Depression and Suicidal Ideation Among Men who have sex with men and Transgender Women in Chiang Mai, Thailand

<ns3:p> Background High burden of depression and suicidality were reported among men who have sex with men (MSM) and transgender women (TGW) globally. Currently, in Thailand, many of them can access to pre-exposure prophylaxis (PrEP) services for HIV prevention. We determined depression severity and suicidal ideation in PrEP users and non-users and associated factors. Methods A cross-sectional study was conducted at two HIV prevention clinics in Chiang Mai, Thailand. Inclusion criteria were: 1) aged ≥20 years, 2) having sexual behaviours consistent with MSM or TGW; and 3) being a current PrEP user (using PrEP for ≥6 months) or non-user (never used PrEP). Socio-demographic data was collected by face-to-face interview. Depression and suicidal ideation were assessed using the Patient Health Questionnaire-9 (PHQ-9), and the Columbia-Suicide Severity Rating Scale (C-SSRS), respectively. Group differences between PrEP users and non-users were examined and multiple linear regression was applied to identify associated factors. Results A total of 150 MSM and TGW (75 PrEP users; 75 non-users) were included. Clinically significant depression (PHQ-9 scores ≥10) was observed in four PrEP users (5.3%) and 10 non-users (13.3%). PrEP users had significantly lower mean depression scores than non-users (3.80 ± 3.46 vs. 5.96 ± 3.76, <ns3:italic>p</ns3:italic> &lt; 0.001). Suicidal ideation was uncommon, without difference between groups ( <ns3:italic>p</ns3:italic> = 0.47). In adjusted models, PrEP use was associated with lower depression severity ( <ns3:italic>B</ns3:italic> = −0.231, <ns3:italic>p</ns3:italic> = 0.025), whereas higher education and high stress level were associated with depression. Depression severity was the only significant predictor of suicidal ideation (OR = 2.82, <ns3:italic>p</ns3:italic> = 0.028). Conclusions Lower depression frequency and severity among PrEP users suggesting that engagement with HIV-prevention services might positively affect the mental health well-being of the key populations. Incorporating depression and/or suicidal ideation screening into HIV-prevention packages would allow timely support or linkage to mental health services. </ns3:p>