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Clinician-Assessed Depression and HAART Adherence in HIV-Infected Individuals in Methadone Maintenance Treatment

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Annals of Behavioral Medicine

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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Conflict of interest statement

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, USA

    Jeffrey S. Gonzalez Ph.D., Abigail Batchelder M.P.H. & Howard Newville M.A.

  2. Albert Einstein College of Medicine, Yeshiva University, Rousso Building, 1300 Morris Park Avenue, Bronx, NY, 10461, USA

    Jeffrey S. Gonzalez Ph.D.

  3. Massachusetts General Hospital, Boston, MA, USA

    Jeffrey S. Gonzalez Ph.D., Christina Psaros Ph.D. & Steven A. Safren Ph.D.

  4. Harvard Medical School, Boston, MA, USA

    Christina Psaros Ph.D. & Steven A. Safren Ph.D.

  5. Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Allison Applebaum Ph.D.

Authors
  1. Jeffrey S. Gonzalez Ph.D.
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  2. Christina Psaros Ph.D.
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  3. Abigail Batchelder M.P.H.
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  4. Allison Applebaum Ph.D.
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  5. Howard Newville M.A.
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  6. Steven A. Safren Ph.D.
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Corresponding author

Correspondence to Jeffrey S. Gonzalez Ph.D..

Additional information

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

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