
95%
Confidence
Interval
---
REF
1.40
2.05
1.25, 1.58
1.63, 2.57
--
--
REF
1.80
1.21
0.99
0.50
1.18
1.56, 2.07
1.04, 1.41
0.59, 1.66
0.33, 0.74
0.95, 1.47
REF
1.60
1.17
1.01
0.49
1.16
1.37, 1.88
1.00, 1.37
0.60, 1.72
0.33, 0.73
0.93, 1.44
REF
2.54
1.44
2.11, 3.06
1.26, 1.65
REF
1.71
1.23
1.40, 2.10
1.07, 1.42
REF
3.08
3.77
1.61
2.01
1.86, 5.12
3.01, 4.72
1.29, 2.01
1.78, 2.27
REF
3.19
3.72
1.30
--
1.92, 5.31
2.95, 4.69
1.03, 1.64
--
1.02
1.01, 1.02
--
--
REF
1.45
1.47
1.28, 1.63
1.17, 1.85
--
--
REF
0.94
2.09
1.37
2.75
1.05
1.30
2.35
2.58
0.80, 1.09
1.83, 2.39
1.20, 1.56
1.86, 4.08
1.04, 1.06
1.22, 1.38
2.09, 2.64
2.27, 2.94
REF
1.06
2.41
-2.14
-----
0.90, 1.24
2.10, 2.77
-1.43, 3.21
-----