Abstract
Background
The impact of measurement methods on the relationship between depression and HIV treatment adherence has not been adequately examined.
Purpose
The purpose of this paper is to examine the relationship between clinician- and patient-rated depression and HIV medication adherence.
Methods
The participants were 91 HIV-infected individuals in methadone maintenance. Depression was assessed via clinician ratings (Clinical Global Impression Scale and Montgomery Asberg Depression Rating Scale) and self-report (Beck Depression Inventory-Short Form). Clinicians rated substance abuse using the Clinical Global Impression Scale and a structured interview. HIV medication adherence was measured over the following 2 weeks using electronic caps.
Results
Each unit increase in the Clinical Global Impression Scale was associated with 75% increased odds of nonadherence (OR = 1.75, p = 0.002, 95% CI = 1.23–2.48). Similarly, for each standard deviation Montgomery Asberg Depression Rating Scale increase, there was a 2.6-fold increased odds of nonadherence (OR = 2.60, p = 0.001, 95% CI = 1.45–4.67). Substance abuse and self-reported depression severity were not significantly related to adherence.
Conclusions
Clinician-rated depression severity was a strong predictor of nonadherence. Assessment methods may influence the relationship between depression and HIV nonadherence.
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The authors have no conflict of interest to disclose.
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The funding for this project is from grant R-01DA018603 awarded to Dr. Steven Safren.
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Gonzalez, J.S., Psaros, C., Batchelder, A. et al. Clinician-Assessed Depression and HAART Adherence in HIV-Infected Individuals in Methadone Maintenance Treatment. ann. behav. med. 42, 120–126 (2011). https://doi.org/10.1007/s12160-011-9268-y
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DOI: https://doi.org/10.1007/s12160-011-9268-y