Research Article Open Access Health Care: Current Reviews Suryawanshi et al., Health Care Current Reviews 2016, 4:3 DOI: 10.4172/2375-4273.1000176 Volume 4 • Issue 3 • 1000176 Health Care Current Reviews, an open access journal ISSN:2375-4273 Keywords: Community collectivization; Mental health; Depression; MSM, High risk population; India Introduction Mental health problems are among the most signiicant contributors to the global burden of disease and disability with a global prevalence of 13% [1]. According to the WHO report, individual-level attributes and behaviors (low self-esteem, emotional immaturity, medical illness and substance use), environmental factors (poor access to basic services, discrimination, social and gender inequalities) and social and economic circumstances (loneliness, family conlict/neglect, exposure to violence/abuse, low income and poverty) are contributing factors to mental health and wellbeing [2]. In addition, the mental health issues, especially among the marginalized population of female sex workers (FSWs), Men Who have Sex with Men (MSM) and injecting drug users (IDUs) and people living with HIV (PLHIV) is a serious concern for the efective HIV prevention eforts. he studies among FSWs revealed that high prevalence of violence, drug use and discrimination and HIV risk afect the mental health of this population [3-5]. However, the research among people living with HIV (PLHIV) in low and middle income countries signify the prevalence of mental health problems like depression ranging from 11% to 63% and depression is linked to poor adherence to antiretroviral therapy [6-8]. Globally, as compared to the general population, a community based sample of MSM is at increased risk of experiencing mental health problems. he factors contributing to poor mental health of MSM are depressive symptoms, substance use disorders, mental disorders-anxiety, panic, mood, suicidal ideation, discrimination, suicidal symptoms among individuals reporting same sex behavior or identifying as a homosexual, partner violence and childhood sexual abuse. hese hazardous psychosocial health problems had oten been considered as a source of explaining the distribution and consequences of HIV infection among MSM [9-18]. Abstract Background: The role of community collectivization with mental health among Men who have Sex with Men (MSM) is understudied in developing countries. This study examines the prevalence of mental depression, and its association with community collectivization among MSM in India. Data and methods: The data used for this study are from a cross-sectional, Behavioral Tracking Survey conducted between January and February, 2012 among 1176 MSM from Andhra Pradesh, a southern state of India. Mental depression among MSM was assessed using Patient Health Questionnaire-2 scale. Univariate, bivariate and multivariate logistic regression models were used for analysis in this study. Results: The average age of MSM was 28.2 years (SD: ± 6.2 years) and more than one-third of MSM (35%) in the survey reported to have any mental depression in Andhra Pradesh. MSM, who had a high level of collective identity (not ashamed to be MSM) (33% vs. 41%, AOR: 0.54, 95% CI: 0.34-0.85) and collective agency (member of the community group) (34% vs. 38%, AOR: 0.46, 95% CI: 0.26-0.81) were less likely to be depressed as compared to their counterparts. Those who were members of the community group and had not experienced any violence, were less likely to have any depression (31% vs. 37%, AOR: 0.44, p=0.012). Conclusion: This study highlights that community led structural interventions are more successful and effective in HIV prevention along with enhancing positive mental health among the key population. This study demands for more community engagement activities in order to deal with mental health problems. This study recommends for further research and to explore the new community led structural approaches with innovative ideas for integrated mental health counselling services among MSM. Association between Community Collectivization and Mental Depression among Men Who Have Sex with Men in Andhra Pradesh, India Suryawanshi D 1 , Patel SK 2 *, Sharma V 1 , Adhikary R 2 and Bharat S 1 1 School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India 2 HIV and AIDS Program, Population Council, New Delhi, India *Corresponding author: Sangram Kishor Patel, HIV and AIDS Program, Population Council, Golf Links, New Delhi-110003, India, Tel: +91-11-41743410; Fax: +91-11-24645060; E-mail: skpatel@popcouncil.org Received August 23, 2016; Accepted September 19, 2016; Published September 25, 2016 Citation: Suryawanshi D, Patel SK, Sharma V, Adhikary R, Bharat S (2016) Association between Community Collectivization and Mental Depression among Men Who Have Sex with Men in Andhra Pradesh, India. Health Care Current Reviews 4: 176. doi: 10.4172/2375-4273.1000176 Copyright: © 2016 Suryawanshi D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. In India, a range of 10-12% of lifetime prevalence of mental health disorders is observed and of which MSM faces many psychosocial challenges due to their stigmatized sexual orientation and are highly vulnerable to a variety of societal stressors resulting in poor mental health [19]. Despite the extensive HIV prevention eforts, the MSM continues to constitute a high-risk group (HRG) with national HIV prevalence of 4.4% and 10.1% in Andhra Pradesh [20]. Factors such as stigma, discrimination, and violence lead to several co-occurring mental health problems among MSM, which in turn restrict their ability to beneit from risk reduction counselling and moderate the beneicial impact of HIV prevention approaches/eforts [21]. Recent studies have shown the interrelationship between psychosocial factors and elevated HIV risk among MSM [21,22]. In order to address these elevated levels of HIV risk among MSM, a community-led structural intervention (CLSI) plays an architect role to address stigma, violence and harassments of MSM in public spaces and helps to create an enabling environment for them. he CLSI stands on three major pillars: creating an enabling environment, control over access and utilization of services