AIDS and Behavior

, Volume 17, Issue 8, pp 2765–2772

Does Effective Depression Treatment Alone Reduce Secondary HIV Transmission Risk? Equivocal Findings from a Randomized Controlled Trial

  • Alexander C. Tsai
  • Matthew J. Mimiaga
  • James W. Dilley
  • Gwendolyn P. Hammer
  • Dan H. Karasic
  • Edwin D. Charlebois
  • James L. Sorensen
  • Steven A. Safren
  • David R. Bangsberg
Original Paper

DOI: 10.1007/s10461-013-0600-3

Cite this article as:
Tsai, A.C., Mimiaga, M.J., Dilley, J.W. et al. AIDS Behav (2013) 17: 2765. doi:10.1007/s10461-013-0600-3

Abstract

Depressed mood has been associated with HIV transmission risk behavior. To determine whether effective depression treatment could reduce the frequency of sexual risk behavior, we analyzed secondary outcome data from a 36-week, two-arm, parallel-design, randomized controlled trial, in which homeless and marginally housed, HIV-infected persons with comorbid depressive disorders were randomized to receive either: (a) directly observed treatment with the antidepressant medication fluoxetine, or (b) referral to a local public mental health clinic. Self-reported sexual risk outcomes, which were measured at 3, 6, and 9 months, included: total number of sexual partners, unprotected sexual intercourse, unprotected sexual intercourse with an HIV-uninfected partner or a partner of unknown serostatus, and transactional sex. Estimates from generalized estimating equations regression models did not suggest consistent reductions in sexual risk behaviors resulting from treatment. Mental health interventions may need to combine depression treatment with specific skills training in order to achieve durable impacts on HIV prevention outcomes.

Keywords

HIVDepressionAntidepressive agentsSexual behaviorProtected sexHomeless persons

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Alexander C. Tsai
    • 1
    • 2
    • 3
  • Matthew J. Mimiaga
    • 3
    • 4
  • James W. Dilley
    • 5
    • 6
  • Gwendolyn P. Hammer
    • 7
  • Dan H. Karasic
    • 5
  • Edwin D. Charlebois
    • 8
  • James L. Sorensen
    • 5
  • Steven A. Safren
    • 3
    • 9
    • 10
  • David R. Bangsberg
    • 2
    • 3
    • 11
  1. 1.Chester M. Pierce, MD Division of Global Psychiatry, Department of PsychiatryMassachusetts General HospitalBostonUSA
  2. 2.Center for Global HealthMassachusetts General HospitalBostonUSA
  3. 3.Harvard Medical SchoolBostonUSA
  4. 4.Department of EpidemiologyHarvard School of Public HealthBostonUSA
  5. 5.Department of PsychiatrySan Francisco General Hospital at the University of California at San FranciscoSan FranciscoUSA
  6. 6.Alliance Health ProjectSan FranciscoUSA
  7. 7.Communicable Disease Emergency Response BranchCalifornia Department of Public HealthSacramentoUSA
  8. 8.Center for AIDS Prevention Studies, Department of MedicineUniversity of California at San FranciscoSan FranciscoUSA
  9. 9.Fenway HealthBostonUSA
  10. 10.Behavioral Medicine Service, Department of PsychiatryMassachusetts General HospitalBostonUSA
  11. 11.Mbarara University of Science and TechnologyMbararaUganda