Depressive symptoms and associated factors among men who have sex with men in Malaysia

There is a high prevalence of mental health issues, including depressive symptoms, among men who have sex with men (MSM) globally. Such a study has not been done in Malaysia, a setting where stigma and discrimination are particularly high and same-sex behaviors are criminalized. While HIV and sexual behavior among MSM in Malaysia are well studied, their depressive symptoms remain underexplored. Therefore, the purpose of this study was to determine the proportion of MSM in Malaysia who experience depressive symptoms. In this study, we conducted a secondary data analysis of the baseline data of the Project JomPrEP, which is a randomized controlled trial of a smartphone app-based study to evaluate its efficacy for improving HIV prevention outcomes among Malaysian MSM. Participants were recruited between November 2023 and September 2024 (N=268). Patient Health Questionnaire-9 scale was used to assess depressive symptoms. Bivariate and multivariate logistic regression analyses were conducted. Participants (mean age = 28.85 years) were predominantly Chinese (44.8%) or Malay (38.1%), with most earning 1200–1500 RM monthly (57.5%), having tested for HIV (86.2%), reporting 0–4 sexual partners in the past six months (69.8%), and experiencing depressive symptoms (23%), suicidal thoughts (37.3%), or suicide attempts (12.3%). Findings suggest that participants with suicidal thoughts (aOR=5.397, p=<0.001), suicide attempts (aOR=1.114, p=0.003), and fair self-rated health (aOR=12.590, p=0.004) were significantly more likely to report depressive symptoms. This study may provide evidence for the integration of mHealth applications to alleviate symptoms of depression in Malaysian MSM.