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Purpose <p>This study aimed to characterize the longitudinal trajectories of depression, anxiety, and poor sleep among MSM newly diagnosed with HIV, and secondarily to explore potential causal relationships of HIV infection on these mental health outcomes.</p> Methods <p>A prospective repeated-measures study was conducted between 2017 and 2020 at Beijing Youan Hospital. Newly diagnosed MSM patients with HIV were consecutively enrolled. Depressive and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), while sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI). Follow-up assessments were performed at 4, 12, and 24 weeks to track longitudinal changes in mental health status. As a complementary approach, Mendelian randomization (MR) analysis was employed to explore potential causal relationships of HIV infection on depression, anxiety, and sleep disturbances.</p> Results <p>A total of 1,170 MSM newly diagnosed with HIV were enrolled. The prevalence of depression, anxiety, and poor sleep decreased from 26.82%, 33.90%, and 65.91% at baseline to 12.75%, 15.47%, and 46.28% at week 24, respectively. Longitudinal analysis revealed that the prevalence of poor sleep among MSM newly diagnosed with HIV remained above 45% throughout the follow-up period, consistently exceeding the peak prevalence of depression or anxiety by over 20%. While depression and anxiety declined rapidly by week 4 and remained predominantly mild, a modest rebound occurred for moderate-to-severe cases at week 24 and for poor sleep at week 12. Notably, individuals with normal baseline sleep also exhibited a slight rebound increase in PSQI scores at week 12. MR analysis found no potentially causal association between HIV infection and depression (IVW: OR = 1.001, <i>P</i> = 0.208), anxiety (OR = 1.001, <i>P</i> = 0.051), and sleep disorders (OR = 1.002, <i>P</i> = 0.893), respectively.</p> Conclusions <p>Although the overall prevalence of mental problems showed a declining trend, poor sleep demonstrated persistence and a rebound pattern. Proactive screening and mental support during the initial post-diagnosis period are essential to address modifiable risk factors and improve long term outcomes.</p>

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Longitudinal trends and causal relationships of depression, anxiety, and sleep quality among MSM newly diagnosed with HIV

  • 期刊论文

  • 发表日期：

    2026年6月3日

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  • Xue Yang,
  • Zaicun Li,
  • Ying Shao,
  • Jianwei Li,
  • Jiangzhu Ye,
  • An Liu,
  • Limin Xin,
  • Lijun Sun

摘要

Purpose

This study aimed to characterize the longitudinal trajectories of depression, anxiety, and poor sleep among MSM newly diagnosed with HIV, and secondarily to explore potential causal relationships of HIV infection on these mental health outcomes.

Methods

A prospective repeated-measures study was conducted between 2017 and 2020 at Beijing Youan Hospital. Newly diagnosed MSM patients with HIV were consecutively enrolled. Depressive and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), while sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI). Follow-up assessments were performed at 4, 12, and 24 weeks to track longitudinal changes in mental health status. As a complementary approach, Mendelian randomization (MR) analysis was employed to explore potential causal relationships of HIV infection on depression, anxiety, and sleep disturbances.

Results

A total of 1,170 MSM newly diagnosed with HIV were enrolled. The prevalence of depression, anxiety, and poor sleep decreased from 26.82%, 33.90%, and 65.91% at baseline to 12.75%, 15.47%, and 46.28% at week 24, respectively. Longitudinal analysis revealed that the prevalence of poor sleep among MSM newly diagnosed with HIV remained above 45% throughout the follow-up period, consistently exceeding the peak prevalence of depression or anxiety by over 20%. While depression and anxiety declined rapidly by week 4 and remained predominantly mild, a modest rebound occurred for moderate-to-severe cases at week 24 and for poor sleep at week 12. Notably, individuals with normal baseline sleep also exhibited a slight rebound increase in PSQI scores at week 12. MR analysis found no potentially causal association between HIV infection and depression (IVW: OR = 1.001, P = 0.208), anxiety (OR = 1.001, P = 0.051), and sleep disorders (OR = 1.002, P = 0.893), respectively.

Conclusions

Although the overall prevalence of mental problems showed a declining trend, poor sleep demonstrated persistence and a rebound pattern. Proactive screening and mental support during the initial post-diagnosis period are essential to address modifiable risk factors and improve long term outcomes.