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Title

Psychiatric Risk Factors for HIV Disease Progression

Authors

Carrico AW, Riley ED, Johnson MO

Network Affiliation

Other

Organization

 

Journal Name

JAIDS

Publication Date

11/24/2010

PubMed Search

http://www.ncbi.nlm.nih.gov/sites/21116186

Link to full-text

http://journals.lww.com/jaids/Abstract/2011/02010/Psychiatric_Risk_Factors_for_HIV_Disease.9.aspx

PMID

21116186

Abstract

Background: In the era of antiretroviral therapy (ART), depression and substance use predict hastened HIV disease progression, but the underlying biological or behavioral mechanisms that explain these effects are not fully understood.
Methods: Using outcome data from 603 participants enrolled in a randomized controlled trial of a behavioral intervention, binary logistic and linear regression were employed to examine whether inconsistent patterns of ART utilization partially mediated the effects of depression and substance use on higher HIV viral load over a 25-month follow-up.
Results: Elevated affective symptoms of depression independently predicted ART discontinuation [adjusted odds ratio = 1.39, 95% confidence interval (CI) = 1.08 to 1.78], and use of stimulants at least weekly independently predicted intermittent ART utilization (adjusted odds ratio = 2.62, 95% CI = 1.45 to 4.73). After controlling for the average self-reported percentage of ART doses taken and baseline T-helper (CD4+) count, elevated depressive symptoms predicted a 50% higher mean viral load, and weekly stimulant use predicted a 137% higher mean viral load. These effects became nonsignificant after accounting for inconsistent patterns of ART utilization, providing evidence of partial mediation.
Conclusions: Inconsistent patterns of ART utilization may partially explain the effects of depression and stimulant use on hastened HIV disease progression.

Keywords

 

Topic

Adherence; Risk Assessment

Attachments

Created at 1/14/2011 12:21 PM by Mooney, Jessica L
Last modified at 1/14/2011 12:21 PM by Mooney, Jessica L