Original Paper

AIDS and Behavior

, Volume 14, Issue 2, pp 272-279

Depression Symptoms and Treatment Among HIV Infected and Uninfected Veterans

  • Kristen SueokaAffiliated withYale University School of Medicine
  • , Joseph L. GouletAffiliated withYale University School of MedicineVA Connecticut Healthcare System—11ACSLG
  • , David A. FiellinAffiliated withYale University School of Medicine
  • , David RimlandAffiliated withVA Medical Center and Emory University School of Medicine
  • , Adeel A. ButtAffiliated withVA Pittsburgh Healthcare System and University of Pittsburgh
  • , Cynthia GibertAffiliated withVA Medical Center and George Washington University Medical Center
  • , Maria C. Rodriguez-BarradasAffiliated withMichael E. De Bakey VAMC and Baylor College of Medicine
  • , Kendall BryantAffiliated withNational Institute on Alcohol Abuse and Alcoholism, National Institutes of Health
  • , Stephen CrystalAffiliated withThe Institute for Health, Health Care Policy and Aging Research, Rutgers University
    • , Amy C. JusticeAffiliated withYale University School of MedicineVA Connecticut Healthcare System—11ACSLG Email author 

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Abstract

Depression is one of the most common comorbid conditions affecting persons with HIV. We compared depressive symptoms and depression treatment using data from the Veterans Aging Cohort Study (VACS), a prospective cohort of HIV-infected and uninfected subjects. We identified subjects with a Patient Health Questionnaire score of 10 or greater. Treatment was defined as prescription of a selective serotonin reuptake inhibitor (SSRI) or mental health counseling. Overall, 16% of 4,480 subjects had depressive symptoms, and HIV-infected patients were more likely to have had depressive symptoms (OR = 1.38, 95% CI = 1.18, 1.62). Geographic site of care and having a mental health provider at the clinic was associated with treatment. In multivariable models restricted to 732 patients with depressive symptoms, receipt of depression treatment did not differ by HIV status (Adjusted OR = 1.11, 95% CI = 0.80, 1.54). Non-Hispanic whites were more likely to receive treatment (Adjusted OR = 2.09, 95% CI 1.04, 4.24). Primary care and HIV providers were equally unlikely to treat active depressive symptoms. Treatment variation by race, site, and availability of a mental health provider, suggests targets for intervention.

Keywords

HIV-infection Depression Psychiatric status rating scales Anti-depressive agents